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conferenceseries.com
Volume 5, Issue 3 (Suppl) Occup Med Health Aff, an open access journal
ISSN:2329-6879 Occupational Health-2017
September 13-14, 2017
.
September 13-14, 2017 | Dallas, USA
Occupational Health & Safety
6th International Conference and Exhibition on
Antidotes for occupational exposures: Poisoned cases report and literature review
Sung-Yuan Hu1, 2, 3, 4, Szu-Ying Hsieh1, Chia-Lung Hsu1, Che-Yu Kuo1, 2, Hsin-En Ho1, 2, 3, 5, Wei-Min Chu3, 4, 6, Cheng-Han Tsai 6, 2 and Yu-Tse Tsan1, 2
1Director, Division of Clinical Toxicology, Department of Emergency Medicine, Taiwan
Introduction: Most poisoned cases caused by occupational exposures were accidently due to errors of personal or mechanical
operations. Certain poisons, such as cyanide and cyanogenic compounds, caused by occupational exposures may be lethal, but only
few antidotes had been used to recuse these occupational workers.
Material & Methods: This was a retrospective study of poisoned cases caused by occupational exposures and the use of antidotes
between 2007 and 2015 in Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital,
Taiwan.
Results: According to the category of poisons, five index poisoned cases caused by occupational exposures were reviewed, including
acrylonitrile, aniline, mercury, 2-chloroethanol and hydrogen fluoride. Routes of exposures and the use of antidotes were reported
in poisoned cases.
Discussion: In general, management of poisoned cases caused by occupational exposures included decontamination for respiratory
tract, skin and mucosa; resuscitation to stabilize poisoned patients with airway protection, oxygen and fluid. The use of antidotes for
specific situations according to the characteristics of occupational poisons. Acute life support was an important issue for all poisoned
cases, but only few specific antidotes were undertaken for detoxification through different mechanisms which were described as
follows. Sodium nitrite oxidized hemoglobin to methemoglobin which binds the free cyanide and could enhance endothelial cyanide
detoxification. Methylene blue converted methemoglobin (Fe3+) to hemoglobin (Fe2+). DMPS was a chelating agent for chelation
of metal ions. Fomepizole was a competitive inhibitor of the alcohol dehydrogenase which is found in the liver. Calcium gluconate
rapidly combines with fluoride ion in the tissue.
Conclusion: Primary prevention for occupational exposures through education, personal protective equipment and the checkpoint
of the environmental safety was recommended. Decontamination, resuscitation and the use of antidotes for specific situations should
be undertaken immediately to reduce injury if the occupational exposures occurred
Biography
Sung-Yuan Hu has his expertise in Internal Medicine, Emergency and Critical Care Medicine, Occupational Medicine and Toxicology. He is the Director, Division of
Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan.
Sung-Yuan Hu et al., Occup Med Health Aff 2017, 5:3 (Suppl)
DOI: 10.4172/2329-6879-C1-034