RARE OCCUPATIONAL CAUSE OF NASAL SEPTUM PERFORATION: NICKEL EXPOSURE

被引:10
作者
Bolek, Ertugrul Cagri [1 ]
Erden, Abdulsamet [2 ]
Kulekci, Cagri [3 ]
Kalyoncu, Umut [2 ]
Karadag, Omer [2 ]
机构
[1] Hacettepe Univ, Fac Med, Dept Internal Med, Ankara, Turkey
[2] Hacettepe Univ, Fac Med, Dept Internal Med, Div Rheumatol, Ankara, Turkey
[3] Hacettepe Univ, Fac Med, Dept Otorhinolaryngol, Ankara, Turkey
关键词
Occupational medicine; Nickel; Nickel exposure; Nasal septum perforation; Occupational toxic heavy metal exposure; Inhalation toxicity; REFINERY WORKERS; MORTALITY; TOXICITY; CANCER; BLOOD;
D O I
10.13075/ijomeh.1896.01019
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Many etiologies are held accountable for nasal septum perforations. Topical nasal drug usage, previous surgeries, trauma, nose picking, squamous cell carcinoma, some rheumatological disorders such as granulomatosis with polyangiitis (Wegener granulomatosis), some infectious diseases such as syphilis and leprosy are among the causes of the perforations. Occupational heavy metal exposures by inhalation rarely may also cause nasal septum perforation. Here, we present a 29-year-old patient without any known diseases, who is a worker at a metallic coating and nickel-plating factory, referred for investigation of his nasal cartilage septum perforation from an otorhinolaryngology clinic. The patient questioning, physical examination and laboratory assessment about rheumatic and infectious diseases were negative. There was a metallic smell in the breath during the physical examination. The analysis showed serum nickel level at 31 mu g/l and urine nickel at 18 mu g/l (84.11 mu g/g creatinine). Other possible serum and urine heavy metal levels were within normal ranges. Nickel exposure is usually together with other heavy metals (chromium or cadmium), it is rarely alone. Nickel ingested by inhalation usually leads to respiratory problems such as reduced olfactory acuity, ulcers, septum perforation or tumors of the nasal sinuses. This case demonstrates the importance of occupational anamnesis and awareness of diagnosis.
引用
收藏
页码:963 / 967
页数:5
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