Written By: Dr. Jassin Jouria
Several employees from a local glass etching company present to the Emergency Room complaining about progressive shortness of breath and a cough that started earlier this afternoon. All of the employees are young and otherwise healthy without any known medical problems. They each complain of difficulty breathing, worse with exertion, as well as a cough that initially started as dry but now is “pink and frothy”. The emergency room physician, suspecting an inhaled chemical exposure, immediately orders a chest X-ray of the brain to evaluate for pulmonary edema.
One of the many painful injuries one can suffer in the workplace is a chemical spill injury. Chemical spill injuries occur when any body part comes into contact with hazardous chemicals. Hazardous chemicals produce their ill effects in three ways: local action, inhalation, or ingestion.
Chemical Spill Injuries at Workplace-Some Statistics
The Occupational Safety and Health Administration (OSHA) published alarming data regarding workplace chemical injuries. The data suggest that 14,024 fatal and nonfatal occupational chemical injuries occurred in 2012. Needless to say, the number is only increasing day by day.
At-risk Occupations for Chemical Spill Injuries
Although the risk of chemical leakage and spills resulting in serious injuries exist in almost all industrial professions, some occupations are at a far greater risk. These include:
- Chemical Manufacture industry
- Leather Industry
- Agriculture industry
- Mining (coal, copper, and other metals)
- Petroleum industry
Risk of Chemical Spill Injuries at Workplace
The risk of chemical spill injuries can range from toxic fumes and gases inhalation to contact with corrosive acids and alkalis. Acute or chronic exposure to hazardous chemicals results in ill effects on the human body mostly affecting the lungs, eyes, and skin.
At the workplace, the most common hazardous chemical groups include:
- Acids
- Alkalis
- Hydrocarbon derivatives
- Metallic dust
- Agricultural chemicals
- Pesticides
- Coal
- Natural gas
- Petroleum fuels
What Does the Law Say About Chemical Spill Injuries in the Workplace?
The Occupational Safety and Health Administration (OSHA) has designed the Hazard Communication Standard (HCS). The HCS aims at ensuring that all at-risk workers are adequately informed about all the toxic, hazardous chemicals in their workplace. Furthermore, it aims at ascertaining the provision of Personal Protective Equipment (PPE). The HCS also has set the minimum exposure levels of different toxic chemicals. An emergency management protocol has been established. These protocols are to be followed in case of accidental spillage, inhalation, or ingestion of any toxic chemical.
Types of Chemical Injuries at Workplace
Although toxic chemicals produce a wide variety of injuries in the workplace, they are classified into three main types.
Occupational Lung Diseases
Occupational lung diseases result from long-term exposure to toxic gases that adversely affect the lungs causing inhalation injuries. Sometimes, even a single exposure to toxic fumes can result in devastating lung problems. These industrial gases and fumes mainly produce the following pathologies in the lungs:
- Inflammation
- Lung scarring
- Stiffening of lung tissue
The clinical manifestations in the exposed workers are:
- Productive or non-productive cough
- Chest pain and tightness
- Shortness of breath
- Irregular breathing patterns
- Even increased risk of lung cancer
Steps in Management of Occupational Lung Diseases:
There is no definite cure for lung problems resulting from inhalation of toxic chemicals and gases at the workplace. However, the most important factor in improving the prognosis of such diseases is preventing further exposure and inhalation. A few methods can help reduce the risk, such as:
- Using personal protective equipment (PPE). All employees should use PPE when working with toxic fumes or chemicals.
- Ensuring the use of face masks and respirators
- Make sure that adequate ventilation is present in the workplace all the time
- Strictly avoiding smoking. Smoking and occupational exposure to chemicals significantly increase the risk of lung cancer.
Occupational Ocular Injuries
Ocular injuries are caused by the contact or spillage of toxic chemicals in the eye. The severity of ocular chemical injuries varies with the most threatening symptom being profound visual consequences.
Usually, alkalis are a more common cause of ocular injuries than acids. Ammonia is the most toxic alkali that can cause ocular injuries. Symptomology of alkali ocular injuries is more severe since the penetration is greater. The corneal epithelium gets corroded followed by penetration into deeper layers of the eye.
Acids cause much more localised ocular surface injuries. They mainly cause denaturation and coagulation of proteins in the eye. Acid injuries mainly include opacification of the lens and uveitis.
Steps in Management of Ocular Chemical Injuries:
Ocular chemical injuries can present as an ophthalmic emergency. It is therefore important to appropriately manage such cases. Timely treatment can reduce the risk of blindness and handicap. These measures include:
- Irrigate the eye with a copious amount of water or normal saline. Do not wait to get to a hospital. Try to rinse off as much chemical as you can using plain tap water.
- Wash the hands and eyes thoroughly with soap
- Remove contact lenses as they can irritate the eyes even more
- Always wear safety goggles or eye shields while working with chemicals.
- Seek medical attention as soon as you can. Eyes are sensitive body parts and you should not take any chances if you experience chemical ocular injuries.
Occupational Chemical Burn Injuries
Burn injuries resulting from chemical exposure are one of the most common types. These injuries result from cytotoxic and corrosive chemicals. These chemicals act on the skin and mucosal lining (mouth or genitals). They are classified into acid burns, alkali burns, phosphorus burns, etc.
Steps in Management of Chemical Burn Injuries:
- Remove all articles of clothing
- Make sure you get to a safe place. Make sure you get away from all the chemicals.
- Wash the wound site with a large amount of water.
- Relieve pain by analgesics.
- If the chemicals have come into contact with a large body surface, seek medical attention immediately.
You should also let your employer and occupational health department know about the incident. This will allow the employer to make changes to the workplace.
Meet the Author Dr. Jassin Jouria
Dr. Jassin Jouria is a practicing Emergency Medicine Physician who specializes in resuscitation of critical patients. The majority of his clinical work is at the Decatur County Memorial Hospital Emergency Department in Greensburg, Indiana. Learn More About the Author.
References:
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- https://journals.sagepub.com/doi/10.1177/2165079915576924
- https://www.mayoclinic.org/first-aid/first-aid-chemical-burns/basics/art-20056667#:~:text=Chemical%20burns%20are%20tissue%20damage,caused%20by%20a%20milder%20chemical.
- https://www.osha.gov/chemical-hazards
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