摘要
目的调查分析一起某塑胶工厂食堂发生的植物皂素中毒事件的原因和特点,为皂素中毒事件预防控制提供参考。方法使用食物中毒个案调查表收集深圳市某塑胶工厂中毒患者资料,通过现场调查和电话访问等方法收集本次中毒事件相关信息,通过回顾性队列研究分析事件发生的可疑餐次和可疑食品。结果此次皂素中毒事件共发现患者8例,员工罹患率为28.57%(8/28)。患者临床症状以头晕(100%)、呕吐(87.50%)为主。员工食用4月10日公司食堂提供的中餐者罹患率(50.00%)显著高于未食用当日中餐者(0%)(P=0.008,RR=+∞),当日中餐食用薯蓣骨头汤者罹患率(100%)高于未食用者(0%)(P<0.001)。检测患者呕吐物、剩余食品(薯蓣)样品和食品原材料(生薯蓣)皂素毒素阳性。结论该事件为一起皂素毒素中毒事件,致病因子为4月10日中餐未煮熟的薯蓣骨头汤。薯蓣属食物含有植物皂素,食用时需煮熟煮透避免引起中毒。
Objective To investigate and analyze the causes and characteristics of a food poisoning event induced by plant saponins in the canteen of a plastic factory so as to provide a basis for preventing and controlling poisoning due to saponins. Methods A food poisoning case questionnaire was used to collect the data concerning poisoning patients in a plastic factory in Shenzhen City. The related information about the poisoning event was collected by means of on-site investigation and telephone interview, and a retrospective cohort study was conducted to ascertain the suspicious meal times and food. Results A total of 28 patients were involved in this saponins poisoning incident, with the attack rate of 28.57%(8/28). They main clinical manifestations were dizziness(100%) and vomiting(87.50%). The attack rate was significantly higher in the employees who had lunch in the canteen on April 10 than in those who did not have(50% vs. 0%, P=0.008, RR=+∞) as well as higher in the employees who ate Dioscorea hispida Dennst and bone soup than in those who did not eat(100% vs. 0%, P<0.001). Toxic saponins were detected in the patient's vomit, the remaining food(Dioscorea) and food raw material. Conclusions This incident was a food poisoning event due to toxin saponins, and the suspicious food was undercooked Dioscorea hispida Dennst and bone soup at lunch on April 10. The food of Dioscoreaceae contains plant saponins, which needs to be well cooked to avoid causing poisoning.
引文
[1] 杨湘霞,汪莉,霍雪霞.含皂素食物中毒的调查与检测[J].实用预防医学,2004,11(6):1149-1150.
[2] 王勇,刘伟光,吕嵩.哈尔滨市近年发生多起豆角中毒事件的调查分析[J].中国预防医学杂志,2007,8(4):460-461.
[3] 孙长灏,凌文华,黄国伟.营养与食品卫生学[M].第7版.北京:人民卫生出版社,2017:471.
[4] 周志峰,邓凯杰,王永刚,等.一起东北油豆角引起的食物中毒事件的调查与处理[J].现代预防医学,2014,41(12):2160-2161.
[5] 李洁.一起豆皂素食物中毒的调查[J].中国校医,2004,18(5):387.
[6] 黄含含,李霞,高文远,等.薯蓣属药用植物的亲缘关系研究[J].中国校医,2015,40(17):3470-3479.
[7] Pinder AR.An alkaloid of Dioscorea hispida dennst[J].Nature,1951,168:1090.