Abstract
White phosphorus is an incendiary agent used in particular types of ammunition. Exposure
to phosphorus-containing compounds may cause severe burn injuries. Systemic effects
may be fatal for the casualty even though only a small surface of the body is burned.
We report 4 cases of white phosphorus burn injuries due to an exceptional accident
mechanism. All casualties were holidaymakers in a coastal area at the Baltic Sea and
confused white phosphorus ammunition residues with amber on a beachwalk. The supposed
treasure was taken into the pants pocket. The phosphorus substances ignited spontaneously
when they dried because of the body heat. Injury patterns combined simultaneous full
thickness burn injuries of both hands with a burn injury of one thigh or the abdominal
region. The acute treatment and the controversy surrounding decontamination of such
patients are discussed. In addition, pathology of tissue damage and systemic injury
are elucidated.
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© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
