Phossy jaw

Phossy jaw, formally phosphorus necrosis of the jaw, is an occupational disease of those who work with white phosphorus, also known as yellow phosphorus, without proper safeguards. It was most commonly seen in workers in the match-stick industry in the 19th and early 20th century. Modern occupational hygiene practices have eliminated the working conditions which caused this disease.

Symptoms and treatment

Those with phossy jaw would begin suffering painful toothaches and swelling of the gums. Over time, the jaw bone would begin to abscess. Affected bones would glow a greenish-white colour in the dark.[1][2] The condition also caused serious brain damage. Surgical removal of the afflicted jaw bones could save the patient; otherwise, death from organ failure would follow. The disease was extremely painful and disfiguring to the patient, with dying bone tissue rotting away accompanied by a foul-smelling discharge. However, removal of the jaw bone had serious effects on patients' ability to eat, leading to further health concerns including malnutrition.

Match industry

White phosphorus was the active ingredient of most matches from the 1840s to the 1910s and exposure to the vapour from this caused a deposition of phosphorus in the jaw bones[3] of workers in the industry. Concern over phossy jaw contributed to the London matchgirls strike of 1888, and although this strike did not end the use of white phosphorus, William Booth and The Salvation Army opened a match-making factory in 1891 which used the much safer, though more expensive, red phosphorus.[4] The Salvation Army also campaigned with local retailers to get them to sell only red phosphorus matches.[4]

However it was not until the use of white phosphorus was prohibited by the international Berne Convention in 1906, and these provisions were implemented in national laws over the next few years, that industrial use ceased.[5]

A related condition, bisphosphonate-associated osteonecrosis of the jaw (BON), has been described as a side-effect of amino-bisphosphonates, a class of phosphorus-based drugs that inhibit bone resorption and are used widely for treating osteoporosis, bone disease in cancer and some other conditions.[6] BON, sometimes called "bis-phossy jaw",[7] is primarily associated with the use of intravenous bisphosphonates in the treatment of cancer. The percentage incidence of BON from this use is approximately 1000 times higher than the incidence of BON caused by the use of oral bisphosphonates.[8]

See also


  1. "Workshops of Horror". New Zealand Department of Labour.
  2. Zosia Chustecka (2005). "Bisphosphonates and jaw osteonecrosis". Medscape.
  3. Marx RE (November 2008). "Uncovering the cause of "phossy jaw" Circa 1858 to 1906: oral and maxillofacial surgery closed case files-case closed". J. Oral Maxillofac. Surg. 66 (11): 2356–63. doi:10.1016/j.joms.2007.11.006. PMID 18940506.
  4. 1 2 Fact and Fiction Archived August 19, 2008, at the Wayback Machine.
  5. Phossy jaw
  6. Durie BG, Katz M, Crowley J (July 2005). "Osteonecrosis of the jaw and bisphosphonates". N. Engl. J. Med. 353 (1): 99–102; discussion 99–102. doi:10.1056/NEJM200507073530120. PMID 16000365.
  7. Mario Abu-Id et al. "'Bis-phossy jaws' – High and low risk factors for bisphosphonate-induced osteonecrosis of the jaw". Department of Oral and Maxillofacial Surgery and Plastic Surgery, Asklepios Klinik Nord, Hamburg, Germany. Journal of Cranio-Maxillofacial Surgery. 04/2008; 36(2):95-103. DOI: 10.1016/j.jcms.2007.06.008
  8. Cartsos VM, Zhu S, Zavras AI (January 2008). "Bisphosphonate use and the risk of adverse jaw outcomes: a medical claims study of 714,217 people". J Am Dent Assoc. 139 (1): 23–30. doi:10.14219/jada.archive.2008.0016. PMID 18167381.
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