• Journal of the Korean Institute of Gas
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• v.15 no.3
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• pp.26-30
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• 2011

Instantaneous water heater being not properly installed and not adequately maintained may produce fatal accidents due to carbon monoxide poisoning and suffocation. Insufficient supply of air into the gas appliance for complete burning of the fuel or blocking the outlet of the combustion gas could be a cause to increase carbon monoxide concentration in the exhaust gas of the gas appliance. In this work, the experiments are done with a collected instantaneous water heater using in domestic and the concentration of oxygen near the gas appliance and carbon monoxide in exhaust gas are observed to investigate the risk of instantaneous water heater. The concentration of oxygen near the gas appliance is reduced until 17.7% for the ratio of the ventilation area and floor area being 3.5%. If the outlet of combustion gas is blocked, the carbon monoxide concentration is steeply increasing more than 4,000ppm. Therefore, periodic checking the outlet of combustion gas is more important than vent area to reduce the risk of carbon monoxide poisoning.

• Journal of Medicine and Life Science
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• v.18 no.2
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• pp.25-30
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• 2021

Many people reported suspected food poisoning after consuming food at the same snack bar on June 18, 2020. Thus, an in-depth epidemiological investigation was conducted to identify the infectious agent and establish additional food poisoning prevention measures. The study included people who reported to the local public health center after June 18 with acute gastroenteritis symptoms within 4 days of consuming food from the snack bar. The onset of symptoms and food items consumed by individuals were then investigated via phone calls and on-site visits. Afterward, the infectious agent was identified from human samples (stool or rectal swab) of four restaurant employees and 89 people and from environmental samples (materials, cooking utensils, and water). The analysis revealed that the incubation period ranged from 2 hours to 92 hours, with a median and mode of 16 hours and 12 hours, respectively. Moreover, the epidemic curve had a unimodal shape because of common exposure, which reached its peak on June 18. After monitoring for 8 days, which is more than twice the maximum incubation period of 92 hours, the end of the epidemic was declared on June 28 as no additional cases were reported. Analysis of human and environmental samples revealed Salmonella bareilly of the pulsed-field gel electrophoresis pulsotype SAPX01.017 as the causative agent. Therefore, it was concluded that the food poisoning outbreak was caused by S. bareilly.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.247-254
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• 1999

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

• Journal of agricultural medicine and community health
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• v.40 no.4
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• pp.228-239
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• 2015

Objectives: The purpose of this study was to measure the symptom prevalence of acute pesticide poisoning among farmers in Gyeong-gi province and to investigate the occupational risk factors. Methods: The subjects were 663 farmers using pesticide directly or indirectly and the survey was performed during 2013. 7. 11 - 2014. 8. 27. The data were analyzed by SPSS 21.0. Results: The prevalence of acute pesticide poisoning was 6.63% and dizziness was the most common symptom. Acute pesticide poisoning was related with 'days of pesticide use per year', 'lifetime pesticide application days', 'the number of pesticide mixture' and 'type of farming'. Conclusions: It is necessary to manage and educate the pesticide poisoning-vulnerable group more systematically. Afterward additional study is needed to investigate the farming safety behavior and delicate amount of pesticide exposure.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.42-48
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• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.3
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• pp.336-342
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• 2019

Introduction: An unexpected death was reported in a beginner immediately after starting the work at a plating factory. After the incident, air sampling was performed using a simulation of the situation as it had been at the time. Methods: To evaluate the airborne concentration of hydrogen cyanide, a total of six samples were collected: one personal sample, three area samples, and two background samples (office and outdoors). Hydrogen cyanide measurement was performed according to the standard sampling protocol recommended by the U.S. NIOSH (National Institute of Occupational Safety and Health). Results: The highest concentration of hydrogen cyanide was 0.938 ppm measured in a sample collected from the plating bath area with local exhaust ventilation. This value was approximately 20% of the ceiling occupational exposure limit. The personal sample showed a concentration of 0.135 ppm. Samples collected near the bath in which the incident occurred and a dehydrator showed hydrogen cyanide concentrations of 0.236 ppm and 0.101 ppm, respectively. Hydrogen cyanide was not detected in the background samples (office and outdoors). Conclusions: It is necessary to use proper ventilation systems and respirators in plating factories to prevent acute poisoning. Furthermore, it is important to educate and train new workers dealing with toxic substances.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.127-132
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• 2021

Purpose: It is known that the most common cause of gas poisoning in Korea is suicide attempts by burning ignition coals. Ignition coals are made from waste wood, and studies have been reported that heavy metals are emitted when this coal is burned. However, there was no study on how much heavy metal poisoning occurs in the human body through this, so this study was planned to find out whether the concentration of heavy metals in the blood increased in patients exposed to ignition coal combustion. Methods: From April 2020 to April 2021, blood lead, mercury, and cadmium concentrations were investigated in carbon monoxide poisoning patients who visited one regional emergency medical center in Seoul, and their association with exposure time, source of poisoning, and rhabdomyolysis were investigated. Results: During the study period, a total of 136 carbon monoxide poisoning patients were tested for heavy metals, and 81 cases of poisoning by ignition coal were reported. When comparing poisoning caused by combustion of ignition coal and other substances, there was no difference in the concentrations of lead, mercury, and cadmium in the blood, and there was no difference in the number of patients above the reference range. However, the patients exposed to more than 5 hours of ignition coal gas exposure are more frequent than those in the group less than 5 hours in lead (51.4% vs. 23.9%, p=0.012). Conclusion: Compared to poisoning with other combustible substances, the blood concentration of lead, mercury, and cadmium does not increase further in patients with gas poisoning by ignition coal. However, prolonged exposure may result in elevated levels of lead.

• 한국임상약학회:학술대회논문집
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• 2004.07a
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• pp.64-64
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• 2004

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.95-100
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• 2011

Purpose: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. Methods: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients' electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. Results: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. Conclusion: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.33-39
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• 2005

Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.