A Case of Intermediate Syndrome of Organophosphate Poisoning after Dermal Exposure / 대한산업의학회지

BACKGROUND: Organophosphate poisoning is one of the most common toxicologic emergencies in Korea. Acute organophosphate poisoning and delayed polyneuropathy by ingestion are well published. There have been several reports about intermediate syndrome in organophosphate poisoning by ingestion but few about intermediate syndrome via dermal route. CASE REPORT: We observed a 59-years-old male who had weakness of proximal limb muscles and respiratory muscles 2 days after dermal exposure by unidentified pesticide. The paralytic symptoms lasted up to 20 days but the delayed polyneuropathy did not develop. The patient needed mechanical ventilatory support for 2 weeks and had completely recovered from IMS 6 weeks later. Electrophysiological study was characterized by an axonal polyneuropathy pattern on the proximal limb muscles. Serum acetylcholinesterase level was below half of normal level. Clinical manifestations and electrophysiological study support the clinical diagnosis of intermediate syndrome. CONCLUSION: Intermediate syndrome is commonly developed by ingestion of organophosphate but, as in this case, dermal absorption can also lead to intermediate syndrome. More detailed history taking and close observation is needed for about 3 or more days after intoxication because of the risk of respiratory failure.

Seasonal Variations of the Urinary N-Methylformamide Concentration among Workers at a Synthetic Leather Factory / 대한산업의학회지

OBJECTIVES: This study was carried out to identify seasonal variations of urinary concentrations of N-methylformamide (NMF) among workers employed at a synthetic leather factory. METHODS: Study subjects consisted of 16 male and 6 female workers who were involved in the direct treatment of dimethylformamide (DMF) in a synthetic leather factory. By using health examination data and the results of air measurements and biologic monitoring conducted in February and July, 2001, we identified seasonal variations of the DMF concentrations in the air and NMF concentrations in urine. RESULTS: 1) In winter and summer, average temperatures at the working sites were 3.2 degrees C and 26.5 degrees C, respectively and average humidities were 35.4 % and 84.5 %, respectively. 2) Airborne DMF concentrations were not significantly different between summer (13.78 ppm) and winter (11.55 ppm). 3) NMF concentrations in urine were found to be significantly higher in summer (96.09 mg/g creatinine) than in winter (31.23 mg/g creatinine) (p<0.001). CONCLUSIONS: The seasonal difference in the urinary excretion values of NMF may be due to increased dermal absorption of DMF with the higher ambient temperature and humidity in summer and the increased area of exposed skin.