Chemical Incidents How to manage them before they become an accident? 13 th APRIL 2017
One accident => Potential risks 1. Human chemical contamination 2. Chemical spill on the floor Which chemical? Often unknown Concentrated acids or bases Important reaction Irreversible consequences Oils, solvents Weak reaction Reversible consequences
1. Chemical Risk Which consequences? 1/ For a chemical splash: human risk Chemical burn Work loss Inability to go back to work Surgical operations(worst cases) Social incidence
1. Chemical Risk Exemple of accident: concentrated sulfuric acid in Australia, 2010 4 employees in a chemical plant A pipe containing 100% sulfuric acid failed Workers have been placed under safety showers immediately and driven to the hospital Burns size in between 2 50% BSA One patient had to be amputated above the knee immediately and tissues had to be excised. One patient had to undergo immediate tissues excision. Toma s B. O Neill *, Jeremy Rawlins, Suzanne Rea, Fiona Wood Burns Service of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia 1. IntroductionMass burn
1. Chemical Risk Which consequences? 2/ For a chemical spill Risk of secondary contamination for human if no proper care is given when retrieving the chemical Floor and environment contamination by non-identified corrosive or toxic products Retrieving and treatment of a liquid chemical are complicated
1. Chemical Risk Source : http://www.electronista.com/articles/13/01/28/pair.of.hydrofluoric.acid.leaks.not.reported.to.authorities/ Examples of spills South Korea, January 2013 10L leakage of gaseous hydrofluoric acid in a micro-electronic company The spill is covered with a plastic bag 5 employees from the maintenance are in contact with the spill. One of them died following the contact with the chemical.
1. Chemical Risk Places at risk in the hospital Specific hazardous chemicals: Formaldehyde: corrosive, toxic and carcinogenous Cytostatics: toxic, carcinogenic and mutagenous Acids, Bases: irritants and corrosives Detergents Places where corrosive products are most frequently found: o Laboratories o Pharmacy o Mortuary o Operating Room
2. Chemical splash Which solutions? 1/ Facing chemical splashes Which norm? Norm EN 15154 Plumbed in devices (parts 1-2) Non-plumbed-in devices (parts 3-4) containing water or a substance with at least equals qualities to drinkable water.
2. Chemical splash Water MECHANICAL EFFECT UNIVERSAL PRODUCT DILUTION PROBLEM WITH CONCENTRATED PRODUCTS TIME OF INTERVENTION LENGHT OF RINSING HYPOTONICITY
2. Chemical splash DIPHOTERINE solution Liquid : mechanical effect Absorption capacity: stops the product s agressiveness and keeps its polyvalence Hypertonicity : prevents penetration Class IIa sterile medical devices Non dangerous products (innocuity proven) => Conform to the norm
2. Chemical splash ph Demonstration o Illustration of the difference water/ Diphoterine solution with ph experience
2. Chemical splash ALCOA AUSTRALIA STUDY - Study realized by the coordinator Dr. Donaghue The study began in 2006, published in 2010 3 Alumina refineries 180 cases of alkali skin splashes (ammonia/caustic soda) Conclusions of the study: No sign of chemical injury for more than 50% of the cases rinsed with DIPHOTERINE solution, 21,4% with water. Decrease of the rate of injury needed a medical care of 24,7%. Clinical results significantly better with a first rinsing with DIPHOTERINE solution.
2. Chemical splash An additional risk : hydrofluoric acid HF : a corrosive and toxic product H + F - Hydrofluoric acid Corrosion and Necrosis by intracellular calcium chelation Anhydrous > 70 % 50-70 % 20-50 % 1% 5% 7% 10% < 20 % 20% A small splash due to highly concentrated HF can have fatal consequences
ph pf 2. Chemical splash Hexafluorine solution Liquid : keeps its mechanical effect Apsorption capacity: - Stops corrosive action of H + ions (3 fixed ions by a molecule) - Stops toxic action of F - ions (6 fixed ions by molecule) Hypertonicity: prevents penetration Application : ocular and cutaneous Decontamination of HF Results on the ph Decontamination of HF Results on the pf 7 7 6,5 6,5 6 6 5,5 5 4,5 4 3,5 ph Water Physiological ph ph Hexafluorine ph 10% CaGlu 5,5 5 4,5 4 3,5 pf Hexafluorine pf Water pf 10% CaGlu Physiological pf 3 3 2,5 2,5 2 0 5 10 15 20 25 30 Volume (ml) 2 0 5 10 15 20 25 30 Volume (ml)
2. Chemical splash Diphoterine and Hexafluorine solutions o References : o Swedish Work Environment Authority (Karolinska Institute) 2011 o Book on Intoxications, First Aid Management, France 2011 o Zeitschrift für praktische Augenheilkunde (ZPA on DOG in 2010) and the French Journal of Ophtalmology (JFO during SFO in 2008) o Medical devices in conformity with the standard EN 15154-3 and -4 o A list of tested products > 1000 substances and mixes Improvement of first emergency for all types of chemical splashes.
2. Chemical splash Eye decontamination 500 ml of Diphotérine or Hexafluorine solution for an intervention within the first minute Class IIa medical devices 50 ml for an intervention within the first 10 seconds
2. Chemical splash Skin decontamination > 100 ml for a face or one hand > 200 ml for a limb or a torso 5 litres for full body (Diphotérine or Hexafluorine ) >
3. Chemical spills Which solutions? 2/ Facing chemical spills Natural absorbents Synthetic absorbents Polyvalent absorbents or specific neutralizing absorbents Different displays: wipes, rings, powders, granulates
3. Chemical spills Technical facts Polyvalent neutralizing absorbent for all liquid chemical spills Effective on: o Acids, o Bases, o Solvents, o Oils, o Oxydizers, o Reducers, o HF, Formaldehyde Coloured ph indicator to identify rapidly the risk. Leaves a perfectly dry and non-slippery floor.
3. Chemical spills Trivorex neutralizing absorbent: efficiency on formaldehyde VIDEO TRIVOREX 1. Polymerisation 2. Stops vapors 3. Easy to retreive
3. Chemical spills Packaging Shakers (1L), Buckets (13L) Storage No validity date Keep away from humidity Properties Non Toxic Non Irritant Non Corrosive Non Sensitizer Non Explosive
3. Chemical spills PREVOR s absorbent range - Complete (4 absorbents) - Adapted to your needs (Absorbent or Neutralizing absorbent) - Answer all problematics - For all spills: small to important
3. Chemical spills References in hospital laboratories Public Laboratories and hospitals using Trivorex Paris hospitals: formaldehyde protocol of use, (2008) Curie Institute: emergency kits with Trivorex, (2015) Rennes: formaldehyde spills, (2014) Brest: labs, mortuary, ORs, and pharmacy, (2014) Limoges: endoscopic disinfectants, (2012) Recommendations for certifications of medical biology laboratories, Clinical Biology Annals, M. Vaubourdolle, Medical Biologist at Paris Hospitals (2013) : Diphoterine solution chemical splashes Trivorex neutralising absorbent for chemical spills
Prevor solutions for a more reliable management of chemical incidents On humans with Diphoterine and Hexafluorine solutions For the management of chemical spills with Trivorex neutralizing-absorbent and the absorbent range
Thank you for your attention!