Koo D, Goldman L, Baron R
Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Am J Ind Med. 1995 Apr;27(4):545-53. doi: 10.1002/ajim.4700270407.
An outbreak of dermatitis occurred among county jail inmates who removed dead fish from the Sacramento River in California after a spill of metam sodium. The spilled chemical decomposes to methylisothiocyanate (MITC), a known skin irritant. A retrospective cohort study was conducted among the inmates and their crew leaders. Among 42 jail group members, 27 had dermatitis involving the feet and ankles; dermatitis was associated with lower extremity water contact (RR = 3.4, 95% CI 1.0-11.8); the attack rate increased with length of time spent in the water. For comparison, other state and federal employees who worked in the river at the same time were also interviewed. None reported dermatitis. Over three-quarters (24/31) of these other clean-up workers whose feet became wet changed to dry clothing immediately; none of the jail group changed immediately. The river concentration of MITC measured 20-40 ppb at the time of exposure. We speculate that prolonged wetness, occlusive boots, friction, and heat contributed to chemical irritation at this low concentration; the experience of the other clean-up workers suggests that this outbreak could have been prevented.
在加利福尼亚州萨克拉门托河发生甲基异硫氰酸钠泄漏后，从河中清理死鱼的县监狱囚犯中爆发了皮炎。泄漏的化学物质分解为甲基异硫氰酸酯（MITC），一种已知的皮肤刺激物。对这些囚犯及其组长进行了一项回顾性队列研究。在42名监狱小组成员中，27人患有累及足部和脚踝的皮炎；皮炎与下肢接触水有关（相对危险度=3.4，95%可信区间1.0-11.8）；发病率随在水中停留时间的延长而增加。作为对照，同时在河中工作的其他州和联邦雇员也接受了访谈。没有人报告患皮炎。这些脚部弄湿的其他清理工人中，超过四分之三（24/31）立即更换为干衣服；监狱小组中没有人立即更换。接触时河中MITC的浓度为20-40 ppb。我们推测，长时间潮湿、密闭的靴子、摩擦和热量在这种低浓度下导致了化学刺激；其他清理工人的经历表明，这次疫情本可以预防。
