Death Related to Aluminum Phosphide Poisoning from 2013 to 2018 in Alborz-Iran and Preventive Measures

Abstract

Background: Aluminum phosphide (ALP) is a highly toxic pesticide used to protect rice from pests in Iran, and it is inexpensive and available for use as a means of suicide. Objectives: This study aims to show the trend of deaths due to ALP poisoning in Alborz province from 2013 to 2018 and to investigate their sociodemographic, toxicological, and forensic characteristics. Methods: In this cross-sectional study, all cases of fatal poisoning due to ALP were included. All demographic and poison lab information was extracted from forensic records. We used SPSS 22 software to calculate the incidence of death and chi-square and t-tests for data analysis. Results: A study of 140 cases due to ALP poisoning over six years showed that the mean incidence rate of death referred to the legal medicine organization was 8.3 cases per million of the population of Alborz province. The highest and lowest mortality rates were 12.53 per million in 2014 and 5.42 per million in 2015, respectively. The mean age of the deceased was 32.1 years, the male/female ratio was 1.5, 53.6% had undergraduate education, and 56.5% were employed. Additionally, 99.2% of deaths were due to suicide. Conclusions: The findings showed that many deaths caused by ALP were intentional and suicidal. Strict implementation of the law banning the sale of ALP tablets to the public, educating and warning about the risks of ALP, and strengthening social support, especially in high-risk groups, can reduce the incidence of deaths from ALP poisoning.