一起急性三氯甲烷中毒事故的调查

A Case Report on Acute Trichloromethane Poisoning

[目的]通过对一起某工艺品厂发生的急性三氯甲烷中毒事故的调查分析,以引起相关企业和职业卫生监督机构的重视,采取有效的职业卫生防护措施,避免类似中毒事故再次发生。[方法]通过问卷形式,详细询问中毒病人的职业史、病史及就诊经过,查阅病人住院病历记录;对作业场所进行职业卫生学调查和职业卫生检测。[结果]作业场所三氯甲烷时间加权平均容许浓度（PC-TWA）为366.6～403.4mg/m3,超标17.3～19.2倍;诊断为（三氯甲烷）急性重度中毒性肝病患者2名,急性中度中毒性肝病患者1名,急性轻度中毒性肝病患者1名。患者经护肝等对症治疗1个月后肝功能正常、症状好转出院。[结论]企业主管对三氯甲烷的危害性认识不足,未采取有效防护措施是导致本次中毒事故发生的主要原因。政府和相关企业应引起高度重视,加强对有毒物品的管理,采取有效的防治措施,保护劳动者的身体健康。

[ Objective ] Through investigating and analyzing a case of acute trichloromethane poisoning in one handicraft factory, to alert relevant enterprises and occupational health supervision agencies and put forward preventive measures to avoid similar poisoning accidents from happening again. [ Methods ] Patients＇ information was collected using questionnaires, such as occupational history, medical history, and corresponding diagnosis and treatment for the current event. In addition, a field investigation on occupational health hazards was conducted in the reported workplaces. [ Results ] The PC-TWA values of trichloromethane in the workplaces were 366.6-403.3 mg/m3, up to 17.3-19.2 times of the relevant occupational exposure limit. All four patients were diagnosed with trichloromethane-related acute toxic liver disease： two were graded severe, one was moderate, and one was mild to the severity of clinic symptoms. After symptomatic treatment for one month, the patients were discharged from the hospital with improved liver functions and alleviated symptoms. [ Conclusion ] The main cause of the poisoning accident lies in the employers＇ lack of awareness of potential hazards of trichloromethane and effective protective measures. Therefore, it is recommended that the local government and enterprises should strengthen toxic substance management and take effective protective measures to protect workers＇ health.