甲苯造成急性中毒之病例報告及文獻回顧

A Case Report of Toluene Intoxication

陳一中(Y. C. Chen) ； 陳永煌(Y. H. Chen) ； 蘇文麟(W. L. Su) ； 劉紹興(S. H. Liou)

《中華職業醫學雜誌》 5卷2期 (1998/04) Pp. 111-116

https://doi.org/10.30027/CJOM.199804.0003

摘要

甲苯(toluene,methybenzen)為具揮發性的芳香烴化合物，在現代的日常生活中被應用在各種有機代學成品，如油漆、染料、塗漆、汽油、黏著劑等溶劑中都含有甲苯。二位二十歲左右男性，從事大樓之防水粉刷工程，在粉刷電梯間時被發現昏到在密閉空間內，送達醫院時呈現急性呼吸衰竭的現象，實驗室檢查出現呼吸性酸中毒、白血球升高、高血糖等現象。給予呼吸機及輸液等治療回復正常。此種甲苯中毒的類似情形並不少見，只是程度上有所差異，從略感不適到昏迷至死均可能發現，因其可恢復性而被忽略，所以本文希望能籍著此一病例之報告，能使甲苯在職業性及日常生活使用上所可能造成的危害被重視。

關鍵字

甲苯 ； 急性呼吸衰竭 ； 呼吸性酸中毒

並列摘要

Several studies of people exposed for extended petiods to toluene were undertaken in the late 1980s, as a result of the well-established behavioral effects of acute exposure and the abuse potential of this widely used industrial chemical. However, published reports have identified relatively few significant differences between exposed and referent populations. Iregren found differences between 38 rotogravure printers (exposed daily to 50 ppm at the time of the study but to about 150 ppm in prior years) and 38 electronics workers (control data gathered earlier)on a test of simple reaction time, and Cherry and colleagues reported coordination (grooved pegboard speed) and reading deficits in 49 rubberized mat workers (exposed daily to about 100 ppm but with peak exposures up to 500 ppm in prior years) as compared to 59 manual labcrers not exposed to toluene. Hanninen’s group observed greater distractibility (embedded figures) and poorer performance in a test of spatial relations (block design) in 43 rotogravure printers (exposed to a mean of 117 ppm toluene)as compared with offset (unexposed)printers. Orbaek and Nise found a broad range of deficits in a study of 30 printers exposed to toluene (43 ppm in one company and 157 ppm in a second company) when compared to 72 referents in various manufacturing occupations. Deficits in coding (digit symbol), memory (Benton visual retention), and vocabulary (synonyms)were reported. Foo and Colleagues found significant behavioral effects in 30female electronics workers exposed to a mean of 80 ppm toluene when compared to coworkers with much lower exposures (13 ppm). The effects were correlated with measured dose level for digit span, digit symbol, visual reproduction, Benton visual retention, rrooved pegboard, and trail making.

並列關鍵字

toluene ； respiratory failure ； respiratory acidosi