Lung function before and after a large chlorine gas release in graniteville, South Carolina

Kathleen A. Clark, Wilfried J.J. Karmaus, Lawrence C. Mohr, Bo Cai, Pallavi Balte, James J. Gibson, Dennis Ownby, Andrew B. Lawson, John E. Vena, Erik R. Svendsen

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Rationale:OnJanuary 6, 2005 a train derailment led to an estimated 54,915-kg release of chlorine at a local textile mill in Graniteville, South Carolina. Objectives: We used the employee health spirometry records of the textile to identify enduring effects of chlorine gas exposure resulting from the incident on the lung function of workers employed at the textile mill. Methods: Spirometry records from 1,807 mill workers (7,332 observations) were used from 4 years before and 18 months after the disaster. Longitudinal analysis using marginal regression models produced annual population mean estimates for FEV1, FVC, and FEV1/FVC ratio. Covariate adjustment wasmade for sex, age, smoking, height, season tested, technician, obesity, season3 year interactions, and smoker3year interactions.The increased prevalence ofmillworkers having accelerated FEV1 decline was also evaluated after the chlorine spill. Measurements andMain Results: In the year of the accident, we observed a significant reduction in mean FEV1 (-4.2% predicted; P = 0.019) when compared with the year before the incident. In the second year, partial recovery in the mean FVC % predicted level was seen, but the cohort's average FEV1/FVC ratio continued to decrease over time. Severe annual FEV1 decline was most prevalent in the year of the accident, and independent of mill worker smoking status. Conclusions: The Graniteville mill worker cohort revealed significant reductions in lung function immediately after the chlorine incident. Improvement was seen in the second year; but the proportion of mill workers experiencing accelerated FEV1 annual decline significantly increased in the 18 months after the chlorine incident.

Original languageEnglish (US)
Pages (from-to)356-363
Number of pages8
JournalAnnals of the American Thoracic Society
Issue number3
StatePublished - Mar 2016
Externally publishedYes


  • Chlorine gas
  • Disaster epidemiology toxic gas exposure
  • Graniteville
  • Lung function
  • Rapid FEV1 decline

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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