Summary: A 26-year-old male patient presented to the Emergency Department with chemical burns sustained at his workplace, reportedly from 4% Sodium Hydroxide exposure. Despite wearing full personal protective equipment (PPE), including a body suit, goggles, boots, gloves, and a hood, the patient experienced contact burns on his forehead. Immediately following the exposure, he initiated workplace decontamination procedures, rinsing his suit and irrigating the affected area before seeking medical attention. He presented with persistent forehead pain without visual symptoms. Initial examination was conducted, there was an erythematous area of 4x2 cm over the central forehead, two smaller sub-centimetre brown spots above his left eyebrow, and the glabella. The eye examination was normal. The patient received continuous irrigation with normal saline until pH normalization, and the burns team was consulted. During treatment, physicians recognized a pattern consistent with prior cases involving similar injuries, which prompted further inquiry. Upon subsequent questioning, it was revealed that the chemical spill incident involved multiple index casualties, who had presented separately to the emergency department throughout the day. Both the patient and his coworker, involved in the chemical spill cleanup, were unaware of additional casualties and had chosen not to disclose specific details, including the company’s name. The link was made through address correlation. All patients were treated conservatively, discharged without complications, and had uneventful follow-ups. This case underscores the crucial management of early decontamination and burns management. Proper workplace protocols for PPE use are also paramount. The coordination of responses via a safety manager and proper communication through national networks is also key to ensuring a timely response and appropriation of resources. Finally, the critical need for clinicians to maintain a high index of suspicion in potential mass workplace incidents, particularly when patients may withhold details due to confidentiality concerns or limited awareness.
Yeong et al. (Sun,) studied this question.