A Family Doctor’s Tale – OCCUPATIONAL TRICHLOROETHYLENE POISONING
DOC WHAT IS OCCUPATIONAL TRICHLOROETHYLENE POISONING?
Trichloroethylene (Photo credit: Wikipedia)
Occupational Trichloroethylene (TCE) poisoning
An occupational Trichloroethylene (TCE) poisoning is a solvent poisoning condition caused by excessive exposure to Trichloroethylene resulting in respiratory,heart,gastrointestinal, skin and mucosal symptoms.
Trichloroethylene (TCE) poisoning occurs when workers are exposed to it due to ingestion by accident. Poisoning can occur when the Trichloroethylene (TCE) is absorbed into the body by inhalation or skin contact and mucosal contact.
What are the Signs and symptoms of occupational Trichloroethylene (TCE) poisoning?
Acute Trichloroethylene (TCE) exposure at high levels can cause sudden onset of skin rash, pneumonitis, giddiness, confusion, headache, convulsions and coma.
Acute presentation of Trichloroethylene (TCE) poisoning are:
Neurological:
1.excitement
2.giddiness
3.euphoria
followed by
1.depression
2.headache
3.nausea
4.drowsiness
5.coma
Skin and mucosa:
1.skin rash and itch
2.eye irritation
3.nose irritation
Respiratory:
1.chemical pneumonitis
2.respiratory failure
Cardiovascular:
1.arrhythmia
2.cardiac arrest
Chronic presentation of Trichloroethylene (TCE) poisoning are:
Neurological:
1.headache
2.irritability
3.fatigue
4.insomnia
Renal:
1.renal tubular damage
2.proteinuria
Skin
1.dermatitis
2.rash
GIT:
1.liver dysfunction
2.hepatitis
General:
severe allergic reaction leading to Stevens Johnson syndrome with fever , rash and jaundice with 2-3 weeks of exposure.
Diagnostic Criteria of Work relatedness:
A good occupational history of work exposure to Trichloroethylene (TCE) is important in diagnosing work place Trichloroethylene (TCE) poisoning.
Supporting workplace monitoring and reports will provide more evidence to determine the diagnosis of work related Trichloroethylene (TCE) poisoning.
Investigation to establish work relationship to Trichloroethylene (TCE) poisoning:
Get an occupational history to establish if the worker is exposed to Trichloroethylene (TCE) during:
1.degreasing of metal parts in metal, electronic, automobile, aircrafts and ships industries
2.removal of paints from contaminated parts
3.wood and furniture industry
4.farming
5.gardening
Correlate workplace monitoring and reports of Trichloroethylene (TCE) poisoning cases will provide more evidence to determine the diagnosis of work related Trichloroethylene (TCE) poisoning.
Management:
1.Treatment of all workers with abnormal blood Trichloroethylene (TCE) results and the blood tests repeated after every 3 months until results are normal.
2.All workers with Trichloroethylene (TCE) poisoning should be reassigned to another area without exposure to Trichloroethylene (TCE).
3.Some workers with severe signs of Trichloroethylene (TCE) poisoning may required hospitalization.
4.maintain good personal hygiene , wear personal protective equipment and practice good work practices to prevent contact and inhalation of toxic agent.
5.Avoid smoking and eating with hands at workplaces which may be exposed to Trichloroethylene (TCE).
6.Put in place control measures to reduce exposure to Trichloroethylene (TCE)
7.Education of workers of the dangers of Trichloroethylene (TCE) poisoning and how to reduce exposure.
8.follow up on cases to monitor disease and whether the patient need hospitalization
