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July 11, 1980

Acute Phosphine Poisoning Aboard a Grain Freighter: Epidemiologic, Clinical, and Pathological Findings

Author Affiliations

From the Bureau of Epidemiology, Center for Disease Control, Atlanta (Drs Wilson and Landrigan); the Massachusetts Regional Poison Control System and the Department of Pediatrics, Harvard Medical School, Children's Hospital Medical Center, Boston (Dr Lovejoy); and the Department of Toxicology, Harvard University School of Public Health, Boston (Dr Jaeger). Dr Landrigan is now with the Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati.

JAMA. 1980;244(2):148-150. doi:10.1001/jama.1980.03310020024020

Two children and 29 of 31 crew members aboard a grain freighter became acutely ill after inhaling the toxic fumigant phosphine; one child died. Predominant symptoms were headache, fatigue, nausea, vomiting, cough, and shortness of breath. Abnormal physical findings included jaundice, paresthesias, ataxia, intention tremor, and diplopia. Focal myocardial infiltration with necrosis, pulmonary edema, and widespread small-vessel injury were found at postmortem examination of the dead child. The surviving child showed ECG and echocardiographic evidence of myocardial injury and transient elevation of the MB fraction of serum creatinine phosphokinase. Illness was significantly associated with living or working amidships or on the forward deck areas of the vessel. Phosphine gas was found to have escaped from the holds through a cable housing located near the midships ventilation intake and around hatch covers on the forward deck. The outbreak illustrates the hazards associated with shipboard fumigation.

(JAMA 244:148-150, 1980)

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