Successful treatments of lung injury and skin burn due to hydrofluoric acid exposure

Recent growth in the electronics and chemical industries has brought about a progressive increase in the use of hydrofluoric acid (HF), along with the concomitant risk of acute poisoning among HF workers. We report severe cas es of inhalation exposure and skin injury which were successfully treated b y administering a 5% calcium gluconate solution with a nebulizer and applyi ng 2.5% calcium gluconate jelly, respectively. Case 1. A 52-year old worker used HF for surface treatment after welding stainless steel, and was hospi talized with rapid onset of severe dyspnea. On admission to the critical ca re medical center he had widespread wheezing and crackles in his lungs. Che st radiograph showed a fine diffuse veiling over both lower pulmonary field s. Severe hypocalcemia with high concentrations of F in serum and urine wer e disclosed. He was immediately given 5% calcium gluconate solution by inte rmittent positive-pressure breathing (IPPB), utilizing a neblizer. On the 2 1st hospital day, chest film and CT scan did not demonstrate any abnormalit y. He was discharged very much improved on the 22nd hospital day. Case 2: A 35-year old worker at an electronics factory was admitted to his local hos pital with severe skin burn on his face and neck after exposure to 100% HF. Treatment began with immediate copious washing with water for 20 min. Calc ium gluconate 2.5% gel (HF burn jelly) was applied to the area as a first-a id measure. Persistent high concentrations of serum and urinary F were disc losed for 2 weeks. After treatment with applications of HF burn jelly, he w as confirmed as being completely recovered. The present cases and a review of published data suggest that an adequate method of emergency treatment fo r accidental HF poisoning is necessary.