Ammonia is a chemical people may have exposure to in certain industrial or agricultural settings. In high levels, ammonia can harm the lungs and require treatment.

Ammonia is a colorless gas with a strong odor. It is a chemical that naturally occurs in the environment, including in the air, water, and soil. It is present in plants, animals, and humans. It is also an ingredient in many industrial and household cleaning products.

High levels of ammonia can irritate the throat and lungs as well as the mouth, skin, and eyes. In very high levels, ammonia can damage the lungs and may be fatal.

This article explains the most common ways people risk exposure to high levels of ammonia, the symptoms of exposure, when to contact a doctor, and the treatment options.

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If high levels of ammonia get into the lungs, a person may experience short- or long-term problems affecting their respiratory tract.

Immediate health implications

The Centers for Disease Control and Prevention (CDC) highlights several ways inhaling ammonia can affect a person in the short term.

Inhaling ammonia may cause burning in the throat and windpipe. It may also cause swelling and narrowing of the airways and air sacs in the lungs.

Ammonia may lead to corrosion of the mucous membranes of the lungs. Damage to the airways may lead to respiratory distress or failure.

If there is not enough ventilation, or if people are in an enclosed space, asphyxiation may occur.

Exposure to the same levels of ammonia is more significant in children than adults due to increased lung surface area in relation to body weight. Higher concentrations of ammonia may also occur closer to the ground.

Long-term health implications

Ammonia may cause a buildup of fluid in the lungs, which can lead to severe complications without prompt treatment.

The level of injury from ammonia exposure may depend on the concentration of ammonia, the duration of exposure, and how deeply people inhale the ammonia.

Severe lung injury may lead to acute respiratory distress syndrome (ARDS). ARDS causes low levels of oxygen in the blood, and people may require mechanical ventilation.

Frequent exposure to ammonia may lead to chronic irritation of the respiratory tract and may cause:

Symptoms of ammonia in the lungs and signs of ammonia exposure may include:

  • burning sensation in the throat
  • coughing
  • difficulty breathing
  • tight chest
  • altered mental state
  • runny nose
  • eye irritation
  • skin burns

People may be exposed to ammonia through the environment or household and industrial cleaners containing ammonia.

According to the CDC, the level of exposure may depend on factors such as:

  • the dose of ammonia
  • duration of exposure
  • type of work

Who is most at risk of ammonia exposure?

People who may be more at risk of ammonia exposure through their work include:

  • agricultural workers using soil fertilizer
  • miners or metallurgic workers
  • people working in petroleum refining
  • industrial workers manufacturing fertilizers, rubber, plastics, urea, nitric acid, fibers, synthetic resin, solvents, or other chemicals
  • people using a commercial refrigerant in food processing, are near cold storage or de-icing operations, or who produce ice

People need immediate medical attention if they are exposed to ammonia and have any symptoms of ammonia in the lungs.

First aid care for ammonia exposure includes:

  • keeping the airways open
  • providing respiration support
  • moving the affected person to an area with fresh air

When the affected person is moved to a medical facility, a doctor will carry out a brief physical examination to assess the level of ammonia exposure and damage to the lungs. Further tests may include:

  • blood and urine tests
  • kidney function tests
  • pulmonary function tests, which measure the function of the lungs
  • heart rate and rhythm monitoring
  • oxygen blood level testing
  • bronchoscopy, which allows doctors to look inside the lungs

Ammonia poisoning has no antidote. Instead, treatment focuses on reducing and managing any injury the exposure has caused.

Treatment for ammonia in the lungs may include:

  • supplying humidified oxygen
  • using bronchodilators, which are medications to make breathing easier
  • diluting any ingested ammonia with water or milk

Preventing ammonia in the lungs may include avoiding high risk settings where ammonia may be present, or using protective breathing equipment if at risk of ammonia exposure.

Protective measures may include:

  • using a respirator or breathing equipment to protect against ammonia inhalation
  • wearing protective clothing and boots to shield against hazardous chemicals
  • wearing gloves and eye protection to shield the skin and eyes
  • reporting any leaks or spills immediately and evacuating the area
  • labeling all containers and storing ammonia in a safe place away from heat sources
  • keeping water at hand for decontamination

In most cases, people may be able to leave the hospital after treatment and 6 hours of monitoring. People may need to stay in the hospital for longer if they:

  • have significant injury
  • experience respiratory distress
  • have persistent symptoms
  • are unable to feed through the mouth

Severe ammonia inhalation may result in complications, such as:

  • ARDS
  • acute lung injury
  • obstructive airway disease
  • chronic lung disease

Mild ammonia exposure leaves the body through urine within a few days.

In severe cases of ammonia exposure, people need hospital treatment, but most people recover.

Ammonia is a colorless gas that people may be exposed to in certain industrial or agricultural settings. High levels of ammonia can be harmful. Inhaling ammonia may cause damage to the lungs and respiratory tract.

Inhaling ammonia may cause coughing, burning in the throat, and difficulty breathing. Ammonia may cause lung damage, but many people can recover with prompt medical treatment.