一起焚烧固废物引起氟聚合物烟尘热事件调查

An investigation on an outbreak of fluoropolymer fume fever caused by incineration of solid waste

目的调查某太阳能电池生产企业一起以发热、咳嗽、胸闷为主要症状的暴发事件的病因,为现场处置和预防此类事件再次发生提供依据。方法对所有病例的临床表现和流行病学特征进行描述性分析;对作业场所环境及工业生产"三废"处置情况开展卫生学调查;对病例咽拭子及生产过程使用的循环水开展军团菌检测;采用便携式GC-MS检测仪对固废焚烧产生有毒气体进行现场模拟实验查找并确认病因。结果共发现52例病例,罹患率为42.76%,其分布符合同源一次暴露暴发特征;病例临床表现符合烟尘热特点;采集的所有标本军团菌检测均为阴性;在事件发生车间的12个生产岗位中,岗位压缩空气使用量越大罹患率越高(P<0.01)。在事件发生的前一天傍晚该企业曾大量焚烧含氟固废物,生产厂房的压缩空气站进风口正处于焚烧点位置的下风侧,模拟实验检测结果显示,现场固废物焚烧后,周围环境空气中氟苯和二氟苯的检测值分别高达435 mg/m3和513 mg/m3。结论该事件系企业违规焚烧含氟固废物产生的有毒烟尘,经生产厂房的压缩空气站输入厂房,造成厂房内的作业工人吸入较高浓度的有机氟引起氟聚合物烟尘热暴发。

Objective To investigate the cause of an outbreak that with fever, chest tightness, cough as the main symptoms in a production enterprise of solar cells, and to provide suggestrons for the on - site disposal and preventing of re - issued. Methods Clinical features and epidemiological characteristics of the cases were analyzed. The workplaces and treatment of industrial wastes were investigated. Legionella in the throat swab sample and residual water during the processes were detected. Simulation test for poisonous gas from waste incineration was performed using a portable GC - MS detector. Results 52 cases were found and the attack rate was 42. 16% . The case distribution was consistent with the characteristics of the outbreak of a homologous exposure. Legionella test result was negative. Clinical symptoms of patients were similar to those of fume fever. In the 12 jobs, the higher the amount of compressed air used in the job, the higher the incidence rate was,and there were statistical correlation between the two （ P 〈 0. 01）. A large number of fluorine - containing solid waste was burned in the evening before the onset of the disease. The compressed air station was downwind from the location of waste incineration, and the simulation test showed that the concentrations of fluobenzene and two - fluobenzene were 435 and 513 mg/m^3, respectively. Conclusion The toxic smoke produced by illegal incineration of fluorine - containing solid waste, from the compressed air station into the workshop, causing the workers exposed to organic fluoride poisoning, and then the fluoropolymer fume fever outbreak. Fortunately, we disposed it timely and effectively, and all cases quickly recovered and no secondary occurred.