How unclogging a sink can be lethal: case report of an accidental methyl bromide poisoning leading to a multiple organ failure

Abstract

Methyl bromide (CH3Br) is a colorless and odorless volatile gas, used as an insecticide, fire extinguisher, fumigant, and refrigerant. Although forbidden since 1987 for domestic use, it is still used in industry, for example, to fumigate agricultural fields which are for importation in the United States. Here is the case of a 74-year-old man who was accidentally exposed to methyl bromide after using an old fire extinguisher. Even though he finally survived, he developed a severe multiple organ failure and spent 2 months in intensive care unit. We present in this report all the difficulties we had to diagnose this unusual poisoning.

Evaluation of the effect of photoplethysmograms on workers’ exposure to methyl bromide using second derivative

“…A low vascular load can be caused by high flexibility or poor left ventricular ejection. Considering that an old man exposed to MB had a cardiogenic shock with a left ventricular ejection fraction of 30% ( 13 ), it can be presumed that MB exposure lowered the b/a and SDPTG-AI of fumigators while raising their d/a and e/a values due to decreased left ventricular ejection. Therefore, we can infer that the inverse alteration in SDPTG values within the fumigator group as they age, despite an increase in the mean concentration of urinary Br- after work, may be attributed to a reduction in left ventricular ejection due to MB exposure.…”

“…Recent studies on asymptotic workers exposed to MB have reported negative effects on the central and autonomic nervous systems ( 11 , 12 ). Moreover, acute coronary syndrome occurred in a patient exposed to MB from an old fire extinguisher, leading to cardiogenic shock ( 13 ). Therefore, concerns of work safety and health issues are still a challenge to those who conduct MB fumigation and inspect MB-fumigated shipping container and cargoes ( 14 ).…”