Acute exposure to white phosphorus: a topical problem in Ecuador (South America)

There is evidence of a growing number of cases of intoxication due to white phosphorus (WP) in Ecuador. These cases mainly occur after consuming the so-called 'little devils'. This work involved a retrospective-type observational descriptive analysis of all the cases registered in the country in a time interval of 19 years. A total of 590 cases were described in this period. The age of the intoxication cases ranged from 2 to 70 years, with an average of 18.27 years. With respect to genre, women were the most affected (68%). The aetiology observed was intentional or violent in 98.6% of the cases registered, the onset of the problem being the most commonly cited cause. The quantity consumed varied between 1 and 70 tablets (0.3-21g). WP produces hepatic and renal failure, which leads to secondary cardiac failure, which is the cause of death. The mortality observed exceeds 10% of the intoxicated people. The main reason for the ingestion of WP is for autolitical purposes, due to a high component of depressive affectation in the majority of patients. Supplementary psychiatric studies will be required in the future to determine the main causes. The posterior hepatic damage, which is considered as an after-effect could not be confirmed, as there are no follow-up protocols, although the hepatotoxity of this substance is obvious. The utility of a specific antidote for this type of intoxication has not been demonstrated. However, the importance of an early gastric wash/aspiration and the administration of large doses of activated carbon prove to be very important. A determinant factor in the quality of survival is early and appropriate health care for the intoxicated people.