Toxicology on aluminium phosphide, the characteristics, fatal dose,fatal period, sign and symptoms, postmortem appearance and medicolegal importance are discussed.

1. MARYAM JAMILAH BINTI ABDUL HAMID
082013100002
IMS BANGALORE
Aluminium Phosphide

2. LEARNING OUTCOME
Source
Characteristics
Mode of poisoning & fatal
dose
Signs and symptoms
Post-mortem appearance
Medicolegal importance

3. Source & characteristics
 Greyish green tablet, metallic taste, garlicky
odour
 Solid fumigant pesticide, insecticide and
rodenticide
 Widely used as grain preservative (phosphite &
hypophosphite of aluminium are non-toxic
residues left in the grains)
 Celphos, Alphos, Quickphos, Phostoxin,
Phosphotex
 Each tablet is 3g, can liberate 1g of phosphine
(PH3) when come in contact with moisture
 HCl in stomach accelerate the convertion

5. Mode of poisoning & fatal dose
1. Ingestion
 Fatal dose: 0.5 g (1-3 tablets)
 Fatal period: 1-4 hours. Majority die within 24
hours
2. Inhalation
 Fatal dose: inhale phosphine 400-600 ppm
 Fatal period: 1-4 hours. Majority die within 24
hours

6. Absorption & Excretion
Ingest
 Absorbed from GI tract by simple diffusion
 Then, some ALP metabolised in liver &
phosphine is slowly released
 Phosphine is oxidised slowly to oxyacids
 Excreted in urine as hypophosphine
Inhale
 Rapidly absorbed from the lungs
 Excreted unchanged form through lungs

7. Action
 Inhibits respiratory chain enzymes and has
cytotoxic action
 Inhibits electron transport; inhibits cytochrome
oxidase

8. Signs and SymptomsINHALATION
MILD: irritation of mucous membrane, acute
respiratory distress, dizziness, easy fatigue,
tightness in the chest, nausea, vomiting,
diarrhoea, headache
MODERATE: ataxia, numbness, paraesthesia,
tremors, diplopia, jaundice, muscular weakness,
incoordination and paralysis
SEVERE (PH3> 0.3 ppm): adult respiratory
distress syndrome, cariac arrhythmias, congestive
cardiac failure, pulmonary edema, convulsions,
coma

9. MILD: nausea, vomiting, headache, abdominal pain
(patients usually recover)
MODERATE & SEVERE: systemic manifestations are
early and progressive and mostly fatal
GIT: nausea, vomiting, diarrhoea, retrosternal pain
CVS: hypotension, shock, arrhythmias, myocarditis,
pericarditis, acute congestive heart failure
RS: cough, dyspnoea, cyanosis, pulmonary edema,
respiratory failure
HEPATIC: jaundice, hepatitis, hepatomegaly
RENAL: renal failure
CNS: headache, dizziness, altered mental state,
restlessness, convulsions, acute hypoxic
encephalopathy, coma
RARE: muscle wasting, tenderness and bleeding

10. Complications
 Cardiogenic shock (most common cause of
death)
 Pericarditis
 Acute congestive cardiac failure
 Acute massive GI bleeding
 ARDS (high mortality)

11. Postmortem appearances
 Garlic-like odour at the mouth & nostrils & gastric
content
 Blood-stained froth in the mouth & nostrils
 Mucous membrane of the lower part of
esophagus, stomach & duodenum are congested
 Decreasing congestion of GI in small intestine
 Lungs, liver, spleen, kidneys & brain are
congested
 Centrizonal haemorrhagic necrosis of the liver
may be seen

14. Histopathology
 Stomach: congestion, edema, leucocytic
infiltration, sloughing of gastric mucosa
 Lung: congestion, edema, desquamation of
respiratory epithelium, thickened alveoli,
lymphocytic infiltration
 Kidneys: congestion, necrosis, tubular
degeneration and regeneration
 Adrenals: congestion, haemorrhage, necrosis,
area of lipid depletion in cortex
 Heart: congestion, edema, fragmentation of
fibres, focal necrosis, leucocytic infiltration
 Brain: congestion, edema

15. Medicolegal importance
 Suicidal in rural area of india
 Accidental poisoning by farmer who sleep near
godown; leaking phosphine from godown is
possible
 Accidental poisoning by children which mistakenly
ingest the tablets

16. Chemical tests
 5 ml of gastric aspirate + 15 ml of water are put in
a flask and the mouth is covered with a filter
paper impregnated with 0.1 N silver nitrate. Flask
is heated at 50C for 15-20 minutes. Filter paper
turns black if phosphine present.
 A piece of filter paper impregnated with 0.1 N
silver nitrate solution is used in the form of mask
through which the patient breathes for 5-10
minutes. Filter paper turns black if phosphine
present. (POSITIVE only when >6 g is ingested)

17. REFERENCES
 K.S NARAYAN REDDY,The Essentials of
Forensic Medicine and Toxicology, 33rd Edition, p.
527-529
 R.K. SHARMA, Concise Textbook Of Forensic
Medicine & Toxicology, 2nd Edition
 V V PILAY, Textbook of Forensic Medicine &
Toxicology, 15th Edition