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Gray Batchelder  
#1 Posted : 04 April 2010 16:44:26(UTC)
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Gray Batchelder

Acute exposure to hydrofluoric acid solution, several droplets to feet and legs, not treated other than water wash several hours later. Former employee, now associates joint pain in feet to exposure and wants to be compensated. Acute exposure happened in 1990 and symptoms started about a year after the exposure and medical exam has not produced a alternative explanation. Many preventative steps currently in place however we also have an exposure protocol: Immediate water deluge of affected area Immediate notification and activation of emergency medical team Application of 2.5% calcium gluconate gel Full medical evaluation and treatment by medical doctor familiar with HF exposure Comments on exposure protocol and apparent chronic symptoms of HF exposure would be welcome.
stephendclarke  
#2 Posted : 04 April 2010 19:31:43(UTC)
Rank: Forum user
stephendclarke

Hi, Its many years since I used HF in a former life and at the time the long term chronic effect on bone tissue was what really scared me and so your description of your former employee's symptoms ring true to me although I have no medical training. As to the exposure protocol the key points for me in addition to your own are as follows: Casualty to be taken immediately to nearest source of clean water. Deluge with cold or luke warm water (Do not rub or scrub the skin). At same time quickly remove casualty’s contaminated clothing. Protect yourself from splashes. Continue to deluge for 10 min or longer if chemical still on the skin. Apply calcium gluconate gel on and around affected area. Massage continuously until pain relieved, this will take at least 15 min. Continue during transport to hospital. Cover area with dressing soaked in gel, bandage tightly. Everyone exposed to HF should be taken to A&E without delay even if no apparent damage. The requirement for a medical doctor familiar with HF exposure is vital, as its not unknown in my experience for the injured party to know more about the chemical than the Dr Regards Steve
Gray Batchelder  
#3 Posted : 04 April 2010 20:18:57(UTC)
Rank: Forum user
Gray Batchelder

Thanks Steve, Your points on exposure protocol could have been read from our emergency card! I just put in the four most important for the patient. Dr. has not identified any bone tissue issues.
Adrian Watson  
#4 Posted : 05 April 2010 07:56:03(UTC)
Rank: Forum user
Adrian Watson

Flourosis - see Hamilton and Hardy Industrial Toxicology at page 184 for details.
Jane Blunt  
#5 Posted : 06 April 2010 07:50:26(UTC)
Rank: Super forum user
Jane Blunt

I would add that, without education and training, users not understand the need for proper treatment. This is how the initial lack of first aid treatment occurred, so it would appear.
John J  
#6 Posted : 06 April 2010 15:14:33(UTC)
Rank: Super forum user
John J

gray Batchelder wrote:
Acute exposure to hydrofluoric acid solution, several droplets to feet and legs, not treated other than water wash several hours later. Former employee, now associates joint pain in feet to exposure and wants to be compensated. Acute exposure happened in 1990 and symptoms started about a year after the exposure and medical exam has not produced a alternative explanation. Many preventative steps currently in place however we also have an exposure protocol: Immediate water deluge of affected area Immediate notification and activation of emergency medical team Application of 2.5% calcium gluconate gel Full medical evaluation and treatment by medical doctor familiar with HF exposure Comments on exposure protocol and apparent chronic symptoms of HF exposure would be welcome.
I would suggest it is up to the injured party to prove a relationship between the HF exposure and the illness and I believe they will struggle. Is the claim not time barred anyway based on the fact he was aware of the issue in 1991? The protocol for just washing with copious amounts of water was a will recognised one at that time and for severe cases the wound would be debrided to prevent an excalation of the injury. Based on the fact that he did not recieve further treatment I would suggest his exposure was low and the actions taken adequate.
Gray Batchelder  
#7 Posted : 06 April 2010 18:40:26(UTC)
Rank: Forum user
Gray Batchelder

Hello and thank you all. The exposure happened a long time ago, and should not have happened; basically we were upgrading semiconductor fab. An old plastic wet bench was certified by the safety engineer to be free of hazardous materials (oops) and a labor went to work to cut up the plastic wet bench with a saw and a liquid splashed out on to his leather safety boots and jeans. Since there was a posted decontamination sticker signed by the engineer the labor assumed it was water and went about work, at home he showered that night. Burning started later that night, but since he has consumed a lot of ethanol.... He brought his burned boots in the next day and the incident was investigated which lead to chemical analysis- the boots were damaged by HF(and the eventual sacking of a safety engineer). Employee refused medical treatment, just wanted new boots but was still drunk and he was sacked as well. This happened in the USA and under that state's workers compensation system an illness claim can be filed up to 30 years post incident. Sorry to ramble on... I have read on flourosis, excellent reference. Anyone aware of a connection of joint pain? Think our current procedures are ok, and they are subject to constant review! Use of HF with the high consequence of exposure needs robust systems in place as all pointed out.
John J  
#8 Posted : 07 April 2010 13:50:21(UTC)
Rank: Super forum user
John J

Gray, I'd suggest you look more towards the alcohol in relation to joint pain rather than a single exposure to HF. I'm also surprised the HF burnt through the leather as it would normally permeat through rather than burn, sounds more like hydrochloric acid. Out of interest what strength was the HF?
Gray Batchelder  
#9 Posted : 07 April 2010 14:00:02(UTC)
Rank: Forum user
Gray Batchelder

Hello, 49% HF (BOE with HCL solution). Most likely the HCL did the char as you suggested.
Adrian Watson  
#10 Posted : 07 April 2010 22:51:50(UTC)
Rank: Forum user
Adrian Watson

Advanced flourosis can cause joint and bone pain. Regards
John J  
#11 Posted : 08 April 2010 11:47:43(UTC)
Rank: Super forum user
John J

I'd suggest that with a single exposure that did not require any medical treatment, other than flushing the wound, that fluorosis is not an issue,
Gray Batchelder  
#12 Posted : 08 April 2010 22:54:27(UTC)
Rank: Forum user
Gray Batchelder

I am inclined to agree with John J, but akwatson's reference, and lots of pictures of fluorosis will sway any ALJ/juror with the way the WC system is in favor of the worker. Anyway thanks all for you help!
Adrian Watson  
#13 Posted : 09 April 2010 08:35:54(UTC)
Rank: Forum user
Adrian Watson

Be careful - don't prejudge the facts! It may be not be likely but it may be more likely than not. Remember in general the person only has to show on the balance of probabilities that they have had a loss resulting from an injury, (both subject to tests of proximity and foreseeability in negligence), caused by a breach of a duty owed to them. The court only has to accept a medical diagnosis of flourosis (based upon their symptoms and the signs (x-ray evidence showing flourosis) of disease and the exclusion of alternative causes), and the injury was linked to an accident involving HF, then there would be evidence of causation. Then the person would have to show breach of a duty owed to them - that tends to be the easiest bit. Regards
John J  
#14 Posted : 09 April 2010 11:53:24(UTC)
Rank: Super forum user
John J

I agree but my point is there will not be x-ray evidence of fluorosis on this exposure scenario. If the individual was just claiming for injury from the burn it is clear cut but they are claiming a relationship between this and the ankle. This will be impossible to proove when there is clear evidence that there are other factors that could cause it and no evidence to support it. Ultimately the courts will decide whether any of us are right or wrong.
John J  
#15 Posted : 09 April 2010 15:28:27(UTC)
Rank: Super forum user
John J

It may also be worth considering that there are less than a dozen incidences of skeletal fluorosis recorded in the US every year and these are generally attributed to consistant over exposure to fluorides in drinking water or high fluoride exposure over many years. There are far more HF injuries reported every year, as its in everything from wheel cleaner to rust remover.
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