title: Combination alkali/thermal burns caused by 'black liquor' in the pulp and paper industry.
abstract: Three patients are presented, who sustained a unique type of burn injury while working in the pulp and paper industry in Canada. These patients suffered combination chemical (pH 11-13) and thermal (85-95 degrees C) injuries, when they were exposed to 'black liquor'--a solution which is used in the pulp and paper industry to convert wood chips to pulp. Black liquor can rapidly cause devastating thermal-corrosive burns to the skin, eyes, lungs, and upper gastrointestinal tract. One patient sustained a relatively minor, full skin thickness 3 per cent body surface area (BSA) injury to both feet and lower legs. The second patient, who was sprayed with the heated black liquor solution, sustained a full skin thickness injury to 40 per cent BSA and also suffered virtual loss of vision in one eye. The third patient, who was also sprayed with the solution, sustained a 98 per cent full skin thickness burn and severe inhalation injury, and died during day 1 postburn. Photographic documentation of all three patients is presented. The principles of treatment of this type of burn injury are reviewed. All of these burns were preventable.
authors.affiliation: Ross Tilley Burn Centre, Wellesley Hospital, Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Winemaker
authors.forename: L
authors.initials: L
authors.lastname: Douglas
authors.forename: W
authors.initials: W
authors.lastname: Peters
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000468:Alkalies / Q000009:adverse effects*; D002057:Burns, Chemical / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002170:Canada; D006801:Humans; D008297:Male; D008875:Middle Aged; D010209:Paper
chemical_list: D000468:Alkalies