Chlorinated lime poisoning

Ingredients include:

• Calcium hydroxide
• Calcium hypochlorite

This poison can be used in:

• Bleach
• A number of manufacturing processes

Note: This list may not include all sources of chlorinated lime.

Chlorinated lime poisoning can cause symptoms in many parts of the body.

BLOOD

• Severe change in the acid level in the blood (pH balance), which leads to damage in all of the body organs

EYES, EARS, NOSE, AND THROAT

• Loss of vision
• Severe pain in the throat
• Severe pain or burning in the nose, eyes, ears, lips, or tongue

GASTROINTESTINAL SYSTEM

• Blood in the stool
• Burns and possible holes in the throat (esophagus)
• Severe abdominal pain
• Vomiting
• Vomiting blood

HEART AND CIRCULATORY SYSTEM

• Collapse
• Low blood pressure that develops rapidly (shock)

LUNGS AND AIRWAYS

• Breathing difficulty (from breathing in the chlorinated lime)
• Throat swelling (which may also cause breathing difficulty)

SKIN

• Burns
• Holes (necrosis) in the skin or tissues underneath
• Irritation

Seek medical help right away. Do not make a person throw up unless told to do so by poison control or a health care provider.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

Chlorinated lime may be confused with dry lime or quicklime. Dry lime or quicklime (calcium oxide) is one of the few chemical toxins that should NOT be irrigated immediately with water. Dry lime reacts with water to form calcium hydroxide, and this reaction can cause severe burns. Dry lime or quicklime should be brushed off the skin, or swept out of the eyes with a cotton swab prior to irrigation.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a provider. Do not give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the person breathed in the poison, immediately move them to fresh air.

Get the following information:

• Person's age, weight, and condition
• Name of the product (and ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

• Blood and urine tests.
• Breathing support, including oxygen through a tube into the lungs, and a breathing machine (ventilator).
• Bronchoscopy -- camera down the throat to look for burns in the airways and lungs (if the poison was aspirated).
• Chest x-ray.
• Electrocardiogram (ECG).
• Endoscopy -- camera down the throat to look for burns in the esophagus and the stomach.
• Fluids through a vein (by IV).
• Medicine to reverse the effect of the poison and treat symptoms.
• Surgical removal of burned skin (skin debridement).
• Tube through the mouth into the stomach to aspirate (suck out) the stomach. This is done only when the person gets medical care within 30 to 45 minutes of the poisoning, and a very large amount of the substance has been swallowed.
• Washing of the skin (irrigation) -- perhaps every few hours for several days.

How well a person does depends on the amount of poison swallowed and how quickly treatment is received. The faster the person gets medical help, the better the chance for recovery.

Swallowing such poisons can have severe effects on many parts of the body. Burns in the airway or gastrointestinal tract can lead to tissue death. This may result in infection, shock, and death, even several months after the substance was swallowed. Scar tissue in the affected areas can lead to long-term problems with breathing, swallowing, and digestion.

Agency for Toxic Substances and Disease Registry (ATSDR) website. US Department of Health and Human Services, Public Health Service. ToxFAQs for calcium hypochlorite/sodium hypochlorite. wwwn.cdc.gov/TSP/ToxFAQs/ToxFAQsDetails.aspx?faqid=928&toxid=192. Updated October 25, 2011. Accessed December 6, 2023.

Hoyte C. Caustics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Levine MD. Chemical injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 55.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.