Acute dermal and inhalation exposure

A 52 year old man who worked in a fabric coating plant was splashed over approximately 20% of his body surface with DMF when a machine malfunctioned. He washed the DMF from his skin put on the same clothes and drove home. He noticed that the odour of DMF was strong in the car. He had dermal irritation and hyperaemia as the only immediate effects. Then, 62 hours after the incident, he developed epigastric pain of increasing severity and vomiting. On examination, he was hypertensive. Despite severe abdominal pain there was no tenderness or rigidity. He complained of weakness and inco-ordination but there were no objective neurological changes. Liver function tests showed that bilirubin, AST and ALT were elevated. These had been normal on routine testing less than 2 months earlier. Prothrombin time, amylase, lipase and alkaline phosphatase, chest X-ray and urine analyses were normal. He had leucocytosis. His symptoms resolved within 4 days. A liver biopsy 11 days after the incident revealed minimal septal fibrosis and accumulations of mononuclear cells (Potter, 1973).

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