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An Epistaxis Emergency Associated with Multiple Pollutants in Elementary Students.

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Environmental pollution, specifically chromic acid mist and formaldehyde, caused a sudden increase in nosebleeds (epistaxis) among elementary students. Air quality in the school and surrounding areas exceeded safe limits, leading to nasal irritation and bleeding emergencies.

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Area of Science:

  • Environmental Health
  • Epidemiology
  • Occupational Health

Background:

  • Epistaxis emergencies in students due to environmental pollution are rare.
  • A cluster of 22 epistaxis cases occurred in elementary students within 7 days.

Purpose of the Study:

  • To investigate the cause of an epistaxis emergency in elementary students.
  • To identify the environmental factors contributing to acute nasal bleeding in a school setting.

Main Methods:

  • Field epidemiological investigation of epistaxis cases.
  • Air quality monitoring for chromic acid mist (Cr6+), HCL, H2SO4, and formaldehyde.
  • Comparison of nasal mucosa condition between case and control groups.

Main Results:

  • Air concentrations of Cr6+ exceeded emission limits near the school and residential areas.
  • Formaldehyde levels in classrooms surpassed indoor air quality standards.
  • Abnormal nasal mucosa was significantly more prevalent in students exposed to pollutants compared to a control group from an unpolluted area.

Conclusions:

  • Excessive chromic acid mist and formaldehyde exposure likely caused acute nasal mucosal irritation, leading to epistaxis.
  • Pre-existing nasal lesions may increase susceptibility to environmentally induced epistaxis.
  • Lessons on factory siting, emission control, and indoor air quality are crucial for preventing such incidents.