In a mismanaged petrochemical factory, the workers were continuously exposed to heavy density of hydrocarbon fumes in the environment. An explosion occurred setting vapor on fire. Describe the pathological events likely to occur in the eyes and lungs. How will you suspect and diagnose?

In such a scenario of continuous exposure to heavy hydrocarbon fumes followed by an explosion setting vapor on fire, workers are at risk of experiencing various pathological events in the eyes and lungs.

Eyes:

• Chemical Conjunctivitis: Exposure to hydrocarbon fumes can cause irritation and inflammation of the conjunctiva, leading to symptoms such as redness, tearing, and a sensation of foreign body in the eyes.
• Corneal Injury: Direct contact with hydrocarbon vapors or flames can cause thermal burns to the cornea, resulting in pain, blurred vision, and potential damage to the corneal epithelium.

Lungs:

• Acute Respiratory Distress Syndrome (ARDS): Inhalation of hydrocarbon fumes and combustion products can lead to chemical pneumonitis and subsequent development of ARDS. This life-threatening condition is characterized by severe inflammation of the lungs, impaired gas exchange, and respiratory failure.
• Chemical Aspiration Pneumonitis: Inhalation of hydrocarbon vapors or combustion products may lead to chemical irritation and inflammation of the airways and lung tissue, resulting in symptoms such as cough, chest pain, and difficulty breathing.

Suspecting and Diagnosing:

1. Clinical Assessment: Medical personnel should evaluate workers presenting with symptoms such as eye irritation, respiratory distress, or burns. A thorough history should be obtained, including details of exposure to hydrocarbon fumes and involvement in the explosion.
2. Physical Examination: Examination of the eyes may reveal conjunctival injection, corneal abrasions, or signs of thermal injury. Respiratory examination may reveal crackles, wheezes, or decreased breath sounds, indicating possible lung injury.
3. Diagnostic Tests: Diagnostic tests such as chest X-rays or computed tomography (CT) scans can help identify lung injuries such as pneumonitis or ARDS. Ophthalmologic evaluation may include slit-lamp examination to assess for corneal injuries.
4. Laboratory Investigations: Blood gas analysis may reveal hypoxemia and respiratory alkalosis in patients with ARDS. Elevated levels of inflammatory markers such as C-reactive protein (CRP) or procalcitonin may indicate lung inflammation.
5. Follow-up Monitoring: Patients should be closely monitored for the development of complications such as respiratory failure, corneal ulcers, or systemic toxicity. Prompt initiation of supportive measures and appropriate medical interventions is crucial for optimizing outcomes and preventing long-term sequelae.

Overall, prompt recognition of symptoms, thorough clinical evaluation, and appropriate diagnostic testing are essential for suspecting and diagnosing eye and lung injuries resulting from exposure to hydrocarbon fumes and subsequent explosion. Early intervention can help mitigate the severity of injuries and improve patient outcomes.