Gallagher F, Mason H J
Health & Safety Executive, Field Operation Directorate Yorkshire and North East, Sheffield, UK.
Occup Med (Lond). 2004 Oct;54(7):483-8. doi: 10.1093/occmed/kqh084. Epub 2004 Sep 17.
This report describes carbon monoxide (CO) poisoning in two workers using a hired forklift truck within a coldstore. The diagnosis was not considered until day 6 of the incident, and so measurements of blood or breath CO at the time of acute illness were unavailable.
To determine whether CO poisoning may be diagnosed retrospectively, where blood or breath CO measurements are unavailable, in the context of this particular incident.
Detailed clinical histories were obtained. Estimation of possible levels of CO exposure were made based on computer biokinetic modelling based on the Coburn-Foster-Kane equation.
The combined method used supports the diagnosis of CO poisoning in these two cases.
Clinical assessment, in combination with mathematical exposure modelling, may lead to successful retrospective diagnosis of CO poisoning and identify putative work activities. CO poisoning should be suspected whenever internal combustion engines are used within buildings and workers complain of relevant symptoms. Hospital departments should maintain a high level of vigilance towards such incidents as this, and should routinely undertake a direct measure of the saturation of haemoglobin by CO, i.e. blood carboxyhaemoglobin or breath CO.
本报告描述了两名在冷藏库中使用租用叉车的工人发生一氧化碳（CO）中毒的情况。直到事件发生第6天才考虑到诊断，因此无法获得急性发病时血液或呼出气体中CO的测量值。
在这一特定事件背景下，确定在无法获得血液或呼出气体中CO测量值的情况下，是否可以进行一氧化碳中毒的回顾性诊断。
获取详细的临床病史。基于Coburn-Foster-Kane方程，通过计算机生物动力学建模对可能的CO暴露水平进行估计。
所采用的综合方法支持这两例一氧化碳中毒的诊断。
临床评估与数学暴露建模相结合，可能成功地对一氧化碳中毒进行回顾性诊断，并确定假定的工作活动。只要在建筑物内使用内燃机且工人出现相关症状，就应怀疑一氧化碳中毒。医院科室应对此类事件保持高度警惕，并应常规进行一氧化碳对血红蛋白饱和度的直接测量，即血液碳氧血红蛋白或呼出气体中的CO。
