Annals of Occupational and Environmental Medicine

  • Volume 34
  • /
  • Pages.16.1-16.11
  • /
  • 2022
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  • 1225-3618(pISSN)
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  • 2052-4374(eISSN)
The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Electrocardiogram abnormalities in antimony exposed workers in the automotive brake lining manufacturing industry: a case report

  • Ha-ram Jo (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital) ;
  • Seongyong Yoon (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital) ;
  • Jinseok Kim (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital) ;
  • Seong-yong Cho (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital) ;
  • Jong-min An (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital) ;
  • Gayoung Kim (Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital)
  • Received : 2022.02.10
  • Accepted : 2022.06.14
  • Published : 2022.12.31
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Abstract

Background: Antimony is used in catalysts, pesticides, brake systems, pharmaceuticals, and synthetic fire retardants in the plastic, paint, and rubber industries. Accumulation of trivalent antimony compounds in the body can cause cardiotoxic effects and increase the risk of electrocardiogram (ECG) abnormalities and sudden death. Antimony exposure can result in action potential prolongation, causing a cardiac repolarization delay, which appears as QTc prolongation and T-wave abnormalities on the ECG. There are no studies on antimony-associated cardiac toxicity in Korea. Case presentation: Accordingly, the present study reports cases of ECG abnormalities in workers handling antimony trisulfide at a company located in the Gyeongsangbuk-do region. Nineteen workers employed at an automobile brake lining manufacturer were exposed to antimony trisulfide dust through thermoforming, grinding, and drilling processes. In 2020, the workers were reported to work 12-hour shifts, 5 days a week. The time-weighted average (TWA) of antimony trisulfide exposure measured in workers was 0.0028 mg/m3. Two workers were excluded from the analysis due to pre-existing medical conditions (cardiovascular disease). Of the remaining 17 workers, ECG abnormalities were found in 41% (seven out of 17: four with QTc prolongation and T-wave abnormalities; two with only T-wave abnormalities; and one with only QTc prolongation). Conclusions: This case report outlines the first few cases in Korea in which potential cardiac toxicity caused by occupational exposure to antimony was identified. However, data regarding cardiac toxicity caused by antimony exposure are still lacking in Korea; thus, additional studies are needed to identify causal relationships.

Keywords

Acknowledgement

This work was supported by the Soonchunhyang University Research Fund and by the Environmental Health Center, Soonchunhyang University Hospital, Gumi, South Korea.

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