Phosphorus Poisoning
Phosphorus
Phosphorus is used in
the manufacture of matches, fireworks, rodenticide, and fertilizers. Three
forms of phosphorus are available white, red, and black. Yellow phosphorus is
formed by a small amount of red phosphorus resulting discoloration of white
phosphorus.
Mechanism of action: It affects cellular
oxidation, and it is highly corrosive and is also a general cellular poison.
Cardiovascular collapse occurring after ingestion results not only from fluid
loss caused by vomiting and diarrhea but also from a direct toxic effect on the
heart and vascular tone.
Sign and symptoms: Ingestion of elemental
white or yellow phosphorus typically causes severe vomiting and diarrhea,
having a garlic-like odor. Other signs and symptoms of severe poisoning are
dysrhythmias, coma, hypotension, and death. It can also cause liver become
swollen, fatty, and soft suggestive of acute liver atrophy etc.
Fatal dose: 60-120 mg
Fatal Period: 2-8 days
Treatment: Gastric lavage using potassium permanganate, stomach can be washed with
copper sulphate solution, or 0.2 gm copper sulphate may be given every 5
minutes until vomiting occurs. It coats the particles of phosphorus with a film
of copper sulphide which is harmless. Copper sulfate reacts with phosphorus to
form cupric phosphate, which is black and assists in visualizing phosphorus.
Autopsy findings Signs of jaundice, multiple haemorrhages in the skin, the gastric and
intestinal contents may smell of garlic and may be luminous.
Phossy jaw: The frequent inhalation of fumes over a period of years causes necrosis
of the lower jaw in the region of a decayed tooth. Initially there is toothache
followed by loosening of the teeth, necrosis of tooth, swelling of jaw.
Osteomylitis and necrosis of jaw occurs with multiple foul smelling pus discharging sinuses. Phossy jaw known as phosphorus necrosis of the jaw
was an occupational disease affecting those who worked with white phosphorus
(also known as yellow phosphorus) without proper safeguards. It was most seen
in workers in the matchstick industry in the 19th and early 20th centuries. It
was caused by white phosphorus vapor, which destroys the bones of the jaw.
Modern occupational hygiene practices have since eliminated the working
conditions that caused this disease.
Medico legal aspects
Accidental poisoning
may occur in chidlrens, it may be used for homicides, and it can be used for
criminal abortion.
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