Phosgene is an insidious poison as the odor may not be noticed and symptoms may be slow to appear.[13] Phosgene can be detected at 0.4 ppm, which is four times the Threshold Limit Value. Its high toxicity arises by the action of the phosgene on the proteins in the pulmonary alveoli, which are the site of gas exchange: Their damage disrupts the blood-air barrier, causing suffocation. It reacts with the amines of the proteins, causing crosslinking via formation of urea-like linkages, in accord with the reactions discussed above.
Phosgene poisoning may cause respiratory and cardiovascular failure, which results from low plasma volume, increased hemoglobin concentration, low blood pressure, and an accumulation of fluid in the lungs. Secondary systemic damage is the result of anoxia.
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