Acute phosphine poisoning on board a bulk carrier: analysis of factors leading to a fatal case

Loddé, Brice; Lucas, David; Letort, Jean-Marie; Jégaden, D.; Pougnet, Richard; Dewitte, Jean‐Dominique

doi:10.1186/s12995-015-0050-0

Cited by 24 publications

(23 citation statements)

References 24 publications

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“…Ponadto załoga może być dłużej narażona na działanie czynnika toksycznego, a większa ekspozycja jest związana z poważniejszymi następstwami zatrucia [3,4]. Z tych względów szanse uratowania osób z najcięższy-mi objawami zatrucia są znacznie mniejsze niż wówczas, gdy natychmiast zostaje udzielona pomoc medyczna i wdrożone są właściwe procedury leczenia.…”

Section: Wstępunclassified

Late effects of mass acute phosphine poisoning – Case report

Waszkowska¹,

Walusiak‐Skorupa²,

Merecz-Kot³

et al. 2018

Med Pr

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StreszczenieW artykule przedstawiono przypadek zbiorowego ostrego zatrucia fosfanem (PH 3 ) wśród załogi statku handlowego. Badaniu poddano wszystkie osoby w 3 miesiące po zdarzeniu w celu oceny późnych zdrowotnych następstw wypadku. W trakcie hospitalizacji wykonano konsultacje specjalistyczne i badania laboratoryjne, na których podstawie u 5 osób stwierdzono toksyczne uszkodzenie wątroby. Natomiast u 5 innych pacjentów rozpoznano zaburzenia stanu psychicznego w postaci zaburzeń adaptacyjnych i zespołu stresu pourazowego. Wyniki badań wskazują, że w podobnych przypadkach ocena funkcjonowania psychicznego pacjentów powinna być nieodzownym elementem procedury diagnostyczno-terapeutycznej. Med. Pr. 2018;69(3) Słowa kluczowe: ostre zatrucie, zespół stresu pourazowego, fosforan glinu, fosfan, marynarze, zatrucie zbiorowe AbstractThis paper reports the case of collective acute phosphide (PH 3 ) intoxication among the crew aboard a merchant ship. All the intoxicated individuals were hospitalized 3 months after the accident. The aim of examinations was to identify late health effects of the accident. Laboratory tests and consultations were performed during their stay in the hospital. There were 5 cases of toxic liver damage. other 5 patients were diagnosed with posttraumatic stress disorder and adjustment disorders. The results of the study suggest that in cases of acute phosphide intoxication, the assessment of patients' psychological functioning should be an indispensable part of diagnostic procedure. Med Pr 2018;69(3) WSTĘPFosforan glinu należy do grupy najczęściej stosowanych insektycydów i rodentycydów w krajach rozwijających się. Jest używany m.in. w transporcie morskim do ochrony ładunku, np. surowców i produktów spożywczych, przed szkodnikami. W zależności od temperatury i wilgotności względnej powietrza dochodzi do hydrolizy tego związku, w której wyniku powstaje fosfan/fosforowodór (PH 3 ), gaz o wysokiej toksyczności nie tylko dla zwierząt, ale także ludzi.Mechanizm toksyczności tego związku polega na hamowaniu oksydazy cytochromu c w mitochondriach.Fosforowodór wykazuje nieswoiste działanie wielonarządowe, dlatego powoduje bardzo szerokie spektrum objawów zatrucia. W warunkach narażenia inhalacyjnego działa drażniąco na błonę śluzową układu oddechowego. Przyczyną zgonów w następstwie ostrego zatrucia jest obrzęk płuc. Objawy neurologiczne towarzyszące zatruciu to: ból głowy, drgawki, śpiączka. Do najczęstszych objawów zatrucia ze strony układu pokarmowego należą: brak apetytu, nudności, wymioty, biegunka, żółtaczka. W przebiegu ostrego zatrucia może dochodzić do zaburzeń zachowania i zaburzeń psychotycznych. Nie ma swoistej odtrutki na ten związek, a podstawową formą leczenia skutków ostrego zatrucia

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Section: Wstępunclassified

Late effects of mass acute phosphine poisoning – Case report

Waszkowska¹,

Walusiak‐Skorupa²,

Merecz-Kot³

et al. 2018

Med Pr

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“…The autoignition temperature of pure PH 3 is 38 °C but the presence of impurities, particularly diphosphine (PH 2 -PH 2 ), often causes the reacting product to ignite spontaneously at room temperature and form explosive mixtures with air at concentrations greater than 1.8% [2]. Thus, the AlP presence has a significant effect on the safety of waste fumigant residues, and can be hazardous to humans, animals, and the environment if not handled properly [8,9]. However limited researches have focused on it.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, several safety accidents caused by improper handling of AlP fumigant residues have been reported posing a substantial risk to the health of food inspection and quarantine personnel, as well as food safety [8,10,11]. Hence, there is an urgent need to identify suitable methods for handling waste fumigants to ensure smooth workflow during the inspection and quarantine of imported foodstuff and guarantee steady progress in food safety strategy.…”

Section: Introductionmentioning

confidence: 99%

“…Equipment requirements for incineration are substantial and need to be set up in close proximity, resulting in higher costs and operational difficulties. Additionally, waste fumigants produced during shipping exhibit higher fluctuating concentrations of residual AlP, compared to waste fumigants generated by ordinary food storage increasing the risks of these techniques [8,11,14]. Furthermore, due to differences in temperature and duration of food storage, waste fumigants two to five times the volume of the original fumigant, containing undecomposed AlP (3-30 wt.…”

Section: Introductionmentioning

confidence: 99%

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Study of aluminum phosphide levels in waste fumigants from food shipments following simple immersion treatment

Wan¹,

Chen²,

Jia³

et al. 2018

Environ. Protect. Eng.

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Increasing concentrations of aluminum phosphide (AlP) in waste fumigants and residues pose a serious threat to human health. This study focused on the effectiveness of the widely used simple immersion treatment for waste fumigants from shipments, which usually have a higher concentration of residual AlP. A field survey of an operational process was conducted followed by a quantitative analysis of the immersion treatment's hydrolytic effect on AlP. Further investigation on the safety of waste fumigants after the immersion treatment was conducted. It was found that the AlP concentration in the waste fumigant varied significantly with the sampling date, ranging from 12.93±0.67 wt. % to 29.50±1.18 wt. %. Simple immersion treatment could reduce the concentration of residual AlP in waste fumigants but the hydrolytic effect varied largely ranging from 19.5% to 31.9%. The concentration of residual AlP remained high (9.1-20.1 wt. %) after the immersion treatment. About 3.2-15.2 wt. % of AlP remained in the samples, following an additional 40 days of natural air-drying when phosphine gas release was not detected. The study indicates that conventional simple immersion treatment cannot ensure the complete hydrolysis of AlP from waste fumigants of shipments.

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“…The exploitation of certain resources will always expose seafarers to other carcinogens [3]. The transported goods, or their treatment, will always expose the seamen to risks, such as poisoning [4]. Seamen will always be exposed to risk of infection, especially during a stopover [5].…”

mentioning

confidence: 99%

When do the economic aspect and ecology policies defend health of mariners?

Pougnet¹,

Pougnet

Lucas³

et al. 2017

International Maritime Health

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*Seamen can develop many pathologies: respiratory diseases, cutaneous diseases, cancer, joint pathologies etc. Several studies have shown the significant risk of cancer to seamen, particularly in engineers [1]. There are several reasons for these cancer risks.Seamen worked for a long time at the edges of boats containing asbestos. This explains a number of lung cancer and the mesothelioma [2]. Regulations have evolved in many countries. In France, for example, the use of asbestos in construction was banned in 1996. We can assume that over time this risk of asbestos-exposure cancer will go down and disappear.Unfortunately, there are other carcinogens on ships. Polycyclic aromatic hydrocarbons (PAHs) are also carcinogenic. They also have neurological toxicity during acute poisoning. Therefore, seamen are still exposed, particularly in engine rooms [1]. What can be done to reduce this exposure?Developments of an ecological economy could reduce these exposures. Indeed, we are witnessing the emergence of new, greener technologies in maritime transport (https://www.meretmarine.com/fr/content/fairtransport-relance-le-commerce-maritime-la-voile). The goal of these new technologies is to reduce global warming of the Earth (http:// www.bretagne-info-nautisme.fr/fr/actualites/actualites/unnouveau-bateau-pour-transporter-feves-de-cafe-et-cacao). Several manufacturers are developing wind powered ships.What are the consequences for the health of seamen? They will work less at engine rooms. There will be less PAH and exhaust emissions. Seamen will be less exposed.It is logical to presume that the risks of acute intoxication and cancer will be reduced.Nevertheless, these new technologies will not solve all the occupational health problems of seamen. The exploitation of certain resources will always expose seafarers to other carcinogens [3]. The transported goods, or their treatment, will always expose the seamen to risks, such as poisoning [4]. Seamen will always be exposed to risk of infection, especially during a stopover [5].On the other hand, new occupational health issues may arise. For example, will the new materials themselves have health effects? Will shipbuilding workers be affected by other diseases? As for the seamen who sail on these boats, will they have new pathologies? We know, for example, that seamen have a lot of accidents at work [1]. New tasks on these wind-powered ships may have an impact on the frequency of accidents.Finally, there is a question of social justice. Indeed, in Europe, there is a considerable social class gradient in male mortality. Might these new technologies create a new gradient between seamen on ships built in countries with high levels of ecological development and others seamen? The vigilance of marine physicians around the world will highlight these new dynamics of public health. In our countries, the French Society of Maritime Medicine and the Spanish Society of Maritime Medicine are developing a program to evaluate occupational risks on board these new ships. Firstly, studies of new...

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Acute phosphine poisoning on board a bulk carrier: analysis of factors leading to a fatal case

Cited by 24 publications

References 24 publications

Late effects of mass acute phosphine poisoning – Case report

Late effects of mass acute phosphine poisoning – Case report

Study of aluminum phosphide levels in waste fumigants from food shipments following simple immersion treatment

When do the economic aspect and ecology policies defend health of mariners?

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