Work-related chemical exposures presenting to an emergency department in Singapore

Abstract

Background: Singapore is a small industrialized island state with a low accident rate and few hazardous chemicalrelated injuries reported. However, the use of chemicals continues to increase and pose hazards in the workplace. Aims To study workplace chemical injuries and exposures to improve worksite safety. Methods: Work-related chemical exposure cases were identified from emergency department (ED) computerized records from 2007 to 2010. Results: A total of 239 cases were identified. Most of the patients were male (92%) and young adults (73% aged between 21 and 40 years). Fifty per cent of the workers were foreign workers. Most of them were cleaners, labourers and technicians (53%) and worked mainly in the construction and manufacturing industries (47%). All the exposures were acute and presented within 4 h of the exposure incident (52%). Most of the chemical exposures were to the eye (55%) and skin (32%). The chemicals involved included corrosives (41%), hydrocarbons (18%) and cleaning solutions (9%). Prehospital decontamination (eye and skin irrigation) was performed for 54% of the workers. Antidote treatment with calcium gluconate for hydrofluoric acid exposure was used for five patients in the ED. Only 11% of patients were admitted. Four patients had surgical procedures and five patients had long-term complications. Forty-five incidents were notified to the Ministry of Manpower. The under-reporting rate for cases with >3 days of medical leave was 66%. Conclusions: Work-related chemical exposures that present to the ED had low morbidity. Most of the workers did well with immediate decontamination and supportive treatment but antidotes were required for some exposures. © The Author 2013. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.