Guidotti T L
Occupational Health Program, University of Alberta, Faculty of Medicine, Edmonton, Canada.
Occup Med (Lond). 1996 Oct;46(5):367-71. doi: 10.1093/occmed/46.5.367.
Hydrogen sulphide (H2S) is the primary chemical hazard in natural gas production in 'sour' gas fields. It is also a hazard in sewage treatment and manure-containment operations, construction in wetlands, pelt processing, certain types of pulp and paper production, and any situation in which organic material decays or inorganic sulphides exist under reducing conditions. H2S dissociates into free sulphide in the circulation. Sulphide binds to many macromolecules, among them cytochrome oxidase. Although this is undoubtedly an important mechanism of toxicity due to H2S, there may be others H2S provides little opportunity for escape at high concentrations because of the olfactory paralysis it causes, the steep exposure-response relationships, and the characteristically sudden loss of consciousness it can cause which is colloquially termed 'knockdown.' Other effects may include mucosal irritation, which is associated at lower concentrations with a keratoconjunctivitis called 'gas eye' and at higher concentrations with risk of pulmonary oedema. Chronic central nervous system sequelae may possibly follow repeated knockdowns: this is controversial and the primary effects of H2S may be confounded by anoxia or head trauma. Treatment is currently empirical, with a combination of nitrite and hyperbaric oxygen preferred. The treatment regimen is not ideal and carries some risk.
硫化氢（H₂S）是“含硫”气田天然气生产中的主要化学危害。它在污水处理和粪便储存作业、湿地建设、毛皮加工、某些类型的纸浆和造纸生产以及任何有机物质腐烂或无机硫化物在还原条件下存在的情况下也是一种危害。H₂S在循环中会分解为游离硫化物。硫化物会与许多大分子结合，其中包括细胞色素氧化酶。尽管这无疑是H₂S毒性的一个重要机制，但可能还有其他机制。由于H₂S会导致嗅觉麻痹、暴露-反应关系陡峭，以及会导致意识突然丧失（俗称“击倒”），所以在高浓度时几乎没有机会逃脱。其他影响可能包括粘膜刺激，在较低浓度时与一种称为“气眼”的角膜结膜炎有关，在较高浓度时与肺水肿风险有关。反复“击倒”后可能会出现慢性中枢神经系统后遗症：这存在争议，而且H₂S的主要影响可能会因缺氧或头部创伤而混淆。目前的治疗是经验性的，首选亚硝酸盐和高压氧联合治疗。该治疗方案并不理想，且有一定风险。
