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韩国因皮肤接触含草甘膦、草铵膦及表面活性剂的除草剂而导致的严重化学灼伤。

Severe chemical burns related to dermal exposure to herbicide containing glyphosate and glufosinate with surfactant in Korea.

作者信息

Shin Jihyun, Lim Namkyu, Roh Sangchul

机构信息

Department of Occupational and Environmental Medicine, Dankook University Hospital, Cheonan, Korea.

Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Cheonan, Korea.

出版信息

Ann Occup Environ Med. 2020 Jul 20;32:e28. doi: 10.35371/aoem.2020.32.e28. eCollection 2020.

Abstract

BACKGROUND

Glyphosate and glufosinate use widely used as herbicide ingredients. There have been several reported cases of chemical burns caused by dermal exposure to glyphosate-containing herbicide, and patients in these cases were discharged without fatal complications. There were no cases of severe symptoms due to non-oral exposure of glufosinate-containing herbicides. Here, we report a case of fatality accompanied with severe chemical burns in an 81-year-old man who did not wash his skin for more than 48 hours after dermal exposure to herbicide containing glyphosate and glufosinate with surfactant (HGlyGluS).

CASE PRESENTATION

An 81-year-old male with no underlying disease was admitted to the emergency department (ED). He had sprayed HGlyGluS with a manual knapsack sprayer 3 days ago and had not wash away the herbicide. On arrival, he was drowsy and had multiple severe corrosive skin lesions. Skin necrosis (10 × 15 cm) on the right shoulder and skin lesions with subcutaneous fat exposure (15 × 20 cm) on the right thigh were observed. Although he was treated including continuous renal replacement therapy, antibiotic apply, debridement operations, and so on, he was unable to recover and expired.

CONCLUSIONS

We suggest that prolonged dermal exposure to HGlyGluS induces fatality. Further studies including prolonged dermal exposure and ingredients of surfactants should be carried out. Also, it is necessary to educate farmers that it is very important to wash immediately after dermal exposure to pesticide.

摘要

背景

草甘膦和草铵膦作为除草剂成分被广泛使用。已有多例经皮肤接触含草甘膦除草剂导致化学灼伤的报告病例,这些病例中的患者均已出院,未出现致命并发症。尚无因非经口接触含草铵膦除草剂而出现严重症状的病例。在此,我们报告一例81岁男性患者,其在皮肤接触含草甘膦、草铵膦及表面活性剂的除草剂(HGlyGluS)后超过48小时未清洗皮肤,最终死亡并伴有严重化学灼伤。

病例介绍

一名无基础疾病的81岁男性被送往急诊科。他3天前用手动背负式喷雾器喷洒了HGlyGluS,之后未清洗掉除草剂。入院时,他嗜睡,有多处严重腐蚀性皮肤损伤。观察到右肩部皮肤坏死(10×15厘米)以及右大腿皮肤损伤伴皮下脂肪外露(15×20厘米)。尽管对他进行了包括持续肾脏替代治疗、应用抗生素、清创手术等治疗,但他仍未能康复并最终死亡。

结论

我们认为,皮肤长时间接触HGlyGluS会导致死亡。应开展包括皮肤长时间接触及表面活性剂成分等方面的进一步研究。此外,有必要对农民进行教育,使其了解皮肤接触农药后立即清洗非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3031/7406703/ce41b1a2f0c2/aoem-32-e28-g001.jpg

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