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Aluminium and zinc phosphide poisoning.
1National Poisons Information Service, City Hospital, Birmingham, UK. alexproudfoot@mortonhall.demon.co.uk
Clinical Toxicology (Philadelphia, Pa.)
|March 13, 2009
Summary
Aluminium and zinc phosphide poisoning is caused by phosphine, which damages mitochondria and causes circulatory collapse. There is no antidote, and treatment focuses on supportive care for severe toxicity.
Area of Science:
- Toxicology
- Environmental Health
- Occupational Safety
Background:
- Aluminium and zinc phosphides are widely used as insecticides and rodenticides.
- Acute poisoning can occur through ingestion or inhalation of phosphine gas.
- Both direct and indirect exposure routes pose significant health risks.
Purpose of the Study:
- To elucidate the mechanisms of phosphine toxicity.
- To describe the clinical features of phosphide poisoning.
- To outline current management strategies for phosphine and metal phosphide poisoning.
Main Methods:
- Review of existing literature on phosphine toxicity.
- Analysis of in vitro and in vivo studies on phosphine's effects on cellular respiration and mitochondrial function.
- Compilation of clinical data on poisoning cases.
Main Results:
- Phosphine inhibits oxidative respiration and disrupts mitochondrial morphology, independent of cytochrome c oxidase inhibition.
- Phosphine generates hydroxyl radicals, leading to lipid peroxidation and cellular damage.
- Clinical manifestations include circulatory collapse, pulmonary edema, metabolic acidosis, and organ failure.
Conclusions:
- Phosphine toxicity involves multifaceted mechanisms beyond cytochrome c oxidase inhibition.
- Effective treatment is limited, with supportive care being the mainstay.
- Understanding these mechanisms is crucial for developing targeted interventions.
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