| An Unusual Case of Organophosphate Intoxication of a Worker in a Plastic Bottle Recycling Plant: An Important Reminder Chao-Ling Wang,1,2 Hung-Yi Chuang,3 Chen-Yang Chang,3 Shao-Tuan Liu,3 Ming-Tsang Wu,2,4 and Chi-Kung Ho2,3 1Department of Family Medicine, Yuan's General Hospital, Kaohsiung, Taiwan
2Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan
3Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
4Division of Environmental Health and Occupational Medicine, National Health Research Institute, Kaohsiung, Taiwan Abstract
A young man was sent to our emergency unit because he had suffered from vomiting and cold sweating for 2 days. At the time he was admitted, he had no acute abdominal pains or gastrointestinal symptoms, and a physical examination revealed nothing but a faster heart rate and moist, flushing skin. The patient had worked for 6 years at a plastic bottle-recycling factory, but none of his co-workers had the same symptoms. Nevertheless, because the plant also recycled pesticide bottles, we suspected organophosphate pesticide intoxication. The patient's plasma acetylcholinesterase level was checked, revealing 1498.6 µU/L (normal range: 2,000-5,000) on the first day and 1,379 µU/L on the second day. Upon questioning, the patient recalled that one of his shoe soles had been damaged and that his foot had been wet from walking all day in rain collected on the factory floor on the day that his symptoms first occurred. We conducted a study in the change of preshift and postshift acetylcholinesterase levels among six of his co-workers on a rainy day. We used the Wilcoxon signed rank test to compare the preshift and postshift plasma acetylcholinesterase levels ; no significant difference was revealed (p = 0.600) , leaving contamination via the damaged shoe sole suspect. We reviewed the literature on organophosphate intoxication ; pesticide bottle-recycling factories were reported to be at a low risk of organophosphate toxicity in the working environment. However, because the potential risk of intoxication is still present, protective equipment such as clothing, gloves, and water-proof shoes should be worn, and employees should be educated on the potential risks. Key words: organophosphate, personal hygiene, plastic recycling. Environ Health Perspect 108:1103-1105 (2000) . [Online 27 October 2000] http://ehpnet1.niehs.nih.gov/docs/2000/108p1103-1105wang/ abstract.html Address correspondence to C-K Ho, Department of Occupational Medicine, Kaohsiung Medical University Hospital, 100 Shih-Chuang First Road, Kaohsiung City 807, Taiwan. Telephone: +886-7-3115974. Fax: +886-7-3115948. E-mail: kmco6849@ms14.hinet.net We appreciate the cooperation of workers and employers. This work was supported by the Department of Health, the Executive Yuan, Taiwan, Republic of China (DOH-89-TD-2106) . Received 11 July 2000 ; accepted 12 September.
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