Progress in Analytical Methods of Halogenated Disinfection By-Products

Ensuring the health and safety of drinking water is crucial for both nations and their citizens.Since the 20th century,the disinfection of drinking water,effectively controlling pathogens in water sources,has become one of the significant advances in public health.However,the disinfectants used in the process,such as chlorine and chlorine dioxide,react with natural organic matter in the water to produce disinfection by-products(DBPs).Most of these DBPs contain chlorine,and if the source water contains bromine or iodine,brominated or iodinated DBPs,collectively referred to as Halogenated disinfection byproducts(X-DBPs),are formed.Numerous studies have found that X-DBPs pose potential risks to human health and the environment,leading to widespread concern.Mass spectrometry has become an important means of discovering new types of X-DBPs.This paper focuses on the study of methods for analyzing X-DBPs in drinking water using mass spectrometry.

Simultaneous Control of Microorganisms and Disinfection By-products by Sequential Chlorination

Objective To introduce a new sequential chlorination disinfection process in which short-term free chlorine and chloramine are sequentially added. Methods Pilot tests of this sequential chlorination were carried out in a drinking water plant. Results The sequential chlorination disinfection process had the same or better efficiency on microbe （including virus） inactivation compared with the free chlorine disinfection process. There seemed to be some synergetic disinfection effect between free chlorine and monochloramine because they attacked different targets. The sequential chlorination disinfection process resulted in 35.7%-77.0% TTHM formation and 36.6%-54.8% THAA5 formation less than the free chlorination process. The poorer the water quality was, the more advantage the sequential chlorination disinfection had over the free chlorination. Conclusion This process takes advantages of free chlorine＇s quick inactivation of microorganisms and chloramine＇s low disinfection by-product （DBP） yield and long-term residual effect, allowing simultaneous control of microbes and DBPs in an effective and economic way.

Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

Removal of disinfection by-products formation potential by biologically intensified process

The removal of disinfection by-products formation potential(DBPFP) in artificially intensified biological activated carbon(IBAC) process which is developed on the basis of traditional ozone granular activated carbon was evaluated. By IBAC removals of 31% and 68% for THMFP and HAAFP were obtained respectively. Under identical conditions, the removals of the same substances were 4% and 32% respectively only by the granular activated carbon(GAC) process. Compared with GAC, the high removal rates of the two formed potential substances were due to the increasing of bioactivity of the media and the synergistic capabilities of biological degradation cooperating with activated carbon adsorption of organic compounds. A clear linear correlation(R 2=0.9562 and R 2=0.9007) between DOC HAAFP removal rate and Empty Bed Contact Time(EBCT) of IBAC process was observed, while that between THMFP removal rate and EBCT of GAC was R 2=0.9782. In addition certain linear correlations between THMFP, HAAFP and UV 254 (R 2=0.855 and R 2=0.7702) were found for the treated water. For IBAC process there are also more advantages such as long backwashing cycle time, low backwashing intensity and prolonging activated carbon lifetime and so on.

Prescreening teratogenic potential of chlorinated drinking water disinfection by-products by using Hydra regeneration assay

Practicability of method for the Hydra regeneration assay on the prescreening teratogenic potential of chlorinated drinking water disinfection by products was studied through both the assays of toxicity of adult Hydra (T) and inhibition of the growth of regeneration Hydra (I) by using chloroform, dichloromethane and chloroacetic acid. The results showed that T 50 / I 50 ratios of chloroform and chloroacetic acid were 2 77 and 6 16 respectively, with teratogenic potential. T 50 / I 50 ratio of dichloromethane was 1.69, with weaker teratogenic potential. These experimental results indicated preliminarily that the Hydra regeneration assay has certainly applied value as a prescreening assay for developmental toxicity.

A prototype for on-site generation of chlorinated disinfectant for use in rural aqueducts

Sodium hypochlorite has significant potential as a sanitation solution in hard-to-reach areas.Few studies have investigated the optimal electrolysis parameters for its production with volumes greater than 1o L.This study evaluated sodium hypochlorite production through electrolysis in a 22-L prototype and identified the optimal operating parameters.Tests were performed using graphite electrodes with areas of 68.4 cm^(2) at the laboratory scale and 1865.0 cm^(2) at the prototype scale.A design for experiments with different operating times,chloride concentrations,and electric current intensities was developed.The optimal operating time,sodium chloride concentration,and current intensity at the laboratory scale were 120 min,150 g of chloride per liter,and 3 A,respectively,leading to the production of 5.02 g/L of the disinfectant with an energy efficiency of 12.21 mg of Cl_(2) per kilojoule.At the prototype scale,the maximum sodium hypochlorite concentration of 3.99 g of chloride per liter was achieved with an operating time of 120 min,a sodium chloride concentration of 100 g of chloride per liter,and a current intensity of 70 A,reaching an energy efficiency of 42.56 mg of Cl_(2) per kilojoule.In addition,this study evaluated the influences of the chloride concentration,current intensity,and operating time on the production of sodium hypochlorite at the two scales,and formulated the equations showing the trends of sodium hypochlorite production and energy efficiency in the electrochemical systems.The 22-L prototype model for production of this oxidizing substance is promising for disinfection of large volumes of water in areas that are difficult to access.

Removal characteristics of disinfection by-products formation potential by bioaugmentation activated carbon process

The high-active bacteria were screened from 8 dominant bacteria obtained from the natural water body,and then the bioaugmentation activated carbon was formed by hydraulic immobilization of the high-active bacteria. Plant-scale studies on removal characteristics of disinfection by-products formation potentials (DBPFP) by bioaugmentation activated carbon process were conducted for micro-polluted raw water treatment. The results show that the bioaugmentation activated carbon process has adopted better purification efficiency to THMFP and HAAFP than traditional biological activated carbon process,and that average removal efficiencies of THMFP and HAAFP can reach 35% and 39.7% during the test period,increasing by more than 10% compared with traditional biological activated carbon process. The removal efficiencies of THMFP and HAAFP are stable because of the biodegradation of the high-active bacteria and the adsorption of active carbon. The biodegradability of CHCl3 formation potential is better as compared with that of CHCl2Br and CHClBr2 formation potentials among THMFP,and high removal efficiency of CHCl3formation potential is obtained by bioaugmentation degradation of the high-active bacteria. The biodegradability of HAAFP is better in comparison with that of THMFP,and the chemical properties of HAAFP are propitious to adsorption of activated carbon. Thus,HAAFP is on predominance during the competitive removal process with THMFP.

Use of graphene nanocomposites for air disinfection in dental clinics:A game-changer in infection control

This manuscript features the promising findings of a study conducted by Ju et al,who used graphene nanocomposites for air disinfection in dental clinics.Their study demonstrated that,compared with conventional filters,graphene nanocom-posites substantially improved air quality and reduced microbial contamination.This manuscript highlights the innovative application of graphene materials,emphasizing their potential to enhance dental clinic environments by minimizing secondary pollution.On the basis of the unique antimicrobial properties of gra-phene and the original study’s rigorous methodology,we recommend using gra-phene nanocomposites in clinical settings to control airborne infections.

Effects of Penicillium spp. and Trichoderma spp.on Pleurotus ostreatus Growth and Screening of Effective Disinfectants

[Objective] This study was conducted to investigate the effects of Penicillium spp. and Trichoderma spp. on the growth of Pleurotus ostreatus （oyster mushroom） and to screen effective disinfectants to control them and other pathogenic microbes. [Method] Six strains or species of Penicilliurn and Trichoderma were inocu- lated into PDA plates growing with P. ostreatus to observe the growth of their mycelia. And the inhibitory effects of hydrogen peroxide, bromogeramine bromide, 84 disinfectant, lysol, potassium permanganate, and 75% medical alcohol on Trichoderma pleuroticola, Trichoderma viride, Trichoderma harzianum, Penicillium citrinum, Penicillium thomii and Penicillium brevicompactum were detected. [Result] Confrontation test revealed that Penicillium spp. and Trichoderma spp. competed for nutrients with P. ostreatus mycelia, antagonized against the growth of P. ostreatus mycelia, invaded and twined around P. ostreatus mycelia, and also produced toxins poisoning P. ostreatus mycelia. The six disinfectants exhibited different inhibitory effects against different species of Penicillium and Trichoderma. Among them the in- hibitory effects of bromogeramine bromide against the six species of Penicillium and Trichoderma were significantly different. However, the inhibitory effects of 3% hydrogen peroxide, 84 disinfectant, 5% lysol, potassium permanganate and 75% medical alcohol were significantly different among Penicillium spp., but did not among Tri- choderma spp. [Conclusion] Bromogeramine bromide can be used to control the bacteria and fungi in mushroom production for it has significant inhibitory effects on the six species of both Penicillium and Trichoderma.

Is the Potential Interconnection between Antibiotic Susceptibility and Disinfectant Resistance a Threat to Food Safety?

The prevalence of antibiotic susceptibility and disinfectant resistance in bacterial pathogens causes a serious problem not only to food safety but also to public health, which directly or indirectly leads to treatment and disinfection failures. In this review, multidrug resistance, the mechanism of disinfectant resistance, the methods for detecting disinfectant resistance and the cross-resistance between an- tibiotics and disinfectants are summarized. More efforts should be devoted to explor- ing the professional guidance of using antibiotics and disinfectants, and to develop- ing the comprehensive detection with genetic and molecular methods is highly ex- pected.

Characterization of dissolved organic matter fractions and its relationship with the disinfection by-product formation

Dissolved organic matter （DOM） has been identified as precursor for disinfection by-products （DBPs） formation during chlorination. Recently, it has been demonstrated that the characteristics of DOM influence the DBPs formation mechanism. A study was, therefore, initiated to investigate the effects of DOM fractions on DBPs formation mechanism. In the chlorination process, organic acids are dominant precursors of total thihalomethanes （TTHM） because of the vc-o and unsaturated structures. Furthermore, the TTHM formation of organic acids was affected by pH more greatly. Based on the fluorescence spectroscopy analysis, DOM fractions contained several fluorescence substances. During chlorination, humic acid-like substances were found to exhibit high chlorine reactivity and hydrophobic organics decomposed to smaller molecules faster than hydrophilic organics even at lower chlorine dosages. Unlike hydrophobic fractions, hydrophilic organics showed no toxicity following chlorination, suggesting that the toxic structures in hydrophihc organics showed high chlorine reactivity during chlorination.

Effects of molasses on the fermentation characteristics of mixed silage prepared with rice straw, local vegetable by-products and alfalfa in Southeast China

This experiment was conducted to study the effect of molasses on the fermentation characteristics of mixed silage ensiled rice straw and vegetable by-products with alfalfa.Mixture（202 g kg^-1 dry matter（DM））consisting of rice straw,broccoli residue and alfalfa at the ratio of 5：4：1 was ensiled with three experimental treatments：（1）no additives（control）;（2）molasses at 2.5%（M1）;（3）molasses at 5%（M2）on a fresh matter basis of mixture,respectively.All treatments were packed into laboratory-scale silos,and three silos per treatment were sampled on days 1,3,5,14 and 30.The result showed that the p H value of all mixed silages decreased gradually with the time of ensiling except for the control silage,in which a significant increase（P〈0.05）on day 30 occurred.The lactic acid content increased gradually with the time of ensiling and reached the highest value on day 14,and a marked decrease（P〈0.05）was found in the control silage on day 30.The changes of acetic acid content showed similar pattern with lactic acid content.A trace amount of propionic and butyric acid contents were found in the three mixed silages during the fermentation period.Comparing to the control,M1 and M2 treatments improved the fermentation quality of mixed silages as indicated by higher（P〈0.05）lactic acid contents and lower（P〈0.05）p H and ammonia-N contents.The Flieg points also showed that M1 and M2 silages were well preserved,whereas the control silage had a bad quality.Overall,the findings of this study suggested that adding molasses could improve fermentation quality of mixed silage,and M1 was more suitable for practical application.

Preparation and Evaluation of Novel Solid Chlorine Dioxide-based Disinfectant Powder in Single-pack

Objective To prepare and evaluate novel chlorine dioxide-based disinfectant powder in single-pack that is more convenient for use and transportation. Methods Orthogonal experiment was performed to determine the recipe of the disinfectant powder. Stability test, suspension quantitative bactericidal test, simulation field triM, and animal toxicity test were carded out to observe its bactericidal and toxicological effects. Results The orthogonal experiment showed that the type of water solution had no effect on the disinfectant powder and the best ratio of sodium chlorite to solid acid was 1：3. Ten grams of the disinfectant powder was fully dissolved in 20 mL water for 2 min, and diluted to 500 mL in water. After 5-10 min, the concentration of chlorine dioxide （CIO2） solution was 266 mg/L to 276 mg/L. After stored at 54℃ for 14 d, the average concentration of CIO2 was decreased by 5.03%. Suspension quantitative bactericidal test showed that the average killing logarithm （KL） value for both Staphylococcus aureus and Escherichia coli in 100 mg/L CIO2 solution for 2 min was over 5.00. In simulation field triM, the average descending KL value for Escherichia coli in the solution containing 100 mg/L CIO2 for 5 min was over 3.00. The mouse acute LD50 in the solution 5 times exceeded 5000 mg/kg. The disinfectant powder was not toxic and irritative to rabbit skin and had no mutagenic effect on mouse marrow polychromatic erythrocytes （PCE）. Conclusion The stability and bactericidal efficacy of solid chlorine dioxide-based disinfectant powder in single-pack are good. The solution containing 100 mg/L CIO2 can kill vegetative forms of bacteria. The concentration of CIO2 on the disinfecting surface of objects is 100 mg/L. The disinfectant powder is not toxic and irritative.

Enhanced Disinfection Effect of a Compound Disinfectant against Bovine Herpes Virus Type 1 at Low Temperature

A compound disinfectant, which consisted of didecyldimethylammonium chloride (DDAC), ortho-dichlorobenzene (1,2-dichlorobenzene, ODB), and chlorocresol (4-chloro-3-methylphenol, CC), and its component chemicals were individually tested for effectiveness against bovine herpes virus type 1 (BHV-1). DDAC, DDAC+ODB, DDAC+CC, and DDAC+ODB+CC showed effectiveness against BHV-1 at room temperature. However, ODB, CC, and ODB+CC showed no virucidal effects. The effects of all disinfectants tested were decreased at low temperature. DDAC showed disinfectant effects at a dilution of 1/800 and DDAC+ODB, DDAC+CC, and DDAC+ODB+CC at dilutions of 1/800 and 1/1600 at low temperature in the presence of 2% fetal bovine serum (FBS) but ODB, CC, and ODB+CC showed no virucidal effects. At low temperature and in the presence of 10% FBS, DDAC, DDAC+ODB, and DDAC+CC showed disinfectant effects at dilutions of 1/800, whereas ODB, CC, and ODB+CC showed no virucidal effects. DDAC+ ODB+CC was more effective (at 1/800 and 1/1600) than the other disinfectants under these conditions. In conclusion, a combination of three disinfectant components (DDAC+ODB+CC), enhanced the disinfectant effects at low temperature and in organic matter contamination.

Flashlight contamination and effectiveness of two disinfectants in a stomatology hospital

Aim: This study aims to assess the infection risks of flashlight contamination in a stomatology hospital and compare the disinfection effectiveness of alcohol (75%) and disinfecting wipes.Background: The flashlight is a basic non-critical medical device in oral and maxillofacial surgery wards. Wounds are mostly found in oral cavities;therefore, reusable flashlights may be a potential source of nosocomial infections (NIs). However, the microbial flora present in flashlights used in hospitals has not yet been explored. Methods: This study investigated the microbial contamination of 41 flashlights used in a stomatology hospital in Guangzhou in March 2016. Results: Results indicated that 75.6%(31/41) of the flashlights had microbial contamination. Gram-positive bacteria accounted for 72.7%(24/33)of the microbial groups contaminating the flashlights, and Gram-negative bacteria (21.2%, 7/33), and fungi (6.1%, 2/33) constituted the remaining contaminants. The predominantly isolated species was Staphyloccus (66.7%, 22/33), especially Staphylococcus aureus (24.2%, 8/33). Approximately 77.3%(17/22) of the types of bacteria detected in the hands were same as those in the corresponding flashlights. Both the bacterial overstandard and S. aureus detection rates of doctors' flashlights were higher than those of nurses' flashlights (16/17 vs. 14/23, 7/17 vs. 1/23, respectively) (P < 0.05). Moreover, both disinfectants performed excellently, and their eligibility rates were not significantly different (17/17 vs. 14/14) (P>0.05). Conclusion: Flashlights are potential causes of NIs. Disinfecting flashlights could be an effective and practical infection control method.

Effects of Replacing Fishmeal with Animal By-products Meal Supplementation in Diets on the Growth and Nutrient Utilization of Mangrove Red Snapper

A feeding trial was conducted for 75 d to evaluate the nutritive value of a mixture of animal by-products （MAB） as a possible protein source in diets for juvenile mangrove red snapper, Lutjanus argentimaculatus （mean initial body weight, 30 g）. Fish were fed one of five isonitrogenous diets （40% crude protein） replacing 0, 25% （MAB25）, 50% （MAB50）, 75% （MAB75） and 100% （MAB100） of fish meal protein with similar percentages of MAB. The MAB consisted of 25% cow liver meal, 20% leather meal, 20% meat and bone meal, 15% blood meal, 10% APC （poultry feather meal）, 8% poultry manure dried, 1.5% choline and 0.5% chromic oxide. After 75 d of feeding, fish fed with diets MAB50, MAB75 and MABI00 exhibited significantly lower growth performance than that of fish fed with control and MAB25 diets. The optimum level of MAB was estimated to be 23%. Replacement of fish meal by MAB23% showed the following performance： maximum weight gain, 510%; SGR, 2.39% and FCE, 2.83%. The MAB substitution up to 75% of fish meal protein in diets did not show differences in apparent protein digestibility （83.6% for MAB25, 79.2% for MAB50, 78.7% for MAB75） compared with control （83.4%）, whereas in MABI00 group digestibility （65.3%） was significantly lower than in other groups. The apparent phosphorus absorption of test diet groups was significantly higher （37.1% for MAB25, 28.5% for MABS0, 55.6% for MAB75 and 54.5% for MABI00） than that of control （1 1.2%）. The levels of protein and ash in the whole body, carcass and viscera increased as MAB substitution in diets increased, whereas lipids and moisture remained consistent among all treatment groups. These results showed that approximately 23% of fish meal protein could be replaced by a mixture of animal by-products for juvenile snapper growing from 30 g to 167 g in 75 d without compromising growth performance and feed efficiency.

Nitric acid pressure leaching of limonitic laterite ores:Regeneration of HNO3 and simultaneous synthesis of fibrous CaSO4·2H2O by-products

An innovative technology,nitric acid pressure leaching of limonitic laterite ores,was proposed by our research team.The HNO3 regeneration is considerable significance for the improvement of the proposed technology and its commercial application,but it has not been systematically investigated.Herein,regenerating HNO3 from Ca(NO3)2 solution with low-cost H2SO4,and simultaneous synthesis of fibrous CaSO4·2H2O by-products were studied.As a theoretical basis,the solubility of CaSO4·2H2O in HNO3 medium is studied.It is concluded that the solubility of CaSO4·2H2O increases with increasing temperature or increasing HNO3 concentration,which has considerable guiding significance for the subsequent experimental research and analysis.Then,the effects of various factors on the residual Ca^2+ concentration of filtrate,the regenerated HNO3 concentration and the morphology of synthesized products are investigated using ICP-AES and SEM.And the effect mechanism is also analyzed.The results indicate the regenerated HNO3 concentration reaches 116 g/L with the residual Ca^2+ concentration being 9.7 g/L at the optimum conditions.Moreover,fibrous CaSO4·2H2O by-products with high aspect ratios(length,406.32μm;diameter,14.71μm;aspect ratio,27.62)can be simultaneously synthesized.

Neem by-products in the fight against mosquito-borne diseases:Biotoxicity of neem cake fractions towards the rural malaria vector Anopheles culicifacies(Diptera:Culicidae)

Objective: To evaluate the ovicidal, larvicidal and adulticidal potential of neem cake fractions of different polarity against the rural malaria vector Anopheles culicifacies(An.culicifacies).Methods: Neem cake fractions' total methanol extract(NTMeOH), total ethyl acetate extract(NTAc OEt), ethyl acetate fraction after repartition with NTMe OH(NRAc OEt),butanol fraction after repartition with NTMeOH(NRBuOH), and aqueous fraction after repartition of NTMeOH(NRH2O) were tested against An. culicifacies eggs, fourth instar larvae and adults.Results: In larvicidal experiments, NTMeOH, NTAcOEt, NRAcOEt, NRBuOH and NRH2O achieved LC50 values of 1.32, 1.50, 1.81, 1.95 and 2.54 mg/L, respectively. All fractions tested at 150 mg/L were able to reduce egg hatchability of more than 50%, with the exception of NTAc OEt and NRAc OEt. In adulticidal assays, NTMeOH, NTAcOEt,NRAcOEt, NRBuOH and NRH2O achieved LC50 values of 3.01, 2.95, 3.23, 3.63 and3.00 mg/L, respectively.Conclusions: Overall, this study suggests that the methanolic fractions of neem cake may be considered as a new and cheap source of highly effective compounds against the rural malaria vector An. culicifacies.

Comprehensive utilization of corn starch processing by-products:A review

Corn is a high starchy cereal crop with the highest production and provides over 85%of the starch produced worldwide.Various by-products,differentiated by technological process features such as steep liquor,corn germ,corn bran,gluten,are created largely during corn starch processing.They are inexpensive,nutrient-rich,and vary widely in chemical composition such as proteins,oils,carbohydrates,and minerals.In an increasingly resource-constrained modern world,the utilization approach of these by-products for non-starch industrial processing is attractive widely considering both nutritive value and economic aspects.In fact,at present,applications of these by-products can often be found in feed,fermentation,nutrient extraction and other industries.For example,protein-rich corn gluten can be used as a good animal feed,and corn germ can be used as a raw material for the high-quality edible oil industry.Undoubtedly,increasing utilization means that these by-products will no longer be treated as waste but will be transformed into high value-added products.In this work,the separation process and chemical composition of several main by-products of the corn starch industry is briefly described,and the application in many industrial fields of these by-products over the last ten years are discussed in particular.This review attempts to summarize all aspects of the application and research of these by-products.For the by-products of the corn starch industry,the most promising way is to be utilized in high value and used to produce high value-added products.According to the characteristics of their chemical composition,they have a better application prospect and research significance in the industries directly related to human beings,such as medicine,green food and health care products.In fact,in recent years,some researchers have recognized this and carried out the research.It is clear fromthese studies that the main issues to be faced nowand in the future are how to produce efficiently while maintaining the quality of the product and using it effectively.The retrospective discussions also provide some ideas for other grain and oilseed crops to be fully utilized.

Chlorine poisoning caused by improper mixing of household disinfectants during the COVID-19 pandemic:Case series

BACKGROUND Misuse of disinfectants during the coronavirus disease 2019 pandemic has led to several poisoning incidents.However,there are few clinical case reports on poisoning caused by improper mixing of household disinfectants.AIM To summarize the clinical characteristics and treatment effects of chlorine poisoning caused by improper mixing of hypochlorite bleach with acidic cleaning agents.METHODS We retrospectively analyzed baseline and clinical data,clinical symptoms,and treatment methods of seven patients with chlorine poisoning who were admitted to the National Army Poisoning Treatment Center.RESULTS Among the seven patients,the average poisoning time(exposure to admission)was 57 h(4-240 h).All patients were involved in cleaning bathrooms.Chest computed tomography scans revealed bilateral lung effusions or inflammatory changes in five patients.The partial pressure of oxygen decreased in six patients,and respiratory failure occurred in one.Five patients had different degrees of increase in white blood cell count.Humidified oxygen therapy,non-invasive mechanical ventilation,anti-inflammatory corticosteroids,antioxidants,and antibiotics were administered for treatment.The average length of hospital stay was 7 d(4-9 d).All seven patients recovered and were discharged.CONCLUSION Improper mixing of household disinfectants may cause damage to the respiratory system due to chlorine poisoning.Corticosteroids may improve lung exudation in severe cases,and symptomatic supportive treatment should be performed early.