Hydrofluoric Acid Burns: A Case Report

반도체 공장에서 발생한 불산에 의한 화학화상 1예

  • Lee, Ji-Eun (Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Suh, Byung-Seong (Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jo, Chan-Ho (Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Won-Cheol (Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 이지은 (성균관대학교 의과대학 강북삼성병원 산업의학과) ;
  • 서병성 (성균관대학교 의과대학 강북삼성병원 산업의학과) ;
  • 조찬호 (성균관대학교 의과대학 강북삼성병원 산업의학과) ;
  • 이원철 (성균관대학교 의과대학 강북삼성병원 산업의학과)
  • Published : 2011.06.30

Abstract

Background: Hydrofluoric acid_(HF) is widely used in many industrial and domestic settings such as etching glass, and polishing metals. HF is one of the most corrosive inorganic acids and can produce progressive and serious tissue necrosis with severe pain. Since HF chemical burns can be asymptomatic for the first few hours, it is crucial to understand its toxicity and the early use of antidote. Case: A 37-year-old man presented with erythematous lesion and pain on his face, anterior neck, both forearms, both thighs, and left ankle after injury resulting from a chemical burn caused by HF. He showed normal vital signs and dyspnea, but complained of a sore throat. Liquid form of HF had splashed on his face and anterior neck first and run down his forearms and thighs while working at HF supply tanks. Some of the HF was splashed into his mouth. He immediately removed his clothes and showered with abundant water. A 4.5% calcium gluconate jel was applied to the involved area. He was given subcutaneous injection of 10% calcium gluconate solution. During 17 days of admission he didn't show any signs of systemic intoxication or deep tissue defects. Conclusions: Immediate cleansing of the affected area with running cold water is the first critical treatment for a chemical burn due to HF. Applying calcium gluconate gel within one hour was very effective for preventing further damage to the injured area as well as systemic injury. In order to reduce the risk of accident and perform first-aid treatment quickly, it is imperative to provide workers with safety education and establish safety facilities.

배경: 불산은 여러 산업영역에서 유리의 식각, 금속의 체척 등에 광범위하게 쓰이고 있다. 부식성이 큰 무기산인 불산에 노출되면 극심한 통증을 동반한 화학 화상과 지속적이고 심각한 조직 괴사에 빠질 수 있다. 불산에 의한 화상은 초기에 증상이 없을 수 있으므로 불산의 독성에 대한 이해와 안티도트를 이용한 빠른 치료가 필수적이다. 증례: 37세 남자가 얼굴, 목, 양쪽 팔 배면, 양쪽 허벅지 앞면, 왼쪽 발목의 통증과 발적성 병변을 주소로 응급실에 방문하였다. 생체 활력 징후는 정상이었고 목 따가움과 숨 가쁨을 호소하였다. 불산을 공급하는 장치에서 일하던 중 액체 형태의 불산이 얼굴과 목에 튄 후 양 팔과 다리로 흘렀으며 입 안에도 조금 들어갔다고 진술하였다. 사고 후 즉시 옷을 벗고 물로 세척하였으며 사업장 부속 의원에서 4.5% 칼슘 글루코네이트 겔을 도포하였다. 응급실 내원 후 10% 칼슘 글루코네이트 용액을 수상 부위에 피하 주사 하였다. 17일간의 입원 기간 동안 급성 독성이나 심부 조직 및 뼈의 손상은 관찰되지 않았다. 결론: 불산에 의한 화학화상의 첫 번째 치료는 즉각적 인 세척이다. 빠른 시간 내에 칼슘 글루코네이트 겔을 수상 부위에 도포하면 추가적인 조직손상이나 전신 합병증을 막을 수 있다. 사고 위험을 줄이고 즉각적인 응급처리를 위해서는 근로자들의 안전교육 및 보다 적절한 안전장치가 필요하다.

Keywords

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