Phosgene Oxime

Background

Phosgene oxime, known as "CX" in the military, is a human-made chemical warfare agent. Phosgene oxime was first made in 1929, but it has never been used on the battlefield.

Phosgene oxime is a type of agent called an urticant or nettle agent. It causes strong itching and a rash similar to hives when it touches the skin. Phosgene oxime is also called a corrosive agent because it causes a specific type of skin and tissue damage.

There is limited specific information on this chemical. It can be described as:

• Colorless as a solid.
• Yellowish brown as a liquid.
• An unlikeable and irritating scent.

Where it is found

Phosgene oxime is not found naturally in the environment.

Phosgene oxime has never been used during wartime, despite being made as a chemical warfare agent.

Phosgene oxime vapor (gas) is heavier than air, so it will settle in lower areas. Phosgene oxime does not last in the environment for very long. It breaks down in soil within 2 hours when temperatures are normal. It breaks down in water within a few days.

How it works

Phosgene oxime causes instant and almost unbearable pain on exposed skin and eyes. When breathed in, it causes immediate irritation to the respiratory (breathing) tract. Phosgene oxime can go through clothing and rubber faster than other chemical warfare agents.

Signs and symptoms

Signs and symptoms occur immediately following a phosgene oxime exposure. The level of phosgene oxime poisoning depends on the amount exposed, how the person is exposed, and for how long.

Phosgene oxime can have the different effects on specific parts of the body.

Showing these signs or symptoms does not necessarily mean that a person has been exposed to phosgene oxime.

Eyes

Signs and symptoms include severe pain and irritation and eye tearing. There is also possible temporary blindness.

Respiratory tract

Signs and symptoms include:

• Immediate irritation to the upper respiratory (breathing) tract
• Runny nose
• Hoarseness
• Sinus pain

Getting phosgene oxime through the skin or breathing it in may cause:

• Fluid build up in the lungs (pulmonary edema).
• Shortness of breath.
• Cough.

Skin

In a few seconds: Pain occurs.

In 30 seconds: Blanching (whitening) of the skin circled by red rings will occur.

In about 15 minutes: Skin starts showing hives.

After 24 hours: Whitened areas of skin become brown and die and a scab is formed.

Itching and pain may continue as you heal.

Exposure

People's chance of exposure depends on how close they are to the place where the phosgene oxime was released.

Air: People can be exposed through skin contact, eye contact, or breathing it in.

Water: People can be exposed by touching or drinking water that contains phosgene oxime.

Food: People can be exposed by eating the food. People can also be exposed directly by touching liquid phosgene oxime.

What to do if you are exposed

Get away

Get fresh air by leaving the area where the phosgene oxime is. Moving to an area with fresh air is a good way to reduce the chances of exposure to phosgene oxime.

If phosgene oxime was released outside, move away from the area. Go to the highest ground possible, because phosgene oxime is heavier than air and will sink to lower areas.

If phosgene oxime was released indoors, get out of the building.

Take off your clothes

Remove the clothing with liquid phosgene oxime on it as quickly as possible. Cut clothes off instead of pulling it over the head. If you are helping others, do not touch unsafe areas and take off the clothing as quickly as possible.

Wash your body

Wash any phosgene oxime from your skin with lots of soap and water. Washing with soap and water will protect you and others 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 dirty 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.

Throw your clothes away

If possible, put the clothing in a plastic bag. Then put the first plastic bag in a second plastic bag. Throwing away your clothes this way helps protect you and others from any chemicals that might be on your clothes.

If you put your clothes in bags, let the local or state health department or emergency personnel know when they come. Do not handle the plastic bags.

Treatment

There is no cure for phosgene oxime.

Treatment involves removing the phosgene oxime from the body as soon as possible. Treatment also includes providing supportive medical care in a hospital setting.

Long-term health effects

No information is available on the long-term health effects of phosgene oxime in humans.

More information

You can contact one of the following:

• Regional poison control center: 1-800-222-1222
• Centers for Disease Control and Prevention Public Response Hotline
  • Phone: 800-CDC-INFO
  • Teletypewriter (TTY): 888-232-6348
  • E-mail inquiries: cdcinfo@cdc.gov