Acute occupational phosphine intoxications in the maritime shipping sector: a scoping review

The aim is to assess the prevalence and knowledge on acute occupational exposure to phosphine in the shipping industry. We followed PRISMA guidelines for scoping review. We searched in 4 databases without language and date restrictions for scientific articles in peer-reviewed and gray literature. We found 13 peer-reviewed articles and 63 articles in gray literature. These covered 56 incidents from 1963 to 2019 for a total of 254 victims and 22 fatalities. There is an increase in the number of reported cases over the last 20 years. Neurologic and gastrointestinal symptoms are predominant, and hospitalization is needed in 80% of cases. Our review underlined the principal risk as gas exposure through leaks between holds and the ventilation system. Further studies on the knowledge and the prevention in order to improve good practices onboard, prevent the risk of fire explosion, and a global reporting system of new cases are recommended.

本研究旨在评估航运业中磷化氢（phosphine）急性职业暴露的流行情况与认知水平。本研究遵循PRISMA指南开展范围综述（scoping review）。我们在4个数据库中进行了检索，未设置语言与时间限制，检索范围涵盖同行评议学术文献与灰色文献（gray literature）。最终纳入13篇同行评议文献与63篇灰色文献，覆盖1963年至2019年间的56起暴露事件，共计254名受害者与22名死亡病例。近20年报告病例数呈上升趋势。神经系统与胃肠道症状为主要临床表现，80%的病例需接受住院治疗。本综述明确了主要风险来源：船舶舱室与通风系统之间的泄漏引发的气体暴露。本研究建议开展针对职业暴露认知与预防措施的进一步研究，以优化船上作业的良好操作规范、防范火灾爆炸风险，并建立全球新发病例报告系统。