Risky business: Exploring the circumstances and causes of acute chemical exposures at the workplace

The Dutch Poisons Information Centre (DPIC) has recently reported an increase in occupational incidents involving hazardous substances. These incidents pose significant health risks to workers, bystanders, and emergency responders, and cause both social and economic damage. To identify risk factors and to develop risk mitigation strategies, we analyzed the prevalence, characteristics, and causes of acute occupational intoxications reported to the DPIC.

Retrospective studies showed that the number of acute occupational intoxications reported to the DPIC almost doubled from 475 in 2016 to 936 in 2022. The majority of the reported occupational poisonings were small-scale incidents, involving a single patient. However, between 2016 and 2023, 516 large-scale incidents were reported that involved exposure of multiple individuals, including bystanders and emergency responders. In these multi-patient incidents, most victims (89%) inhaled gases or vapors. Most incidents occurred at the factories themselves (87%), while 10% involved transport. Dangerous substances were predominantly released due to leakages (80%) or as a result of fire or explosion (13%).

The DPIC routinely collects data on acute occupational intoxications, providing valuable insight into demographics, exposure characteristics, symptoms at consultation, and treatment advice. However, retrospective data are often incomplete, particularly regarding the course, circumstances, and causes of occupational intoxications. Therefore, a prospective study interviewing 310 affected workers was conducted. The majority of the interviewed patients developed only mild health effects and recovered quickly (77% within 1 week). Incidents occurred mainly in the “industry” (25%) sector, followed by the “construction” (14%) and “agriculture” (10%) sectors. The majority of patients were exposed through multiple routes, primarily via eye contact (40%), followed by inhalation (34%) and skin contact (33%). Exposure to hazardous substances can occur at different times during work. Notably, cleaning activities were responsible for a higher percentage of accidents (33%) than activities during the actual production or use of hazardous substances (21%). Causes reported by patients included technical factors (such as damaged packaging (24%) and damaged equipment (10%)), organizational factors (such as lack of work instructions (44%) and poor communication or planning (31%)) and personal factors (such as not following work instructions (13%) and not wearing mandatory personal protective equipment (12%)). It is interesting to note that 50% of patients cited personal circumstances, including fatigue, stress, time pressure and inaccuracy, as a potential cause of the accident.

While employers in the Netherlands are legally obliged to report severe accidents resulting in death, hospitalization, or permanent injury to the Labour Inspectorate, the DPIC data also include less severe incidents, providing a more comprehensive overview of workplace risks related to hazardous substances.

This thesis highlights the importance of accurate monitoring and closer collaboration between various stakeholders, such as the government, businesses and research institutes. Only by combining data and developing targeted prevention strategies can the number of incidents involving hazardous substances at work be effectively reduced.