Incidents exposure, hydrofluoric acid

Deaths occurred after accidental releases of uranium hexafluoride at uranium-processing facilities in 1944 and 1986, but these deaths were not attributed to the uranium component of this compound (Kathren and Moore 1986 Moore and Kathren 1985 USNRC 1986). These releases resulted in the generation of concentrated aerosols of highly toxic hydrofluoric acid and uranyl fluoride. In the 1944 incident exposure time was estimated to be only 17 seconds, deaths occurred in 2 of 20 workers within an hour and were attributed to severe chemical burns of the lungs. In the 1986 incident, 1 of 23 workers died from massive pulmonary edema, indicating that inhalation of hydrofluoric acid was responsible for death. Estimated airborne concentrations were 20 mg uranium hexafluoride/m for a 1-minute exposure and 120 mg uranium hexafluoride/m for a 60-minute exposure (15.2 and 91 mg U/m, respectively). 

Successful treatment of severe exposures is dependent on rapid reactions by those responding to the incident and by the affected person(s). In the following sections, reference is made to various medications specific to the treatment of hydrofluoric acid exposure. It is unlikely that the typical rescue squad called to the scene will have these medications so they should be part of the first aid supplies maintained in the immediate area where exposures may occur. Have someone call for emergency medical assistance as soon as possible and direct them to arrange treatment with a physician or trauma center familiar with chemical bums. In all types of exposure, the first action recommended is prolonged flushing with copious amounts of water so an eyewash station, a shower and a source of potable water should be immediately available. 

During a 4-year time period from 1976 to 1980 in Boston, Massachusetts, USA, 857 inpatients were admitted to a specialized bum center [30]. Of these, 35 (4 %) had chemical injuries. Involved chemicals included acids (hydrochloric, sulfuric, hydrofluoric, chlorosulfonic, trichloroacetic, and undetermined acidic substances) (10 cases) and alkaline caustic substances (lye, cement) (9 cases). The chemical exposures were work related in 51 % of cases, and in 7 cases (20 %), they were due to deliberate chemical assaults. Some patients had relatively immediate copious water washing and some did not. Patients with delayed water decontamination had a fivefold greater incidence of fullthickness chemical skin injuries, but even immediate and copious potable water washing was unable to prevent chemical skin injuries in all cases [30]. 

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