[THE RISK OF THE DEVELOPMENT OF OCCUPATIONAL CHRONIC FLUORIDE POISONING].

On the basis of individual occupational fluoride loads (IOFN) it was established that under current levels of air pollution of the working area by fluorine compounds, occupational fluorosis can occur in mostly sensitive workers with 66 or more years of accumulated period of work, while the most vulnerable are workers with of 9.4 or more years of accumulated period of work. The results obtained in comparison of clinical data with individual fluoride load, testify that in the high-risk group for the development of occupational fluoride intoxication include workers with an average accumulated period of work of 10.5 years or more and Individual Occupational Fluoride Load (IOFL) as 67,7 or more grams. In the high-risk group there are included workers with an average accumulated period ofwork of 13.7 years and IOFL as 89.8 grams or more. With the use of ultrasound densitometry there was revealed a clear cut dynamics of the increase of the speed of ultrasonic wave with the rise in the accumulated period of work at the plant, which indicates to a gradual increase in bone tissue density.

The tissue distribution of fluoride in a fatal case of self-poisoning.

The purpose of this paper is to report a case of fluoride poisoning along with a discussion of poisoning characteristics, analytical procedures, and a review of previous reports of fatal intoxications with analytical data. A case of suicidal ingestion of 40 mL of a rust removal agent containing hydrofluoric acid and ammonium fluoride by a 33-year-old white male is presented. He had an organic personality disorder with residual schizophrenia and previous suicide attempts with therapeutic drugs and cleaning products. At admission, he presented with a Glasgow coma score of 3, third degree atrioventricular block, and asystole. Resuscitation efforts were performed during which the patient suffered two episodes of ventricular fibrillation followed by asystole. In spite of advanced resuscitation efforts and the administration of calcium chloride, he died 2.5 h after the ingestion. Analytical data in the hospital showed calcium levels of 3.1 mg/dL and metabolic acidosis. Internal findings were erosive gastritis, brain edema, and pulmonary and hepatic congestion. Quantitation of fluoride was performed using an ion-selective electrode for the anion. Disposition of fluoride in the different tissues was as follows: peripheral blood, 19.4 mg/L; urine, 670 mg/L; vitreous humor, 2.5 mg/L; liver, 40.0 mg/kg; kidney, 60.0 mg/kg; lung, 17.5 mg/kg; brain, 2.5 mg/kg; spleen, 30.0 mg/kg; bone, 0.5 mg/ kg; and gastric content, 1120 mg/L (67 mg total). Validation of the analytical method was performed using different spiked tissues, in a range of concentrations from 2.4 to 475 mg/L or mg/kg, and submitting them to dilution (1:25) to avoid the matrix effect and to bring these concentrations to the range of the aqueous calibration curve (0.19-19 mg/L). Limits of detection and quantitation were 0.02 and 0.1 mg/L, respectively. The linearity of the method, for all studies tissues, was excellent, with r(2) values of 0.999. Accuracy and precision were within 10.5% and 5.7%, respectively. Fluoride analyses using the ion selective electrode are simple, sensitive, and rapid. This report provides an extensive tissue distribution study of fluoride after a well documented case of acute poisoning. Based on the autopsy findings, patient history, toxicology results, and previously reported data the forensic pathologists ruled that the cause of death was due to a fluoride poisoning, and the manner of death was listed as suicide.