Hydrogen Sulfide poisoning.
Case of Hydrogensulfide (H2S) poisoning in Denmark.
I adress you, as we are having a serious problem concerning the diagnosis and treatment of employees at the emergency ward at Bornholm Hospital (A Danish island located in the Baltic Sea of Northern Europe).
The Bornholm Hospital is a regional hospital serving the 42.000 inhabitants on the island. The hospital is known as a well functioning unit. On Sunday the 7th of October 4 persons - nurses and secretary - went into a room in the emergency ward. The persons got serious CNS-sympthoms including near fainting. Afterwards they were extremely tired, dizzy, and had nausea. Some had irritation of the eyes. They all complained about feeling short of breath. The persons were given oxygen on mask and experienced relief of sympthoms. When they were taken off oxygen support the sympthoms aggravated.
As no explanation was found concerning the initial cases work continued in the same part of the hospital. Unfortuntely 8 more persons were having the same symptoms.
The first 4 persons were referred to Rigshospitalet and in the early hours of October 10th. They were referred for immediate hyperbaric treatment. 6 more patients were referred in the following days. The patients have been given 2 to 8 treatments with initial alleviation of the symptoms, but later the extreme tiredness reapper.
The patients we send home 19th and 21st. One of the patients who were considered very little affected and without any complaints on the 19th was readmitted to Bornholm Hospital on the 22nd. This patient experienced relief by administration of oxygen on mask.
As mentioned, the patients are still extremely tired, dizzy, and have nausea. No focal neurology has been found. The neurologists are of the opinion that the pnenomena are functional. All biochemical analyses are normal. Only the respiratory capacity is reduced as an expression of the reduced physical capacity.
The rationale for hyperbaric treatment was exposure to hydrogen sulfide. The construction of the sewers of the hospital supports this hypothesis, - but no definitve proof is found. Bornholm is surrounded by various substances from WWII and the cold war, but none of these substances to our knowledge give rise to provide a relation to the incident.
The questions are therefore:
Do you have had similar incidents ?
Do you have any clue to what substance/gas/agent/virus/bacteria could cause the incident?
If the intoxication is H2S, hydrogensulfide, which treatment do you consider most appropiate?
Ole Hyldegaard, MD, Ph.D, DM.sc
Ole Hyldegaard, MD, Ph.D., Dr.Med.Sci.
Anaesthesiology, Diving and Hyperbaric Medicine
Director of Research - Laboratory of Hyperbaric Medicine
Center of Head and Orthopedics, Dept. of Anaesthesia,
University Hospital - Rigshospitalet