Aluminium phosphide poisoning

Aluminium phosphide poisoning is a form of poisoning that occurs from ingesting or inhaling aluminium phosphide (AlP), a chemical compound commonly used as a pesticide and rodenticide. This type of poisoning is a significant health concern, especially in agricultural areas where the substance is frequently used. Aluminium phosphide releases phosphine gas (PH3), a highly toxic substance, when it comes into contact with moisture, including humidity in the air or acids in the stomach.

Symptoms

The symptoms of aluminium phosphide poisoning can vary depending on the amount of the substance ingested or inhaled. Early symptoms often include:

• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Dizziness and headache

Severe poisoning can lead to more serious health issues such as:

• Cardiovascular collapse
• Pulmonary edema
• Acute kidney injury
• Liver failure
• Metabolic acidosis

Diagnosis

Diagnosis of aluminium phosphide poisoning is primarily based on the clinical history of exposure and the presenting symptoms. Specific tests to detect the presence of phosphine gas in the blood or breath may also be conducted. However, such tests are not widely available and require specialized equipment.

Treatment

Treatment for aluminium phosphide poisoning focuses on supportive care and managing complications, as there is no specific antidote. Treatment strategies may include:

• Gastric lavage with potassium permanganate to oxidize phosphine gas
• Administration of intravenous fluids
• Use of vasopressors for cardiovascular support
• Supplemental oxygen or mechanical ventilation for respiratory distress

Prevention

Preventing exposure to aluminium phosphide is crucial to avoid poisoning. This can be achieved through:

• Proper storage and handling of the chemical
• Use of personal protective equipment (PPE) during application
• Education and training for individuals who work with aluminium phosphide

Epidemiology

Aluminium phosphide poisoning is more common in rural agricultural areas, particularly in developing countries where the use of this pesticide is widespread. Cases of intentional poisoning, either accidental or as a means of suicide, have also been reported.

Conclusion

Aluminium phosphide poisoning is a serious and potentially fatal condition that requires immediate medical attention. Awareness and education about the safe handling and use of aluminium phosphide, along with prompt and effective treatment of poisoning cases, are essential to prevent fatalities.