The chloride anion is an essential nutrient for metabolism. Chlorine is needed for the production of hydrochloric acid in the stomach and in cellular pump functions. The main dietary source is table salt, or sodium chloride. Overly low or high concentrations of chloride in the blood are examples of electrolyte disturbances. Hypochloremia (having too little chloride) rarely occurs in the absence of other abnormalities. Its sometimes associated with hypoventilation. It can be associated with chronic respiratory acidosis. Hyperchloremia (having too much chloride) usually does not produce symptoms. When symptoms do occur, they tend to resemble those of hypernatremia (having too much sodium). Reduction in blood chloride leads to cerebral dehydration; symptoms are most often caused by rapid rehydration which results in cerebral edema. Hyperchloremia can affect oxygen transport.
Chlorine is a toxic gas that attacks the respiratory system, eyes, and skin. Because it is denser than air, it tends to accumulate at the bottom of poorly ventilated spaces. Chlorine gas is a strong oxidizer, which may react with flammable materials. Chlorine is detectable with measuring devices in concentrations as low as 0.2 parts per million (ppm), and by smell at 3 ppm. Coughing and vomiting may occur at 30 ppm and lung damage at 60 ppm. About 1000 ppm can be fatal after a few deep breaths of the gas. The IDLH (immediately dangerous to life and health) concentration is 10 ppm. Breathing lower concentrations can aggravate the respiratory system and exposure to the gas can irritate the eyes. The toxicity of chlorine comes from its oxidizing power. When chlorine is inhaled at concentrations greater than 30 ppm, it reacts with water and cellular fluid, producing hydrochloric acid (HCl) and hypochlorous acid (HClO). When used at specified levels for water disinfection, the reaction of chlorine with water is not a major concern for human health. Other materials present in the water may generate disinfection by-products that are associated with negative effects on human health.
In the United States, the Occupational Safety and Health Administration (OSHA) has set the permissible exposure limit for elemental chlorine at 1 ppm, or 3 mg/m3. The National Institute for Occupational Safety and Health has designated a recommended exposure limit of 0.5 ppm over 15 minutes. In the home, accidents occur when hypochlorite bleach solutions come into contact with certain acidic drain-cleaners to produce chlorine gas. Hyperchlorite bleach (a popular laundry additive) combined with ammonia (another popular laundry additive) produces chloramines, another toxic group of chemicals.