title: 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 chemical-related injuries reported. However, the use of chemicals continues to increase and pose hazards in the workplace.
  
  
  OBJECTIVE
  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 4h 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%). Pre-hospital 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.
authors.affiliation: Department of Emergency Medicine, Clinical Toxicology Consultation Service, Changi General Hospital, Singapore 529889, Republic of Singapore.
authors.forename: H H
authors.initials: HH
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Teo
authors.forename: H C
authors.initials: HC
authors.lastname: Tseng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D011041:Poisoning / Q000453:epidemiology*; D012846:Singapore / Q000453:epidemiology
keywords: Chemical exposure; chemicals; hazard; injury; occupational; occupational disease; poisoning; safety; work; workplace.