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Case Report
- A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process
- Jong Hyun Hwang, Jung Il Kim
- Ann Occup Environ Med 2022;34:e22. Published online August 29, 2022
- DOI: https://doi.org/10.35371/aoem.2022.34.e22
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Abstract
Abstract in Korean
PDF Background Several cases of chloroform-induced hepatotoxicity have been reported worldwide, but only 2 cases have been reported in Korea. We encountered a case of toxic hepatitis due to chloroform exposure in February 2022 and report the diagnosis process and clinical findings.
Case presentation A 38-year-old employee in charge of the coating after washing (degreasing) at an automotive parts manufacturer complained of jaundice and was diagnosed with acute toxic hepatitis. After the initial diagnosis, he continued to work, his symptoms worsened, and he was hospitalized for 8 days. Liver ultrasonography (elastography) revealed acute hepatitis. The washing agent contained chloroform, which was not listed on the materials safety data sheet, and the concentrations of chloroform in the workplace were up to 4.7 times the time-weighted average.
Conclusions This patient showed typical toxic hepatitis with chloroform; further follow-up studies are required. Both employers and workers should be aware of information on toxic substances and take precautions to avoid exposure.
- 자동차 부품 제조사의 코팅 공정에서 클로로포름에 의해 발생한 독성 간염 1례
배경
클로로포름에 의해 유발된 간 독성은 세계적으로 적은 건수의 보고가 있었으며 국내에서는 단 2건만 보고되었다. 저자는 2022년 2월, 클로로포름으로 인한 독성간염 발생 1예를 경험하였고, 이에 대한 진단과정 및 임상소견을 보고하고자 한다.
사례 보고: 자동차 부품업체에서 세척(탈지) 후 코팅을 담당하는 38세 직원이 황달을 주소로 내원하여 급성독성간염 진단을 받았다. 초기 진단 후에도 계속 업무에 종사하뎠고 증상이 악화되어 8일간 입원 치료하였다. 간 초음파 검사(탄성조영술)에서 급성 간염이 관찰되었다. 세척제에는 MSDS에 등재되지 않은 클로로포름이 포함되어 있으며 작업장 내 클로로포름 농도는 TWA의 4.7배까지 검출되었다.
토의 및 결론: 이 사레는 클로로포름에 의한 전형적인 독성간염을 보여 주었으며 추후 지속적인 추적관찰이 필요하다. 저자는 고용주와 근로자 모두 독성 물질에 대한 정보를 정확히 인식하고 노출을 피하기 위한 예방 조치를 취해야 한다고 강조한다. -
Citations
Citations to this article as recorded by
- Occupational disease monitoring by the Korea Occupational Disease
Surveillance Center: a narrative review
Dong-Wook Lee, Inah Kim, Jungho Hwang, Sunhaeng Choi, Tae-Won Jang, Insung Chung, Hwan-Cheol Kim, Jaebum Park, Jungwon Kim, Kyoung Sook Jeong, Youngki Kim, Eun-Soo Lee, Yangwoo Kim, Inchul Jeong, Hyunjeong Oh, Hyeoncheol Oh, Jea Chul Ha, Jeehee Min, Chul
The Ewha Medical Journal.2025;[Epub] CrossRef - Morbidity of aircraft workers with temporary disability
Olga A. Molchanova, Olga G. Bogdanova, Vladimir A. Pankov, Mikhail Yu. Itygilov
Hygiene and sanitation.2023; 102(8): 836. CrossRef
- Occupational disease monitoring by the Korea Occupational Disease
Surveillance Center: a narrative review
- 2,336 View
- 10 Download
- 1 Web of Science
- 2 Crossref
Case Report
- Acute liver injury in two workers exposed to chloroform in cleanrooms: a case report
- Young Joong Kang, Jungho Ahn, Yang-In Hwang
- Ann Occup Environ Med 2014;26:49. Published online November 4, 2014
- DOI: https://doi.org/10.1186/s40557-014-0049-5
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Abstract
PDF
We report 2 cases of hepatotoxicity in cleanroom workers due to high retained chloroform air concentrations. The women, aged 34 and 41 years, who had been working in a medical endoscopic device manufacturer as cleanroom workers for approximately 40–45 days suffered severe liver damage. Two measured time-weighted averages of the chloroform concentration in the air in the cleanroom were 82.74 and 64.24 ppm, which are more than 6 times the legal occupational exposure limit in Korea. Only 7% of the cleanroom air was newly introduced from outside. The clinical courses of these cases and workplace inspection, led us to conclude that both cases of hepatotoxicity were caused by chloroform exposure.
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Citations
Citations to this article as recorded by- Cytotoxicity and genotoxicity evaluation of chloroform using Vicia faba roots
Xue Li, Ang Li, Ming Zhang, Tianpeng Gao
Toxicology and Industrial Health.2023; 39(10): 603. CrossRef - Acute liver injury in a non-alcoholic fatty liver disease patient with chloroform exposure: a case report
Yosuke Suehiro, Takuro Uchida, Masataka Tsuge, Eisuke Murakami, Daiki Miki, Tomokazu Kawaoka, Michio Imamura, Hiroshi Aikata, Koji Arihiro, Shiro Oka
Clinical Journal of Gastroenterology.2023;[Epub] CrossRef - A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process
Jong Hyun Hwang, Jung Il Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef - Exposure to organic solvents and hepatotoxicity
Cristiano Brauner, Dvora Joveleviths, Mário R. Álvares-da-Silva, Norma Marroni, Silvia Bona, Elizângela Schemitt, Raissa Nardi
Journal of Environmental Science and Health, Part A.2020; 55(10): 1173. CrossRef - Chronic, Recreational Chloroform-Induced Liver Injury
Emily A. Minor, Mackenzie S. Newman, Justin T. Kupec
Case Reports in Hepatology.2018; 2018: 1. CrossRef - 3-methyadenine attenuates chloroform-induced hepatotoxicity via autophagy activation
Lei WANG, Xiankui LI, Cai CHEN
Biomedical Research.2018; 39(2): 87. CrossRef - Chloroform ingestion causing severe gastrointestinal injury, hepatotoxicity and dermatitis confirmed with plasma chloroform concentrations
Dushan Jayaweera, Shawkat Islam, Naren Gunja, Chris Cowie, James Broska, Latesh Poojara, Michael S. Roberts, Geoffrey K. Isbister
Clinical Toxicology.2017; 55(2): 147. CrossRef
- Cytotoxicity and genotoxicity evaluation of chloroform using Vicia faba roots
- 602 View
- 4 Download
- 7 Web of Science
- 7 Crossref
Case Report
- 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
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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. -
Citations
Citations to this article as recorded by- Assessing Structural and Optical Properties of PTQ10-Based Donor Polymers in Solution for Eco-Friendly Photovoltaics: A Multiscale Modeling Study
Rafael B. Ribeiro, Leandro R. Franco, Alexandre Holmes, Tárcius N. Ramos, Ergang Wang, Márcio T. do N. Varella, C. Moyses Araujo
The Journal of Physical Chemistry B.2025; 129(23): 5887. CrossRef - Recent advances in non-fullerene organic photovoltaics enabled by green solvent processing
Shilin Li, Hong Zhang, Shengli Yue, Xi Yu, Huiqiong Zhou
Nanotechnology.2022; 33(7): 072002. CrossRef - A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process
Jong Hyun Hwang, Jung Il Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef - Aliphatic Halogenated Hydrocarbons: Report and Analysis of Liver Injury in 60 Patients
Rolf Teschke
Journal of Clinical and Translational Hepatology.2018;[Epub] CrossRef - A Study on Fabrication of 3D Dual Pore Scaffold by Fused Deposition Modeling and Salt-Leaching Method
Hae-Ri Shim, Jong Young Kim
Transactions of the Korean Society of Mechanical Engineers A.2015; 39(12): 1229. CrossRef - 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
- Assessing Structural and Optical Properties of PTQ10-Based Donor Polymers in Solution for Eco-Friendly Photovoltaics: A Multiscale Modeling Study
- 269 View
- 1 Download
- 6 Crossref
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