The typical scenario is a worker who opens the top of a petroleum storage tank to visually inspect the contents.
Hypotheses for cause of sudden death:
(1) oxygen deficiency caused by hydrocarbon-rich vapor
(2) ventricular fibrillation due to sensitization caused by inhaled hydrocarbon
Possible risk factors:
(1) high environmental temperatures (making hydrocarbons more volatile)
(2) not standing upwind of the hatch
(3) older age or comorbid cardiac conditions
(4) multiple tanks interconnected
(5) recent exercise to climb to the top of the tank
Near-misses may be indicated by complaints of:
(1) dizziness
(2) confusion
(3) immobility
(4) collapse
Solutions:
(1) external monitoring of tank contents
(2) wearing of self-contained breathing apparatus (SCBA)
(3) degassing of tank prior to looking in
The diagnosis requires exclusion of other causes.
