Three cases of intoxication due to nickel tetracarbonyl are described. Early in March of 2008, an employee working as a mechanic came to the BASF SE site medical clinic in Ludwigshafen complaining predominantly of cough and breathing difficulties. That morning he had experienced nausea and one bout of vomiting. He had been dismantling reactors and pipes in a propionic acid plant over a period of several days as part of periodic maintenance activities. No specific exposure event was reported by the employee. Based on knowledge of the plant operations (nickel tetracarbonyl is used as catalyst), a urine sample was collected for determination of urinary nickel concentrations. This determination revealed a high level of nickel in the urine and resulted in a diagnosis of nickel tetracarbonyl intoxication. The same diagnosis was established for two additional employees found to have similar symptoms, who were being treated by external physicians as suspect cases of common cold and incipient pneumonia, respectively. Chest x-rays showed a peribronchial infiltration. Laboratory blood analyses were consistent with a non-specific inflammatory response. Within one week the symptoms resolved and the clinical examination findings returned to normal. The implications of these findings to work and medical practices in areas where potential exposure to nickel carbonyl may occur are discussed.
