广东省阳江某刀具厂急性亚硝酸盐中毒调查

Investigation on acute nitrite poisoning in Yangjiang city, Guangdong province,China

目的 揭示广东省阳江某刀具厂急性中毒事件的主要原因 ,探讨中毒的主要危险因素。方法 对工厂管理人员、中毒患者、经治医生、生活用水的污染过程以及工业废水的处理、排放细节进行现况调查。采用面对面问卷调查员工的发病情况和主要暴露因素。结果 发病 36例 ,罹患率为16 .4 % (36 2 2 0 )。饮用水集中在当天下午上班后 13∶0 0至 15∶30 ,发病高峰在 15∶0 0左右 ,潜伏期中位数为 90min。不同饮水量的工人罹患率不同 ,随着饮水量的增加 ,罹患率也增加 ,存在比较明显的剂量反应关系 (χ2 趋势 =79.115 ,P <0 .0 1)。实验室检测工人饮用后的残留水亚硝酸盐含量严重超标。结论 此事件为一起饮用水被亚硝酸盐污染导致的急性中毒。当地刀具生产企业对亚硝酸盐等有毒化学品的保管使用、供水系统的设计以及工业废水处理排放后对人群健康和环境的影响值得有关部门的密切关注。

Objective To determine the cause of acute poisoning occurred in a factory in Yangjiang city, Guangdong province. Methods In a cross sectional study, interviews were conducted with the administratives of the factory and the local physician. A review was conducted on the water system used for industrial purposes and a separate system used by workers for drinking water. Treatment and discharge of industrial waste water were examined. Face to face interview was conducted to identify risk of exposure for illness among workers. Results A total number of 36 cases were identified in the plant and the attack rate was 16.4 % (36/220). The incubation period (time between drinking polluted water and the onset of symptoms) had a median of 90 minutes (range:30 230 minutes). Consuming water at the factory increased the attack rate and a dose response effect was identified (χ 2 trend = 79.115 , P < 0.01 ). The nitrite content of residuals in drinking water exceeded the WHO standard (1 ppm). Conclusions The accident of acute poisoning was due to drinking water contaminated with sodium nitrite. The prevention of drinking water contaminated by toxic chemicals like sodium nitrite, and the design of industrial and potable water supply system need to be carefully reviewed. Regulations should be developed and enforced to minimize the impact of industrial waste water discharges to guarantee the access to clean drinking water.