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Thursday, March 8, 2012

Docs Suspect Benzene-Like Compound Caused The Poisoning; State Sets Up High-Level Investigation

'Kids may have traded dye as colours'

More than 195 people were hospitalized in the city with complaints of giddiness, burning sensation on skin, nausea and vomiting after reports of colour poisoning. 

    Police suspected the toxic substance may have come from a deserted leather tannery in Dharavi. The Dharavi police registered an FIR against unknown persons for causing harm by dangerous means, voluntarily causing hurt and mischief under sections 337, 338, 324, 325 and 425 of the Indian Penal Code. "There is a major leather tanning industry in Dharavi," said assistant commissioner of police Prabhakar Satam. "It is possible that some children mistook leftover tanning dye for Holi colours and traded in it." 
    Health minister Suresh Shetty asked a team from the Food and Drug Administration (FDA) to collect samples and investigate the incident. A little later, the police asked officials from the forensic science laboratory to collect colour samples. 
    Most patients said they experienced the symptoms a few hours after playing with the colours, while some said they started feeling uneasy after coming in contact with water. 
    Nitin Tak (12), who was admitted to Sion Hospital's ward 3, only remembered having "taken gulal" from his friends. "I started playing holi at around 8am. After two-three hours, I came home, took a shower and went off to sleep," 
he said. Tak's mother Huli said he woke up in a daze, feeling giddy and unable to walk. He was rushed to the hospital. 
    At Rajawadi Hospital in Ghatkopar, 12 patients, including two children, were admitted for colour poisoning. Residents of the Railway Colony in Kurla, they showed symptoms similar to those exhibited by Dharavi patients. The hospital, early on, said that two patients were critical and admitted in MICU. Around 11pm, one 13-year-old patient, Vicky Valmiki, died. "The patients came with symptoms like nausea, giddiness, headache and were immediately admitted," said a doctor from the hospital. 
    The director of major hospitals and dean of KEM Hospital, Dr Sanjay Oak, said it was suspected that a chemical compound like Benzene (commonly used in paint and dye industry) caused the poisoning. "But we will know for sure only after the tests. At least the symptoms of patients are hinting towards that." Oak added that all patients will be discharged after 24 hours. "The antidote has been given. Now, oxygen administration and monitoring is being done." Oak explained that colour poisoning occurs as toxic chemical get absorbed through the skin and deprive the body of oxygen. Most patients were given the methylene blue injection that helps haemoglobin carry oxygen better. Though Sion Hospital initially ran out of stock, it managed to restore the supply by making immediate purchases. 
    The state government has 
    set up a five-member committee to probe the Dharavi episode, said additional chief secretary Jayant 
    Kumar Banthia. The panel 
    will be headed by medical education secretary I S Chahal and will include state pollution control board member secretary Milind Mhaiskar, additional municipal commissioner Manisha Mhaiskar, FDA commissioner Mahesh Zagade, a joint commissioner of police, the director of industrial safety, and the director of health department. The committee will submit its report in two weeks. "We will ensure that such incidents do not get repeated in the future," Banthia said. 
    (With inputs from 
    S Ahmed Ali) 

Doctors suspect the people who took ill and were admitted to Sion and Rajawadi hospitals were exposed to a compound like Benzene (commonly used in paint and dye industry). The compound was absorbed by the skin, triggering methemoglobinemia 
Toxic elements get diffused through the epidermis, depending on factors such as water solubility and the epidermis' thickness. Children are more vulnerable. The absorbed chemicals move down first to the dermis (where the network of blood capillaries begin) and then to the subcutaneous tissue and eventually enter the larger blood vessels 
Methemoglobinemia begins with oxidation of the blood's haemoglobin—an iron-carrying metallo-protein that transports oxygen to various cells in the body. The oxidised haemoglobin is called methemoglobin (metHb) and it, unlike haemoglobin, has low affinity for oxygen. As the proportion of metHb in blood increases, the concentration of oxygen in the blood decreases 
In methemoglobinemia, patients get less oxygen and suffer breathlessness to begin with. Cyanosis (skin turning blue), altered mental status, headache, fatigue, exercise intolerance, dizziness and loss of consciousness can also occur. The colour of blood also changes from bright red to chocolate brown. In severe cases, seizures, coma and death can occur 
The antidote, methylene blue, is easily available. However, long-term effects on various internal organs cannot be predicted, say doctors. The people at Sion Hospital will be under observation for only a while to ensure that their red blood cells go back to normal

TINGED WITH PAIN: Many kids were admitted to Sion Hospital as they complained of giddiness and nausea after playing with Holi colours


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