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Archives of Industrial Hygiene and Toxicology

The Journal of Institute for Medical Research and Occupational Health

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Volume 63, Issue 1

Issues

A Systematic Review of Aluminium Phosphide Poisoning

Omid Mehrpour
  • Department of Clinical Toxicology, Birjand University of Medical Sciences (BUMS), Birjand
  • Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences (BUMS), Birjand
  • Other articles by this author:
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/ Mostafa Jafarzadeh
  • Department of Forensic Medicine and Toxicology, Faculty of Medicine, Birjand University of Medical Sciences (BUMS), Birjand
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mohammad Abdollahi
  • Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • Other articles by this author:
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Published Online: 2012-03-26 | DOI: https://doi.org/10.2478/10004-1254-63-2012-2182

A Systematic Review of Aluminium Phosphide Poisoning

Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fluid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management.

Sustavni pregled otrovanja aluminijevim fosfidom

Svake godine u svijetu oko 300.000 ljudi umre od trovanja pesticidima. Najčešći pesticidni spojevi su organofosfati i fosfidi, ponajviše aluminijev fosfid. On je poznat kao otrov samoubojica, jer ga je lako nabaviti, a nema djelotvornoga protuotrova. Toksičnost duguje otpuštanju fosfinskoga plina u trenutku kada tableta dođe u dodir s vlažnim okružjem. Fosfinski plin ponajviše djeluje na srce, pluća, probavni sustav i bubrege. Znakovi i simptomi trovanja obuhvaćaju mučninu, povraćanje, uznemirenost, bol u trbuhu, lupanje srca, refraktorni šok, srčane aritmije, plućni edem, dispneju, cijanozu i osjetilne promjene. Dijagnoza se zasniva na kliničkom opažanju, pozitivnom nalazu testa na fosfin sa srebrnim nitratom, aspiratu iz želuca te biokemiji crijeva. Otkrije li se rano, liječenje obuhvaća ispiranje želuca kalijevim permanganatom, odnosno kombinacijom kokosova ulja i natrijeva bikarbonata, aktivni ugljen te palijativnu skrb. Usmjereno liječenje obuvhaća intravensku primjenu magnezijeva sulfata i kokosova ulja. Korisnim se može pokazati liječenje acidoze ranom intravenskom primjenom natrijeva bikarbonata i liječenje srčanoga šoka odgovarajućom tekućinom i vazopresorom te refraktornog šoka, intraaortalnim balonom odnosno digoksinom.

Korisnim se može pokazati i trimetazidin, budući da sprječava ventrikularne ekstrasistole i bigeminiju te čuva oksidativni metabolizam. Ovaj članak donosi pregled različitih vidova trovanja aluminijevim fosfidom, uključujući njegovu epidemiologiju, toksičnost, kliničke znakove i simptome te medicinsku obradu.

Keywords: human poisoning; mechanism of toxicity; phosphine; phosphides; pesticides

Keywords: fosfin; pesticidi; toksičnost; trovanje

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About the article


Published Online: 2012-03-26

Published in Print: 2012-03-01


Citation Information: Archives of Industrial Hygiene and Toxicology, Volume 63, Issue 1, Pages 61–73, ISSN (Print) 0004-1254, DOI: https://doi.org/10.2478/10004-1254-63-2012-2182.

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Food and Chemical Toxicology, 2015, Volume 80, Page 182
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DARU Journal of Pharmaceutical Sciences, 2015, Volume 23, Number 1
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Journal of Medical Hypotheses and Ideas, 2012, Volume 6, Number 1, Page 32
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Journal of Forensic Sciences, 2015, Volume 60, Page S261
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International Journal of Pharmacology, 2013, Volume 9, Number 8, Page 493
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Case Reports, 2014, Volume 2014, Number jun04 1, Page bcr2014203989
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Asian Journal of Animal and Veterinary Advances, 2014, Volume 9, Number 5, Page 302
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Cellular and Molecular Neurobiology, 2014, Volume 34, Number 2, Page 269
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Renal Failure, 2013, Volume 35, Number 8, Page 1170
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