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Carbon dioxide is a simple asphyxial gas, with low concentrations having an excitatory effect on the respiratory center, while high concentrations have an inhibitory effect on the respiratory center. Simple carbon dioxide poisoning is rarely seen clinically. This article reviews and analyzes the treatment process of 9 cases of acute inhalation carbon dioxide poisoning in a cargo ship carbon dioxide leakage accident in May 2019, summarizes clinical treatment experience, and provides timely and effective treatment for acute pulmonary edema caused by acute inhalation carbon dioxide poisoning. In particular, the application of hormones has a good prognosis, improving clinicians' understanding of the disease.
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Humans , Carbon Dioxide , Ships , Accidents , Pulmonary Edema , Treatment Outcome , Poisoning , Accidents, OccupationalABSTRACT
Objective To detect and analyze the susceptibility genes of methyl acetate poisoning in patients by whole exome sequencing. Methods Two patients with occupational acute severe methyl acetate poisoning and their first-degree relatives who work in the same occupation and position with similar working hours were selected as the research subjects by judgment sampling method. Peripheral blood was collected for whole exome sequencing. The sequencing data was compared with the public genome database to screen the mutation sites and find out the gene sites related to methyl acetate poisoning. The suspected pathogenic mutation genes were annotated and interpreted. Results The results of whole exome sequencing showed that there were 40 differential genes between the patients with methyl acetate poisoning and their first-degree relatives, including 80 single nucleotide polymorphisms and eight Indel with specific marker sequence index. Among these, the genes with strong correlation were carboxyesterase 1 (CES1) and mucin (MUC) 5B. The CES1 gene loci c.248C>T (p.Ser83Leu) heterozygous mutations, MUC5B gene loci c.6635C>T (p.Thr2212Met) and c.7685C>T (p.Thr2562Met) heterozygous mutations in patients with methyl acetate poisoning were detected. They were missense mutations. By constructing a protein-protein interaction network, a total of 11 pairs of interactions with high levels of evidence were identified, involving genes such as lysine methyltransferase 2C, HECT and RLD domains containing E3 ubiquitin protein ligase 2, neutrophil cytoplasmic factor 1, nicotinamide adenine dinucleotide phosphate oxidase 3, C-terminal binding protein 2, zinc finger protein 717, FSHD region gene 2 family member C, FSHD region gene 1, MUC4, MUC6, MUC5B, and MUC12. Conclusion The polymorphism of CES1 and MUC5B genes may be related to the occurrence and development of methyl acetate poisoning in patients.
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An accident of mixed acute gas poisoning accident happened in a place in GuangDong in March 2018. To investigates three poisoning workers and related clinical data were summarized., we tested the field air and analyzed the accident reasons. This event due to the staff lack of occupational protection awareness and illegal operation. The working environment must be ventilated before limited space operation, and must be sure that the limited space is safe by toxic gas monitoring. In case of occupational acute gas poisoning, rescuers should help the persons who are poisoned reasonably and meanwhile their own safety.
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Objective@#Analysis of occupational poisoning character and laws in Jiangsu Province from 2006-2015, so as to provide scientific basis for the formulation of effective intervention measures and prevention strategies.@*Methods@#According to the data of Jiangsu province occupational poisoning cases reports of year 2006 to 2015, by EXCEL arranged, using SPSS software to do epidemiological data statistical analysis.@*Results@#In the past ten years, the number of occupational poisoning cases reported in Jiangsu province increased first and then declined. 547 cases of acute occupational poisoning reported in Jiangsu province from 2006-2015 years (35.82% of the total poisoning cases, the same below) , 980 cases of chronic occupational poisoning (64.18%) . The ratio of male and female in acute poisoning was 2.48, while 1.55 of chronic poisoning. The cases of poisoning reported were young and middle-aged, and working years was mainly in 5 years. The cases reported in the south of Jiangsu (mainly is chronic poisoning) is higher than that in the northern part of Jiangsu (mainly is acute poisoning) , which is more economically underdeveloped.. The reported highest mortality rate of occupational poisoning is asphyxia gas poisoning (5.43%) , followed by irritating gas poisoning (2.99%) and organic solvent poisoning (0.47%) . Many more occupational poisoning cases reported from large, joint-stock enterprises, especially chronic poisoning. Meanwhile more cases of acute poisoning reported from small, micro private enterprises.@*Conclusion@#Although a decline in occupational poisoning cases in Jiangsu, the prevention and treatment measures are still not lax. According to the species of toxic, regional economic differences, the scale of the enterprises and the type of economy, the characteristic key classification and prevention should be carried out. Expand the coverage of hospitals in the diagnosis and reporting of occupational poisoning diseases, and strive to improve the quality of occupational disease reports.
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OBJECTIVE: To investigate the clinical features and treatment methods of occupational acute dimethyl oxalate(DMO) toxic nephropathy. METHODS: Occupational history,clinical manifestation,laboratory examination and therapy of one occupational DMO poisoning case were retrospectively analyzed. RESULTS: The patient was exposed to a large amount of DMO in a short time,with the main symptoms of dizziness,fatigue,nausea,vomiting,bloating,and oliguria.Glomerular filtration reduced after 48 hours of disease onset,serum urea nitrogen was 21. 9 mmol/L and serum creatinine was 788 μmol/L. Renal biopsy showed glomerular mesangial proliferative lesions,tubulointerstitial lesions,small arterial intima thickening and hyaline degeneration. Early treatment,including hemodialysis,hemoperfusion,hormone shock therapy,protection of myocardium,renal function,and improvement of circulation achieved a good clinical prognosis.CONCLUSION: The main clinical manifestation of acute DMO poisoning is acute kidney injury. Blood purification treatment and hormone shock therapy should be used early.
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OBJECTIVE: To analyze the epidemiological characteristics and predict epidemiological trends of occupational chemical poisoning,based on directly reported data during 2006-2015 in Guangdong Province. METHODS: The data of patients with occupational chemical poisoning reported from National Information Surveillance System for Occupational Disease and Occupational Health from 2006 to 2015 in Guangdong Province were collected. The epidemiological characteristics were retrospectively analyzed. The autoregressive integral moving average model( ARIMA model) was established and validated based on the number of the new onset cases and was used to predict the trends of occupational chemical poisoning from 2017 to 2020 in Guangdong Province. RESULTS: From 2006 to 2015,1 288 new cases of occupational chemical poisoning were reported in Guangdong Province,which accounted for 24. 4% of the total number of new cases of occupational diseases in the province( 5 283 cases). Among the new cases,the percentage of acute and chronic poisoning was 21. 7%( 279/1 288) and 78. 3%( 1 009/1 288). There was 74. 7%( 962/1 288) of organic solvent poisoning. Five kinds of new occupational chemical poisoning were found. Most of the new cases were male,accounting for 56. 7%( 729/1 288). They were mainly distributed and concentrated in Pearl River Delta Region,accounting for 95. 9%(1 235/1 288). Shenzhen,Dongguan and Guangzhou were the most three cities which had 425,325 and 209 cases respectively,all of them accounted for 74. 4%( 959/1 288). The new cases of poisoning mainly distributed in medium and small enterprises( 72. 0%),private economic enterprises( 50. 9%) and manufacturing industries(70. 5%). The number of occupational chemical poisoning diseases decreased first,and increased,and the proportion to the total number of occupational diseases in Guangdong Province showed a straight downward trend(P < 0. 01). The median age at diagnosis was 35 years old and the median work year at diagnosis was 2. 0 years,and both of them showed an increasing trend( P < 0. 01). CONCLUSION: Occupational chemical poisoning in Guangdong Province has certain characteristic of crowd aggregation and epidemic trends.
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Se efectuó una revisión bibliográfica exhaustiva con vistas a demostrar la relación existente entre ciertas profesiones y las intoxicaciones por metales pesados. A tales efectos, en el presente artículo se describen las fuentes de emisión y las aplicaciones de dichos metales, así como las afecciones que provocan a la salud. Se constató que las intoxicaciones diagnosticadas en trabajadores de la provincia, en el período 2000-2016, estuvieron asociadas a diferentes empleos, tales como reparación de baterías, plomería, soldadura y odontología. A partir de lo anterior se exponen algunas recomendaciones a considerar en los campos salud ocupacional-metales pesados
An exhaustive literature review aimed at demonstrating the existent relationship between certain professions and poisonings due to heavy metals was carried out. To such effects, the emission sources and uses of these metals are described in this work, as well as the disorders that cause to health. It was verified that the poisonings diagnosed in workers of the province, during 2000-2016, were associated with different jobs, such as batteries repair, plumbing, welding and dentistry. From the above-mentioned, some recommendations to consider everything regarding occupational health-heavy metals are exposed
Subject(s)
Poisoning , Metals/poisoning , Occupational Diseases/chemically induced , Occupational Risks , Occupational Health , Heavy Metal Poisoning/diagnosisABSTRACT
The number of chemicals that are synthesized each year has been steadily increasing. Chemicals are of immense benefits to mankind,many of which,however,have a significant negative impact on the environment as well as human health primarily due to their inherent chemistry and toxici?ty. Human exposure to numerous toxic chemicals takes place not only in the environment and but also in the workplace. Therefore,new approaches to toxicology need to developed. A milestone in this regard is the versions of the US National Research Council ″Toxicity Testing in the 21st Century:a Vision and a Strategy ″ and ″Science and Decisions:Advancing Risk Assessment ″. The versions require a radical paradigm shift in the approach to safety assessment and in the traditional procedure where animal experiments used to be the dominating technology. The future of toxicology suggests a new conceptual framework within which in vitro and in silico approaches based on human materials are used to under?stand disease pathways at multiple biological levels that are analogous to adverse outcome pathways in toxicology. This paper focuses on the many challenges and issues that need to be solved in this area.
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OBJECTIVE: To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. METHODS: By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups: the control group( n = 58) and the treatment group( n = 58). Subjects in the control group were given vitamin B_(12) and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy( infraredtherapy,microwave irradiation therapy),Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. RESULTS: Before treatment,no significant differences( P > 0. 05) were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency( MDL),motor nerve conduction velocity( MCV),sense nerve conduction velocity( SCV) of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators( P < 0. 05),with larger extend of improvement noted in the treatment group than in the control group( P < 0. 05). No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group( P < 0. 05). CONCLUSION: The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.
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OBJECTIVE: To analyze the clinical features of occupational chronic toxic peripheral neuropathy caused by1-bromopropan( 1-BP). METHODS: Clinical data of 4 patients who suffered from occupational chronic toxic peripheral neuropathy caused by 1-BP were collected for retrospective analysis. RESULTS: The 4 male patients were ultrasonic cleaning operation workers in a hardware vacuum coating enterprise. They were exposed to high levels of 1-BP for 9-11 months. The main clinical manifestations were varying degrees of sensory disorder and dyskinesia. The main symptoms were progressive increase of numbness and fatigue in the lower extremities. These symptoms might be accompanied by unsteady gait.Physical examination showed muscle strength weakness in the double lower limbs. The hypalgesia,pselaphesia,topesthesia and pallesthesia decreased in the double lower limbs or 4 limbs. The bilateral achilles tendon reflex mainly showed reduced or disappeared. One case had sensory ataxia. Electroneuromyography examination showed different levels of peripheral nerve damage among the cases. The motor nerve conduction velocity and sensory nerve conduction velocity reduced commonly. The axon and myelin sheath damage were visible. On the basis of GBZ / T 247-2013 Diagnosis of Occupational Chronic Toxic Peripheral Neuropathy Caused by Chemicals,these cases were diagnosed as occupational chronic toxic peripheral neuropathy caused by 1-BP. CONCLUSION: Long-term exposure to high level 1-BP can lead to chronic poisoning with peripheral nervous system damage. The diagnosis can be made based on the 1-BP exposure history,clinical features and the neurogenic damage found in electroneuromyography examination.
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Although acute occupational poisonings are very rare officially, it seems that there are a considerable number of unreported cases seen from non-intentional poisoning cases of the national injury and poisoning survey on discharged patients. Establishing a proper national surveillance system for acute occupational poisonings is needed. It is difficult for clinical physicians to diagnose acute occupational poisonings appropriately because the victims who usually are not mentally alert can not provide the information on the workplace hazard. Consulting a specialist of occupational and environmental medicine may help to reveal the cause of poisoning. Furthermore, reporting to the public organization such as workers health center and Korea occupational safety and health is helpful to prevent additional injuries.