Annals of Occupational and Environmental Medicine

  • Volume 35
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  • Pages.34.1-34.8
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  • 2023
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  • 1225-3618(pISSN)
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  • 2052-4374(eISSN)
The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater

  • Hyeonjun Kim (Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital) ;
  • Seunghyeon Cho (Department of Occupational and Environmental Medicine, Chonnam National University Hospital) ;
  • Inho Jung (Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital) ;
  • Sunjin Jung (Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital) ;
  • Won-Ju Park (Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital)
  • Received : 2023.03.31
  • Accepted : 2023.07.31
  • Published : 2023.12.31
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Abstract

Background: Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident. Case presentation: In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge. Conclusions: We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

Keywords

Acknowledgement

We thank all the members of the Health Promotion Center at Chonnam National University Hwasun Hospital. We thank all the members of the Department of Occupational and Environmental Medicine at Chonnam National University Hwasun Hospital and Chonnam National University Hospital. We wish the patient good health and well-being.

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