White phosphorus is a highly reactive chemical element, typically appearing as a translucent, waxy solid that can range from colorless to yellowish. It possesses a distinct garlic-like odor and is manufactured from phosphate rocks. This substance is pyrophoric, meaning it ignites spontaneously upon exposure to air, making it extremely flammable.
Exposure Pathways and Initial Reactions
The human body can encounter white phosphorus through several primary routes, each leading to immediate and distinct reactions. Dermal contact results in immediate, intensely painful burns, often described as second- or third-degree injuries. The affected skin may appear yellowish, and a characteristic garlic-like odor might be present, sometimes accompanied by visible smoke emanating from the burn site.
Inhalation of white phosphorus smoke or fumes primarily affects the respiratory system. This exposure can lead to irritation of the upper respiratory tract, coughing, and headaches. Delayed accumulation of fluid in the lungs, known as pulmonary edema, can occur. The smoke is harmful to the eyes and respiratory passages because phosphorus oxides dissolve in moisture to form corrosive phosphoric acids.
Ingestion triggers immediate gastrointestinal distress. Individuals may experience burning pain in the throat and abdomen, accompanied by intense thirst, nausea, vomiting, and severe abdominal pain. The vomitus and feces can emit a garlic odor and may even glow in the dark due to the presence of phosphorescent phosphorus. Even small amounts, such as 50-100 milligrams or 1 milligram per kilogram of body weight, can be lethal.
Direct Tissue Destruction
Direct contact with white phosphorus leads to severe and immediate localized damage, primarily through chemical and thermal injuries. White phosphorus ignites spontaneously when exposed to air, typically at temperatures ranging from 30 to 50 degrees Celsius. This ignition initiates a highly exothermic reaction, releasing significant heat and causing the substance to burn fiercely at temperatures between 800 and 2500 degrees Celsius. The burning continues until the phosphorus is consumed or deprived of oxygen.
The resulting burns are profoundly painful and can be full-thickness, extending through all layers of the skin. White phosphorus particles readily adhere to skin and clothing. Because the substance is highly lipid-soluble, it can penetrate deeply into underlying fatty tissues, muscles, and even bone. This deep penetration leads to extensive tissue necrosis at the point of contact.
The appearance of these burns is distinctive, often characterized by a yellowish discoloration and a necrotic, sloughed appearance. In dark conditions, the affected areas may appear phosphorescent. Smoke may continue to emanate from the wound as residual phosphorus particles react with air. These deep and complex burns heal much slower than typical thermal burns.
Internal Organ Damage
Once absorbed into the bloodstream, white phosphorus or its toxic byproducts can cause widespread systemic effects and significant internal organ damage. The liver is particularly vulnerable, often developing hepatic necrosis and liver failure. This damage is characterized by extreme fatty changes, sometimes resulting in a yellowish appearance of the liver and severe jaundice. White phosphorus interferes with protein synthesis, specifically apolipoprotein, and causes mitochondrial damage. These changes can progress rapidly, with significant fatty degeneration observed within hours of exposure.
The kidneys are also susceptible to damage, frequently manifesting as acute kidney injury and renal failure. The absorbed substance disrupts normal cellular metabolism within kidney tissues, contributing to their dysfunction. This can lead to impaired waste filtration and fluid balance.
The cardiovascular system can also suffer severe consequences. Effects include myocardial depression and various arrhythmias. Electrocardiogram (ECG) abnormalities, such as ST depression, QT elongation, and microvoltage of the QRS complex, have been observed. In severe cases, systemic absorption can lead to complete cardiovascular collapse. The overall mechanism involves the substance interfering with cellular processes and generating free radicals, causing widespread cellular harm.
Widespread Bodily Disturbances
White phosphorus poisoning can trigger broader systemic disturbances. A significant concern is the development of critical electrolyte imbalances, most notably hypocalcemia, or dangerously low calcium levels in the blood. This imbalance can lead to severe muscle spasms, seizures, and cardiac arrest due to the heart’s reliance on precise calcium levels for proper function. Hyperphosphatemia, an excess of phosphate in the blood, often accompanies hypocalcemia.
Another serious complication is disseminated intravascular coagulation (DIC), a complex disorder where the body’s blood clotting processes become dysregulated. This condition can lead to excessive bleeding and widespread abnormal clotting, further compromising organ function and blood flow.
The systemic toxicity of white phosphorus can progress to multi-organ dysfunction syndrome (MODS) and shock. This represents a severe, life-threatening condition where multiple organ systems begin to fail simultaneously. Chronic exposure, particularly through inhalation of fumes, can also lead to “phossy jaw,” characterized by the breakdown and destruction of the jaw bones. Systemic effects can sometimes be delayed, appearing up to 24 hours after exposure.