Seong-Yong Cho

Acute Symptoms after a Community Hydrogen Fluoride Spill

ObjectivesThis study was conducted to describe the demographic characteristics, and clinical signs and symptoms of patients who visited a general hospital because of the release of chemically hazardous hydrogen fluoride that occurred on September 27, 2012 in Gumi City, Korea.MethodsThe medical records at 1 general hospital 9 km from the accident site were reviewed using a standardized survey format. There were 1,890 non-hospitalized and 12 hospitalized patients exposed to hydrogen fluoride between September 27 and October 13 2012.ResultsAmong the 12 hospitalized patients, 11 were discharged within 1 week and the other was hospitalized for 10 days. The chief complaints were respiratory symptoms such as hemoptysis and shortness of breath, gastrointestinal symptoms, neurologic symptoms, sore throat, and lip burn.The number of non-hospitalized patients exhibited a bimodal distribution, peaking on the first and twelfth days after the accident. Their chief complaints were sore throat (24.1%), headache (19.1%), cough (13.1%), and eye irritation (9.2%); some patients were asymptomatic (6.2%). Patients who visited the hospital within 3 days (early patients) of the spill more often had shortness of breath (27.0%) and nausea (6.3%) as the chief complaints than patients who visited after 3 days (late patients) (3.5% and 2.6%, respectively). However, cough and rhinorrhea were more common in the late patients (14.0% and 3.3%, respectively) than in the early patients (5.0% and 0.0%, respectively). Patients who were closer to the accident site more often had shortness of breath and sputum as the chief complaints than patients who were farther away. The mean serum calcium concentration was 9.37 mg/dL (range: 8.4–11.0 mg/dL); none of the patients had a decreased serum calcium level. Among 48 pulmonary function test results, 4 showed decreased lung function. None of the patients had abnormal urine fluoride levels on the eighth day after exposure.ConclusionsPatients hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation.

Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident.

ObjectivesThis study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea.MethodsWe investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area.ResultsThe subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics.ConclusionsThe subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.

Acute health effects of accidental chlorine gas exposure

ObjectivesThis study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.MethodsWe analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.ResultsImmediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).ConclusionsThe 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

Effectiveness of participatory training for the promotion of work-related health and safety among Korean farmers

This study was conducted to explore the effectiveness of participatory training for promoting farmer’s health and reducing agricultural work-related injuries. Candidates for this study included 595 farmers in 8 rural villages of South Korea. The one-day course participatory training was administered to 217 (36.5%) farmers and included an action-checklist, a good example presentation, and group discussion. The follow-up visit to participants’ houses and farms was performed after 1 to 3 months. A direct interview survey was administered pre- and post-trainings. The total number of proposed action plans for the improvement of working condition was 620. It was observed that 61.5% of action plans (72.2% of short term and 41.3% of long term plans) were completely implemented. In regards to health and safety indices, the proportion of current smokers was reduced from 29.8% to 25.3% in the group that underwent training. The pesticide intoxication was reduced from 16.1% to 4.8% in participants that underwent training. However, the agricultural injury rate was unchanged in both groups. This study reports significant beneficial effects of participatory training in the agriculture sector in Korea.