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

Seong-Yong Cho; Kuck-Hyun Woo; Jin-Seok Kim; Seong-Yong Yoon; Joo-Yong Na; Jin-Hyun Yu; Yong-Bae Kim

doi:10.1186/2052-4374-25-36

Journal List > Ann Occup Environ Med > v.25(1) > 1124805

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Cho, Woo, Kim, Yoon, Na, Yu, and Kim: Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident

Research Article

Ann Occup Environ Med 2013;25(1):36.

Published online: 4 February 2013

DOI: https://doi.org/10.1186/2052-4374-25-36

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

Seong-Yong Cho¹, Kuck-Hyun Woo¹, Jin-Seok Kim¹, Seong-Yong Yoon¹, Joo-Yong Na¹, Jin-Hyun Yu¹, Yong-Bae Kim^2,

¹Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk 730–706, South Korea

²Department of Preventive Medicine, Soonchunhyang University School of Medicine, Cheonan, 23-20, Bongmyung-dong, Cheonan-si, Choongchungnam-do 330–721, South Korea

^*Correspondence: atlask@sch.ac.kr Department of Preventive Medicine, Soonchunhyang University School of Medicine, Cheonan, 23-20, Bongmyung-dong, Cheonan-si, Choongchungnam-do 330-721, South Korea Full list of author information is available at the end of the article

Received 11 September 2013 Revised 29 October 2013 Accepted 28 November 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This 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.

Methods

We 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.

Results

The 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.

Conclusions

The 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.

Key Words:

Key Words

Hydrofluoric acid, Chemical hazard release, Firefighters

References

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Table 1

Comparison between the general characteristics and symptoms according to distance from the accident site

	Less than 100 m (N=140)		100 m-1 Km (N=173)		More than 1 Km (N=35)		p-value*
	N	%	N	%	N	%	p-value*
Age (years)							0.000
< 30	21	58.3	14	38.9	1	2.8
30∼39	56	51.4	44	40.4	9	8.3
40∼49	45	32.4	79	56.8	15	10.8
≥ 50	18	28.1	36	56.3	10	15.6
Gender							0.031
Male	138	42.1	157	47.9	33	10.1
Female	2	10.0	16	9.2	2	5.7
Smoking							0.532
No smoker	100	42.2	112	47.3	25	10.5
Current smoker	40	36.0	61	55.0	10	9.0
Job							0.000
Firefighter	116	47.3	102	41.6	27	11.0
Police officer	20	43.5	26	56.5	0	0.0
Volunteer firefighter	4	11.8	23	67.6	7	20.6
Special warfare reserved force	0	0.0	22	95.7	1	2.9
Abnormal symptoms
Throat^†	24	17.1	36	20.8	4	11.4	0.082
Nose^‡	18	12.9	17	9.8	6	17.1	0.924
Eye^§	42	30.0	30	17.3	7	20.0	0.026
Lung^∥	49	35.0	50	28.9	8	22.9	0.115
Skin**	15	10.7	20	11.6	3	8.6	0.886
Heart⁺⁺	0	0.0	0	0.0	0	0.0	–
Nerve^‡‡	15	10.7	14	8.1	1	2.9	0.141
Stomach^‡‡‡	4	2.9	5	2.9	1	2.9	0.993

^* Chi-square test for trend.

^† Throat pain, change of voice, dry mouth.

^‡ Rhinorrhea, nasal obstruction, nasal pain, nasal bleeding.

^§ Ocular pain, red eye, blurred vision, lacrimination.

^∥ Cough, sputum, chest discomfort, dyspnea.

^** Skin pruritus, skin rash, skin pain.

⁺⁺ Palpitation, left chest pain.

^‡‡ Fatigue, Headache, dizziness, arm/leg claudication, muscle weakness, inattention, muscle pain.

^‡‡‡ Vomiting, dyspepsia, nausea, diarrhea, abdominal pain.

Table 2

Comparison between the general characteristics and abnormal symptoms according to working duration at the accident area

	Less than 1 hours (N=28)		1–10 hours (N=272)		More than 10 hours (N=48)		p-value*
	N	%	N	%	N	%	p-value*
Age (years)							0.972
< 30	1	2.8	30	83.3	5	13.9
30∼ 39	13	11.9	77	70.6	19	17.4
40∼ 49	11	7.9	114	82.0	14	10.1
≥ 50	3	4.7	51	79.7	10	15.6
Gender							0.569
Male	26	7.9	256	78.0	46	14.0
Female	2	10.0	16	80.0	2	10.0
Smoking							0.403
No smoker	17	7.2	186	78.5	34	14.3
Current smoker	11	9.9	86	77.5	14	12.6
Job							0.001
Firefighter	16	6.5	184	75.1	45	18.4
Police officer	7	15.2	36	78.3	3	6.5
Volunteer firefighter	4	11.8	30	88.2	0	0.0
Special warfare reserved force	1	4.3	22	95.7	0	0.0
Abnormal symptoms
Throat^†	8	28.6	45	16.5	22	22.9	0.840
Nose^‡	3	10.7	30	11.0	8	16.7	0.344
Eye^§	5	17.9	63	23.2	11	22.9	0.688
Lung^∥	3	10.7	86	31.6	18	37.5	0.027
Skin**	2	7.1	32	11.8	4	8.3	0.946
Heart⁺⁺	0	0.0	0	0.0	0	0.0	–
Nerve^‡‡	1	3.6	22	8.1	7	14.6	0.079
Stomach^‡‡‡	0	0.0	6	2.2	4	13.8	0.018

^* Chi-square test for trend.

^† Throat pain, change of voice, dry mouth.

^‡ Rhinorrhea, nasal obstruction, nasal pain, nasal bleeding.

^§ Ocular pain, red eye, blurred vision, lacrimination.

^∥ Cough, sputum, chest discomfort, dyspnea.

^** Skin pruritus, skin rash, skin pain.

⁺⁺ Palpitation, left chest pain.

^‡‡ Fatigue, Headache, dizziness, arm/leg claudication, muscle weakness, inattention, muscle pain.

^‡‡‡ Vomiting, dyspepsia, nausea, diarrhea, ab dominal pain.

Table 3

Comparison between the general characteristics and abnormal symptoms according to respiratory protector device used

	No wear (N=91)		Disposable or cotton mask (N=114)		Gas mask (N=11)		SCBA (N= 132)		p-value*
	N	%	N	%	N	%	N	%	p-value*
Age (years)									0.000
< 30	5	13.9	8	22.2	2	5.6	21	58.3
30∼ 39	22	20.2	33	30.3	2	1.8	52	47.7
40∼ 49	47	33.8	46	33.1	4	2.9	42	30.2
≥ 50	17	26.6	27	42.2	3	4.7	17	26.6
Gender									0.012
Male	81	24.7	108	32.9	10	3.0	129	39.3
Female	10	50.0	6	30.0	1	5.0	3	15.0
Smoking									0.101
No smoker	56	23.6	79	33.3	5	2.1	97	40.9
Current smoker	35	31.5	35	31.5	6	5.4	35	31.5
Job									0.000
Firefighter	51	20.8	59	24.1	3	1.2	132	53.9
Police officer	16	34.8	22	47.8	8	17.4	0	0.0
Volunteer firefighter	21	61.8	13	38.2	0	0.0	0	0.0
Special warfare reserved force	3	13.0	20	87.0	0	0.0	0	0.0
Abnormal symptoms
Throat^†	13	14.3	21	18.4	3	27.3	27	20.5	0.262
Nose^‡	10	11.0	12	10.5	1	9.1	18	13.6	0.468
Eye^§	21	23.1	19	16.7	2	18.2	37	28.0	0.139
Lung^∥	34	37.4	33	28.9	4	36.4	36	27.3	0.208
Skin**	5	5.5	19	16.7	1	9.1	13	9.8	0.977
Heart⁺⁺	0	0.0	0	0.0	0	0.0	0	0.0	–
Nerve^‡‡	9	9.9	8	7.0	0	0.0	13	9.8	0.840
Stomach^‡‡‡	0	0.0	7	6.1	0	0.0	3	2.3	0.941

^* Chi-square test for trend.

^† Throat pain, change of voice, dry mouth.

^‡ Rhinorrhea, nasal obstruction, nasal pain, nasal bleeding.

^§ Ocular pain, red eye, blurred vision, lacrimination.

^∥ Cough, sputum, chest discomfort, dyspnea.

^** Skin pruritus, skin rash, skin pain.

⁺⁺ Palpitation, left chest pain.

^‡‡ Fatigue, Headache, dizziness, arm/leg claudication, muscle weakness, inattention, muscle pain.

^‡‡‡ Vomiting, dyspepsia, nausea, diarrhea, abdominal pain.

Table 4

Analysis of the individual symptoms according to distance from the accident site

	Less than 100 m (N= 140)		100 m-1 Km (N=173)		More than 1 Km (N=35)		Total		p-value*
	N	%	N	%	N	%	N	%	p-value*
Throat
Throat pain	24	10.8	36	17.1	4	11.8	64	13.7	0.882
Nose
Rhinorreha	15	6.8	13	6.2	4	11.8	32	6.9	0.698
Nasal obstruction	5	2.3	2	1.0	2	5.9	9	1.9	0.881
Nasal pain	1	0.5	2	1.0	0	0.0	3	0.6	0.932
Eye
Ocular pain	28	12.6	22	10.5	5	14.7	55	11.8	0.143
Red eye	7	3.2	5	2.4	0	0.0	12	2.6	0.122
Blurred vision	4	1.8	4	1.9	2	5.9	10	2.1	0.612
Lacrimination	6	2.7	3	1.4	0	0.0	9	1.9	0.084
Lung
Cough	32	14.4	29	13.8	2	5.9	63	13.5	0.017
Sputum	17	7.7	20	9.5	4	11.8	41	8.8	0.871
Chest discomfort	16	7.2	12	5.7	2	5.9	30	6.4	0.141
Dyspnea	1	0.5	1	0.5	2	5.9	4	0.9	0.084
Skin
Skin pruritus	10	4.5	9	4.3	2	5.9	21	4.5	0.560
Skin rash	6	2.7	6	2.9	0	0.0	12	2.6	0.227
Skin pain	0	0.0	6	2.9	1	2.9	7	1.5	0.064
Nerve
Fatigue	17	7.7	15	7.1	0	0.0	32	6.9	0.034
Headache	19	8.6	11	5.2	0	0.0	30	6.4	0.003
Dizziness	5	2.3	1	0.5	1	2.9	7	1.5	0.262
Arm/leg claudication	2	0.9	4	1.9	0	0.0	6	1.3	0.903
Stomach
Vomiting	3	1.4	3	1.4	1	2.9	7	1.5	0.947
Other	4	1.8	6	2.9	2	5.9	12	2.6	0.459
Total	222	100.0	210	100.0	34	100.0	466	100.0

^* Chi-square test for trend.

Table 5

Analysis of the individual symptoms according to working time

	Less than 1 hours (N= 28)		1–10 hours (N=272)		More than 10 hours (N=48)		Total		p-value*
	N	%	N	%	N	%	N	%	p-value*
Throat
Throat pain	8	32.0	45	12.6	11	13.3	64	13.7	0.840
Nose
Rhinorreha	2	8.0	23	6.4	7	8.4	32	6.9	0.207
Nasal obstruction	1	4.0	6	1.7	2	2.4	9	1.9	0.726
Nasal pain	0	0.0	3	0.8	0	0.0	3	0.6	0.830
Eye
Ocular pain	4	16.0	45	12.6	6	7.2	55	11.8	0.713
Red eye	1	4.0	10	2.8	1	1.2	12	2.6	0.663
Blurred vision	0	0.0	7	2.0	3	3.6	10	2.1	0.094
Lacrimination	0	0.0	7	2.0	2	2.4	9	1.9	0.281
Lung
Cough	2	8.0	49	13.7	12	14.5	63	13.5	0.056
Sputum	0	0.0	33	9.2	8	9.6	41	8.8	0.043
Chest discomfort	1	4.0	24	6.7	5	6.0	30	6.4	0.349
Dyspnea	0	0.0	4	1.1	0	0.0	4	0.9	0.803
Skin
Skin pruritus	2	8.0	18	5.0	1	1.2	21	4.5	0.285
Skin rash	1	4.0	9	2.5	2	2.4	12	2.6	0.884
Skin pain	0	0.0	6	1.7	1	1.2	7	1.5	0.623
Nerve
Fatigue	2	8.0	21	5.9	9	10.8	32	6.9	0.039
Headache	1	4.0	23	6.4	6	7.2	30	6.4	0.178
Dizziness	0	0.0	5	1.4	2	2.4	7	1.5	0.189
Arm/leg claudication	0	0.0	6	1.7	0	0.0	6	1.3	0.760
Stomach
Vomiting	0	0.0	3	0.8	4	4.8	7	1.5	0.003
Other	0	0.0	11	3.1	1	1.2	12	2.6	0.844
Total	25	100.0	358	100.0	83	173.2	466	100.0

^* Chi-square test for trend.

Table 6

Analysis of the results of the electrolyte analysis, pulmonary function test, electrocardiography, and chest radiography according to distance from the accident site

Characteristic	Less than 100 m (N=140) Mean ± SD	100 m-1 Km (N=173) Mean ± SD	More than 1 Km (N= 35) Mean ± SD	p-value*
Serum electrolyte
Calcium (mg/dL)	9.41±0.37	9.41±0.37	9.45±0.36	0.579
Phosphorus (mg/dL)	) 3.44±0.70	3.44±0.46	3.37±0.35	0.767
Spirometry^†
FVC (L)	4.50±0.67	4.36±0.75	4.59±0.86	0.019
FVC% (%)	90.57±10.01	90.68±11.35	95.66±11.43	0.019
FEV1 (L)	3.67±0.60	3.55±0.62	3.64±0.67	0.060
FEV1% (%)	91.80±10.97	92.54±11.61	95.60±12.58	0.104
FEV1/FVC	81.63± 6.56	81.58±6.02	79.45±6.05	0.257
FEF25–75 (L)	3.70±1.08	3.59±0.97	3.40±0.97	0.366
FEF25–75% (%)	95.20±24.59	97.57±23.85	94.80±27.98	0.568

^* Adjusted for age, sex, smoking, time of hospital visit, time of working at accident spot, and respirator protector using ANCOVA test.

^† FVC, forced vital capacity; FVC%, FVC percent; FEV1, 1 second forced expciratory volume.

FEV1; FEV1 percent, FEF25-75, forced expiratory flow rate25-75; FEF25-75%; FEF25–75 percent.

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