Case Study

A 12-year-old boy was riding his bicycle to a fast-food restaurant when he slipped and fell in a shallow puddle of a foul-smelling liquid in the restaurant's parking lot. He became nauseous, vomited, and left the parking lot feeling dizzy and with blurred vision. He stumbled home, pushing his bicycle. A bystander smelled the puddle of liquid and notified the police who discovered that a farm vehicle had spilled a 50-gallon barrel of dicofol, a chlorinated hydrocarbon and DDT analogue. The barrel was spilled as a truck drove into the fast-food restaurant and the employees didn't bother to clean it up.

At home, the boy lay on his bed with his soaked clothing and slept. When his mother came home, she found him somnolent and insisted he shower.

After the shower he felt better, but his mother laundered the clothing he was wearing, along with the bedding, and returned them to the boy's room. He continued to be symptomatic, even though she laundered the clothing several times. A week later the boy was referred to the consultant's office by the health department.

In the office, the boy was wearing clothing (not those he was wearing the day of the incident) that reeked of a hydrocarbon chemical. He was led to a back room and asked to disrobe. The clothing was taken outside and bagged. While the vital signs were normal, the boy was ataxic, demonstrated nystagmus, and his speech was slurred. His breath had a hydrocarbon odor. Samples of his blood, subcutaneous fat and urine were collected and were later found by a reference laboratory to be positive for dicofol. A complete blood count, urinalysis, and blood chemistries were all normal.

The boy's mother was asked to destroy all clothing, furniture, and appliances that had come in contact with the contaminated clothes the boy was wearing the day of the incident. This resulted in the destruction of the family's entire wardrobe, the boy's bed, a couch, and the washer. A report was made to the county health department as required by state law. A week after the decontamination, the ataxia, nystagmus, and hydrocarbon breath were gone. The slurred speech resolved in 2 weeks. A month after the exposure, a psychological test demonstrated cognitive and emotional deficiencies. A second test performed 2 months later was normal. Three months after decontamination, the boy was completely normal and he remained so for another 2 years of monitoring. No medication or treatment was given other than removal from exposure and decontamination.

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