Ammonia Exposure

What to do right away

1. Get away from the source. Move into fresh air immediately. Do not re-enter the area to rescue someone without protection; call 911.
2. Call for help. Call 911 for breathing problems, eye splashes with concentrated ammonia, or burns. Otherwise call Poison Control at 1-800-222-1222 (US) for advice.
3. Remove contaminated clothing, cutting it off rather than pulling it over the head if possible. Remove contact lenses.
4. Flush eyes immediately with lukewarm clean water or saline for at least 15 to 20 minutes, holding the eyelids open. With alkali burns, continue rinsing on the way to hospital.
5. Rinse skin with large amounts of lukewarm water for at least 15 to 20 minutes.
6. If swallowed: do not make the person vomit. If they can swallow and are fully awake, Poison Control may advise a small amount of water. Seek emergency care.

Do not try to "neutralize" ammonia with vinegar or other acids. The reaction produces heat and worsens burns.

How ammonia harms the body

Ammonia is highly water-soluble. When it contacts moist tissue (eyes, mouth, airways, sweaty skin), it forms ammonium hydroxide, a strong alkali. Alkalis cause liquefactive necrosis: they dissolve tissue and keep penetrating deeper until diluted. This is why prolonged irrigation is critical and why eye injuries can be severe.

Because it dissolves so readily, ammonia mostly injures the upper airways first. Its strong smell usually makes people leave quickly, limiting exposure. But high concentrations, or being trapped, can damage the lower airways and lungs.

Common sources of ammonia exposure

Symptoms of ammonia exposure

Inhalation

• burning nose and throat, coughing, sneezing
• hoarseness, which can signal swelling of the voice box
• chest tightness, wheezing and breathlessness
• in severe exposure: stridor, airway swelling, and fluid in the lungs (pulmonary edema), which can be delayed by several hours

Eyes

• intense burning, tearing and redness
• swelling of the eyelids
• cloudy cornea, blurred vision
• in severe cases, permanent scarring, glaucoma or blindness

Skin

• redness, pain and blisters
• deep burns with concentrated ammonia
• frostbite-like injuries from liquid anhydrous ammonia, which is stored under pressure and evaporates at very low temperatures

Swallowing

• burning of the mouth, throat and chest
• drooling, vomiting, difficulty swallowing
• risk of perforation of the esophagus or stomach

Hospital treatment

• Airway and breathing: oxygen, humidified air and inhaled bronchodilators for wheezing. People with hoarseness, stridor or facial burns may need early intubation (a breathing tube) before swelling closes the airway.
• Observation: people with significant inhalation are usually monitored for several hours, and sometimes overnight, because lung injury can be delayed.
• Eye care: continued irrigation until the eye surface pH is normal, followed by urgent ophthalmology assessment. Treatment may include antibiotic drops, steroid drops and other measures to support healing.
• Burn care: wound cleaning, dressings and referral to a burn unit for extensive burns. See chemical burns.
• Swallowed ammonia: endoscopy to assess injury to the esophagus and stomach.
• Chest X-ray and blood gas tests to monitor lung function.

There is no antidote. Treatment is supportive.

Long-term effects

Most people with brief, low-level exposure recover completely within a day or two. After severe exposure, possible lasting effects include:

• reactive airways dysfunction syndrome: asthma-like symptoms after a single high exposure
• bronchiectasis or scarring of the airways
• chronic cough
• corneal scarring and vision loss
• esophageal narrowing after swallowing

Preventing ammonia exposure

• Never mix ammonia-based cleaners with bleach or other cleaning products.
• Use cleaners in well-ventilated rooms, and wear gloves.
• Store products in original containers, out of reach of children.
• In farm and industrial settings, follow safety procedures, use protective equipment (goggles, face shields, gloves and respirators) and keep emergency eyewash stations and water nearby.

Frequently asked questions

What should I do if I inhale ammonia?

Move to fresh air right away. If you have trouble breathing, wheezing, hoarseness or chest pain, call 911. For mild irritation from a household cleaner, call Poison Control at 1-800-222-1222 for advice. Most mild symptoms settle within hours in fresh air.

What are the symptoms of ammonia poisoning?

Symptoms include burning eyes, nose and throat, coughing, wheezing, chest tightness and breathlessness. Skin and eye contact cause burns. Severe exposure can cause airway swelling and fluid in the lungs, sometimes hours later.

What happens if you mix bleach and ammonia?

Mixing bleach and ammonia creates chloramine gases, which irritate the eyes and lungs and can cause coughing, breathlessness and chest pain. Leave the area, ventilate it, and call Poison Control or 911 if symptoms are significant.

How long do ammonia exposure symptoms last?

Mild irritation usually clears within a few hours to a day after leaving the area. Burns to the eyes, skin or airways can take days to weeks to heal, and severe exposures can cause lasting lung or eye damage.