Orimo H, Yamamoto O, Kobayashi M, Yasuda H
Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
J UOEH. 2001 Mar 1;23(1):69-75. doi: 10.7888/juoeh.23.69.
We report two patients who suffered from acid burns while working in chemical factories. Case 1: a 44-year-old man who received burn induced by nitric acid on the face and extremities. Despite his protecting facial mask, he was exposed to nitric acid on his face through a gap between the mask and skin surface. Nitric acid was also sprinkled on his scalp which was not covered by a helmet or a protecting device. In addition, he suffered from acid burn on the right scapular region, the right upper arm, and the lower extremities through the work clothes. Case 2: a 26-year-old man who suffered from sulfuric acid burn on the forearms. Both patients were accidentally exposed to acids while they filled tanks with the acids through a hose. Following the manual of the factories, they washed the exposed skin with water for more than 15 minutes after the exposure. Although they recovered without any serious sequel, there remained partial deep tissue destruction of the skin. We reviewed these two cases from the aspect of industrial medicine, and proposed the following three points for improvement in the workplace to prevent accidental acid burns. 1) re-education or enlightenment activities for the well-experienced workers to avoid negligence to the danger of strong acid. 2) recommendation to take a complete shower to avoid overlooking of unaware acid injury. 3) improvement in the protecting facial mask. In addition, clinicians who examine acid-burn patients should not pass over the presence of deep ulcers lying behind the thick crust on the injured area.
我们报告了两名在化工厂工作时遭受酸烧伤的患者。病例1:一名44岁男性,面部和四肢遭受硝酸烧伤。尽管他戴着防护面罩,但由于面罩与皮肤表面之间的缝隙,他的面部仍接触到了硝酸。硝酸还洒在了他未被头盔或防护装置覆盖的头皮上。此外,他的右肩胛区、右上臂和下肢通过工作服也遭受了酸烧伤。病例2:一名26岁男性,前臂遭受硫酸烧伤。两名患者在通过软管向罐中灌注酸时意外接触到了酸。按照工厂的操作手册,他们在接触酸后用清水冲洗暴露的皮肤超过15分钟。尽管他们康复后没有留下任何严重后遗症,但皮肤仍存在部分深层组织破坏。我们从工业医学的角度对这两个病例进行了回顾,并提出了以下三点改进工作场所的建议,以防止意外酸烧伤。1)对经验丰富的工人进行再教育或启蒙活动,避免对强酸危险的疏忽。2)建议进行全身淋浴,以避免忽视未察觉的酸损伤。3)改进防护面罩。此外,检查酸烧伤患者的临床医生不应忽略受伤部位厚痂下深层溃疡的存在。