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Open Access Case report

Hydrogen sulphide inhalational toxicity at a petroleum refinery in Sri Lanka: a case series of seven survivors following an industrial accident and a brief review of medical literature

Mitrakrishnan Chrishan Shivanthan1*, Harshani Perera1, Saroj Jayasinghe12, Panduka Karunanayake12, Thashi Chang12, Sujatha Ruwanpathirana1, Nilwala Jayasinghe1, Yamini De Silva1 and Dinushka Jayaweerabandara1

Author Affiliations

1 National Hospital of Sri Lanka, Colombo, Sri Lanka

2 Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

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Journal of Occupational Medicine and Toxicology 2013, 8:9  doi:10.1186/1745-6673-8-9

Published: 11 April 2013

Abstract

This case series details clinical observations in 7 survivors of accidental hydrogen sulphide inhalation toxicity at a petroleum refinery in Sri Lanka. One survivor developed status epilepticus and severe neurotoxicity whilst another survivor developed delayed respiratory failure; both patients required intensive care management. One victim manifested mild bronchospasms in the immediate post-exposure period and another developed mild perioral numbness 2 days following the exposure. A brief literature review explores the manifestations, pathophysiology and available modalities of treatment of hydrogen sulphide inhalation toxicity.

Hydrogen sulphide (H2S) is a highly toxic gas. Accidental deaths following H2S exposure is a known hazard amongst petroleum workers exposed to by-products of refineries. Toxicity results mainly due to cellular respiratory poisoning which impairs oxidative phosphorylation. The heart, brain and the lungs are the organs most commonly affected in H2S inhalational toxicity leading to varied clinical presentations.

Keywords:
Hydrogen Sulfide/Sulphide; H2S; Petroleum; Inhalation; Toxicity; Industrial accident