一起由磷化铝引起的家庭聚集性中毒事件的调查分析

目的 分析一起由磷化铝引起的家庭聚集性中毒事件的流行病学特征，为今后处置类似事件提供科学的依据。方法 对2021年济南市商河县一起急性中毒事件开展现场流行病学调查和实验室检测。调查主要针对病例及其家属进行面访，并入户考察和采集食品、环境标本和病例标本。结果 本事件共涉及7人，其中病例6例，罹患率85.7%，病例男女比例1∶1.33（3∶4），1例死亡。指示病例发病时间为23日20时左右，末例发病时间为24日6时左右，推测潜伏期为8～12小时。临床表现以呕吐（100%）、阵发性腹痛（100%）、恶心（43%）和腹泻（43%）为主。未发现家庭成员有可疑共同暴露餐次和可疑暴露食品。实验室在所采集的环境空气样本和死亡病例的血中检出磷化氢（PH3）。结论 本次事件是一起磷化铝使用不当引起的家庭聚集性磷化铝中毒事件，储粮间的磷化铝吸潮挥发产生的磷化氢是主要致病因素。

An investigation on a family cluster poisoning event caused by aluminum phosphide

Objective To analyze the epidemiological characteristics of a family cluster poisoning event caused by aluminum phosphide, and to provide a scientific basis for dealing with similar incidents in the future. Methods On-site epidemiological investigation and laboratory tests were conducted on an acute poisoning incident in 2021 in Shanghe county, Jinan. The investigation mainly focused on face-to-face interviews with cases and their families. Collection of food, environmental specimens, and case specimens were done during household visits. Results This poisoning event involved seven people, including six cases and one death, with an attack rate of 85.7% and a male to female case ratio of 1:1.33 (3:4). The onset of the indicated cases was around 20:00 on the 23rd and the last case was around 6:00 on the 24th, with a presumed incubation period of 8 to 12 hours. Clinical presentation was dominated by vomiting (100%), paroxysmal abdominal pain (100%), nausea (43%), and diarrhea (43%). No family members were found to have suspected co-exposure meals or suspected exposed foods. Phosphine (PH3) was detected by the laboratory in the ambient air samples collected and in the blood of the deceased case. Conclusion This incident was a family aggregation poisoning caused by improper use of aluminum phosphide, and phosphine generated by moisture absorption and volatilization of aluminum phosphide in the food storage room is the main pathogenic factor.