title: Acute hydrofluoric acid exposure reported to Taiwan Poison Control Center, 1991-2010.
abstract: BACKGROUND
  Hydrofluoric acid (HF) is a dangerous chemical that can cause severe cutaneous burns as well as possible systemic toxicity.
  
  
  METHODS
  We retrospectively analyzed all human HF exposure cases reported to the National Poison Control Center of Taiwan between 1991 and 2010.
  
  
  RESULTS
  In this 20-year survey, 324 calls were identified, with a majority of dermal exposure (84%). Occupational exposure accounted for 80% of all cases, with workers in semiconductor industry (61%), cleaning industry (15%), chemical or metal industry (13%), and other industries (11%). Electrolyte imbalances were uncommon, hypocalcemia, hypomagnesemia, and hypokalemia were recorded in 8.6%, 1.2%, and 1.5% of all cases, respectively. Most cases (64%) of dermal exposure received antidotal treatment. Treatment modalities of dermal exposure included calcium gluconate soaking, 49.8%; intravenous calcium, 20.6%; and topical use of calcium gluconate gel, 13.9%. Twenty patients (7%) received surgery. Following HF exposure, the majority of patients presented with mild (56.5%) or moderate (36.7%) toxic effects. However, four patients were severely intoxicated; two patients died of HF-related dysrhythmia and shock.
  
  
  CONCLUSIONS
  Significant symptomology may occur following HF exposure, and most of the HF exposure required hospitals evaluation. Calcium gluconate soaks appear to be effective in reducing local pain and tissue damage. Hyperkalemia should not be overemphasized as a common finding in HF exposure, hypokalemia tends to occur in cases of severe HF poisoning.
authors.affiliation: 1Division of Clinical Toxicology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: M-L
authors.initials: ML
authors.lastname: Wu
authors.forename: C-C
authors.initials: CC
authors.lastname: Yang
authors.forename: J
authors.initials: J
authors.lastname: Ger
authors.forename: W-J
authors.initials: WJ
authors.lastname: Tsai
authors.forename: J-F
authors.initials: JF
authors.lastname: Deng
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000188:drug therapy; D002125:Calcium Gluconate / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D006858:Hydrofluoric Acid / Q000633:toxicity*; D007221:Industry; D008297:Male; D016273:Occupational Exposure; D011039:Poison Control Centers; D012189:Retrospective Studies; D012666:Semiconductors; D013624:Taiwan
chemical_list: D006858:Hydrofluoric Acid; D002125:Calcium Gluconate
keywords: Hydrofluoric acid; exposure; hypocalcemia; hypokalemia