In recent Japan, there happen 20 fatal occupational accidents per year due to exposure to toxic substances. Itis only a tiny percentage for < 2% of whole fatal occupational accidents of >1,000 per year. Consequently, the risks posed by toxic substances in occupational setting have not been fully recognized. Fluoride compounds are used in a wide range of applications throughout downstream industries. Hereby, we describe occupational fluoride compound intoxication cases caused by HF gas inhalation exposure, contact with HF solutions and 1,1,2,3,3-pentafluoro-3-chloropropene (Perfluoroallyl chloride; PFAC) gas inhalation.

A 52-year old worker manufacturing electric condenser cylinders showed severe dyspnea after metal surface cleaning with HF. On arrival at the emergency medical center, X-ray of both his lungs and computed tomography (CT) image showed a fine diffuse veiling over pulmonary fields due to HF chemical pneumonia. Laboratory tests revealed severe hypokalemia of 8.1mg/dL, high serum F of 74.6μg/L, and high urine F of 80mg/L. He was immediately given 5% calcium gluconate solution by intermittent positive-pressure breathing (IPPB), utilizing a nebulizer. He was discharged on the 22^nd hospital day with much improved condition.

A 65-year-old worker was suffered a third-degree skin burn to 5% of his total body surface area with HFsolution that splashed in his face during maintenance of HF liquefying tank pipes. He died shortly thereafter without having received adequate first aid. His serum fluoride concentration was markedly increased at 6.38 mg/dl with hypocalcemia and hyperkalemia.

Fluoride ions from HF can be absorbed into the body, rapidly bind to calcium and result in hypocalcemia. With the onset of clinical hypocalcemia, heart function is impaired and resulting in cardiac dysrhythmia. Calcium gluconate is very effective and the only HF poisoing detoxication drug.

A 39-year-old man was accidentally exposed to PFAC gas while performing chemosynthesis of polymer electrolyte membrane fuel cell (PEMFC). He felt symptoms such as a cold 1-2 hours after he carried out chemical experiment. When he was admitted to hospital and his chest X-ray and computed CT image revealed evidence of pleuritis. Although pulse steroid and antibiotics therapywas started, he expired on the 18^th post exposure day with severe pneumothorax.

There is no direct evidence that he was exposed to PFAC gas and specific mechanism of PFAC toxicity still remains poorly understood except that fluorocarbon derivatives cause flu-like symptoms (polymer fume fever), however, circumstantial evidences of the onset of symptoms, diagnoses of chemical pneumonia, and his entire clinical course strongly suggest the PFAC gas exposure accident.

The present cases indicate that personal protective equipments are essential and an adequate method of emergency first aidtreatment for accidental poisoning is necessary.

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