Accidental acute inhalation

A 25 year old male was overcome by tetrachloroethylene fumes while using it to clean a tank. He wore a general purpose chemical mask and scrubbed the walls with tetrachloroethylene from an open five-gallon bucket. After five minutes the odour became so strong that he left the tank. He removed the mask suspecting it was faulty. He then re-entered the tank but quickly left and put the mask back on to resume work. He was found approximately 10 minutes later unconscious inside the tank. About 30 minutes after he had been removed he was drowsy but well orientated. Vital signs were normal. Neurological examination was also normal except for the Romberg test (swaying of the body when the feet are placed together and the eyes closed). The breath concentration of tetrachloroethylene 90 minutes after cessation of exposure was 105 ppm. This had fallen to less than 5 ppm by 48 hours. LFTs, urinalysis, haematology and a chest X-ray were all normal. He remained drowsy for the rest of the day with fatigue for the next 4 days. There was a mild, transient increase in AST on the 3rd and 4th day and elevation of the urinary urobilinogen on the 9th day (Stewart, 1969).

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