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Inhalational nickel carbonyl poisoning in waste processing workers
Raymond C S Seet1, Azman Johan, Cuthbert E S Teo
1Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. raymond_seet@nus.edu.sg
Chest
|July 9, 2005
Summary
Acute nickel carbonyl poisoning is a severe occupational hazard, often fatal, particularly in subacute cases. Early identification and understanding of its toxic effects are crucial for patient outcomes.
Area of Science:
- Occupational toxicology
- Environmental health
- Pulmonary medicine
Background:
- Nickel carbonyl (Ni(CO)4) is a volatile and highly toxic compound formed from nickel and carbon monoxide.
- Inhalation leads to rapid absorption and systemic distribution, primarily affecting the lungs, brain, adrenal glands, and kidneys.
- Severe acute exposure can be rapidly fatal.
Observation:
- A descriptive study of seven young men with symptoms including fever, chills, chest pain, and dyspnea following suspected nickel carbonyl exposure.
- Clinical and autopsy findings revealed pulmonary consolidation, edema, hemorrhage, and fibrosis.
- Elevated urinary nickel concentrations confirmed exposure, while microbiological investigations were negative for common pathogens.
Findings:
- An unidentified chemical used in nickel waste neutralization was identified as the likely source of exposure.
- Four patients required intensive care unit (ICU) treatment.
- Autopsy findings in three deceased patients demonstrated severe lung damage.
Implications:
- Subacute nickel carbonyl exposure is associated with high mortality.
- Further research is needed to evaluate the efficacy of chelation therapy in managing subacute nickel carbonyl poisoning.
- This study highlights the critical need for stringent safety protocols in industries handling nickel and carbon monoxide.