Baur X, Budnik L T, Preisser A M
Ordinariat für Arbeitsmedizin des Universitätsklinikums Hamburg-Eppendorf und Zentralinstitut für Arbeitsmedizin und Maritime Medizin, Hamburg.
Dtsch Med Wochenschr. 2010 Mar;135(11):516-21. doi: 10.1055/s-0030-1249198. Epub 2010 Mar 10.
The increasing transport of goods worldwide is mainly carried in standard containers. These containers are frequently fumigated in order to protect freight from pests and to follow regulations of importing countries. Fumigants as well as toxic industrial chemicals can adsorb to goods and be emitted from them over various periods of time. This review is based on a literature search, analyses of air samples from a randomized selection of import containers at the port of Hamburg and clinical investigations of intoxicated subject. These data indicate that about 70% of imported containers exceed national or international threshold levels, about one sixth exceeding occupational exposure limits of fumigants and/or toxic industrial chemical, 0.5% had concentrations immediately dangerous to life or health. Intoxications by inhalation mainly occur in workers in the logistics area. No information exists on possible fumigation in small and medium-sized companies where the container units are unloaded. Neurological and respiratory ailments dominated in patients from our outpatient clinic and those reported in the literature: symptoms were often misdiagnosed. Our results confirm findings of other investigators that subjects who unload containers or have otherwise intensive contact with imported goods are frequently exposed to toxic or very toxic volatile chemicals. It can be assumed that there are many unrecognized cases and also health risks to the ultimate consumers of transported goods. History taking targeted on potential exposure is of great diagnostic importance in elucidating typical temporal relationship between exposure by inhalation and symptoms such as headache, skin irritation, cough, dyspnea, diarrhoea and neurological deficits. Detailed investigations by medical specialists is necessary to confirm suspected diagnoses. This should be combined with immediate special analyses of air samples and laboratory tests (biological monitoring).
全球范围内货物运输量的不断增加主要通过标准集装箱进行。这些集装箱经常进行熏蒸处理，以保护货物免受虫害并遵守进口国的规定。熏蒸剂以及有毒工业化学品会吸附在货物上，并在不同时间段内从货物中释放出来。本综述基于文献检索、对汉堡港随机抽取的进口集装箱空气样本的分析以及对中毒者的临床调查。这些数据表明，约70%的进口集装箱超过了国家或国际阈值水平，约六分之一超过了熏蒸剂和/或有毒工业化学品的职业接触限值，0.5%的集装箱浓度对生命或健康构成直接危险。吸入中毒主要发生在物流区域的工人中。对于卸载集装箱单元的中小型公司可能进行的熏蒸情况，尚无相关信息。在我们的门诊诊所患者以及文献报道的患者中，神经和呼吸系统疾病占主导：症状常常被误诊。我们的结果证实了其他研究者的发现，即卸载集装箱或以其他方式与进口货物密切接触的人员经常接触有毒或剧毒挥发性化学品。可以推测，存在许多未被识别的病例，运输货物的最终消费者也面临健康风险。针对潜在接触情况进行病史询问对于阐明吸入接触与头痛、皮肤刺激、咳嗽、呼吸困难、腹泻和神经功能缺损等症状之间典型的时间关系具有重要的诊断意义。医学专家进行详细调查对于确诊疑似病例是必要的。这应与立即对空气样本进行特殊分析和实验室检测（生物监测）相结合。
