Department of Surgery, Minamisoma Municipal General Hospital.
Department of Radiation Protection, Minamisoma Municipal General Hospital.
J Occup Health. 2018 May 25;60(3):271-274. doi: 10.1539/joh.17-0041-CS. Epub 2017 Dec 28.
Legionnaires' disease (LD), which is atypical pneumonia with a broad variety of clinical symptoms, can lead to death despite its low incidence. There are multiple risk factors for LD, yet little information is available concerning what kind of environmental factors are linked to higher risk of LD development. We have experienced a fatal case of LD, which occurred in a decontamination worker after the Fukushima nuclear disaster.
A 53-year-old Japanese male visited our hospital with symptoms of fever, vomiting, diarrhea, and altered mental status, but not with respiratory manifestations. He was engaged in decontamination work, which generally includes operations such as the removal of topsoil in mountainous areas and cleaning roads and roofs of residential buildings with high-pressure water. He was required to wear specific equipment to prevent radiation exposure, and lived in a workers' dormitory or shared house, thereby sharing spaces with other workers. Normal antibiotic therapy did not improve his symptoms following his diagnosis with pneumonia. A urinary antigen detection test was then conducted, leading to a diagnosis of LD. Despite the change of antibiotic to levofloxacin, multiple organ failure led to his death.
Decontamination workers may be at a high risk for developing LD and living and working conditions among them are possible contributors.
军团病（Legionnaires' disease，LD）是一种具有多种临床表现的非典型性肺炎，尽管发病率较低，但仍可导致死亡。LD 有多种危险因素，但有关何种环境因素与更高的 LD 发展风险相关的信息很少。我们曾遇到过一例因福岛核灾难而发生的消毒工人致死性 LD 病例。
一名 53 岁日本男性因发热、呕吐、腹泻和精神状态改变而就诊，但无呼吸道表现。他从事消毒工作，一般包括山区表土清除、高压水清洗居民楼道路和屋顶等作业。他被要求穿戴特殊设备以防止辐射暴露，并居住在工人宿舍或合租房中，因此与其他工人共享空间。在诊断为肺炎后，常规抗生素治疗并未改善他的症状。随后进行了尿抗原检测，导致 LD 诊断。尽管抗生素更换为左氧氟沙星，但多器官衰竭导致他死亡。
消毒工人可能面临较高的 LD 发病风险，他们的生活和工作条件可能是促成因素。
