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Phosphorus

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Critical Care Toxicology

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Abstract

Elemental phosphorus has historical significance as a toxin that can cause impressive morbidity and mortality in patients with gastrointestinal (GI) or dermal exposures. Phosphorus is also recognized as an occupational toxin because of the epidemic of mandibular necrosis known as “phossy jaw” that occurred in the nineteenth century in the manufacturing of matches. Today, phosphorus exposures, either dermatological or via ingestion, are rare [1, 2]. In developing countries, however, reports of ingestion of phosphorus-containing firecrackers or pesticides, and of civilian phosphorus burns, continue to remind us of the severe toxicity of phosphorus [3, 4]. Nevertheless, it is important to recognize that elemental phosphorus can exist in different forms, with vastly different properties and toxicities. Moreover, chemically ambiguous or incorrect nomenclature can cause confusion and uncertainty when managing such exposures.

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Author information

Authors and Affiliations

  1. Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada

    Emily B. Austin

  2. Departments of Emergency Medicine, and of Biomedical and Molecular Sciences, Queen’s University, 76 Stuart St, K7l 2V7, Kingston, ON, Canada

    Marco L. A. Sivilotti

Authors
  1. Emily B. Austin
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  2. Marco L. A. Sivilotti
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Corresponding authors

Correspondence to Emily B. Austin or Marco L. A. Sivilotti .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Austin, E.B., Sivilotti, M.L.A. (2016). Phosphorus. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_47-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_47-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

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