Aluminum phosphide fatalities, new local experience

Area of Science:

• Toxicology
• Environmental Health
• Public Health

Background:

• Aluminum phosphide (AlP) is a low-cost, accessible pesticide used as a rodenticide.
• AlP toxicity arises from phosphine gas liberation upon moisture exposure, causing severe multisystem effects.
• Past parathion insecticide fatalities were common, but AlP is emerging as a significant cause of poisoning.

Purpose of the Study:

• To report on a recent cluster of ten fatalities caused by Aluminum phosphide (AlP) poisoning.
• To investigate the clinical, autopsy, and toxicological findings in AlP intoxication cases.
• To emphasize the need for increased awareness and education regarding AlP hazards.

Main Methods:

• Retrospective analysis of ten AlP fatalities over a three-month period.
• Review of clinical manifestations, scene investigations, autopsies, and histological/toxicological data.
• Case review included age, circumstances of death (accidental, suicidal, homicidal).

Main Results:

• Ten fatalities (ages 1-34) occurred due to AlP rodenticide use near grain stores.
• Circumstances included accidental (6), suicidal (2), and possible homicidal (2) deaths.
• Clinical, autopsy, and toxicological findings confirmed AlP intoxication, though initial recognition was challenging for physicians.

Conclusions:

• The cluster of AlP fatalities suggests a potential shift in pesticide poisoning patterns.
• Physician unfamiliarity with AlP complicates immediate diagnosis and treatment.
• Public and medical education, proper handling, and regulatory adherence are crucial for preventing AlP poisoning.