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chlorine gas exposure. Other authors17 have suggested that preexisting lung conditions do not affect the occurrence of pulmonary sequelae following chlorine gas exposure.

Our patient was exposed to chlorine gas in an industrial setting. Although the patient had a history of cigarette smoking and childhood asthma, he had had no symptoms of reactive airways disease for 20 years prior to this event. Following the chlorine exposure, the patients symptoms rapidly became severely debilitating, necessitating daily therapy with high-dose corticosteroids, frequent use of home oxygen, and self-administered subcutaneous epinephrine.

To our knowledge, this case is unique in the literature. Charan et al3 showed reversible acute airway obstruction shortly after exposure, and Hasan et al13 reported the cases of two asthmatic patients in whom chlorine gas may have exacerbated a state of underlying hyperactivity. No one, however, has reported new onset of severe reversible airway obstruction that persisted several years after chlorine gas exposure. Thus, we believe that our patient represents a unique case of persistently debilitating asthma following acute chlorine gas exposure.

ACKNOWLEDGMENT: Editorial services were provided by Bette R.Haitsch. The authors would like to thank Angela K.Dorman for her assistance in manuscript preparation.


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