Work-related chemical exposures presenting to an emergency department in Singapore

Singapore is a small industrialized island state with a low accident rate and few hazardous chemical-related injuries reported. However, the use of chemicals continues to increase and pose hazards in the workplace.

To study workplace chemical injuries and exposures to improve worksite safety.

Work-related chemical exposure cases were identified from emergency department (ED) computerized records from 2007 to 2010.

A total of 239 cases were identified. Most of the patients were male (92%) and young adults (73% aged between 21 and 40 years). Fifty per cent of the workers were foreign workers. Most of them were cleaners, labourers and technicians (53%) and worked mainly in the construction and manufacturing industries (47%). All the exposures were acute and presented within 4h of the exposure incident (52%). Most of the chemical exposures were to the eye (55%) and skin (32%). The chemicals involved included corrosives (41%), hydrocarbons (18%) and cleaning solutions (9%). Pre-hospital decontamination (eye and skin irrigation) was performed for 54% of the workers. Antidote treatment with calcium gluconate for hydrofluoric acid exposure was used for five patients in the ED. Only 11% of patients were admitted. Four patients had surgical procedures and five patients had long-term complications. Forty-five incidents were notified to the Ministry of Manpower. The under-reporting rate for cases with >3 days of medical leave was 66%.

Work-related chemical exposures that present to the ED had low morbidity. Most of the workers did well with immediate decontamination and supportive treatment but antidotes were required for some exposures.