Phosphorus, Elemental

CAS RN: 7723-14-0

Health Effects

    • A) USES: "Phosphorus" as used in this management indicates only yellow or white phosphorus unless otherwise stated. Phosphorus is a nonmetallic chemical element of the nitrogen family. It is essential for many biologic processes including synthesis of ATP. Yellow and white phosphorus are used in the manufacture of rodenticides, incendiaries, phosphorus compounds, as an igniter in munitions and flares, as an igniter and pigment in fireworks, and as a semiconductor additive. Although no longer used in medicine, phosphorus is still used in some homeopathic medicines. Yellow or white phosphorus was used in the manufacture of matches in the past and was responsible for both chronic poisoning in workers and acute poisoning from ingestion of matches. Modern matches (including the "Strike Anywhere" variety) do NOT contain yellow or white phosphorus, but contain phosphorus sesquifluoride and potassium chlorate. Chronic phosphorus poisoning is now rarely encountered. Red phosphorus is used in the manufacture of safety matches. It is nonvolatile, unabsorbable, and insoluble substance with limited toxicity in humans. However, it may contain traces of yellow phosphorus (up to 0.6%) and large ingestions may result in adverse effects. Black phosphorus is the inert, nontoxic allotropic form of elemental phosphorus.
    • B) TOXICOLOGY: Systemic phosphorus poisoning may occur following oral, inhalational, and dermal exposure. Phosphorus poisoning may cause acute fatty degeneration of the liver, kidneys, brain, and other organs. Early sudden death due to cardiovascular collapse may be induced by hypocalcemia or a direct cardiotoxic effect. Induced hypoglycemia has been responsible for deaths in the past. Phosphorus-induced liver injury may be due to free radical injury and/or inhibition of protein synthesis.
    • C) EPIDEMIOLOGY: Phosphorous poisoning is rare. "Phossy jaw", an occupational illness of matchmakers who developed mandibular necrosis, has been eliminated as matches are no longer manufactured by hand and no longer contain white or yellow phosphorus.
      • 1) ORAL: Ingestion can produce throat irritation and burns, followed by nausea, vomiting, and abdominal pain. Diarrhea may or may not be an early symptom. Gastric contents and stools may be "smoking" and luminescent in the dark, and have a garlicky odor. Phosphorescent eructations from the nose and mouth have also been reported. The absence of early gastrointestinal symptoms should not lead to the conclusion that significant poisoning has not occurred. Neurological symptoms may occur soon after ingestion or late in the clinical course with fulminant hepatic encephalopathy. Lethargy, irritability, delirium, psychosis, stupor, generalized weakness, seizures, and coma may occur. Severe poisoning may manifest as severe electrolyte abnormalities (eg, hypokalemia, hyperchloremia, hypocalcemia and either hyperphosphatemia or hypophosphatemia), hypoglycemia, encephalopathy, cardiac dysrhythmias, liver necrosis, and hepatic and/or renal failure. Other effects following oral ingestion may include clotting abnormalities, hypoprothrombinemia, thrombocytopenia, leukopenia, anemia, pancytopenia, tachypnea, shallow respirations, hyperventilation, and laryngospasm causing dyspnea and/or apnea. Death usually occurs 4 to 8 days after ingestion, but may be delayed. Death in the first 12 hours is usually the result of peripheral vascular collapse. Death within 24 to 48 hours may ensue from peripheral vascular collapse and is frequently accompanied by acute renal failure. Deaths within 48 to 72 hours may result from peripheral vascular collapse or cardiac arrest with hepatic and/or renal failure.
      • 2) INHALATION: Acute inhalational exposure to phosphorus fumes would be expected to produce upper respiratory irritation and possibly delayed onset of acute lung injury. Inhalational exposure may also produce conjunctivitis, ocular irritation, and mucosal irritation of the nose and throat. Acute hepatic damage has also been reported. Chronic industrial inhalational exposure to phosphorus fumes has resulted in symptoms that include bronchitis, anemia, cachexia, and mandibular necrosis ("phossy" or "Lucifer's jaw").
      • 3) DERMAL: Dermal exposure may result in severely painful, necrotic, partial to full thickness yellowish color burns from chemical and thermal effects with a garlic-like odor. Second and third degree burns can occur within a few minutes to hours. Phosphorus absorbed from damaged skin may result in acute systemic phosphorus poisoning.
      • 4) OCULAR: Ocular injury includes foreign body sensation, excessive tearing, blepharospasm, and corneal defect evident by fluorescein staining, corneal perforation, endophthalmitis, and ectropion. Exposure to phosphorus oxides causes eye irritation, blepharospasm, photophobia, and lacrimation. Direct eye contact can cause severe eye damage.
  • A) Phosphorus has been shown to cross the placental barrier, but cases of human fetal poisoning have not been reported.
    • A) IARC Carcinogenicity Ratings for CAS7723-14-0 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
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