Annals of Occupational and Environmental Medicine

Chang Hwan Lee

2 Articles

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline: Chang Hwan Lee, Soo Hyeon Kim, Do Hyung Kwon, Keun Ho Jang, Yong Hoon Chung, Jai Dong Moon; Ann Occup Environ Med 2013;25:31-31. Published online November 1, 2013; DOI: https://doi.org/10.1186/2052-4374-25-31

Objective

To report two cases of methemoglobinemia induced by inhaled nitrobenzene and dermally absorbed aniline.

Methods

We have evaluated a 37-year-old male worker exposed to nitrobenzene by inhalation while conducting maintenance job of mononitrobenzene pump and a 25-year-old male worker exposed dermally to aniline while unloading.

Results

The first case is a 37-year-old male exposed to nitrobenzene. His blood methemoglobin concentration level was initially 19.8%, and chest X-ray was normal. After oxygen therapy, the blood methemoglobin concentration level decreased to 2.1%, and the symptoms were alleviated. The second case is a 25-year-old male exposed dermally to aniline. His chest X-ray was normal, but blood methemoglobin concentration level reached maximally 46.8%. He was treated with methylene blue due to relatively high blood methemoglobin level. Gradually after the treatment, his methemoglobin concentration level was normalized to 0.8% and simultaneously symptoms were resolved.

Conclusions

After the thorough exposure investigations and medical evaluations, we have concluded that these cases were methemoglobinemia induced by occupational exposure to nitrobenzene and aniline. We suggest that businesses which handle methemoglobinemia-causing substances control the engineering process strictly, implement periodic screening, and establish emergency patient management system.

Citations

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Methaemoglobinaemia: a potential confounder in COVID-19 respiratory failure
Yang Lin Ting, Jonathan Zhao Min Lim, Pei Ming Yeo, Wen Yuan Sim
Singapore Medical Journal.2024; 65(Suppl 1): S24. CrossRef
Methaemoglobinaemia due to nitrobenzene poisoning
K. Chandrasekhar, P. Chandana Sree, Bhattaram Siddhartha Kumar, Mounika Nemilete
Journal of Clinical and Scientific Research.2023; 12(Suppl 2): S123. CrossRef
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Herbicide poisoning assocaited methhemoglobinemia as a cause of hypoxia — approach & emergency management — A case report
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Physiology-based toxicokinetic modelling in the frame of the European Human Biomonitoring Initiative
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Environmental Research.2019; 172: 216. CrossRef
Methemoglobinemia Following Monolinuron Ingestion
Guillaume Mortamet, Mehdi Oualha, Sylvain Renolleau, Christian Moesch, Jean-Marc Treluyer
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Methemoglobinemia resulting from exposure in a confined space: Exothermic self-polymerization of 4,4′-methylene diphenyl diisocyanate (MDI) material
Philip A. Smith, Jeffrey Lodwick, Joe Dartt, Jenny R. Amani, Kathleen M. Fagan
Journal of Occupational and Environmental Hygiene.2017; 14(1): D13. CrossRef
Unintentional mass sodium nitrite poisoning with a fatality
Changhwan Lee, Eun Jung Jang, Hyesun Yum, Young Shik Choi, Jeongik Hong
Clinical Toxicology.2017; 55(7): 678. CrossRef
Crystal structure of bis(prop-2-yn-1-yl) 5-nitroisophthalate
K. S. Ezhilarasi, Sivasamy Selvarani, Perumal Rajakumar, B. K. Revathi, G. Usha
Acta Crystallographica Section E Crystallographic Communications.2015; 71(6): o435. CrossRef
The painted shoes
Natália Noronha, André Rosa Alexandre, Joana Cavaca Santos, Fernanda Rodrigues
BMJ Case Reports.2015; : bcr2015210619. CrossRef

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A Suspicious Case of Chloroform Induced Acute Toxic Hepatitis in Laboratory Worker: Dae Gwang Lee, Chang Hwan Lee, Keun Ho Jang, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2012;24(3):304-310. Published online September 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.3.304

Abstract PDF

OBJECTIVES
To report upon a case of toxic hepatitis in a worker exposed to chloroform.
METHODS
A 28-year-old female who had worked as chemical analysis engineer in a laboratory using chloroform was hospitalized due to nausea, vomiting and generalized weakness. The authors evaluated her using blood tests, abdominal CT scan and her occupational history.
RESULTS
The blood tests revealed acute toxic hepatitis. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis could be excluded. But autoimmune hepatitis couldn't be totally ruled out(ANA (++), IgG(serum) 1780 mg/dL). After admission, her symptoms improved and her liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Afterwards, however, her liver enzyme levels increased again one week after returning to her workplace. Subsequent to a job change, her liver enzyme levels reduced and normalized after eight weeks. The airbone laboratory chloroform ranged from 3.155 to 9.037 ppm.
CONCLUSIONS
The authors presume that this patient's liver injury was related to an interaction of chloroform toxicity and a predisposition to autoimmune hepatitis. The rapid improvement of the clinical symptoms and the progressive normalization of the liver function tests once the chloroform exposure eliminated supports the diagnosis.

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Acute liver injury in two workers exposed to chloroform in cleanrooms: a case report
Young Joong Kang, Jungho Ahn, Yang-In Hwang
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef

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