Facts about Bromine: How bromine poisoning is treated

Facts about Bromine

What bromine is

  • Bromine is a naturally occurring element that is a liquid at room temperature.
  • It has a brownish-red color with a bleach-like odor, and it dissolves in water.

Where bromine is found and how it is used

  • Bromine is found naturally in the earth’s crust and in seawater in various chemical forms. Bromine can also be found as an alternative to chlorine in swimming pools.
  • Products containing bromine are used in agriculture and sanitation and as fire retardants (chemicals that help prevent things from catching fire).
  • Some bromine-containing compounds were historically used as sedatives (drugs that can make people calm or sleepy). However, these drugs are for the most part no longer found on the market in the United States.

How you could be exposed to bromine

  • Following the release of bromine into water, you could be exposed by drinking the contaminated water.
  • If food becomes contaminated with bromine, you could be exposed by eating the contaminated food.
  • Following release of bromine gas into the air, you could be exposed by breathing the fumes.
  • Skin exposure to bromine could occur through direct contact with bromine liquid or gas.
  • Bromine gas is heavier than air, so it would settle in low-lying areas.

How bromine works

  • Bromine works by directly irritating the skin, mucous membranes, and tissues.
  • 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.

Immediate signs and symptoms of exposure to bromine

  • Breathing bromine gas could cause you to cough, have trouble breathing, get a headache, have irritation of your mucous membranes (inside your mouth, nose, etc.), be dizzy, or have watery eyes.
  • Getting bromine liquid or gas on your skin could 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) would cause different effects depending on the compound. Swallowing a large amount of bromine in a short period of time would be likely to cause symptoms such as nausea and vomiting (gastrointestinal symptoms).
  • Showing these signs and symptoms does not necessarily mean that a person has been exposed to bromine.

Long-term health effects of exposure to bromine

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

How you can protect yourself, and what to do if you are exposed to bromine

  • First, get fresh air by leaving the area where the bromine was released. Moving to an area with fresh air is a good way to reduce the possibility of negative health effects from exposure to bromine.
    • If the bromine release was outdoors, move away from the area where the bromine was released. Go to the highest ground possible, because bromine is heavier than air and will sink to low-lying areas.
    • If the bromine release was 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” (stay where you are) inside a building to avoid being exposed to the chemical. For more information on evacuation during a chemical emergency, see “Facts About Evacuation” athttp://emergency.cdc.gov/planning/evacuationfacts.asp. For more information on sheltering in place during a chemical emergency, see “Facts About Sheltering in Place” athttp://emergency.cdc.gov/planning/Shelteringfacts.asp.
  • 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.
  • Removing your clothes:
    • Quickly take off clothing that may have bromine on it. Any clothing that has to be pulled over your head should be cut off your body instead of pulled over your head.
    • If you are helping other people remove their clothing, try to avoid touching any contaminated areas, and remove the clothing as quickly as possible.
  • Washing yourself:
    • As 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.
  • Disposing of your clothes:
    • After you have washed yourself, place your clothing inside 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.
    • When the local or state health department or emergency personnel arrive, tell them what you did with your clothes. The health department or emergency personnel will arrange for further disposal. Do not handle the plastic bags yourself.
    • For more information about cleaning your body and disposing of your clothes after a chemical release, see “Chemical Agents: Facts About Personal Cleaning and Disposal of Contaminated Clothing” athttp://emergency.cdc.gov/planning/personalcleaningfacts.asp.
    • If someone has swallowed bromine, do not try to make them vomit or give them fluids to drink.
    • Seek medical attention right away. Dial 911 and explain what has happened

How bromine poisoning is treated

Bromine poisoning is treated with supportive medical care (for example, oxygen, fluids given through a needle into your vein) in a hospital setting. No specific antidote exists for bromine poisoning. (An antidote is a medicine that reverses the effects of a poison.) The most important thing is for people to remove themselves from the exposure site and seek medical treatment as soon as possible.

Bromine Poisoning

Clinical description

The majority of exposures to bromine occur by inhalation and typically lead to symptoms of ocular, nasal, and respiratory irritation. Signs and symptoms of poisoning include eye redness and lacrimation, nose and throat irritation, cough, and dyspnea. Ingestion of liquid bromine can cause abdominal pain and hemorrhagic gastroenteritis with secondary shock. Signs and symptoms might also include brown discoloration of mucous membranes and the tongue (1, 2).

Laboratory criteria for diagnosis

  • Biologic: No specific test for bromine is available; however, detection of elevated bromide levels in serum (reference level is 50-100 mg/L) might indicate that an exposure has occurred.
  • Environmental: Detection of bromine in environmental samples, as determined by NIOSH.

Case classification

  • Suspected: A case in which a potentially exposed person is being evaluated by health-care workers or public health officials for poisoning by a particular chemical agent, but no specific credible threat exists.
  • Probable: A clinically compatible case in which a high index of suspicion (credible threat or patient history regarding location and time) exists for bromine exposure, or an epidemiologic link exists between this case and a laboratory-confirmed case.
  • Confirmed: A clinically compatible case in which laboratory tests on environmental samples are confirmatory.

The case can be confirmed if laboratory testing was not performed because either a predominant amount of clinical and nonspecific laboratory evidence of a particular chemical was present or a 100% certainty of the etiology of the agent is known.