Abstract
BackgroundChemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. This study aimed to investigate the epidemiological characteristics of HF burns within this region.MethodsA 10-year retrospective analysis was conducted using data from all inpatients with HF burns. These patients were treated at the Department of Burns and Plastic Surgery at our hospital between January 2004 and December 2013. Information obtained for each patient included sex, age, occupation, burn location, burn cause, and the hazard category of the chemical which caused the burn. Data regarding wound site and size, accompanying injuries, serum electrolyte levels, operations, length of hospital stay, and mortality were also assessed.ResultsA total of 201 patients (189 males, 12 females; average age: 38.33 ± 10.57 years) were admitted due to HF burns. Over the 10-year period, the morbidity of HF burns in the past 10 years showed a gradual increase, which paralleled the development of local fluoride industries. Most HF injuries were work related and distributed in working-age patients. Aqueous HF solutions, especially highly concentrated ones, were the most common chemical cause of HF burns. Moreover, inappropriate operation, machine problems, and inadequate protection were identified as the leading causes of HF burns in the workplace. The burn area was <5% of TBSA in more than 90% of patients, and the most common burn sites were the head, neck, and upper extremities. Approximately 17% of patients underwent surgical operation. Accompanying injuries should be detected and treated correctly in a timely manner. Lastly, electrolyte imbalances, such as hypocalcaemia, hypomagnesaemia, and hypokalaemia, occurred frequently in patients with HF exposure; however, hyperkalaemia was not encountered in this study.ConclusionBased on the epidemiological results for HF burns in this region, the related enterprises and local authorities should be encouraged to upgrade management policies and to provide necessary occupational hazard education and safety training for high-risk occupations within high-risk working populations. Furthermore, the enhancement of hazardous chemicals management is also needed. Finally, for patients with HF exposure, early and correct pre-hospital triage, treatment and consequent in-hospital treatment and procedures should also be improved.
Highlights
Chemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province
To summarise; this epidemiological study presents characteristic findings related to HF burns in western Zhejiang Province, China
The morbidity of HF burns in the past 10 years showed a gradual increase, which can be attributed to the development of local fluoride industries
Summary
Chemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. By using its rich resources of fluorite, HF can be produced when reacted with concentrated sulphuric acid [9]. This region in China has become the largest industrial producer of fluoride, with an annual HF output of 400,000 tons [10]. With this rapid development of fluoride industries and high turnover of chemical usage within the Zhejiang region, the incidence of chemical burns has increased dramatically. Events with severe casualties caused by HF have been reported [11, 12]
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