Deliberate exposure of humans to chlorine-the aftermath of Ebola in West Africa
Date
2016-11-14
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: During the recent Ebola outbreak, spraying of the environment and humans, including healthcare
workers, with chlorine was wide spread in affected African countries; adverse clinical effects are reported here.
Methods: A cross sectional survey by interview of 1550 volunteers consisting of 500 healthcare workers (HCW), 550
Ebola survivors (EVD) and 500 quarantined asymptomatic Ebola contacts (NEVD) was conducted. Demographics,
frequency of exposure to chlorine, clinical condition after chlorine exposure particularly eye, respiratory and skin
conditions were noted. The length of time HCWs worked in Ebola Treatment Units (ETU), and use of personal
protective equipment was recorded. Verbal consent was obtained from all participants and all responses remained
anonymous. Permission and assistance from the guardian or parent was sought for those below 18 years of age.
Results: 493/500 HCW, 550/550 EVD and 477/500 NEVD were sprayed at least once with 0 · 5 % chlorine. Following
even a single exposure, an increase in the number of eye (all three groups) and respiratory symptoms (in HCW &
EVD) was reported (p < 0 · 001); after multiple exposure, respiratory and skin symptoms increased. In HCW, multiple
vs single exposure was associated with an increase in respiratory (OR = 32 (95 % CI 22 –49) p < 0.001), eyes
(OR = 30 (95 % CI 21 –43) p < 0.001) and skin conditions (OR = 22 (95 % CI 15–32) p < 0.001). The available personal
protective equipment neither reduced nor prevented the adverse effects of chlorine.
Conclusion: Reported exposure to chlorine has usually been accidental. Despite the lack of evidence as a
recognised outbreak control measure, deliberate exposure of humans to chlorine spray was wide spread in Africa
during the Ebola epidemic resulting in serious detrimental health effects on humans. We strongly recommend that
this practice be banned and that alternative safer methods be used.
Description
CITATION: Mehtar, S., et al. 2016. Deliberate exposure of humans to chlorine-the aftermath of Ebola in West Africa. Antimicrobial Resistance and Infection Control, 5:45, doi:10.1186/s13756-016-0144-1.
The original publication is available at http://aricjournal.biomedcentral.com
The original publication is available at http://aricjournal.biomedcentral.com
Keywords
Infection control
Citation
Mehtar, S., et al. 2016. Deliberate exposure of humans to chlorine-the aftermath of Ebola in West Africa. Antimicrobial Resistance and Infection Control, 5:45, doi:10.1186/s13756-016-0144-1