How to Treat Bromine Exposure

"My back injury required physical therapy. My doctor prescribed pool therapy which included doing specific exercises to build the strength of back muscles. When entering the indoor pool area, I noticed a pungent bleach-like odor.

The therapist told me the pool had just been cleaned and everything was fine. I entered, exercised, and departed as instructed. Getting out of the pool, I suddenly seemed to lack coordination and had to be assisted. Within a few hours, I began having shortness of breath and a rash appeared on my skin. Within days it spread to a large part of my body." — Submitted by a reader.

According to the Centers for Disease Control and Prevention, bromine is a naturally occurring element that is liquid at room temperature. It has a brownish-red color and a bleach-like odor and dissolves in water.

History of Bromine

Bromide is a chemical used for many applications - flame retardant, industrial uses, pesticides, sanitary products, fumigants, medicines, dyes, photographic solutions and water purification. Bromine can also be found as an alternative to chlorine in swimming pool treatment and as a fire retardants (chemicals that help prevent things from catching fire).

Exposure Risk

Bromides can act as central nervous system depressant and can lead to irritability, confusion and coordination problems, as well as hallucinations and coma.

The seriousness of poisoning caused by bromine depends on the amount, route, and length of time of exposure, as well as the age and preexisting medical condition of the person exposed. If water or food becomes contaminated, exposure would be the ingesting the chemical. Bromine is reportedly used to bleach white flour and other cooking products. If bromine gas is released in the air, exposure would be by inhalation of the fumes.

Does the pools smell strongly of chemical or have a stinky bleach smell?Absorption of the chemical can happen through direct contact with bromine liquid or gas which irritates the skin, mucous membranes, and tissues. Injection of any chemical can occur if pneumatic devices, such as blowing the chemical off your hand is rated above 30 psi.

Immediate Response

First, move away from the area where bromine is located and to an area with fresh air. If the bromine release was outdoors, move away from the area where the bromine was released. Bromine is heavier than air and will sink to low-lying areas, so go to the highest ground possible.

It is also heavier than water and will sink in the pool and begin off-gassing. Chemicals off-gas at different rates. Manufactured products usually undergo their most noxious (smelly) off-gassing for about a month after they are produced. Some chemicals can emit volatile organic compounds (VOC’s) for years. For example: carpet can off-gas for up to five years. Some chemicals are odorless and may go undetected.

If the bromine release is indoors, get out of the building. If you are near a release of bromine, emergency coordinators may tell you to either evacuate (leave) the area or to “shelter in place” inside a building to avoid being exposed to the chemical.

Immediate Treatment

If someone has swallowed bromine, do not try to make them vomit or give them fluid’s to drink. Seek medical attention right away. Dial 911 and explain what has happened, being sure to tell 911 that you believe bromine is the chemical you or others have been exposed to. This allows emergency responders to prepare to respond to a chemical emergency.

Bromine poisoning is treated with supportive medical care such as oxygen and fluids. No specific antidote (reversal agent) exists for bromine poisoning. The most important thing is for people to remove themselves from the exposure site and seek medical treatment as soon as possible.

Administering chloride (or dietary salt loading protocol) coupled with fluids can help the body to excrete bromide more quickly. Furosemide may help aid urinary excretion in individuals with renal impairment or where bromide toxicity is severe. In one case, hemodialysis was used to reduce bromide’s half-life dramatically improving the patient’s condition.

Bromine SDS First Aid

• Eye Contact: Check for and remove any contact lenses. In case of contact, immediately flush eyes with plenty of water for at least 15 minutes. Cold water may be used. WARM water MUST be used. Get medical attention immediately.
• Skin Contact: In case of contact, immediately flush skin with plenty of water. Cover the irritated skin with an emollient. Remove contaminated clothing and shoes. Wash clothing before reuse. Thoroughly clean shoes before reuse. Get medical attention.
• Serious Skin Contact: Wash with a disinfectant soap and cover the contaminated skin with an anti-bacterial cream. Seek immediate medical attention.
• Inhalation: If inhaled, remove to fresh air. If not breathing, give artificial respiration. If breathing is difficult, give oxygen. Seek immediate medical attention.
• Serious Inhalation: Evacuate the victim to a safe area as soon as possible. Loosen tight clothing such as a collar, tie, belt or waistband. If breathing is difficult, administer oxygen.
• Not breathing: If the victim is not breathing, perform artificial resuscitation via a bag-valve mask. Warning: It may be hazardous to the person providing aid to give mouth-to-mouth resuscitation when the inhaled material is toxic, infectious or corrosive. Seek immediate medical attention.
• Ingestion: Don't induce vomiting unless directed to do so by medical personnel. Never give anything by mouth to an unconscious person.

Acute Signs & Symptoms

Breathing bromine gas can cause cough, trouble breathing, headache, irritation of your mucous membranes (inside your mouth, nose, etc.), dizziness, or watery eyes. Getting bromine liquid or gas on your skin can cause skin irritation and burns. Liquid bromine that touches your skin may first cause a cooling sensation that is closely followed by a burning feeling.

Swallowing bromine-containing compounds (combinations of bromine with other chemicals) cause different effects depending on the compound. Swallowing a large amount of bromine in a short period of time would likely cause symptoms such as nausea and vomiting (gastrointestinal symptoms), and rashes have been reported.

Chronic Signs & Symptoms

Survivors of serious poisoning caused by inhalation of bromine may have long-term lung problems. People who survive serious bromine poisoning may also have chronic (long-term) effects from damage done by what is called systemic poisoning, for example, kidney or brain damage from low blood pressure.

SDS Exposure Controls and Personal ProtectionEngineering Controls - Provide exhaust ventilation or other engineering controls to keep the airborne concentrations of vapors below their respective threshold limit value. Ensure that eyewash stations and safety showers are proximal to the work-station location.

Personal Protection - Face shield. Full suit. Vapor respirator. Be sure to use an approved/certified respirator or equivalent. Gloves. Boots.

Personal Protection in Case of a Large Spill - Splash goggles. Full suit. Vapor respirator. Boots. Gloves. A self-contained breathing apparatus should be used to avoid inhalation of the product. Suggested protective clothing might not be sufficient; consult a specialist BEFORE handling this product.

Exposure Limits - TWA: 0.66 STEL: 1.3 (mg/m3) from ACGIH (TLV) [United States] TWA: 0.1 STEL: 0.2 (ppm) from ACGIH (TLV) [United States] TWA: 0.1 from OSHA (PEL) [United States] TWA: 0.7 (mg/m3) from OSHA (PEL) [United States.

Decontamination Procedures

If you think you may have been exposed to bromine, you should remove your clothing, rapidly wash your entire body with soap and water, and get medical care as quickly as possible. Any clothing should be cut off your body instead of pulled over your head, as not to expose your face, airway and lungs.  If you are helping other people remove their clothing, try to avoid touching contaminated areas and work quickly as possible.

Wash any bromine from your skin with large amounts of soap and water. Washing with soap and water will help you and other people from any chemicals on your body. If your eyes are burning or your vision is blurred, rinse your eyes with plain water for 10 to 15 minutes.

If you wear contacts, remove them and put them with the contaminated clothing. Do not put the contacts back in your eyes (even if they are not disposable contacts). If you wear eyeglasses, wash them with soap and water. You can put your eyeglasses back on after you wash them.

Dispose of all clothing in a plastic bag. Avoid touching contaminated areas of the clothing. If you can’t avoid touching contaminated areas, or you aren’t sure where the contaminated areas are, wear rubber gloves or put the clothing in the bag using tongs, tool handles, sticks, or similar objects.

Anything that touches the contaminated clothing should also be placed in the bag. If you wear contacts, put them in the plastic bag, too. Seal the bag, and then seal that bag inside another plastic bag. Disposing of your clothing in this way will help protect you and other people from any chemicals that might be on your clothes.

More Information on Bromine

You can contact the Regional poison control center at 1-800-222-1222 or the Center for Disease Control and Prevention Hotline at 800-CDC-INFO or 888-232-6348 (TTY).  You can email the CDC at [email protected]. The Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Pocket Guide to Chemical Hazards.