Acute health effects after exposure to chlorine gas released after a train derailment.
Acute health effects after exposure to chlorine gas released after a train derailment.
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DOI：
10.1016/j.ajem.2007.12.006
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Moolenaar RL
中科院分区：
文献类型：
--
作者：
Van Sickle D;Wenck MA;Belflower A;Drociuk D;Ferdinands J;Holguin F;Svendsen E;Bretous L;Jankelevich S;Gibson JJ;Garbe P;Moolenaar RL
2005年1月，一列火车在南卡罗来纳州一家纺织厂的场地上出轨，在一个小镇的中心释放了42至60吨氯气。对病历和尸检报告进行了审查，以描述因氯气暴露而住院或死亡的患者的临床表现、住院过程和病理学。有8人在到达医院之前死亡;在因接触氯而对健康造成严重影响而住院的71人中，有1人在医院死亡。住院患者的平均年龄为40岁（范围：4个月-76岁）; 87%为男性。中位住院时间为4天（范围：1-29天）。25人（35%）入住重症监护室;平均住院时间为3天。许多幸存的受害者出现了显著的肺部体征和严重的气道炎症; 41名（58%）住院患者符合急性呼吸窘迫综合征或急性肺损伤的Po 2/FiO 2标准。在住院期间，40例（57%）出现异常X线检查结果，其中74%在第一天内出现。根据住院时间和重症监护支持的需要，室内空气缺氧和Po 2/FiO 2比值可预测结局的严重程度。这种社区释放的氯气造成了广泛的接触，并导致了严重的急性健康影响和大量的医疗保健需求。脉搏血氧饱和度和动脉血气分析提供了预后严重程度的早期指标。
In January 2005, a train derailment on the premises of a textile mill in South Carolina released 42 to 60 tons of chlorine gas in the middle of a small town. Medical records and autopsy reports were reviewed to describe the clinical presentation, hospital course, and pathology observed in persons hospitalized or deceased as a result of chlorine gas exposure. Eight persons died before reaching medical care; of the 71 persons hospitalized for acute health effects as a result of chlorine exposure, 1 died in the hospital. The mean age of the hospitalized persons was 40 years (range, 4 months-76 years); 87% were male. The median duration of hospitalization was 4 days (range, 1-29 days). Twenty-five (35%) persons were admitted to the intensive care unit; the median length of stay was 3 days. Many surviving victims developed significant pulmonary signs and severe airway inflammation; 41 (58%) hospitalized persons met Po2/Fio2 criteria for acute respiratory distress syndrome or acute lung injury. During their hospitalization, 40 (57%) developed abnormal x-ray findings, 74% of those within the first day. Hypoxia on room air and Po2/Fio2 ratio predicted severity of outcome as assessed by the duration of hospitalization and the need for intensive care support. This community release of chlorine gas caused widespread exposure and resulted in significant acute health effects and substantial health care requirements. Pulse oximetry and arterial blood gas analysis provided early indications of outcome severity.
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影响因子：
1.9
作者：
DAS, R;BLANC, PD
通讯作者：
BLANC, PD
影响因子：
24.3
作者：
Lemiere, C;Malo, JL;Boutet, M
通讯作者：
Boutet, M
DOI：
10.1016/s0361-1124(79)80038-6
发表时间：
1979-01-01
期刊：
JACEP-JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
影响因子：
--
作者：
HEDGES, JR;MORRISSEY, WL
通讯作者：
MORRISSEY, WL
影响因子：
4.9
作者：
Leroyer, C;Malo, JL;Gautrin, D
通讯作者：
Gautrin, D
影响因子：
9.6
作者：
SCHWARTZ, DA;SMITH, DD;LAKSHMINARAYAN, S
通讯作者：
LAKSHMINARAYAN, S