Phosgene is an insidious poison as the odor may not be noticed and symptoms may be slow to appear.
The odor detection threshold for phosgene is 0.4 ppm, four times the threshold limit value (time weighted average). Its high toxicity arises from the action of the phosgene on the ,  and  groups of the proteins in pulmonary alveoli (the site of gas exchange), respectively forming ester, amide and thioester functional groups in accord with the reactions discussed above. This results in disruption of the blood–air barrier, eventually causing pulmonary edema. The extent of damage in the alveoli does not primarily depend on phosgene concentration in the inhaled air, with the dose (amount of inhaled phosgene) being the critical factor. Dose can be approximately calculated as "concentration" × "duration of exposure". Therefore, persons in workplaces where there exists risk of accidental phosgene release usually wear indicator badges close to the nose and mouth. Such badges indicate the approximate inhaled dose, which allows for immediate treatment if the monitored dose rises above safe limits.
In case of low or moderate quantities of inhaled phosgene, the exposed person is to be monitored and subjected to precautionary therapy, then released after several hours. For higher doses of inhaled phosgene (above 150 ppm × min) a pulmonary edema often develops which can be detected by X-ray imaging and regressive blood oxygen concentration. Inhalation of such high doses can eventually result in fatality within hours up to 2–3 days of the exposure.
The risk connected to a phosgene inhalation is based not so much on its toxicity (which is much lower in comparison to modern chemical weapons like sarin or tabun) but rather on its typical effects: the affected person may not develop any symptoms for hours until an edema appears, at which point it could be too late for medical treatment to assist. Nearly all fatalities as a result of accidental releases from the industrial handling of phosgene occurred in this fashion. On the other hand, pulmonary edemas treated in a timely manner usually heal in the mid- and longterm, without major consequences once some days or weeks after exposure have passed. Nonetheless, the detrimental health effects on pulmonary function from untreated, chronic low-level exposure to phosgene should not be ignored; although not exposed to concentrations high enough to immediately cause an edema, many synthetic chemists (e.g. Leonidas Zervas) working with the compound were reported to experience chronic respiratory health issues and eventual respiratory failure from continuous low-level exposure.
If accidental release of phosgene occurs in an industrial or laboratory setting, it can be mitigated with ammonia gas; in the case of liquid spills (e.g. of diphosgene or phosgene solutions) an absorbent and sodium carbonate can be applied.