Metal phosphide poisoning in Menoufia University Hospitals

Abstract

Objective To assess the pattern, severity, and outcome of metal phosphide poisoning cases admitted to Menoufia University Poison and Dependence Control Center (MPCC). Background Over the past years, the consumption of metal phosphide rodenticide has been increasing, causing severe morbidity and elevated mortality. It was the first cause of death in poisoning cases admitted to MPCC during the past 2 years. On phosphides contact with moisture or acids, liberation of phosphine gas leads to widespread organ damage. Phosphine blocks the enzyme cytochrome C oxidase, as a result of which mitochondrial oxidative phosphorylation is inhibited. It also denatures many enzymes involved in cellular respiration and metabolism. Patients and methods A prospective study was conducted on 80 patients with acute zinc and aluminum phosphide (ALP) poisoning who were admitted to MPCC, during the period from the first of September 2015 to the end of February 2016. Results A significant relation was found between zinc phosphide, time passed since exposure, and complaint on arrival (P = 0.04), and a nonsignificant relation between ALP, time passed since exposure, and complaint on arrival was detected (P = 0.1). Highly significant relation was noticed between type of phosphide and both echocardiography and poison severity score (P < 0.001). Relation between type of phosphide and outcome of cases was highly significant. Conclusion Metal phosphide compounds cause very serious manifestations to exposed humans with high mortality, which is especially pronounced in ALP poisoned cases.