Abnormal Electrocardiogram in Patients with Acute Aluminum Phosphide Poisoning

Aluminum phosphide (AlP) is used throughout the world as pesticides to protect stored grains from rodents and other pests (Cienki, 2001). The chemical is usually formulated in pellets, granules or as a dust. Upon contact with moisture in the environment, AlP undergoes a chemical reaction yielding phosphine gas (PH3), which is the active pesticidal component and a very toxic system poison, makes acute AlP poisoning (AAlPP) extremely dangerous (Sasser et al., 1998). AAlPP has been reported in literature since 1985. The majority of cases of AlP poisoning involving intentional suicide acts. It is a major health problem with a high mortality rate especially in developing countries where AlP is low cost and easily accessible (Mehpour et al., 2008; Louriz et al., 2009). Patients who intend to commit suicide take tablets. Once mixed with hydrochloric acid in the stomach, PH3 is immediately released and absorbed rapidly via the lungs causing systemic poisoning (Proudfoot, 2009). However, accidental exposure to AlP is a relatively common cause of poisoning from agriculture chemical exposure in many countries. The manufacture and application of AlP fumigants pose risks of inhalation exposure to PH3 (Sudakin, 2005). During the past 35 years, high mortality rates have been reported following significant exposures to aluminum phosphide. This mortality rates vary from 40% to 80% (Chugh et al., 1991).