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Q J Med 2004; 97: 75-80
© Association of Physicians 2004; all rights reserved.

Secondary contamination in organophosphate poisoning: analysis of an incident

R. Stacey, D. Morfey1 and S. Payne1

From Southampton General Hospital, Tremona Road, Southampton, UK, and 1Ealing Hospital, Uxbridge Road, Southall, Middlesex, UK

Received 24 July 2003 and in revised form 21 November 2003

Background: Acute organophosphate poisoning is rare in the UK, and the risks to attending staff are seldom appreciated.

Study design: Report of an incident.

Results: In May 2001, a 45-year-old man attempted suicide by drinking organophosphate insecticide, and was brought to an urban general hospital in a collapsed state. Twenty-five hospital workers and paramedics sought medical advice after coming into contact with the poisoned patient, of whom ten complained of symptoms related to toxin exposure. Provision of emergency services by the hospital was compromised, and the emergency department was closed until the area was decontaminated and staffing levels could be restored.

Discussion: Ingestion of OP compounds can present a significant risk to health professionals as well as patients. Problems with the management of this patient included late recognition of the need for decontamination, large numbers of non-essential staff coming into contact with the patient, and the difficulty of carrying out medical procedures while wearing protective equipment. Decontamination should always be considered early, and the possibility of an ingested poison being vomited and causing a chemical spill should not be overlooked.

Address correspondence to Dr D. Morfey, Ealing Hospital, Uxbridge Road, Southall, Middlesex UB1 3HW, UK. e-mail: DMorfey{at}aol.com


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