Phosphorus poisoning


  • O.M. Arustamian Bogomolets National Medical University, Kyiv, Ukraine
  • V.S. Tkachyshyn Bogomolets National Medical University, Kyiv, Ukraine
  • V.Ye. Kondratiuk Bogomolets National Medical University, Kyiv, Ukraine
  • O.Yu. Aleksiychuk Bogomolets National Medical University, Kyiv, Ukraine
  • I.V. Dumka Bogomolets National Medical University, Kyiv, Ukraine



phosphorus, acute phosphorus poisoning, chronic phosphorus poisoning, treatment of phosphorus poisoning, prevention of phosphorus poisoning, phosphorism


Phosphorus poisoning is a condition that occurs as a result of inhalation or the ingestion of phosphorus. It is observed in people working at industrial enterprises when acid or water gets on metals contaminated with phosphorus or working with acetylene. The maximum permissible concentration of phosphorus for industrial premises is 0.03 mg/m3. Routes of entry into the body are inhaled and oral, less commonly through damaged skin. Phosphorus after being absorbed penetrates the blood and tissues. It belongs to the group of so-called fermented poisons, which have the highest toxicity and act at the lowest concentration in the blood and tissues. The toxicity of phosphorus is based on the violation of intracellular oxidative processes. Yellow phosphorus is released with exhaled air, as well as feces and sweat. Under industrial conditions, acute phosphorus poisoning is extremely rare and is mainly the result of accidents, mainly when phosphorus gets inside and by inhalation. In acute poisoning, phosphorus primarily affects parenchymal organs, especially the liver, heart and nervous system. With these poisonings, the breakdown of proteins occurs with the formation of fat, leucine, tyrosine, sarcolactic acid. As a result of a large breakdown of protein, the content of nitrogenous products in the blood and their excretion in the urine increase. The lethal dose for yellow phosphorus can be 0.05–0.1 g. The clinical picture of acute phosphorus poisoning has 3 stages. Chronic poisoning with phosphorus is accompanied by a violation of calcium metabolism, accompanied by fragility and brittleness of bone. Chronic white phosphorus poisoning can lead to degeneration of adipose tissue and sequestration of the lower jaw. Chronic phosphorus poisoning is called “phosphorism” and has 3 degrees of severity.


Download data is not yet available.


William F. Durham, Wayland J. Hayes Jr. Organic Phosphorus Poisoning and Its Therapy. Archives of Environmental Health: An International Journal. 1962. 5(1). 2147. DOI: 10.1080/00039896. 1962.10663237.

Brent J., Wallace K.L., Burkhart K.K. Phosphorus. Critical Care Toxicology — Diagnosis and Management of the Critically Poisoned Patient. Philadelphia, PA: Elsevier Mosby, 2005. 851-61 [Google Scholar].

Карабалин С.К., Султанбеков З.К., Карабаева Р.Ж., Бексултанова Г.С. Состояние нервной системы при хронической интоксикации соединениями фосфора в постконтактном (отдаленном) периоде. Acta Biomedica Scientifica. 2009. 1. 165-170.

Tenenbein M. Position statement: Whole bowel irrigation. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J. Toxicol. Clin. Toxicol. 1997. 35. 753-62.

Winek C.L., Collom W.D., Fusia E.P. Yellow phosphorus ingestion-three fatal poisonings. Clin. Toxicol. 1973. 6. 541-545; Yimin L., Jiongliang Z. Research into the relationship of hepatic fibrosis with various biochemical indices induced by carbon tetrachloride, yellow phosphorus, and trinitrotoluene. Weisheng Dulixue Zazhi. 1992. 6(3). 181-183, 209.

Карабалин С.К., Бексултанова Г.С. Синдром вегетативной дистонии у больных с хронической интоксикацией соединениями фосфора в постконтактный период. Медицина и экология. 2007. 2(43). 87-90.

Fernandez O.U., Canizares L.L. Acute hepatotoxicity from ingestion of yellow phosphorus-containing fireworks. J. Clin. Gastroenterol. 1995. 21. 139-42.

Ates M., Dirican A., Ozgor D., Aydin C., Isik B., Ara C. et al. Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus. Liver Transpl. 2011. 17. 1286-91.

Колінковський О.М., Білецька О.Б., Псарьова Т.С., Шапошникова Т.О. Фосфорна аварія: можлива токсиколого-екологічна небезпека для водойм. Довкілля та здоров’я. 2010. 1(52). 22-25.

Mauskar A., Mehta K., Nagotkar L., Shanbag P. Acute hepatic failure due to yellow phosphorus ingestion. Indian J. Pharmacol. 2011. 43. 355-6.

Talley R.C., Linhart J.W., Trevino A.J., Moore L., Bel­ler B.M. Acute elemental phosphorus poisoning in man: Cardiovascular toxicity. Am. Heart J. 1972. 84. 139-40.

Гончаров С.Ф., Бобий Б.В. О некоторых проблемах медицинского обеспечения населения в кризисных ситуациях. Военно-медицинский журнал. 2005. 7. 15-22.

McCarron M.M., Gaddis G.P., Trotter A.T. Acute yellow phosphorus poisoning from pesticide pastes. Clin. Toxicol. 1981. 18. 693-711.

Marin G.A., Montoya C.A., Sierra J.L., Senior J.R. Evalua­tion of corticosteroid and exchange-transfusion treatment of acute yellow-phosphorus intoxication. N. Engl. J. Med. 1971. 284. 125-8.

Ишмаев Н.М., Николина Е.С., Мамонтов В.А., Бурдаков Н.И. Прогнозирование поражающих факторов при транспортных авариях с участием желтого фосфора. Вестник Московского университета. Серия 2. Химия. 2013. 54(1). 49-55.

Akman S.A., Cakir M., Baran M., Arikan C., Yuksekkaya H.A., Tumgor G. et al. Liver transplantation for acute liver failure due to toxic agent ingestion in children. Pediatr. Transplant. 2009. 13. 1034-40.

Maniatis V., Chryssikopoulos H., Roussakis A., Kalamara C., Kavadias S., Papadopoulos A. et al. Perforation of the alimentary tract: Evaluation with computed tomography. Abdom. Imaging. 2000. 25. 373-9.

Волошин В.О., Загоруйко Н.Л., Волянський П.В., Алексєєва Т.Г. Організація надання медичної допомоги населенню на догоспітальному етапі у зоні надзвичайної ситуації. Український журнал екстремальної медицини ім. Р.О. Можаєва. 2001. 2. 36-40.



How to Cite

Arustamian, O., Tkachyshyn, V., Kondratiuk, V., Aleksiychuk, O., & Dumka, I. (2021). Phosphorus poisoning. EMERGENCY MEDICINE, 16(4), 56–63.



Scientific Review