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ACS Central Science Author Interview – Safety First: A Recent Case of a Dichloromethane Injection Injury

Lab safety is everyone’s responsibility. One common piece of equipment that doesn’t always receive as much safety-related attention is the use of needles in chemistry labs.

I recently interviewed Sébastien Vidal and Nicolas Scaglione of the University Lyon 1, who are (respectively) the author/supervisor and the main protagonist of an ACS Central Science editorial, which has generated much discussion in the chemistry community: “Safety First: A Recent Case of a Dichloromethane Injection Injury.”

Read the Open Access Editorial

In this incredible account, Sébastien Vidal outlines the accident that took place and the procedures they followed to obtain medical attention for Nicolas Scaglione.

In our interview, I delved into some more questions with both scientists.

Read the Interview

How did that day start for you, Nicolas?

It started as a normal day. I arrived at the lab, went to my desk to get what I need to start my reaction, and to say hello to everybody in the office. Then, I directly went to the lab to start my reaction, so, it was a typical start.

What happened next?

I was preparing my flask because it was a reaction carried under argon. Then, I wanted to inject my solvent inside the flask, but I forgot to put a needle as an exit. So, when I injected the solvent, because of an overpressure, the stopper popped out of the flask, then, the needle suddenly moved, and it poked my finger which was next to the flask.

Sébastien, you were in your office that morning, what was your first thought when your students came to tell you what had happened?

At first, I felt like this was another simple situation when students get poked with a needle. I was about to go and get the medikit to help him, but when I saw the purple coloration on his finger, I immediately felt that something was wrong.

Then Nicolas told me that he was injecting dichloromethane to set up his reaction that we had discussed the day before. Knowing how toxic this solvent is when in contact with skin (an extreme and immediate burning sensation when the solvent reaches under a rubber glove or wristwatch or ring), this is when I started to realize that this situation would be more complicated than it first seemed.

You knew you needed to act quickly. Fortunately, you have a hospital near campus that you could attend. What was the doctor’s reaction when you arrived?

Nicolas was first examined by a doctor and then the surgeon. We asked at the desk to immediately see a doctor for a quick assessment of the damage. The doctor came after 10-15 minutes, and he confirmed the unusual wound and diagnosed necrosis and nerve damage.

So Nicolas was then set up for a fast track surgery within the next hour but, there was a necessary further delay because another emergency came in just at that time with a worker and all his fingers cut off! After that surgery, the surgeon then started operating on Nicolas’ finger.

We only learned from him a few days after surgery, while Nicolas was going for post-operation follow up, that his first assessment was to cut off the finger due to the extent of the necrosis. But he wanted to try saving the finger for a young man in his early twenties.

Nicolas, you had to have an emergency operation on your finger. Do you remember how you felt when you heard that news?

I was very worried. I didn’t know exactly what was happening to my finger because they told me that it was necrosis. I didn’t really know what the surgeon wanted to do to cure my finger. So, the most stressful part was to not know what was going to happen. However, I was reassured to be with the surgeon that fast, I was afraid to have to wait a long time in this situation.

Sébastien, while Nicolas was in surgery, you reviewed the SDS – Safety Data Sheet – for information about dichloromethane injuries. What did you find?

I could use my smartphone to search on the internet for all possible aspects of this accident. At that time, I did not talk to the surgeon, and I was not even sure of the extent of the wound or even whether the nerve would be affected or not.

So, I searched for information about reported dichloromethane injections or accidents. I could find information about many possible exposures, but nothing about an injection. I even found information about a man who fell into a tank of dichloromethane and did not survive.

Yet, nothing about an injection of this solvent under the skin. I also looked at SDS for similar solvents like chloroform or 1,2-dichloroethane. But, still, without success. This is when I started understanding that such a situation of “injection” was never included in the SDS.

Nicolas, how is your thumb now, almost two years after the incident?

Now, my finger still looks like the picture “1 year after the accident”. My sense of touch is still missing, but I have learned how to live without it. The mobility is fine thanks to the physiotherapy, and I learned how to use my finger as I was used to. To sum up, I can use my finger as it was before the incident, even if sometimes I have some strange feelings.

Sébastien, your goal of sharing this accident was to raise awareness of the dangers of accidental injection and to try to prevent other accidents. Do you feel that you’ve achieved what you set out to do?

Our goal in sharing this accident was to alert chemists about the hazard involved with such a simple procedure that is performed endlessly in organic chemistry laboratories. Even though Nicolas could have performed his injection better, this situation can happen to anyone at any time without knowing the consequences.

It will be very difficult to avoid poking yourself with a needle throughout your career. But just be aware that dramatic consequences might arise under specific circumstances.

Another major concern is the lack of information about the injection of solvent in the SDS. The industry and authorities should consider setting up a campaign for the evaluation of this risk with common organic solvents and then provide to our community a safer set of data for risk management.

Do You Have More Questions?

Since the Editorial was published, Sébastien and Nicolas have received many important follow-up questions via email and on Twitter. In an effort to help continue this dialogue, I’ve listed some of the questions below, with answers from Sébastien and Nicolas.

Members of the community are encouraged to post additional questions via the comments section below so that Sébastien and Nicolas can respond to them as well.

Usually, when you hurt yourself with a needle, you have a tendency (and it is correct to do so) to press on the wound and have blood externalized so that some of the contaminants would be removed. Did you observe any bleeding with this injury?

Sébastien: In the specific case of Nicolas, the wound did not bleed after a few minutes. My first interpretation would be that the immediate necrosis that occurred clotted the blood into a solid material that prevented bleeding. This particularly increased the negative effect of this injection since dichloromethane could then diffuse deeper into tissues.

Nicolas: I don’t remember exactly, but just a few drops as far as I remember, at the very moment of injection, and it stopped very quickly.

How, exactly, did Nicolas stab his finger?

Nicolas: I was preparing my flask because it was a reaction carried out under argon. Then, I wanted to inject my solvent inside the flask, but I forgot to put a needle as an exit. So, when I injected the solvent, because of an overpressure, the stopper popped out of the flask, then, the needle suddenly moved, and it poked my finger which was next to the flask.

What – if any – alternatives to needles should individuals consider using in the lab, to avoid these types of accidents?

Sébastien: We cannot escape from sharp needles in organic chemistry since we need to inject liquids through a rubber stopper that is keeping our reaction vessel air/moisture-free.

But in many other cases, one uses sharp needles when not necessary, and flat-ended needles would be much less hazardous in this respect, or even plastic cones and pipettes would be even more adapted.

Can the article and related material be used in safety lectures?

Yes! The article is available open access under an ACS AuthorChoice license. Terms of use can be reviewed here.

Do you have more questions for Sébastien and Nicolas? Post them below, and they’ll respond!

Lab Safety Webinar

For more on lab safety, view this exclusive free webinar hosted by ACS Chemical Health & Safety Editor-in-Chief Mary Beth Mulcahy, along with the journal’s Managing Editor Kali Miller and ACS Committee on Chemical Safety Chair Ralph Stuart.

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