Registration Dossier

Toxicological information

Exposure related observations in humans: other data

Administrative data

Endpoint:
exposure-related observations in humans: other data
Type of information:
other: review
Adequacy of study:
key study
Reliability:
2 (reliable with restrictions)
Rationale for reliability incl. deficiencies:
other: Published article discussing historical exposure to white phosphorus

Data source

Reference
Reference Type:
publication
Title:
Classical Syndromes in Occupational Medicine Phosphorus Necrosis - A Classical Occupational Disease
Author:
Felton JS
Year:
1982
Bibliographic source:
American Journal of Industrial Medicine 3: 77-120

Materials and methods

Type of study / information:
The paper discusses occurrence of phosphorus necrosis, a historical occupational disease arising from the match making industry
Endpoint addressed:
repeated dose toxicity: oral
repeated dose toxicity: inhalation
repeated dose toxicity: dermal
Test guideline
Qualifier:
no guideline followed
Principles of method if other than guideline:
The paper discusses the history of the occupational disease phosphorus necrosis.
GLP compliance:
no
Remarks:
: not applicable

Test material

Reference
Name:
Unnamed
Type:
Constituent
Test material form:
solid
Details on test material:
Elemental phosphorus is often referred to as yellow phsophorus

Method

Ethical approval:
not applicable
Details on study design:
Not applicable, the paper reviews historical medical data.
Exposure assessment:
not specified
Details on exposure:
Subjects were exposed to white phosphorus in the production of matches, mainly in the Victorian era. The majority of workers were female, and children.

Results and discussion

Results:
Phosphorus necrosis occurred in people working in the match making industry, particularly those with pre-existing dental problems.

Any other information on results incl. tables

Phosphorus necrosis was a classical occupational disease towards the end of the 19thcentury and in the early 20thcentury. Exposure to phosphorus occurred in match making factories. Symptoms of phosphorus necrosis included various degrees of necrosis of the mandible and/or maxilla, extensive facial swelling, loss of teeth, thick pungent pus exuding from the sites of lost teeth and in some cases from draining fistulae. Coughs and bronchitis were also seen. The effects of phosphorus necrosis, termed ‘phossy jaw’, were seen in workers with periodontal disease, tooth extractions etc. Workers exposed to phosphorus typically exhibited breath and urine that was luminescent in the dark. Phosphorus necrosis usually resulted in death. In cases where death did not occur, survivors were left with terrible disfigurements often involving loss of the entire mandible. Treatment of the disease could include removal of loose teeth and sequestration of affected bone in the jaw. Bone that was removed was reported to resemble pumice stone in appearance.

Applicant's summary and conclusion

Conclusions:
Phosphorus necrosis historically occurred in people working in the match making industry, particularly those with dental problems. The condition has essentially been eradicated through modern industrial hygiene measures.
Executive summary:

Phosphorus necrosis was a classical occupational disease towards the end of the 19thcentury and in the early 20thcentury. Exposure to phosphorus occurred in match making factories. Symptoms of phosphorus necrosis include; various degrees of necrosis of the mandible and/or maxilla, extensive facial swelling, loss of teeth, thick pungent pus exuding from the sites of lost teeth and in some cases from draining fistulae. Coughs and bronchitis were also seen. The effects of phosphorus necrosis, termed ‘phossy jaw’, were seen in workers with periodontal disease, tooth extractions etc. Workers exposed to phosphorus typically exhibited breath and urine that was luminescent in the dark. Phosphorus necrosis usually resulted in death. In cases where death did not occur, survivors were left with terrible disfigurements often involving loss of the entire mandible. Treatment of the disease could include removal of loose teeth and sequestration of affected bone in the jaw. Bone that was removed was reported to resemble pumice stone in appearance. The authors note that the condition 'phossy jaw' is historical and has essentially been eradicated through modern industrial hygiene measures.