Kleinfeld M J
J Occup Med. 1980 Dec;22(12):820-1. doi: 10.1097/00043764-198012000-00018.
A 31-year-old patient was admitted to the hospital because of dark red urine which on examination was found to be due to extracellular hemoglobin. The cause of the hemoglobinuria was exposure to arsine gas from a cylinder thought to be empty. The worker's exposure time was approximately one to two minutes. The degree of hemolytic anemia required only one unit of packed red cells. The patient was hydrated intravenously to avoid acute tubular necrosis. The arsenic content in the urine taken was 0.72 mg/L on the day of admission and dropped to 0.1 mg/L on the fourth day of hospitalization. The patient was discharged eight days after admission, when clinical and hematological status had improved sufficiently. Occupational history revealed that protective procedures employed in the handling of the cylinders containing the arsine gas were inadequate. It was found that the valve on one of the cylinders was half-opened and leaking and that the dust caps, which were attached to the outside of the valves of the cylinders, were present on some and not on others and, where present, had been hand-tightened and not wrench-tightened. Moreover, the cylinders although specified to be empty, were not, according to regulations requiring pressure to be less than 25 pounds gauge or 45 absolute.
一名31岁的患者因暗红色尿液入院，检查发现是细胞外血红蛋白所致。血红蛋白尿的原因是接触了一个本以为是空的气瓶中的胂气。该工人的接触时间约为1至2分钟。溶血性贫血的程度仅需输注一个单位的浓缩红细胞。患者接受了静脉补液以避免急性肾小管坏死。入院当天所测尿液中的砷含量为0.72毫克/升，住院第四天降至0.1毫克/升。患者入院八天后出院，此时临床和血液学状况已充分改善。职业史显示，在处理装有胂气的气瓶时所采用的防护措施不足。发现其中一个气瓶的阀门半开且漏气，并且气瓶阀门外部所附的防尘帽，有的有有的没有，即便有也是用手拧紧而非用扳手拧紧。此外，这些气瓶虽标明为空瓶，但根据规定压力应小于25磅表压或45绝对压力，实际并非如此。
