Phosphine Gas Toxicity - An Overview

Introduction:

Phosphine is a colorless gas. Phosphocholine is utilized in the semiconductor sector to inject phosphorus into silicon crystals. Additionally, it functions as a fumigant, a polymerization catalyst, and an intermediary in producing several flame retardants. Phosphine is odorless when pure. However, impure phosphine smells similar to garlic or decaying fish. The threshold at which people can smell phosphine (odor threshold) is insufficient to avoid harmful quantities. It is transported as compressed liquefied gas. Many solids, or phosphides, expel phosphine gas. When phosphine toxicity is anticipated, but no phosphine exposure has occurred, ingestion or transdermal contamination from phosphides should be considered.

What Are the Methods of Dissemination of Phosphine Gas?

The following are the methods of dissemination:

• Phosphine can be emitted as a gas into the air inside buildings.

• Phosphine decomposes in water and cannot contaminate water systems.

• Phosphine is not a food contaminant.

• Phosphine is a gas that can be released into the open air.

• It is improbable that phosphine will contaminate agricultural products if emitted as a gas.

What Are the Routes of Exposure of Phosphine Gas?

Phosphine gas can enter the body through an inhalational route. Moreover, frostbite could result from direct contact with phosphine solutions.

Which Personal Protective Equipment Should Be Used While Handling Phosphine Gas?

The following are the key points to keep in mind while dealing with phosphine gas:

General Information: When entering an area with an unknown contaminant or where the concentration of the contaminant is unknown, First Responders should wear a Level A protective suit and a Chemical, Biological, Radiological, and Nuclear (CBRN) Self Contained Breathing Apparatus (SCBA). Level A protection should be employed until monitoring data confirms the contamination and the contaminant's concentration.

Level A (Red Zone): Here, the highest levels of skin, respiratory, and eye protection are necessary. This is the maximum protection required for workers exposed to unidentified chemical hazards. The following types of equipment may be required:

• Pressure demand supply of air hose respirator with an additional escape bottle or a pressure-demand full-face piece.

• A CBRN agent-protective suit is called a Totally-Encapsulating Chemical Protective (TECP).

• Gloves resistant to chemicals.

• Steel toe and shank boots that are resistant to chemicals.

• When the highest level of skin protection is not required, the highest level of respiratory protection is the bare minimum of protection for employees who may be exposed to unidentified chemical risks. It draws a line of difference from Level A in that it includes a chemically resistant splash suit that is non-encapsulating and protects level A against liquids while not airtight.

• When the pollutant and its concentration are known, choose Air Purifying Respirators (APR) or Powered Air Purifying Respirators (PAPR) if the respiratory protection standards are met. This level is suitable for patient decontamination.

What Are the Signs and Symptoms of Phosphine Gas Toxicity?

The signs and symptoms of phosphine gas toxicity are given below:

Eye Exposure:

• There are no known side effects of phosphorus gas on the eyes.

• Phosphine gas exposure through the eyes has not been linked to systemic harm.

• Although unusual, direct eye contact with compressed or liquid phosphine gas may result in frostbite.

Ingestion Exposure: At room temperature, phosphorus is gas, making ingestion unlikely.

Inhalation Exposure:

• Mild to Moderate: Severe lung irritation, tightness or burning in the chest, coughing up fluorescent green sputum occasionally, dyspnea (difficulty breathing), and fluid buildup in the lungs are some symptoms. Cardiovascular consequences include the reduced ability of the heart to pump an average volume of blood, abnormally low blood pressure (hypotension), dysrhythmia, and irregular heartbeat. A headache, anxiety, agitation, lethargy, drowsiness, weariness, loss of sensation, altered gait, trembling of the extremities during movement, and double vision are examples of nervous system side effects. Several gastrointestinal side effects include liver damage, stomach discomfort, diarrhea, nausea, and vomiting. Sweating and bluish skin staining (cyanosis) are the general consequences.

• Severe: It can cause death. The fluid building up in the lungs (pulmonary edema) is one of the repercussions of the lung. The following cardiovascular side effects are unresponsive to medication: peripheral vascular collapse; abnormal, life-threatening heart rhythms (ventricular dysarhythmias); critically low blood pressure (hypotension); and unusually rapid heartbeat (tachycardia). Seizures and coma (extended periods of unconsciousness) are examples of nervous system side effects.

Skin Exposure:

• There are no documented side effects of phosphorus gas on the skin.

• Skin contact typically does not cause systemic (whole-body) poisoning.

• Frostbite can occur when the skin comes into contact with compressed or liquid phosphine gas.

The body's capacity to make proteins is inhibited by phosphorus. There are dose-dependent adverse health effects from phosphine exposure. Phosphine causes respiratory irritation, affects circulatory and cardiac health, depresses the central nervous system, and causes excruciating stomach discomfort when inhaled.

How to Give First-Aid to the Patient of Phosphine Gas Toxicity?

The immediate first-aid that should be given to the patient with phosphine gas toxicity:

Eye:

• The patient should be removed from the exposure source right away.

• Wash the eyes for maximum of 20 minutes with lukewarm water.

• Heal with lukewarm water if frostbite results from coming into touch with liquid (compressed) phosphine.

• Immediately seek medical help.

Ingestion:

• The patient should be removed from the exposure source right away.

• Ensure that the victim's airway is unobstructed.

• The patient should not intentionally try to vomit.

• For first aid instructions, refer to the Inhalation section.

• Immediately seek medical help.

Inhalation:

• Evaluate the pulse and the respiratory system.

• Ensure that the victim's airway is unobstructed.

• Give oxygen if breathing is challenging or the patient experience shortness of breath.

• Ventilation assistance should be given when needed. The use of a barrier or bag-valve-mask device at all times is advised.

• In the event of apnea, artificial respiration should be started.

• If necessary, intravenous (IV) access should be established.

• The patient should be kept on a heart monitor.

• Check for impaired respiratory function, low blood pressure (hypotension), and irregular heart rhythms (dysrhythmias).

• Secure the airway and respiration by placing a tube into the trachea (endotracheal intubation).

• Start administering intravenous (IV) fluids if signs of shock or low blood pressure (hypotension) are seen.

• Use Benzodiazepines to treat seizures if they happen.

• Immediately seek medical help.

Skin:

• The patient should be removed from the exposure source right away.

• When exposed to a liquid substance (compressed gas), defrost frostbitten skin with lukewarm water and carefully remove any surrounding clothing. Keep the patient warm and silent while drying with fresh towels.

• Immediately seek medical help.

Conclusion

Phosphine gas can cause toxicity and serious health consequences when inhaled. Moreover, phosphine is not a known carcinogen and cannot harm developing or reproducing organisms; it has been linked to chromosomal damage in chronic exposure studies. Chronic exposure to low concentrations can cause gastrointestinal problems, kidney failure, low red blood cell counts (anemia),pneumonia, vision, speech, and motor abnormalities, as well as kidney failure and kidney failure-like symptoms. Seeking immediate medical help is highly advised in case of suspected phosphine gas toxicity.