Kim Joo-An, Yoon Seong-Yong, Cho Seong-Yong, Yu Jin-Hyun, Kim Hwa-Sung, Lim Gune-Il, Kim Jin-Seok
Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea ; Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea.
Department of Preventive Medicine, Soonchunhyang University Medical College, Asan, Chungnam, South Korea.
Ann Occup Environ Med. 2014 Oct 1;26:29. doi: 10.1186/s40557-014-0029-9. eCollection 2014.
This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.
We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.
Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).
The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.
本研究旨在报告2013年3月5日在韩国龟尾市一家工厂发生的氯气意外泄漏事件的经过。我们描述了因氯气导致急性健康问题而住院的2例患者的分析结果，以及209例非住院患者的临床特征。
我们分析了2例住院患者的病历，以及209例非住院患者在门诊治疗期间填写的病历和自我报告问卷。
暴露后，2例住院患者立即出现咳嗽、呼吸困难等急性哮喘样症状，肺功能测试显示限制性和混合性通气功能障碍。病例1在6个月内出现哮喘样症状，呼气峰值流速的日变化率为56.7%。病例2治疗后的第一秒用力呼气容积（FEV1）（93%）较初始FEV1（68%）增加了25%。根据这些临床特征，两例均被诊断为氯气诱发的反应性气道功能障碍综合征（RADS）。209例非住院患者最常见的主要症状是头痛（22.7%），其次是眼部刺激（18.2%）、恶心（11.2%）和咽痛（10.8%），无症状患者占36.5%。对个体症状的多反应分析显示，头痛（42.4%）是最常见的症状，其次是眼部刺激（30.5%）、咽痛（30.0%）、咳嗽（29.6%）、恶心（27.6%）和头晕（27.3%）。
在泄漏现场接触氯气后住院的2例患者表现出与RADS相符的临床过程。209例非住院患者均仅主诉上呼吸道和黏膜刺激症状。
