Phosgene (CG): Exposure, Decontamination, Treatment

• Phosgene is a major industrial chemical used to make plastics and pesticides.
• Phosgene is also known by its military designation CG.
• Phosgene is a toxic gas or liquid that can cause damage to the skin, eyes, nose, throat, and lungs.
• At room temperature phosgene is a gas that may appear colorless or white to pale yellow.
• At low concentrations, it has an odor of newly mown hay or green corn, but its odor may not be noticed by all people exposed. At high concentrations, the odor may be strong and unpleasant.
• With cooling and pressure, phosgene gas can be converted into a liquid so that it can be shipped and stored. When liquid phosgene is released, it quickly turns into a gas that stays close to the ground and spreads rapidly.

• After a release of phosgene into the air, people can be exposed through skin contact, eye contact, or inhaling (breathing in) the phosgene gas.
• Following a release of phosgene liquid into water, people can be exposed by touching or drinking water that contains phosgene.
• Eating, drinking, or touching food or drink contaminated with phosgene can expose people to phosgene.
• If clothing has been in contact with liquid phosgene, people can be exposed by touching the clothing or the phosgene vapors from the contaminated clothing.
• Because phosgene gas is heavier than air, it will sink to low-lying areas and increase the risk of exposure there.

• Food not contained in glass or metal (such as plastic, paper, or cloth containers) that may have come into contact with vapor or liquid phosgene should be avoided.
• If the food is in an undamaged sealed glass or metal container, it should not be affected by a phosgene release. Wash the outside of the container before using.
• If the food smells, tastes, or looks unusual, avoid using the food.
• Follow any directions by local authorities.

Signs and symptoms depend on how much phosgene a person was exposed to, how the person was exposed, and the length of time of the exposure. Some people with asthma or other chronic lung diseases may be more sensitive to breathing phosgene than others.

The odor does not provide sufficient warning of hazardous concentrations in the air. At low concentrations, phosgene’s irritating quality can be mild and delayed, which could cause people to not leave a contaminated area and to continue to inhale phosgene.

During or immediately after exposure to dangerous concentrations of phosgene, the following signs and symptoms may develop. These signs and symptoms may also be delayed for up to 48 hours.

• Chest tightness
• Coughing
• Choking
• Burning sensation in the nose, throat, lungs, and eyes
• Blurred vision
• Difficulty breathing or shortness of breath
• Eyes tearing
• Frostbite if exposed to liquid phosgene
• Headache
• Nausea and vomiting
• Rapid shallow breathing

Exposure to phosgene may result in delayed effects that may not be apparent for up to 48 hours after exposure. People who have been exposed to phosgene should be monitored during that period. Delayed effects may include the following:

• Difficulty breathing
• Coughing up white to pink-tinged fluid (sign of pulmonary edema)
• Low blood pressure
• Respiratory failure
• Heart failure

1. Get away from the area where the phosgene was released and breathe fresh air. Make sure you understand your local emergency notification system if you have one. Refer to emergency broadcasts and local authorities for instructions.

• If the phosgene release was outdoors, go indoors and shelter in place. Make sure windows are closed and ventilation systems are turned off to make sure the contamination does not come inside. If you cannot go indoors, leave the area where the phosgene was released.
• If you cannot get away from the area where phosgene was released, go to the highest ground possible because phosgene is heavier than air and will sink to low-lying areas.
• If the phosgene release was indoors, get out of the building.

2. Get it off your body right away!

Taking off all layers of clothing (including jewelry and accessories) and showering is the best method for removing phosgene from your body. Ideally, undress, blot, and shower immediately or as soon as you can, as described below. If you cannot take off all layers, take off as many clothes as you can.

• If clothes are frozen to your body, do not try to remove until no longer frozen. Instead, begin washing with a lot of lukewarm water. Then remove your clothes.
• Avoid pulling clothing over your head. If you must pull clothing over your head, close your eyes and mouth, and hold your breath so you don’t get phosgene in your eyes, nose, or mouth. Drop clothes to the floor.
• If you wear contact lenses, take them out and place them with your clothing. Do not put contact lenses back in.
• Use separate, dry, clean cloths or paper towels to blot each part of your body where you feel liquid, beginning with your head and hair, and then your face, hands, body, arms, legs, and feet. Blot your skin for 10 seconds, then rub for 10 seconds any places on your skin or in your hair where you can see or feel liquid.
• Continue blotting and rubbing, with clean, dry cloths or paper towels, dropping used things to the floor. Repeat the process several times if you continue to feel liquid on you. Use a separate clean cloth or paper towels for each part of your body, and for each time you repeat the process.
• First wash your hair, face, and hands, and then wash the rest of your body. Wash from your head to your feet, including armpits and groin, with lukewarm water and mild soap (if available) for at least 90 seconds. Use soapy water for a minute, followed by a 30 second plain water rinse. Try not to let the water run into your eyes, nose, or mouth. Do not scrub!
• If your eyes are burning or you can’t see normally, flush your eyes for 10–15 minutes with lukewarm water. Do not use eye drops.
• Dry your face, then tilt your head back and dry your hair, and then dry down your body. Use anything that will soak up water. Drop used things to the floor. Dress in any available clean clothes to prevent hypothermia. This is especially important if temperatures are cool.
• If emergency response services are available, leave used items on the floor and report your location to emergency personnel. Move as far from the used items as possible. Otherwise, put on waterproof or heavy gloves that won’t let liquid seep through. Gather all used things from the floor, including your clothes, and put them in a plastic bag. Close the plastic bag and place it in a second plastic bag. Close up the second bag also.
• Do not put the bags in the regular trash! Place the bags in an area where other people are unlikely to disturb them and come in contact with phosgene. Inform local authorities of the location of the bags for pick up.

3. Get help right away by calling 911, going to the hospital if local officials say it is safe to leave your home, or calling the Poison Control Center at 1-800-222-1222.

No known antidote exists for phosgene exposure. Treatment for phosgene exposure consists of removing phosgene from the body as soon as possible and providing supportive medical care in a hospital setting or by trained emergency responders.

If someone has ingested phosgene, do NOT induce vomiting.

Most people who recover after an exposure to phosgene make a complete recovery. However, there have been reports of chronic bronchitis and emphysema because of phosgene exposure.

Exposure to phosgene can lead to reactive airway dysfunction syndrome (RADS), a chemical irritant–induced type of asthma.