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The Safe and Healthy Autopsy
Published in Julian L Burton, Guy Rutty, The Hospital Autopsy, 2010
Aluminium phosphide is present in some pesticides and reports of suicidal ingestion exist (Anger et al., 2000). When aluminium phosphide comes into contact with water it liberates copious volumes of hydrogen phosphide (phosphine, PH3), an odourless and colourless gas (Sharma and Reader, 2005). This gas is toxic at concentrations of 2 ppm (Anger et al., 2000). Once again the risk is greatest on opening the stomach and this should be performed in a fume cupboard.
Exploring research gaps and trends in the management of acute phosphide poisoning: a systematic review
Published in Critical Reviews in Toxicology, 2023
Zahraa Khalifa Sobh, Marwa Kholief, Eman Khalifa Sobh, Manal Ibrahim Fathy Balah
Aluminum phosphide is a highly toxic compound (oral LD50: 11.5 mg/kg), that is used as a fumigant, insecticide, and rodenticide (Bingham et al. 2001). AlP is commonly available as tablets, therefore, it is described as “rice tablets” or “wheat bills” (trade names: Quickphos, Phostoxin, Bhostoxin, Phostek, Phosphume). Each rice tablet is three grams and is constituted of 56% AlP and 44% aluminum carbonate and releases one gram of PH3 upon exposure to moisture. The AlP tablet is often grayish; however, it could be green or brown. AlP is also available as pellets (trade names: Quickphos, Alphos, Cellphos). Each 0.6 g pellet releases 0.2 grams of PH3 gas upon exposure to humidity. After the release of PH3 gas from AlP formulas, nontoxic aluminum hydroxide residues are left behind (Moghadamnia 2012). The fatal dose of AlP for a 70 kg adult is 150–500 mg for oral intake. Regarding inhalational exposure, the permissible exposure limit (PET) of AlP is 0.3 ppm throughout an 8-h shift. The short-term exposure limit (STEL) is one ppm, and the immediate threat to life and health is 200 ppm. The 400–600 ppm range has been identified for the deadly dose in 30 min (Environmental Protection Agency 1998; Bingham et al. 2001).
Impact of extra-corporeal membrane oxygenation on outcome of aluminium phosphide poisoning complicated with myocardial dysfunction
Published in Clinical Toxicology, 2019
Bishav Mohan, Vivek Gupta, Sarju Ralhan, Dinesh Gupta, Sandeep Puri, Rajesh Mahajan, Abhishek Goyal, Shibba Chhabra, Rohit Tandon, Naved Aslam, Gurpreet Singh Wander, Bhupinder Singh
The baseline characteristics (Table 1) between the two study groups were similar except for the baseline left ventricular ejection fraction (LVEF; %) which was significantly lower in the ECMO group ((median: 24; IQR: 22–28 vs. median: 30; IQR: 26.5–32; p < .0001). Male gender dominated both study groups. The SOFA score was found to be high in both the ECMO and conventional groups (median: 10; IQR: 9–12 vs. median: 11; IQR: 10–12; p = .480). The average ingested dose of aluminium phosphide was also high in both groups. The hospitalisation time was significantly longer in the ECMO group (median: 12 days; IQR: 3–22) compared with that in the conventional group (median: 1 day; IQR: 1–1.0). Supplementary Table 1 shows the demographic and clinical profile of patients in low-risk group of aluminium phosphide poisoning.
Glucose-insulin-potassium infusion for the treatment of acute aluminum phosphide poisoning: an open-label pilot study
Published in Clinical Toxicology, 2020
A. K. Pannu, A. Bhalla, J. Gantala, N. Sharma, S. Kumar, D. P. Dhibar
Agriculture is a major source of income for large scale Asian population, and the pesticides are readily available in rural areas, which make them the most frequent cause of poisoning after intentional ingestion [1–3]. Aluminum phosphide is a highly effective fumigant against insects and rodents in the preservation of stored grain [4,5]. It accounts for a large number of poisoning cases in India, mainly in the northern states [1,6,7]. The common mode of exposure is intentional ingestion. Aluminum phosphide poisoning is associated with a very high case fatality rate (CFR) ranging from 30–80%, mostly within 24–48 h [8–11].