How should occult chemical poisoning be prevented?

Hidden chemical poisoning refers to poisoning patients who never realize that they are exposed to poisons at work or in life. The occurrence of poisoning from the absorption of toxic substances to the occurrence of poisoning occurs unconsciously, and it is called concealed poisoning. It is a special way of poisoning. With the continuous increase in the variety of chemical substances and their wide application, the chance of people being exposed to chemicals has greatly increased. The number of poisoning cases that occurred in this way also increased. Due to the concealment of this type of poisoning, the dose of poisons, the path and timing of poisoning are unknown, the affected organs are different, and the clinical manifestations are complex and diverse, which can easily lead to misdiagnosis. Therefore, understanding the method of prevention of occult poisoning will be beneficial to the early diagnosis of disease and effective treatment to control the occurrence and development of poisoning.

I. Common Causes of Occult Poisoning

1. Occupational factors

Occupational poisoning generally does not belong to the hidden type, but under special conditions, patients do not understand whether they are exposed to toxic substances in the production process, and they have not taken protective measures, resulting in poisoning of contacts.

For example, in 1995 , the foreign-funded enterprises in Guangdong Province suffered from headaches, dizziness, fatigue, nausea, vomiting, unstable gait, drowsiness, confusion, and severe illness among bonded workers in toy factories and plastic products factories. Coma, convulsions, no fever during the course of the disease. Once considered viral encephalitis, the condition can suddenly worsen death. Workers do not know what kind of poison they are exposed to. After occupational epidemiology, toxicology, and toxicological analysis, the cause of poisoning was identified as dichloroethane poisoning. The 3435 adhesive solvent and the ABS solvent 514 contained in the adhesive contacted by the workers contained 79% and 98% dichloroethane, respectively. The correct treatment and protective measures were taken against the cause to control the development of the disease.

Another poisoning cause is that the original contact material does not cause poisoning, but it reacts under special conditions to produce highly toxic substances, and no active protective measures are taken, causing poisoning to the contacts. If ferrosilicon is carried, phosphine gas may be generated due to deliquescence when it is in contact with water or moist air due to the presence of calcium phosphide in the ore, which is highly toxic. Workers in charge of escort suffered from acute poisoning and even death due to inhalation of high concentrations of phosphine under confined conditions.

2. Food contamination

Acute chemical poisoning caused by food poisoning poisons, its characteristics:

(1) Gastrointestinal symptoms predominate in the early stage and are often misdiagnosed as gastroenteritis.

(2) Rodenticides are the most common poisoning species, and there are nitrites, carbon esters, lead, arsenic, antimony, and organophosphorus pesticides.

(3) Type of poisoning. Can cause a large number of people poisoning at once, or repeatedly caused by a small number of poisoning. Early diagnosis and timely treatment can significantly reduce the toxic effects and control the development of poisoning incidents.

Toxic contaminated foods Poisoning Common poisons directly contaminate food ; poisonous containers hold food and drinks ; poisons are misused as condiments and starters. For example , more than 1,000 cases of lard poisoning occurred in the southern part of Jiangxi Province in early 1999 , which was caused by contaminated lard with trimethyltin.

3. Water pollution

It is common for chemical plants to discharge waste water and waste residue into rivers without treatment and pollute water sources. For example, in the 1950s , the water mis-occurred in Japan was confirmed as organic mercury poisoning after more than 10 years of investigation and research.

4. Air pollution

It is mostly a colorless, odorless, non-irritating gas that pollutes the air and is not easily alert. For example, carbon monoxide poisoning accidents that occur repeatedly in worn-out vehicles are often caused by carbon monoxide entering the passenger compartment through cracks in the chassis of the car and causing carbon monoxide poisoning.

5. Substance abuse and murder with poison

In recent years, poisoning caused by the ban on the use of rodenticides such as tetramine, fluoroacetamide, organophosphorus, antimony compounds, etc. has become more common.

Second, the diagnosis of occult poisoning

1. Medical staff should establish a sense of poisoning diagnosis

For diseases with unclear etiology, we must break through the circle of undergraduate diseases and consider the possibility of poisoning. If the patient has abdominal cramps and cannot be explained by common internal and external diseases, lead-free colic should be considered. To do this, be familiar with the toxicological, toxicological, and clinical manifestations of poisoning.

2. Clues to the possibility of chemical poisoning

(1) Get clues from medical history. Ask for a systematic and comprehensive history, especially to understand the presence or absence of suspected toxicants and the incidence of living with the working population.

(2) Through physical examination, discover possible poisoning cues. Such as organophosphorus poisoning in the exhaled breath of patients with garlic odor ; hair loss seen in thorium, chloroprene poisoning ; miosis was found in organic phosphorus, carbamate, sleeping pills and morphine poisoning ; lower extremity skin hyperalgesia found in arsenic, hydrazine poisoning ; Sweating found in dinitrophenol, organophosphorus pesticide poisoning ; skin and mucous membrane purple brown seen in methemoglobinemia, cherry red seen in carbon monoxide poisoning ; nails mees line found in arsenic, barium poisoning.

(3) On-site epidemiological investigation. When poisoning is difficult to find reliable clues in the clinic, on-site investigation is necessary. Carefully investigate the areas where the patient lives and works for suspicious chemical poisons.

(4) Poison detection. In combination with clinical practice, targeted toxicants were detected in the air, water, food, food, earth, and remedies used for eating, and the patient's blood and urine were subjected to toxicological analysis to understand the types and amounts of toxicants.

3. Make a differential diagnosis to prevent misdiagnosis

Through the above steps, a comprehensive analysis was conducted to determine that there was a causal relationship between poisons and diseases and a clear cause of occult poisoning was found.

Third, the prevention of occult poisoning

1. Strengthen the management of poisons.

2. Implement food management regulations and governance of wastes.

3. Obey labor protection laws and regulations.

4. Improve clinical workers' understanding of common causes of chemical poisoning.

5. Carry out popular science education to increase the public's vigilance against chemical poisoning.

This article is sourced from the Internet and compiled and edited by China Rescue Equipment Network.