Zhang Xiangxing, Jian Tianzi, Shi Mengdi, Wang Chen, Jian Xiangdong, Li Qilu
Department of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Pharmacol. 2025 Jul 29;16:1514565. doi: 10.3389/fphar.2025.1514565. eCollection 2025.
Dimethylacetamide (DMAC) is used as a solvent in the dye, leather, and acrylic manufacturing industries. However, it is associated with significant risks of liver and nerve damage. 4,4'-Diaminodiphenyl ether (4,4'-ODA) is a crucial precursor for synthesizing curing agents and dyes but can disrupt the methemoglobin reduction system, resulting in methemoglobinemia.
This paper reports an incident involving a plant pipeline leak on May 10, 2024, which primarily contained a DMAC solution and trace amounts of 4,4'-ODA. The patient's occupational history, onset time of clinical symptoms, physical examination results, laboratory data, and treatment course were analyzed, and follow-up evaluation was performed to monitor the patient's long-term health status.
Two patients exhibited clinical symptoms, including respiratory failure, methemoglobinemia, hemolytic anemia, and acute liver injury due to dermal and respiratory exposure. They were successfully treated and discharged. Notably, Patient 1 was diagnosed with toxic encephalopathy 16 days post-exposure, while Patient 2 developed peripheral neuropathy 58 days post-exposure.
This study aimed to elucidate the clinical characteristics associated with this type of poisoning. Moreover, the incident calls for enhanced safety measures in industries using DMAC and 4,4'-ODA to prevent similar poisoning events.
二甲基乙酰胺（DMAC）在染料、皮革和丙烯酸制造行业用作溶剂。然而，它会带来严重的肝脏和神经损伤风险。4,4'-二氨基二苯醚（4,4'-ODA）是合成固化剂和染料的关键前体，但会破坏高铁血红蛋白还原系统，导致高铁血红蛋白血症。
本文报告了一起2024年5月10日发生的工厂管道泄漏事件，泄漏物主要为DMAC溶液和痕量的4,4'-ODA。分析了患者的职业史、临床症状出现时间、体格检查结果、实验室数据和治疗过程，并进行了随访评估以监测患者的长期健康状况。
两名患者因皮肤和呼吸道接触出现临床症状，包括呼吸衰竭、高铁血红蛋白血症、溶血性贫血和急性肝损伤。他们均成功接受治疗并出院。值得注意的是，患者1在接触后16天被诊断为中毒性脑病，而患者2在接触后58天出现周围神经病变。
本研究旨在阐明此类中毒相关的临床特征。此外，该事件呼吁在使用DMAC和4,4'-ODA的行业加强安全措施，以防止类似的中毒事件。
