Study of zinc phosphide intoxicated cases admitted to poison control centre - Ain shams university hospitals - Egypt [A retrospective study]

ABSTRACT

Acute poisoning with pesticides is a global public health problem and accounts for as many as 300.000 deaths worldwide yearly. Zinc phosphide has been widely used as a rodenticide since 1942-43 and its easy availability pushed up the incidence of self poisoning. This retrospective study was designed to highlight and evaluate the problem of zinc phosphide intoxicated cases presented and admitted to poison control centre [PCCA] during the year 2007, and was compared with its incidence during the previous 5 years, 2002-2006. The comparative study of the previous five years included the number of all cases of intoxication presented to the PCCA from 2002-2006, the number of zinc phosphide intoxication cases during the same period and their classification according to hospital admission Intensive care unit [ICU], inpatient and emergency room [ER]. Regarding the retrospective study of zinc phosphide cases during the year 2007, it was carried out on the medical records of all patients admitted to PCCA during the year 2007, with a discharge disgnosis of zinc phosphide. The following parameters were reviewed and analyzed Sociodemographic data [age, sex, residence and social class], intoxication data [delay time, mode and route of intoxication], presenting symptoms, vital signs, laboratory investigations and ECG monitoring. Different treatment modalities were analyzed and the outcome was recorded. The percentage of zinc phosphide poisoning during the period 2002-2006 in relation to the total number of poisoning cases admitted to PCCA ranged from 2.09%-5.38% and during 2007 it was 3.03%. The inpatient group showed the highest number of cases followed by the ER and then the ICU group. Death rate ranged from 0.3%-0.7% during the years 2002-2006, while during 2007, it was only 0.15%. The total number of cases during the year 2007 were 650 cases. The inpatient group comprised most of the cases followed by ER and ICU groups. The majority of patients were in the age group of 10- female to male ration 1.31 and the majority of patients were from urban areas. Most of the cases [64.8%] presented within a period ranged from 1 < 4 hrs and mostly were suicidal. The major route of exposure was the oral route. There were high significant differences between the different groups as regards temperature, respiratory rate and, pulse. Systolic and diastolic blood pressures were normal in all groups. All ICU cases had mean serum Na[+] and K[+] lower than normal and all groups had normal random blood glucose and CI levels. The ICU group also showed elevation of AST and ALT enzymes. A high significant difference regarding pH, PO2 and HCO[3], between the different groups was found. ECG changes were detected in 75.4% of cases. Emesis with syrup epicac followed by milk was the major elimination method. The majority of cases recovered and only one case died