title: Fatal aluminum phosphide poisonings in Tirana (Albania), 2009 - 2013.
abstract: BACKGROUND
  Acute poisonings particularly through pesticides have become a major public health concern in Albania during the last decade.
  
  
  RESULTS
  The number of fatalities due to aluminum phosphide intoxications was more than doubled during a five year-period from 2009 to 2013, and a cluster of suicides perpetrated with Phostoxin was registered. Several factors are accountable for such a phenomenon, including the fact that aluminum phosphide agents are freely available in the Albanian market, their price is extremely low and they are sold without any legal restriction. The mass media unfortunately warranted an emulating effect to dramatic intoxications, which gained by such means the notoriety of a secure lethal weapon.
  
  
  CONCLUSIONS
  Our experience with more than three hundred intoxications with aluminum phosphide agents in the last five years, showed that a considerable delay from the moment of exposure (mainly through ingestion) to specialized medical help seeking, created a considerable obstacle for a successful treatment of cases, and eventually for the survival of patients. The lack of a specific antidote adds further challenges to all these exposures. The need for public health policies aiming at prevention, awareness, and possibly the substitution of Phostoxin or other aluminum phosphide pesticides with less dangerous agents is formulated.
authors.forename: Zihni
authors.initials: Z
authors.lastname: Sulaj
authors.forename: Alert
authors.initials: A
authors.lastname: Drishti
authors.forename: Irena
authors.initials: I
authors.lastname: Çeko
authors.forename: Amarda
authors.initials: A
authors.lastname: Gashi
authors.affiliation: Biomedical and Experimental Department, Faculty of Medicine, University of Medicine, in Tirana, Albania. gvyshka@gmail.com.
authors.forename: Gentian
authors.initials: G
authors.lastname: Vyshka
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000415:Albania / Q000453:epidemiology; D017607:Aluminum Compounds / Q000008:administration & dosage / Q000191:economics / Q000633:toxicity*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010575:Pesticides / Q000191:economics / Q000633:toxicity*; D010720:Phosphines / Q000008:administration & dosage / Q000191:economics / Q000633:toxicity*; D012189:Retrospective Studies; D013405:Suicide; D055815:Young Adult
chemical_list: D017607:Aluminum Compounds; D010575:Pesticides; D010720:Phosphines; C001864:aluminum phosphide