Registration Dossier

Administrative data

Endpoint:
health surveillance data
Type of information:
other: exposition case
Adequacy of study:
other information

Data source

Reference
Reference Type:
publication
Title:
Méthémoglobinémie sévère après exposition à la p-trifluoromethylaniline lors de travaux de maintenance sur un camion-citerne
Author:
Testud F, Dachraoui A, Perrot D.
Year:
2001
Bibliographic source:
Arch. mal. prof., 62, n°6, 488-492

Materials and methods

Study type:
human medical data
Test guideline
Qualifier:
no guideline required

Test material

Reference
Name:
Unnamed
Type:
Constituent
Details on test material:
no data

Results and discussion

Results:
Methemoglobinemia.

Any other information on results incl. tables

SUMMARY:
A case of severe methemoglobinemia after occupational exposure to p-trifluoromethylaniline was reported. Poisoning resulted from inhalation but especially gross contamination of the hands of the worker, while operating without any individual safety device in the tank of a truck, previously emptied and cleaned out. The severity of methemoglobinemia required admission in a critical care unit and administration of methylene blue. 

The pathophysiology and therapy of methemoglobinemia were discussed. The circumstances of the intoxication were explicated.

 

A worker with only dust mask and cloth gloves had to intervene in the tank of a truck. Presence of solvent odour and feeling of intoxication had to conduct him to go out to fresh air. After 2 hours and half of working (at 17h30), he complained about intense headaches, nausea, dizziness and difficulties in breathing, but no sensation of irritation on skin or mucous.

After a slight feeling of faintness, he had an accident without gravity.

Because of persistence of symptoms, and observation of blue color on lips, gums and fingers, he was carried to hospital. 

At 21 h,the conscious was not altered. Marked cyanosis persists on lips, hands, ears and feet in contrast with globally satisfactorily hemodynamic.

On the other hand, pulse oxymometry showed a decrease of saturation (SpO2) at 65%. Blood analysis showed methemoglobinemia at 55.9% for a total hemoglobin at 153 g/l and a carboxyhemoglobin at 0.3%.

Patient began at 22h30 an oxygen therapy. There was a severe hypoxemia and methemoglobinemia at 57.8%. 

After a treatment with Blue methylene, Fluimicil perfusion and vitamin C, functional signs, cyanosis and hypoxia disappeared.

At midnight,methemoglobinemia decrease at 10.5%, the next day (at 6h) at 3.6% and at 0.1% at midday, then around 18 hours after exposition.

Biological tests showed that liver, kidneys or muscles were not affected.

Applicant's summary and conclusion