Serkan Yılmaz, Murat Pekdemir, Elif Yaka

Kocaeli University Medical Fakulty, Emergency Department, Kocaaeli

Keywords: occupational exposure, emergency treatment, toluene


Background: Occupational exposure to hazardous materials is a serious problem in developing countries. Unfortunately, the different presentations result in nonspecific clinical syndromes, making diagnosis difficult.
Aims: We discuss lessons learned during the assessment and treatment of occupational exposure in two industrial workers.
Case Report: Two employees of a facility that manufactures plastic floor covering were admitted to the emergency department (ED) with complaints including inability to ambulate, lethargy and dizziness. It was thought that the patients’ neurological symptoms resulted from toxic encephalitis and refractory hypokalemia due to renal medullary damage. No material safety data sheets were available for consultation, and the authorities at the manufacturing facility were unable to provide reliable information about the material involved. On-site exposure evaluation was not performed and these conditions made the exact etiology of the patients’ condition unclear. It was thought that toluene, which was used as a solvent during the manufacture of vinyl fluoride, could be responsible for the existing clinical condition. Both patients were treated symptomatically and discharged with minor cognitive impairment, which was assessed during follow-up.
Results and Conclusion: Various difficulties were experienced during the management of patients suffered from occupational exposure. Material safety data sheets for industrial chemicals should be available at manufacturing plants. On-site exposure evaluation would be useful for more accurate assessment of exposed patients.