Phosphine, a short film that was posted recently on YouTube, is topping over 3.5 million viewers and is quickly gaining popularity through WhatsApp and other social networking media. Based on true stories that took place in Jeddah, this movie is an important wake-up call to a silent horrifying killer that is easily distributed and can find its place in homes through a mere phone call or a visit to a pest control store.
According to the American Center of Disease and Control, phosphine is a colorless, flammable and explosive gas that has an odor of garlic or rotten eggs or fish. It can be used as a pesticide in stored grain, in shipyards and at industrial sights. When introduced into the air, it exists as gas; if it reacts with water, it can be broken down but may evaporate into air as well. It is easily inhaled even through water or moisture, thus generating phosphine gas, making it a very dangerous combination when exposed to it.
The movie creators, in corporation with the International Medical Center (IMC) in Jeddah, produced the movie that included interviews with families of those who died of phosphine poisoning as well as doctors who spoke about the dangers of this pesticide. Some of these doctors treated children and other family members that were affected by the pesticide.
The dangers of this pesticide are not very clear among many, yet it is known by the sellers as a pesticide that is not supposed to be used in households. Dr. Samir Al-Sulaimani, professor at King Abdul Aziz University specializing in soil fertility and chemistry, assures that this pesticide is not used for household pests. “Phosphine is actually aluminum phosphide turned phosphine by exposing it to air; it is certainly toxic to humans, yet it is beneficial in agriculture because it contains phosphorus, an element used in fertilizers and also mainly found in the farming industry as a pesticide for its effectiveness in ridding grain silos of rats. But the mixture is low in toxicity because it breaks down and cannot increase by time. The main cause of human poisoning from this pesticide is when there is misuse of it in homes and confining it to closed spaces,” he said.
Sameera Al-Ghamdi, a private sector worker and mother of one, is concerned with this issue due to the fact that her family has dealt with pest and rat infestations for a while. “My family owns an apartment building and they’ve tried everything to deal with pests. We do have a problem when they reappear; there is just no control over them, so we’ve tried everything and we still do when needed but it has never occurred to us that use of this chemical is very harmful. Thankfully we’ve never had to use it and we were never suggested to do so by any of the companies we’ve hired before.”
There is minimal public awareness in the community and as a result this pesticide is not only distributed illegally, it’s sold in places no one expects just like it has been depicted in the film. As a response to the film, the Minister of Commerce and Industry, Dr. Tawfig Al-Rabiah, has vowed to track down stores that sell the lethal pesticide and enforce punishments when found. He has also urged residents to inform the ministry and local law enforcements of any store that is found selling it.
There have been cases that were documented and reported in newspapers before, even in this newspaper a few years back. Unfortunately, even doctors are not aware of the problem due to its close toxicity symptoms with other cases of poisoning such as food poisoning. “As doctors, we can’t quickly conclude that a patient has phosphine poisoning. We first ask what they ate because the symptoms are very similar to food poisoning, for example,” said Dr. Saad Al-Mihiyawi, ENT specialist at the KAAU Hospital. “It takes a long process of questioning until we reach a point where we ask if they smelled something rotten coming from an apartment or residential quarters close by. With this film, doctors must now perform all the necessary preliminary questioning and make sure they ask about any odors. It takes a dedicated doctor to find the problem, and it’s understandable why it would be confusing because the symptoms are so broad.”
When asked about the severity of the agent, Dr. Al-Mihiyawi explained that a victim can start feeling the effects of the exposure as soon as two or three hours from inhalation. “The symptoms start very quickly and can progress in less than a day to something very dangerous. The inhalation of the poisonous gas stops the oxygen from binding with hemoglobin and so the blood is at a loss for oxygen. Oxygen is crucial to the heart and brain and since there is no binding, the victim goes into cardiac arrest and body functions shut down voluntarily due to blockage.” If caught early on, then there is hope. Doctors place the patient on supportive care, meaning they are hooked on a ventilator and oxygen mask for a period of time to compensate. It won’t be an easy task but residents must now take action as soon as they suspect something.
The symptoms include nausea, headaches, dizziness, chest tightness, vomiting, cough, fatigue, loss of feeling, abdominal pain, double vision, and so on. The symptoms can go from mild to severe within hours depending on the dose, explained Dr. Ahmed Nabil Abo-Khatwa, toxicologist in KAAU and the mayor’s advisor at the Jeddah Municipality. “What defines the danger of a poison is the dose, the higher the dose the more dangerous it is. Proximity also plays a major role; if a person is within 30-40 meters, the symptoms will start showing by time; the higher the dose the quicker the appearance of the symptoms.” When asked how can one be prepared and take precautions, Dr. Abo-Khatwa mentioned a handheld device that is sold to detect phospine. “Ironically, it is available in stores all over the city, just like there are devices that detect carbon monoxide. Airplane pilots as well as ship captains use it to make sure that the cockpit and ship’s steering room are clear of phosphine gas. It can easily be obtained and can detect as small as 1 mg.
Dr. Abo-Khatwa goes on to explain the importance of ridding one’s home of the pesticide due to its hazardous content. “First you should never open the box it came in with; you must call the authorities. It’s then transferred to a chemical waste disposal facility in Rabegh, just north of Jeddah where they dispose it off through incineration. The reason for this is because of its intense toxicity. If other means were used such as burial, it can seep into the soil and reach underground water and pipes and contaminate the water. It must be disposed off in controlled conditions.”
Public awareness must increase in the community and society must not wait until the authorities arrive, they must act quickly in order to save their lives, explained Dr. Naeema Akbar, epidemiologist and consultant in community medicine at the Ministry of Health. “From a public health point of view, the situation is dire and one must not take it lightly. Time is of essence with this dangerous gas. The municipality has prohibited its use before and confined it to industrial areas and factories but unfortunately it is sold illegally for financial gains disregarding human life. Residents of residential buildings, complexes and residential compounds must all be aware of the rotten egg or rotten fish smell if detected from sinks, air condition vents and other openings. Flyers must also be put up and given to residents to warn them.”
The movie is an eye awakener. This silent killer is brutal and must be stopped. It is hoped that viewers will continue spreading the word and help in saving lives.