During October through December 2015, three research and development workers in

Question

During October through December 2015, three research and development workers in a company that makes metallic inks in Whoosits, Indiana, were seen in an outpatient clinic of the Indiana University Hospital complaining of cough, with "post nasal drip and flushing of the face daily. She denied any wheezing. Additionally she experienced skin reactions to earrings and her belt buckle that she was previously able to wear without any reactions These items were not pure gold and were made from metal amalgams All three employees worked in the same area in the factory where they had no symptoms doing work that involved formulating polymers and making coatings, nor when working in the same laboratory with metal plating baths. They started on a new project that involved making formulations involving micron-sized silver particles for inks. What further questions might you want to ask? What sources of information might you use? What body system(s) might be affected by this exposure? What do you think the material is and why do you think that? What tests might you ask a physician to run to help you determine possible exposure? How would you protect future employees in this facility that makes these ink formulations?

Explanation / Answer

Ques-1:

Further questions needed to ask as follows

What is the type of nasal drops she is using as post- nasal drip? is it containing silver as chief constituent?

If so,

How many days she has been using these silver containing nasal drops?

Ques-2: The body system mainly affected is "skin" called generalized argyria (skill will become blue or bluish-grey due to pigmentary changes) and vision because silver is going to trigger silver deposit formation inside the dermis and eyes are going to get damaged due to damage to mucous membrane finally conjuctiva

Another organ system is mainly affected due to inhalation of micron sized "silver particles" during formulation at R & D is "lungs" due to silver mediated pulmonary inflammation may lead to lung cancer.

Mercury amalgam containing earrings are going to trigger skin reactions due to affected dermis due to allergic anaphylactic reactions

Ques-3:

She has wearing "metal amalgam" containing earrings and working with microsized silver particles to prepare formulations at R & D. Therefore, amalgam is composed of salts of mercury (Hg). Therefore, the toxicity is due to "mercury" and silver particles as a result she is flushing of her face daily and unable to wear her buckle. Mercury amalgam containing earrings are going to trigger skin reactions due to affected dermis due to allergic anaphylactic reactions

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