Phosphine exposure from a methamphetamine laboratory investigation

Background: Law enforcement personnel may be exposed to a variety of hazardous materials during investigation of clandestine methamphetamine laboratories. Case Report: A 28-year-old forensic specialist investigating a methamphetamine lab was exposed to phosphine without respiratory protection at approximately 2.7 ppm for 20-30 minutes. Shortly following exposure she developed dizziness, cough, headache, and diarrhea, although initial medical evaluation within 1-2 hours was unremarkable. Pulmonary examination at 4 and 7 days postexposure revealed bilateral rhonchi. The cough was worse with exertion, and persisted despite β-agonist and steroid inhaler treatment. Conclusions: This is apparently the first published case of symptomatic occupational phosphine exposure in a law enforcement officer during investigation of a methamphetamine laboratory. If phosphine exposure is suspected, the possibility of delayed pulmonary toxicity should be recognized.