2021年江苏省张家港市一起因防锈液混入自来水导致亚硝酸盐中毒事件的流行病学调查  

An epidemiological investigation of nitrite poisoning caused by tap water contaminated by anticorrosive solution in 2021 at Jiangsu Province,Zhangjiagang City

作　　者：于颖慧[1] 施惠军 陈祝军[1] 王波[2] 张利明[2] YU Yinghui;SHI Huijun;CHEN Zhujun;WANG Bo;ZHANG Liming(Zhangjiagang Center for Disease Control and Prevention,Jiangsu Zhangjiagang 215600,China;Suzhou Center for Disease Control and Prevention,Jiangsu Suzhou 215004,China)

机构地区：[1]张家港市疾病预防控制中心,江苏张家港215600 [2]苏州市疾病预防控制中心,江苏苏州215004

出　　处：《中国食品卫生杂志》2024年第1期79-83,共5页Chinese Journal of Food Hygiene

基　　金：苏州市科技计划项目(SS202043、SS202144)。

摘　　要：目的对一起因企业自来水受污染导致食源性亚硝酸盐中毒事件的原因进行调查和分析,探讨预防控制措施,防范类似事件的再次发生。方法通过现场流行病学调查、卫生学调查及实验室检测等方法追溯中毒原因,分析可能的污染环节。结果共搜索到病例9名,临床症状以口唇紫绀(100.00%)、乏力(66.67%)、恶心(55.56%)为主。流行病学曲线显示为点源暴露模式,首末病例发病时间间隔50 min,平均潜伏期20 min。患者呕吐物、剩余食物和自来水中均检出不同浓度的亚硝酸盐。患者呕吐物亚硝酸盐浓度与舒张压值存在负相关关系(r_(s)=0.798,P<0.05)。所有患者经特异性治疗后,症状得到明显缓解。结论本次事件是酸洗池内含高浓度亚硝酸盐的防锈液在虹吸作用下返流入自来水管道后,通过食用被污染自来水加工后的食物导致的亚硝酸盐中毒,因此企业生产用水应与生活用水分路设置,关键位置安装止回阀,避免类似中毒事件的发生。Objective To prevent the recurrence of nitrite poisoning caused by siphonage through a waterpipe siphon,its causes were investigated and analyzed,and prevention and control measures are discussed.Methods A field epidemiological investigation,hygiene investigation,and laboratory testing were used to identify causes and possible sources of contamination in this poisoning event.Results A total of nine cases were found with cyanosis(100.00%),fatigue(66.67%),and nausea(55.56%).The epidemiological curve showed one point source exposure pattern,with an interval of 50 min between the first and last cases and an average incubation period of 20 min.Different concentrations of nitrite were detected in vomit,residual food,and tap water.A negative correlation was observed between nitrite concentration in vomits and diastolic blood pressures(r_(s)=0.798,P<0.05).Patient symptoms were significantly relieved after receiving specific treatment for nitrite poisoning.Conclusion This incident was caused by an anticorrosive solution containing nitrite in pickling tanks flowing back into the tap water pipeline through siphonage,which led to tap water contamination and poisoning.The sense of responsibility and standardized management of enterprises are suggested to be strengthened.The water pipe network for production should be separated from that of domestic water and non-return valves should be installed at key locations to avoid similar poisoning events.

关 键 词：亚硝酸盐 食物中毒 流行病学调查 防锈液 虹吸作用 江苏省 张家港市 

分 类 号：R155[医药卫生—营养与食品卫生学]