An occupational pipe leak poisoning.

Introduction: Dimethylacetamide (DMAC) is used as a solvent in the dye, leather, and acrylic manufacturing industries. However, it is associated with significant risks of liver and nerve damage. 4,4'-Diaminodiphenyl ether (4,4'-ODA) is a crucial precursor for synthesizing curing agents and dyes but can disrupt the methemoglobin reduction system, resulting in methemoglobinemia. Methods: This paper reports an incident involving a plant pipeline leak on May 10, 2024, which primarily contained a DMAC solution and trace amounts of 4,4'-ODA. The patient's occupational history, onset time of clinical symptoms, physical examination results, laboratory data, and treatment course were analyzed, and follow-up evaluation was performed to monitor the patient's long-term health status. Results: Two patients exhibited clinical symptoms, including respiratory failure, methemoglobinemia, hemolytic anemia, and acute liver injury due to dermal and respiratory exposure. They were successfully treated and discharged. Notably, Patient 1 was diagnosed with toxic encephalopathy 16 days post-exposure, while Patient 2 developed peripheral neuropathy 58 days post-exposure. Discussion: This study aimed to elucidate the clinical characteristics associated with this type of poisoning. Moreover, the incident calls for enhanced safety measures in industries using DMAC and 4,4'-ODA to prevent similar poisoning events.