ORIGINAL RESEARCH article
Front. Toxicol.
Sec. Clinical Toxicology
Volume 7 - 2025 | doi: 10.3389/ftox.2025.1570887
The patterns of dynamic changes in blood toxicant levels, prognosis, and regression in a case of occupational chlorfenapyr exposure
Provisionally accepted
- 1Department of Poisoning and Occupational Diseases, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
- 2School of Public Health, Shandong University, Jinan, Shandong Province, China
- 3School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
- 4Department of Emergency Intensive Care Medicine Center, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Objective: In July 2024, cases of chlorfenapyr poisoning occurred consecutively among workers in a chlorfenapyr production plant in Shandong Province. This study aimed to analyze the clinical characteristics of this event and discuss the significance of toxicant testing and imaging examinations in guiding clinical practice. Methods: We retrospectively analyzed the clinical data of four patients with occupational chlorfenapyr poisoning. Results: All four patients worked in the same factory before admission; three worked in the same workshop, while one worked in the product inspection department. Patients 3 and 4 had no obvious clinical manifestations, whereas patients 1 and 2 primarily presented with hyperhidrosis, fever, and neurological symptoms. Laboratory tests revealed abnormalities in blood counts, liver and kidney function indicators, and cardiac enzyme profiles in some patients. Magnetic resonance imaging revealed varying degrees of abnormal signal changes in the brain and spinal cord in Patients 1, 2, and 3. After comprehensive treatment with blood purification, organ protection, and symptomatic treatment, chlorfenapyr blood concentrations in patients 1, 2, and 3 decreased. Patients 1 and 3 were discharged on the 30th and 14th days of admission, respectively, while patient 2, whose condition worsened, died on the 11th day of treatment after unsuccessful resuscitation. Conclusion: Patients with occupational chlorfenapyr poisoning may have no obvious clinical symptoms or may present with excessive sweating and fatigue in the early stages, unlike patients who have ingested chlorfenapyr orally. Therefore, early detection and imaging examinations are crucial for an accurate diagnosis.
Keywords: chlorfenapyr, Poisoning, event, toxicant detection, Neurological imaging
Received: 11 Mar 2025; Accepted: 28 May 2025.
Copyright: © 2025 Liu, Shan, Wang, Jian, Kan and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yingli Ren, Department of Emergency Intensive Care Medicine Center, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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