首页|一起群体性职业性急性二甲基乙酰胺中毒事件调查

一起群体性职业性急性二甲基乙酰胺中毒事件调查

Investigation of a group occupational acute dimethylacetamide poisoning incident

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目的 对某氨纶制造企业火灾后清釜作业期间发生的1起群体性职业性急性二甲基乙酰胺(DMA)中毒事件进行调查分析.方法 以2023年广东省1起群体性职业性急性化学中毒事件的涉事企业、用人单位、中毒患者和有共同职业接触史的工人为研究对象,收集整理职业卫生现场调查资料、中毒患者临床资料和职业病诊断资料,对中毒原因进行分析.结果 该起事件发生在一家氨纶制造企业清理火灾后聚合反应釜作业期间造成6名清理工人中毒,表现为不同程度的肝脏功能异常和皮肤损伤.6例中毒患者作业时均佩戴长管供气式全面罩,但作业空间局限、通风不良,且每天工作时间>8 h,作业5～13 d后出现不适.事故后调查结果显示,聚合反应釜口旁DMA短时间接触浓度为36.06 mg/m3;生产原辅材料与釜内废料的挥发性有机组分中,DMA占13.74%～30.09%;6例患者尿中均检出N-甲基乙酰胺,最高达1 639.78 mg/g肌酐,远高于其职业接触生物限值(20.00 mg/g肌酐).6例患者均诊断为职业性急性DMA中毒.结论 职业性急性DMA中毒主要引起肝脏损伤,起病隐匿,存在群体性发病风险.火灾后清釜作业空间局限、管理不规范、防护措施不到位、作业时间过长,是导致群体性中毒的主要原因.
Objective To investigate and analyze a group occupational acute dimethylacetamide(DMA)poisoning incident occurred during the post-fire cleaning operation in a spandex manufacturing enterprise.Methods This study focused on the involved enterprise,employing units,poisoning patients,and workers with similar occupational exposure history from a group occupational acute chemical poisoning incident in Guangdong Province in 2023.Occupational health on-site investigation data,clinical records of poisoned patients,and occupational disease diagnostic data were collected to determine the cause of the poisoning.Results The incident occurred at a spandex manufacturing enterprise during the cleaning of polymerization reaction vessels after a fire,resulting in poisoning of six cleaning workers.The clinical symptoms of patients included varying degrees of liver function abnormalities and skin damage.All six patients wore long-tube air-supplied full-face masks during work.The patients were in a confined work space with poor ventilation,and worked more than 8 hours per day.Patients felt unwell after 5-13 days of work.Post-incident investigation revealed that the DMA exposure concentration of short term near the reaction vessels was 36.06 mg/m³.DMA accounted 13.74%to 30.09%of the volatile organic compounds in the raw and auxiliary materials and waste in the vessel.N-methylacetamide was detected in the urine of these six patients,with levels up to 1 639.78 mg/g creatinine,exceeding the occupational exposure limit(20.00 mg/g creatinine).All six patients were diagnosed as occupational acute DMA poisoning.Conclusion Occupational acute DMA poisoning mainly causes liver damage,has a latent onset,and poses a risk of group occurrence.The main causes of group poisoning are confined work space,inadequate management,insufficient protective measures,and excessive working hours.

DimethylacetamideAcute poisoningOccupational poisoningChemical poisoningInvestigation and analysis

黄健、刘晓勇、何金铜、何嘉恒、吴奇峰、江嘉欣

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广东省职业病防治院,广东 广州 510300

中山大学公共卫生学院(深圳),广东 深圳 518107

珠海市职业病防治院,广东 珠海 519099

二甲基乙酰胺 急性中毒 职业中毒 化学中毒 调查分析

广东省医学科学技术研究基金广东省医学科学技术研究基金广东省医学科学技术研究基金广东省卫生健康适宜技术推广项目广州市科技计划项目

C2024030C2021020C2021021202303091440347168202103000012

2024

10.20001/j.issn.2095-2619.20240823

中国职业医学
中华预防医学会 华南区域劳动卫生职业病防治中心

中国职业医学

CSTPCD
影响因子：1.011
ISSN：2095-2619
年,卷(期)：2024.51(4)
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