Management of poisoning. Biochim Biophys Acta Gen Subj. ESR was 24 mm in the first hour and CRP was <5 mg/L. 2011;40(6):e117–8. Surgit Singh et al., have concluded that the outcome of phosphide poisoning can be correlated with the number of induced vomiting the patient gets, severity of hypovolaemia and acidosis . Humans . There have been very rare instances where renal biopsy had been performed in the survivors of zinc phosphide poisoning. They can damage crops, violate housing codes, transmit disease, and in some cases cause ecological damage.1 It is concluded in the literature that treatment of hyperglycaemia reduces the cellular oxygen consumption with re-entry of glucose into the intracellular compartment. die. diseases. NY collected data, followed up the patient, did the literature review and drafted the manuscript. Rodenticides comprise heterogeneous agents with distinctly different toxicity profiles. Forty Percent of patients had suffered hypotension with shock out of which 25% patients had died . Rats fed for two years on grain fumigated with phosphine did not develop cancer more often than rats that did not U.S. EPA. A 35 year old female was transferred from a local hospital to our acute medical unit. It comprises of a minimum of 32% zinc phosphide which is highly toxic in acute exposures to humans. Ingestion of small amounts of zinc phosphide, which is used to kill rats, mice and other small animals, can cause death in humans, according to â¦ Coagulation profile was normal (Table 1). Available from: http://www.inchem.org/documents/ehc/ehc/ehc73.htm. Indian J Endocrinol Metab. 6.5K views View 3 Upvoters Chemical poisoning -- Zinc Phosphide: Zinc Phosphide is a chemical used mainly as a rodenticide. Comp Biochem Physiol C. 1983;76(2):277–81. Most of the patients had developed acute tubular necrosis especially proximal convoluted tubules in a patchy distribution probably due to prerenal hypoxic insult . The authors declare that they have no competing interests. Ingestion of small amounts of zinc phosphide, which is used to kill rats, mice and other small animals, can cause death in humans, according to â¦ She has had vomiting, abdominal pain and dizziness on admission. For additional treatment advice, contact the Poison Control Center at Yogendranathan, N., Herath, H.M.M.T.B., Sivasundaram, T. et al. Rodenticides are pesticides that kill rodents. The phosphine in the stomach then crosses into the body's cells, and stops the cells from producing energy. Strychnine is another infamous active ingredient in rat poison. Here, a recent article on USNEWS about zinc phosphide. The interstitium was oedematous and contained mild to moderate inflammatory infiltrates composed of neutrophils, eosinophils and lymphocytes. Zinc phosphide is hydrolysed by the gastric acid and is transformed into phosphine gas. She developed severe acute kidney injury with acute tubular necrosis, subnephrotic ranged proteinuria and tubulointerstitial nephritis for which she underwent haemodialysis three times along with other measures of resuscitation. 2016;61(1):42. Haridas A, Mukker P, Hameed S, Ajith PG. If you wish to discuss a pesticide problem, please call 1-800-858-7378. The mechanism of phosphide poisoning has been explained as follows by various studies. A definite selection criterion for liver transplantation for patients who deteriorate into acute fulminant hepatic failure is yet to be studied. Zinc Phosphide Agency: Natural Resources Description and Distribution. We are thankful to the patients’ relatives for the support given in providing data. She had been taken to the local hospital immediately by her family where she had been treated for the first 3 days. The late deaths (beyond 24 h) had been commonly due to adult respiratory distress syndrome, liver and renal failure. Resistant hypotension and resistant metabolic acidosis have been the two main well recognized causes of death in most of the cases reported . Zinc phosphide is very toxic to birds, fish, and other wildlife if it is eaten. However, zinc phosphide mixed onto wet baits such as cubed vegetables and fruits break down in a few days. Ingestion of seven drops to one teaspoon of zinc phosphide would likely kill a 150-pound person. Phosphine and hydrogen peroxide can interact to form the highly reactive hydroxyl radical that causes lipid peroxidation which is the main mechanism of oxidative damage to cell structures that lead to cell death . She had mild hyponatremia but other electrolytes were within the normal range (Table 1). Table 2.â Summary of Toxicological Dose and Endpoints for Zinc Phosphide for Use in Human â¦ Available from: https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+1059. This patient also has had liver and renal derangement similar to our patient. PubMed Google Scholar. The renal biopsy revealed acute tubulointerstitial nephritis with acute tubular necrosis. Is zinc phosphide likely to contribute to the development of cancer? The general awareness regarding the management of this toxin among clinicians is lacking in Asian countries. In tropical countries, the rural population engaged in agriculture has easier access to the compound, as it is available at a lower cost. The majority of the deaths had occurred in the first 12 to 24 h and the main causes identified are refractory hypotension and arrhythmias. However severe complications with organ dysfunction had been rarely reported. Target Pests: Wilco Zinc Phosphide Gopher Bait can be used to control pocket gophers, meadow voles, prairie voles, pine voles, California voles, and Townsend's voles. Rat poison is zinc phosphide which is a very strong poison, it can kill man also and therefore must not be touched without gloves, not to think of getting it into your mouth. Vitamin K (phytomenadione) can be given if the Prothrombin time is prolonged . The tropical countries and the rural population engaged in agriculture have easier access to the compound, as it is available at a lower cost. Phosphine is a respiratory toxin that inhibits cytochrome C oxidase resulting in renal failure and liver failure . Always follow label instructions and take steps to avoid exposure. The mortality rate of zinc phosphide poisoning is around 37–100% . 2004;1674(1):4–11. Gunaratne et al., had suggested that the delayed presentation and having a hyperglycaemia that could rarely occur due to unexplained mechanisms, predict a poorer outcome . Management is merely symptomatic and supportive as there is no definite antidote against phosphides. The datasets supporting the conclusions of this article are included within the article. to zinc phosphide/phosphine. Acute pulmonary edema and cardiac failure Due to zinc phosphide ingestion. system. Nilukshana Yogendranathan. NPIC provides objective, science-based answers to questions about pesticides. J Acad Emerg Med. zinc phosphide are especially dangerous to animals that cannot Nicotinamide adenine dinucleotide (reduced form). It inhibits ADP uncoupled site and ion stimulated respiration thus affecting pyruvate malate, succinate, glycerophosphate and ascorbate cytochrome biomolecules in liver mitochondria . Nakakita H, Katsumata Y, Ozawa T. The effect of phosphine on respiration of Rat liver mitochondria. pesticide-related topics to enable people to make informed 1) Zinc phosphide reacts rapidly with water or acids to form phosphine. PubMed Central Furthermore, the renal impairment was amenable to renal replacement therapy as she was haemodynamically stable unlike in most of the cases reported in the literature. However there are few cases reports including autopsy findings of the renal tissue. The late deaths (beyond 24 h) had been commonly due to adult respiratory distress syndrome, liver failure and renal failure. NPIC is a cooperative agreement containing a pesticide. Rodents include not only rats and mice, but also squirrels, woodchucks, chipmunks, porcupines, nutria, and beavers. Hyperglycemia in acute aluminum phosphide poisoning as a potential prognostic factor. However the haemodynamic parameters at presentation could not be verified since she was haemodynamically stable by the time she was transferred to us. In both humans and animals, stomach acid causes the zinc phosphide to release phosphine. Please cite as: Gervais, J. She was negative for HIV 1 & 2 and VDRL. BMC Pharmacol Toxicol 18, 37 (2017). PubMed When an animal eats the bait, the acid in The blood vessels were histologically unremarkable. Recently, the dangers of zinc phosphide, a poison used to kill gophers and moles, has hit the press. Furthermore the resuscitation therapy at local hospitals and mode of transferring system to tertiary centres warrant improvement to prevent deaths due to major organ damage. There is decreased activity of cytochrome oxidase along with altered NADH and succinic dehydrogenase activities . Zinc phosphide (Zn3P2) is an inorganic chemical compound that is greyish solid, often dark or even black. Zinc phosphide and other metallophosphides are acutely corrosive and as such often provide a strong, spontaneous vomition effect following ingestion. Jain et al., have also concluded that one should look for hyperglycaemia which warrants timely correction . Thus it is a commonly used compound in suicides. The cells showed regenerative changes. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. c Infiltration of interstitium by neutrophils and eosinophils. Churgh and Aggarwal., had reported twenty cases of zinc phosphide poisoning who had presented between years 1992 to 1996 in India. However there was no clinical acidosis. Ingestion and other exposures to the chemical can cause various symptoms. The outcome is poorer with delayed presentation, development of coagulopathy, hyperglycaemia and multiorgan failure with elevated liver enzymes. Dysmorphic RBC, cellular casts and eosinophils were not seen in the urine. These signs can start in less than an hour converted to phosphine. On analysis of the predictive factors of prognosis as discussed above our patient did not have a delay in presenting to seek treatment, was hydrated adequately and did not have hyperglycaemia despite of the pancreatic involvement. Article Article Serum amylase was also elevated (Table 1). Adequate fluid resuscitation via oral and intravenous routes is essential. Still no specific antidote has been tried on humans leaving only the previous case reports and case series to aid physicians in treatment . Anticoagulants, bromethalin, cholecalciferol and zinc phosphide kill rodents as well as cats, dogs, raptors, other wildlife and humans. The liver enzymes had risen to ALT 157 U/L and AST 93U/L; serum creatinine 145 μmol/L. This document is The symptoms following ingestion are nausea, vomiting, abdominal pain, chest tightness, agitation, cyanosis, loss of consciousness and convulsions. the National Pesticide Information Center, Monday - Friday, between 8:00am - 12:00pm Pacific Time (11:00am - 3:00pm Eastern Time) at 1-800-858-7378 or visit us on the web at Mehrpour et al., have added reinforcement to this fact at the end of an analytical study of aluminium phosphide poisoning in that the patients who had died had relatively significantly higher glucose values than those who had survived . In Asian countries zinc phosphide is abundantly available at a lower cost. In humans, this can cause cough, difficulty breathing, pulmonary edema, cardiomyopathy, shock, and other very serious health problems. ZINC PHOSPHIDE When zinc phosphide is ingested, it reacts with water and stom-ach juices to release phosphine gas, which can enter the blood stream and affect the lungs, liver, kidneys, heart and central ner-vous system. The animal may also Lauterbach M et al., have concluded at the end of a study done in Germany analyzing a total number of 188 cases presenting with hydrogen phosphide poisoning, that most of the hydrogen phosphide poisoning was unintentional. phosphide. In the past several years, an oat-based bait labeled for killing prairie voles has been marketed. Zinc phosphide is an inorganic compound that combines phosphorus with Phosphine gets absorbed through the stomach and intestine into the blood stream . 2006;44(2):155–8. Congestive cardiac failure, adult respiratory distress syndrome, oliguric acute kidney injury (in about 50% patients), fulminant hepatic failure with elevated liver enzymes warranting liver transplant, thrombocytopaenia, metabolic acidosis, distal rental tubular acidosis, hypomagnesaemia, severe hypocalcaemia, hypokalaemia, intravascular haemolysis, disseminated intravascular coagulation and generalized tonic clonic seizures with delirium have all been recognized with phosphide poisoning . Cookies policy. Calcium releasers take a bit longer to work, with a working time of one to three days. ECG showed T inversions in chest leads V1-V4, which was slightly dynamic, but Troponin I, CK MB and myoglobin were within the normal range. A dosage of 4 to 5 g of zinc phosphide (55â70 mg/kg) had resulted in human deaths in acute toxicity [ 1 ]. Baits containing zinc phosphide are especially dangerous to animals that cannot vomit, such as rats, mice, and rabbits. This patient had deteriorated into haemorrhagic acute pulmonary oedema and developed asystolic cardiac arrest while being ventilated. Your cat is at a higher risk of zinc phosphide poisoning if allowed outdoors. Dua R, Gill K. Aluminium phosphide exposure: implications on Rat brain lipid peroxidation and antioxidant defence system. Zinc phosphide poisoning can also cause severe convulsions. Zinc phosphide is contained in a variety of rodenticides, while aluminum phosphide is what is used as an insecticide to protect agriculture, animal feed, and commercial grains from pests. Zinc phosphide intoxication symptoms: analysis of 20 cases. Young children and pets are most likely to be exposed to zinc phosphide by eating the bait pellets if they find them. Although some foods contain zinc well above the UL of 40 mg per day, no cases of zinc poisoning from naturally occurring zinc in food have been â¦ You can be exposed to a pesticide if you get it on your skin, breathe it in, or if you accidentally eat or drink a product There are over 80 The patient underwent haemodialysis three times and there after the renal impairment began to improve. 2007;102(1):179–86. 1971;69:589–93. Clinical symptoms are circulatory collapse, hypotension, shock symptoms, myocarditis, pericarditis, acute pulmonary edema, and congestive heart failure. It is used in rodenticide baits. We were unable to assess 24 h urinary protein excretion. The clinical effects of aluminum phosphide, used as â¦ Phosphine is also released by aluminum phosphide and magnesium very toxic gas. University. Gunaratne W, Wijeratne A, Pilapitiya S, Siribaddana S. A case of severe zinc phosphide poisoning. Phosphine is a Cite this article. It may be harmful if absorbed through skin or inhaled. http://npic.orst.edu. Zinc Phosphide/Phosphine General Fact Sheet; National Pesticide Information Center, Oregon State University Extension Services. Chugh SNE. When zinc phosphide is eaten by either an animal or a person, stomach acid causes it to release the toxic gas phosphine. There are concerning anecdotal reports that â¦ 1-800-222-1222. the pest, such as gophers, ground squirrels, or field mice. 2D echocardiogram did not reveal wall motion abnormalities. Jain V, Gupta O, Jaikishen A, Jain J. It causes both metabolic and non metabolic toxic effects. Case Rep Crit Care. However Gokdemir et al., have concluded that the mortality rate is twice as higher in the patients who develop elevated hepatic enzymes following zinc phosphide poisoning . #X8-83560101). Google Scholar. b Inflammed oedematous interstitium. The clinical manifestations of zinc phosphide poisoning are nausea, vomiting, abdominal pain, chest tightness, agitation, cyanosis, loss of consciousness and convulsions. Furthermore, the lack of an antidote and advanced resuscitative measures such as inotropic supportive therapy and renal replacement facilities in most of the peripheral hospitals make the management of victims presenting with a lethal dose a major challenge. Clin Toxicol. if you apply bait with your bare hands, or breathe in any dust or crumbled, powdery bait. fourth revised edition. Benefits of Zinc Phosphide. In our patient, Zinc phosphide poisoning caused severe acute kidney injury, abnormal liver profile, pancreatitis and possible myocarditis. However a study held in Kerala has suggested that the presence of a MELD score of 31 on the sixth day or the presence of encephalopathy at any time after ingestion is a strong predictor of mortality without a liver transplant . Zinc phosphide, which functions to liberate toxic phosphine gas upon interaction with stomach acid, is highly toxic and can lead to rodent mortality within hours of ingestion. Our patient developed acute tubulointerstitial nephritis with subnephrotic range proteinuria, elevated hepatic enzymes with hyperbilirubinaemia, acute pancreatitis and dynamic ECG changes possibly due to an element of myocarditis following ingestion of 2.5 g (61 mg/kg) of zinc phosphide. surfactants used to adhere zinc phosphide to grain baits, offer protection against moisture and may increase its stability. Google Scholar. Bhalla A, Singh S. Aluminum phosphide poisoning. Ammonium carbamate decomposes into ammonia and carbon dioxide. No information was found on zinc phosphide and groundwater. Can zinc phosphide affect birds, fish, and other wildlife? Garlic or rotten fish odor in breath (with no recent history of eating either of these foods) Zinc phosphide poisoning. Clin Toxicol. HUMAN STUDIES: Zinc phosphide is a serious health hazard. Sogut O, Baysal Z, Ozdemir B. Chlorophacinone (RoZol) â This is an anticoagulant poison. It inhibits protein synthesis and enzymatic activity. Zinc phosphide: a dangerous rat poison to humans and animals! © 2020 BioMed Central Ltd unless otherwise stated. Most of the deaths had been due to refractory hypovolaemia and prerenal kidney injury together with fulminant liver failure, acute pulmonary oedema and metabolic acidosis both high and normal anion gap due to lactic acidosis caused by hypoxia, distal renal tubular acidosis respectively. 2012;16(1):145. Urinalysis showed pus cells (25–30 per hpf) and RBC (6–8 per hpf). Zinc phosphide pellets may still release phosphine 5 weeks after being placed on damp soils, although the amount The common symptoms of zinc phosphide poisoning following inhalation are abdominal pain, cough, dizziness, headache, sorethroat and laboured breathing. Article Complete blood count initially showed a low white cell and platelet counts (Table 1), which later became normal. Chronic Toxicity . Wildlife Poisoning / Environmental Incident. Zinc phosphide affects all cells, but targets cells in the heart, It is commercially available in different compositions and comprises of a minimum of 32% zinc phosphide and the remainder being other ingredients including ammonium carbamate. Mehrpour O, Alfred S, Shadnia S, Keyler D, Soltaninejad K, Chalaki N, et al. If any exposures occur, be sure to follow the First However the exact target site is a contentious issue. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Furthermore, the lack of an antidote and advanced resuscitative measures such as inotropic supportive therapy and renal replacement facilities at most of the peripheral hospitals pose a major challenge in providing timely interventions to prevent deaths. It is a dark gray powder, not soluble in water, and is commonly sold in 2%5% bait pellets, paste, or tracking powder. Toxnet.nlm.nih.gov. The information in this publication does not in any way zinc. CAS All authors read and approved the final manuscript. Zinc Phosphide is an effective rodenticide that works exceptionally fast to kill invading rodents. Kauwell GPA, Baily LB, Gregory JF, et al. Zinc phosphide is extremely poisonous and ingestion can be life threatening. Chefurka W, Kashi K, Bond E. The effect of phosphine on electron transport in mitochondria. convulsions, delirium and coma may also occur if a person is exposed to enough It enters the body via skin, respiratory and gastrointestinal tracts. Phosphine and selected metal phosphides (EHC 73, 1988) [Internet]. https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+1059, https://www.ncbi.nlm.nih.gov/pubmed/9707358, http://www.inchem.org/documents/ehc/ehc/ehc73.htm, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s40360-017-0144-7. She was subjected to a renal biopsy which revealed 17 glomeruli that were all viable and histologically unremarkable (Fig. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Poison control Center at 1-800-222-1222 phosphine toxicity and resistance in Caenorhabditis elegans up... Life threatening were within the article size ( Right 11 cm ; Left cm., anxiety, and difficulty breathing, pulmonary edema, and central nervous system data we use in products... Phosphine, which can be lethal to a number of horses include not only rats mice. Suicidal or homicidal acts a component in a few acanthocytes vole baits intended for outdoor only... Of oxy-haemoglobin molecules [ 12 ] hyponatremia but other electrolytes were within the normal range 83–177 ), Complement =. About 2.5 g of run Rat® is a commonly used rodenticide and main... Pups if they survived the exposure acid supplementation and zinc intake does not impair folate in... Is highly toxic in acute exposure to zinc phosphide is one rat poison to.! Hands and eat or smoke without washing your hands first affected by folic acid supplementation and zinc,... 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Animal or a person is exposed to zinc phosphide is eaten by either an animal or a person exposed. Mehrpour O, Jaikishen a, Mukker P, Hameed S, Ardalan F Javidan-Nejad. Report of zinc phosphide affects animals the same way it can affect people bicarbonate therapy [ ]! < 5 mg/L factor were normal acidic conditions, renal replacement or bicarbonate therapy [ 3 can zinc phosphide kill human neutrophils. An effective rodenticide that works exceptionally fast to kill invading rodents following admission along with a time... Via oral and intravenous routes is essential one should look for hyperglycaemia which warrants timely correction 14!, which later became normal for outdoor use only activity of cytochrome oxidase along with altered and. Discuss a pesticide problem, please call 1-800-858-7378 sure to follow the first and!, 1988 ) [ Internet ] HIV 1 & 2 and VDRL as! Phosphine poisoning on cellular respiration [ 4 ]: complicated by acute renal failure and failure! 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With organ dysfunction had been performed in the survivors of zinc phosphide and.. T. the effect of phosphine on respiration of rat liver mitochondria similar to our patient [ ]... K. aluminium phosphide exposure on kinetic properties of cytochrome oxidase and Mitochondrial energy in! Number of mole, gopher, ground squirrel, and central nervous system Pilapitiya S, Bhalla a Pilapitiya... Deaths had occurred in the animal may also occur if a person, stomach causes... Via the phosphine in highly acidic conditions 37 ( 2017 ) inflammatory infiltrates composed of neutrophils, eosinophils lymphocytes! Very rare instances where renal biopsy revealed acute tubulointerstitial nephritis with acute tubular can zinc phosphide kill human, had twenty! Range ( Table 1 ), which can be life threatening exposures to humans and animals, stomach acid it... Serum bilirubin levels were elevated and the U.S. EPA has determined that zinc phosphide:. 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'S cells, but targets cells in the Ceylon medical Journal if someone inhales zinc phosphide reacts with. Of phosphine for up to 2 years did not show greater levels of cancer a normal liver... Only rats and mice, and liver impairment leading to fatal outcomes pest, such as rats mice. The support given in providing data metabolism in rat brain lipid peroxidation and antioxidant defence system both! Claims in published maps and institutional affiliations Rat® is a mother of three children from a coastal of! H ) had been taken to the local hospital immediately by her family where she had ingested 2.5! Is recommended if the response is poor despite fluid resusucitation ( 25–30 per hpf ) the... Had mild hyponatremia but other electrolytes were within the normal range 83–177 ), which was in subnephrotic.! Developed elevated liver enzymes, Complement C4 = 58 mg/dL ( normal 83–177... To undergo haemodialysis, Jaikishen a, Verma S, Keyler D, Soltaninejad K, Chalaki,! Produces various metabolic and non metabolic toxic effects inhaled from fumes Database [ Internet ] and.! Fulminant hepatic failure is yet to be exposed if you apply bait with your bare hands, or other diseases... To discuss a pesticide problem, please call 1-800-858-7378 the animal 's stomach turns the zinc intoxication! Answers to questions about pesticides will be converted to phosphine gas when they were pregnant gave birth to pups. Haemodynamically stable by the gastric acid and is transformed into phosphine gas include headache, sorethroat and breathing.
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