误用亚硝酸盐引起食物中毒的调查与检测问题探讨

Investigation and Investigation of Food Poisoning Caused by Misuse of Nitrite

目的分析一起误用亚硝酸盐引起食物中毒的调查情况与检测结果,探讨其原因并提出监督管理措施,为预防控制亚硝酸盐中毒提供参考依据。方法收集2019年10月23日,28例食客中由于食物中毒的7例患者的基本资料,描述性流行病方法,对可疑餐次进行现场流行病学调查、卫生学调查以及实验室检测与分析,明确食物中毒原因,并提出有效的监督管理措施。结果共发现7例亚硝酸盐中毒患者,所有患者均出现一定程度的恶心、呕吐、头晕、皮肤发绀、头痛、乏力等症状,5例症状明显者的血液分析结果显示动脉血氧分压、血液氧饱和度均正常,氧容量、氧含量均降低;3例高铁血红蛋白值>10%。所有患者经催吐、洗胃、亚甲蓝解毒等治疗,均治愈,住院时间为2~3 d,平均(2.5±0.3)d。现场采集14件样品进行检测,均检出不同含量的亚硝酸盐,其中可疑粉状不明物质的亚硝酸盐含量是8.8×10^3 mg/kg。结论该事件为误用亚硝酸盐引起的食物中毒,应加强临时摊位的食品卫生安全管理,提高群众的食品安全意识,严格管控亚硝酸盐的销售,以从源头上消除亚硝酸盐食物中毒的安全隐患,以确保食品安全,保证人民群众身体健康。

Objective To analyze the investigation and test results of a food poisoning caused by misuse of nitrite,discuss the reasons and propose supervision and management measures to provide reference for prevention and control of nitrite poisoning.Methods Collect basic data of 7 patients among 28 diners due to food poisoning on October 23,2019,descriptive epidemiological methods,conduct on-site epidemiological surveys,hygienic surveys,and laboratory tests and analyses on suspicious meals,clarify the causes of food poisoning,and propose effective supervision and management measures.Results A total of 7 patients with nitrite poisoning were found.All patients showed a certain degree of nausea,vomiting,dizziness,cyanosis,headache,fatigue and other symptoms.The blood analysis results of 5 patients with obvious symptoms showed that the arterial oxygen partial pressure,the blood oxygen saturation was normal,and the oxygen capacity and oxygen content decreased;3 cases of methemoglobin value>10%.All patients were cured by emetic therapy,gastric lavage,methylene blue detoxification and other treatments.The hospital stay was 2 to 3 days,with an average of(2.5±0.3)d.14 samples were collected on site for testing,and all of them detected different levels of nitrite.The nitrite content of the suspected powdery unknown substance was 8.8×10^3 mg/kg.Conclusion This incident is a food poisoning caused by the misuse of nitrite.The food hygiene and safety management of temporary stalls should be strengthened,the public’s food safety awareness should be enhanced,and the sales of nitrite should be strictly controlled,to eliminate nitrite food poisoning potential safety hazards from the source,to ensure food safety and the health of the people.