BACKGROUND: In the construction industry, maintaining health and safety of workers often challenging. Among the workers at construction sites, painters are at particular risk of respiratory diseases and neurotoxicity. However, in Korea there is weak enforcement of workers' health and safety practices in the construction industry in Korea. Poisonings frequently occur at (semi)closed construction sites. In this study, we report a case of acute organic solvent poisoning during construction site painting. CASE PRESENTATION: A 71-year-old man was found unconscious at a construction site and immediately transferred to the emergency room. The consciousness level was 'stupor state' and the body temperature was hypothermic, at 32 degrees (Celsius). There were no acute brain or cardiac lesions that would have accounted for the faintness. In addition, blood and urine tests did not indicate a cause of loss of consciousness. He had been painting epoxy to waterproof the basement floor before fainting. According to exposure simulation, the patient was overexposed to various organic solvents, such as approximately 316–624 ppm toluene during the work before fainting. Considering the ventilation status of the workplace and the status of no protection, it is considered that exposure through the respiratory tract was considerable. CONCLUSIONS: The patient in this case lost consciousness during the epoxy coating in a semi-enclosed space. It can be judged as a result of acute poisoning caused by organic solvent exposure and considered to be highly related to work environment.
Aged ; Body Temperature ; Brain ; Consciousness ; Construction Industry ; Emergency Service, Hospital ; Humans ; Korea ; Occupational Diseases ; Paint ; Paintings ; Poisoning ; Respiratory System ; Solvents ; Syncope ; Toluene ; Unconsciousness ; Ventilation

It is unclear whether specific agent groups are associated with outcomes in cases of poisoning-induced out-of-hospital cardiac arrest (P-OHCA). The study population comprised cases of confirmed P-OHCA drawn from the national out-of-hospital cardiac arrest (OHCA) registry (2008–2013). Exposures were categorized into five groups according to the International Classification of Disease, 10th version: group 1, prescribed drugs; group 2, vapors and gases; group 3, pesticides; group 4, alcohol and organic solvents; and group 5, other poisons. The outcome was survival to discharge and good neurological recovery. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to test the association between specific groups and outcomes. A total of 2,083 patients were analyzed; group 1 (10.3%), group 2 (23.6%), group 3 (52.9%), group 4 (1.4%), and group 5 (13.2%). The survival to discharge and good neurological recovery rates were 3.3%/1.3% for all patients, 10.3%/5.6% (group 1), 6.9%/3.4% (group 2), 2.4%/0.4% (group 3), 2.2%/1.0% (group 4), and 3.3%/2.4% (group 5) (all P < 0.001). The aORs (95% CIs) of groups 2–5 compared with group 1 for survival to discharge were 0.47 (0.09–2.51), 0.34 (0.17–0.68), 0.33 (0.14–0.77), and 0.31 (0.13–0.77), respectively. The odds ratios (95% CIs) for good neurological recovery were significant only in group 1, the pesticides group (0.07 [0.02–0.26]) and were not significant in the other groups. P-OHCA outcomes differed significantly among the poisoning agent groups. The pesticides group showed the worst outcomes, followed by the group of vapors or gases.
Classification ; Gases ; Heart Arrest ; Humans ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Pesticides ; Poisoning ; Poisons ; Solvents

OBJECTIVETo analyze the characteristics of acute occupational poisoning accidents reported in Jiangsu Province between 2006 to 2013.

METHODSBased on the reported data of occupational diseases, we analysis indicators such as type, gender, age, and enterprise size of acute occupational poisoning.

RESULTS(1) There were 226 acute occupational poisoning accidents for 8 years with 436 workers poisoned and 13 died. The Poisoning mortality rate was 2.98%. (2) The accidents occurred more frequently from March to August each year. (3) Asphyxiating gases, irritant gases and organic solvents are the main chemicals which caused these poisoning accidents. (4) Most of the cases come from the chemical industry and light industry . They more occurred in men and presented the trend of aging. (5) Most of them are from the south of Jiangsu and coastal areas. New cases of acute occupational poisoning mainly concentrated in small businesses.

CONCLUSIONStrengthening the supervision on high incidence area and high-risk industry is the key point to reduce the incidence of acute occupational poisoning accident.

Accidents, Occupational ; prevention & control ; statistics & numerical data ; Acute Disease ; Chemical Industry ; China ; epidemiology ; Female ; Gases ; Humans ; Incidence ; Industry ; Irritants ; Male ; Occupational Diseases ; epidemiology ; Organic Chemicals ; Poisoning ; epidemiology ; prevention & control ; Solvents

OBJECTIVETo analyze the clinical features and diagnostic points of occupational acute dimethylformamide (DMF) poisoning and to explore the mechanism of occupational acute DMF poisoning.

METHODSA comprehensive analysis was performed on the clinical data of 16 cases of occupational acute DMF poisoning, including symptoms, signs, and laboratory testing results.

RESULTSThe main clinical features of occupational acute DMF poisoning were digestive system impairments, especially abdominalgia. Hemorrhagic gastroenteritis was not found by gastroscopy. There was no significant correlation between the degree of abdominalgia and alanine aminotransferase level (r(s) = 0.109, P>0.05).

CONCLUSIONAbdominalgia is recommended to be one of the reference indices for the diagnosis and degrading of occupational acute DMF poisoning, The mechanism of DMF poisoning remains unclear but it is considered to be related to methyl isocyanate, the intermediate product of DMF metabolism.

Abdominal Pain ; chemically induced ; Alanine Transaminase ; metabolism ; Dimethylformamide ; poisoning ; Humans ; Occupational Exposure ; Solvents ; poisoning

To develop a simple, validated method for identifying and quantifying 1,3-butadiene (BD) in human blood by gas chromatography-mass spectrometry (GC-MS) and head-space gas chromatography (HS-GC). BD was identified by GC-MS and HS-GC, and quantified by HS-GC. The method showed that BD had a good linearity from 50 to 500 microg/mL (r > 0.99). The limits of detection and quantification were 10 microg/mL and 50 microg/mL, respectively. Both the intra-day precision and inter-day precision were < 6.08%, and the accuracy was 96.98%-103.81%. The method was applied to an actual case, and the concentration of BD in the case was 242 microg/mL in human blood. This simple method is found to be useful for the routine forensic analysis of acute exposure to BD.
Adult ; Butadienes/poisoning* ; Forensic Toxicology/methods* ; Gas Chromatography-Mass Spectrometry/methods* ; Gas Poisoning ; Humans ; Male ; Reproducibility of Results ; Sensitivity and Specificity ; Solvents/chemistry* ; Temperature

OBJECTIVE: To develop a sensitive and accurate assay for detecting cinobufagin and resibufogenin in liver tissue using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). METHODS: The homogenization of liver tissue with internal standard dexamethasone was extracted with dichloromethane. The extracts with methanol were purified through ProElut C18 solid phase extraction and tested in positive electrospray ionization with multiple reaction monitoring of HPLC-MS/MS. RESULTS: The good linear relationship of cinobufagin and resibufogenin in liver tissue were 1-204 ng/g and 1-206 ng/g, respectively. The minimal detection threshold (S/N > or = 3) of this method was 0.3 ng/g for both cinobufagin and resibufogenin. The matrix effect was 96.5%-126.7%. The extraction recovery coefficient was 70.0%-82.3%. The precision of intra-day and inter-day was less than 10%. CONCLUSION This method is sensitive and reliable, and can be used in forensic toxicological analysis.
Bufanolides/poisoning* ; Chromatography, High Pressure Liquid/methods* ; Forensic Toxicology ; Humans ; Liver/chemistry* ; Sensitivity and Specificity ; Solvents/chemistry* ; Tandem Mass Spectrometry/methods* ; Tissue Distribution

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.
Arsenic ; Ataxia ; Carbon Disulfide ; Carbon Monoxide ; Cerebellar Diseases ; Delivery of Health Care ; Developing Countries ; Dimethylamines ; Disease Outbreaks ; Electrophysiology ; Gases ; Hexanes ; Hydrogen Sulfide ; Manganese ; Metals, Heavy ; Nervous System ; Neuroimaging ; Neurologic Manifestations ; Neuromuscular Junction Diseases ; Neurotoxins ; Occupational Diseases ; Occupational Health ; Organophosphate Poisoning ; Organophosphates ; Parkinsonian Disorders ; Polychlorinated Biphenyls ; Quaternary Ammonium Compounds ; Semiconductors ; Sodium Fluoride ; Solvents ; Taiwan ; Thallium ; Tin ; Toluene ; Urethane

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.
Arsenic ; Ataxia ; Carbon Disulfide ; Carbon Monoxide ; Cerebellar Diseases ; Delivery of Health Care ; Developing Countries ; Dimethylamines ; Disease Outbreaks ; Electrophysiology ; Gases ; Hexanes ; Hydrogen Sulfide ; Manganese ; Metals, Heavy ; Nervous System ; Neuroimaging ; Neurologic Manifestations ; Neuromuscular Junction Diseases ; Neurotoxins ; Occupational Diseases ; Occupational Health ; Organophosphate Poisoning ; Organophosphates ; Parkinsonian Disorders ; Polychlorinated Biphenyls ; Quaternary Ammonium Compounds ; Semiconductors ; Sodium Fluoride ; Solvents ; Taiwan ; Thallium ; Tin ; Toluene ; Urethane

OBJECTIVETo investigate the rescue modalities and etiology of acute organic solvent poisoning.

METHODSA total of 776 cases of acute organic solvent poisoning were analyzed retrospectively. The kinds of organic solvents, the modes of exposure, the characteristics of poisoning and the methods of treatment were analyzed.

RESULTSPoisoning was due to occupational exposure to organic solvents in 87.4%, the other was exposed in daily life. The total number of organic solvents harming the patients was 55. The most common three of the organic solvent poisoning were halogenated hydrocarbons poisoning, hydrocarbons poisoning, amino- and nitro-hydrocarbons poisoning. The accidents of mass poisoning were increasing in numbers recently, especially the acute halogenated hydrocarbons poisoning.

CONCLUSIONTo know the numerous poisonings responsible for acute solvent poisoning is essential for enhancing the pre-hospital care, emergency treatment and following treatment. Also, extensive clinical knowledge and numerous biologic laboratory tests are needed to improve the diagnosis and rescue of acute solving poisoning. Effect of therapeutic plasma exchange treatment on sever acute poisoning is with a positive attitude.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Hydrocarbons ; poisoning ; Infant ; Male ; Middle Aged ; Occupational Exposure ; Poisoning ; etiology ; therapy ; Retrospective Studies ; Solvents ; poisoning ; Young Adult

We report a rare case of optic nerve atrophy with severe disc cupping resulting from methanol poisoning. A 30-year-old man presented to the hospital complaining of decreased visual acuity in both eyes a day after drinking alcohol containing methanol. His initial visual acuity allowed for only visualizing hand motion and not corrected in either eye. Initial intraocular pressure was within normal limits in both eyes. Initial fundus examination showed optic disc swelling in both eyes. Four years later, he visited our hospital for an eye evaluation. Visual acuity in both eyes still only allowed for visualizing hand motion. No nystagmus was observed in either eye during the optokinetic nystagmus test, and no waves were found in a visual evoked potential test. No specific change was noted on brain magnetic resonance imaging. On fundus examination, there was disc pallor in both eyes and disc cupping with a high cup/disc (C/D) ratio above 0.9 in the left eye. C/D ratio of the right eye was 0.5. Methanol poisoning may induce glaucomatous disc cupping in the late stage as well as optic atrophy. One possible mechanism of disc cupping is ganglion cell loss due to acute demyelination of the retrobulbar optic nerve. This report is the first photographic evidence of methanol induced optic disc cupping in Korea.
Adult ; Diagnosis, Differential ; Evoked Potentials, Visual ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Magnetic Resonance Imaging ; Male ; Methanol/*poisoning ; Optic Atrophy/*chemically induced/pathology/physiopathology ; Optic Disk/drug effects/*pathology ; Papilledema/*chemically induced/pathology/physiopathology ; Severity of Illness Index ; Solvents/poisoning ; Tomography, Optical Coherence ; Visual Acuity