Toxicoepidemiology of Phosphide Poisoning in the Central Part of Iran

Author:

Eizadi-Mood Nastaran1,Momenzadeh Mahnaz2,Sadeghi Masoumeh3,Yaraghi Ahmad4,Sabzghabaee Ali Mohammad2,Alfred Sam5

Affiliation:

1. Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2. Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran

3. Department of Radiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4. Department of Clinical Toxicology, Isfahan University of Medical Sciences, Isfahan, Iran

5. Department of Emergency Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia

Abstract

Objective: Aluminum phosphide (ALP) and zinc phosphide (ZnP) are toxic agrochemical pesticides, which are commonly used as an agent of self-harm in developing countries. Because of high toxicity of phosphides, we evaluated toxico-epidemiology ALP and ZnP poisoning in with respect to outcome. Methods: We performed a cross-sectional study with retrospective chart review including the records for patients admitted due to phosphide poisoning (ALP, ZnP) in a poisoning referral center in Khorshid Hospital, affiliated with Isfahan University of Medial Sciences, Isfahan, Iran. Demographic characteristics, clinical manifestations, outcome (survived or death), and length of hospital stay for the patients were recorded in a data collecting form. Binary backward stepwise logistic regression was used for outcome prediction. Findings: Sixty patients were evaluated in the study. The mean age of patients was 27.61. Thirty-nine patients were men. 96.7% of the patients ingested it intentionally. Most of the patients on admission were conscious (66.7%). Abnormality of EKG was noted in 8.3%. The mortality in ALP and ZnP poisoning was 39.2% and 22.2%, respectively. Serum bicarbonate and base excess in the venous blood gas analysis, systolic blood pressure, and serum sodium level were significantly different between patients with ALP and ZnP poisoning on admission time (P < 0.05). On admission, systolic blood pressure was an important predictive factor for mortality (odds ratio 4.87; 95% confidence interval: 1.5–15.45; P = 0.007). Conclusion: The rate of mortality in phosphide poisoning is high. Knowing predictive factors for mortality help physicians for selecting patients in intensive care unit admission and aggressive treatment.

Publisher

Medknow

Subject

General Medicine,Process Chemistry and Technology,Economic Geology,Fuel Technology

Reference45 articles.

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