Correspondence
Fatal Intoxication with 1,1-Dichloro-1-Fluoroethane
N Engl J Med 1997; 337:940September 25, 1997
- Article
To the Editor:
Hydrochlorofluorocarbons are being developed as alternative solvents for use instead of chlorofluorocarbons, which deplete stratospheric ozone and increase ultraviolet radiation at the earth's surface.1 The metabolism and toxicity of these new hydrochlorofluorocarbons in humans and animals have been only very partially studied.2,3 They are considered to have low toxicity. Among them, 1,1-dichloro-1-fluoroethane is a potential substitute for trichlorofluoromethane (also known as CFC-11) in foam-blowing operations and as a cleaning agent in the computer industry.2,4 We report a fatal intoxication involving 1,1-dichloro-1-fluoroethane.
A 40-year-old man was found collapsed in a factory workroom where he had been cleaning a degreasing tank. The solvent used in the degreasing process was pure 1,1-dichloro-1-fluoroethane (Genosolv 2000, Allied Signal, Morristown, N.J.). The man was found inside the degreasing tank, which was free of liquid. He wore no protective clothes except a surgical mask. His body and clothes were free of any liquid. At postmortem examination there was evidence of violaceous coloration and edema of the face. He had no history of cardiac or respiratory diseases, but there was evidence of chronic alcoholic intoxication. No macroscopic abnormality was found at the autopsy except slight pulmonary edema.
High concentrations of 1,1-dichloro-1-fluoroethane were found in the man's blood (14 mg per liter) and tissues by gas chromatography. The concentrations in the liver and the heart were nearly identical and were twice that in the blood (29 μg per gram). The levels in the lungs and the spleen were lower. No urinary metabolite was found. Structurally related halogenated hydrocarbons, such as 1,1,1-trichloroethane, depress heart rate, contractility, and conduction. They sensitize the heart to the arrhythmogenic effects of endogenous beta-agonists and may induce sudden death.5 The high level of 1,1-dichloro-1-fluoroethane in the heart raises the possibility of a particular tropism for the cardiac tissues and supports the potential cardiotoxicity of the compound. Considering the potential for exposure in humans as the use of this solvent increases, laboratory studies are urgently needed to determine the toxicity profile of 1,1-dichloro-1-fluoroethane and propose guidelines for its safe handling.
5 ReferencesAlain Astier, Ph.D.
Henri Mondor University Hospital, 94010, Créteil, FranceFrançois Paraire, M.D.
Raymond Poincaré University Hospital, 92000, Garches, France1
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