Kim Hyeonjun, Cho Seunghyeon, Jung Inho, Jung Sunjin, Park Won-Ju
Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
Department of Occupational and Environmental Medicine, Chonnam National University Hospital, Gwangju, Korea.
Ann Occup Environ Med. 2023 Aug 21;35:e34. doi: 10.35371/aoem.2023.35.e34. eCollection 2023.
Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident.
In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge.
We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.
硫化氢是一种人类可在职业环境中接触到的有毒物质，工业场所工人硫化氢中毒的病例常有报道。然而，此前并无因未经授权排放废水导致公众中毒的案例，因此描述这起事件很重要。
在韩国全罗南道的一个小村庄，有关于一股可怕恶臭的报告。一名在恶臭区域生活和工作的26岁男子因头痛、头晕、恶心及反复晕厥被送往急诊室。随后警方和环境部调查确定，恶臭的起因是在村民睡觉时通过雨水管道未经授权排放了9吨含硫化氢的废水。该患者既往无病史或症状发作经历。白细胞和心脏标志物升高，心电图显示双房扩大、左心室肥厚及校正QT间期延长。胸部计算机断层扫描检测到心肌肥厚，超声心动图确诊为肥厚型心肌病。住院后，心脏标志物浓度下降，症状改善，患者住院7天后出院。出院后症状未复发。
我们怀疑该患者因接触硫化氢导致此前未被识别的心脏病显现或加重。应关注偶尔发生的局部事件中硫化氢等未经授权排放的可能性及其对公众健康的损害。万一发生此类事故，需要有政府指导方针来调查对健康的影响以及对受暴露居民进行后续临床管理。
