三氯乙烯接触工人出现药疹样皮炎和肝脏损害的分析

目的了解三氯乙烯(TCE)对接触工人的健康损害。方法对2005—2009年发生的10例典型TCE中毒病人进行现场调查和职业卫生检测,记录每个病人的职业接触情况以及临床症状和体征,对肝功能、血常规、尿常规、尿三氯乙酸(TCA)、心电图进行检查分析。结果10例病人中4人发生在电子厂,6人在电镀和五金制品厂;TCE接触工龄35～50d,平均38.6d;出观头晕、头痛、皮肤瘙痒、发热的比例分别为100%、80%、100%和60%;具有皮肤红斑、皮疹、水疱的病人分别为80%、100%和60%;肝功能ALT、AST、总胆红素(T-Bil)异常率分别为80%、60%、40%;心电图检查异常2人,尿TCA升高4人。结论三氯乙烯接触工人可出观药疹样皮炎和肝脏损害,同时对心脏、肾脏也有一定影响。

Analysis on Medicamentose-like Dermatitis and liver damage in Workers with TCE exposure

Objective]To understand the health damage of trichloroethene （TCE） on workers with exposure.Methods]Totally 10 typical TCE patients were performed on-site investigations and occupational health detection,and the main symptoms and signs were recorded;liver function test,routine blood test,urine test,urine trichloroacetic acid （TCA） and ECG were performed.Results]Of 10 patients,4 came from electronic factories,6 came from electroplating or hardware factories.TCE exposure time was 35～50 days （average 38.6 days）,the patients with headache,dizziness,skin itch,fever accounted for 100%,80%,100% and 60%,respectively.Furthermore,80% patients had skin erythema,100% with rashes,and 60% with blisters.In addition,the abnormal rate of liver function test ALT,AST,total T-Bil were 80%,60%,40%,respectively.Abnormal ECG occurred in 2 patients,and the elevated urinary TCA levels were found in 4 patients.Conclusion]TCE exposure can induce medicamentosa-like dermatitis and liver damage,heart and kidney are also involved.