Arsenic poisoning

Arsenic poisoning
Arsenic poisoning
Other names	Arsenicosis
	This person displays some of the symptoms of arsenic poisoning through contaminated water
Specialty	Toxicology
Symptoms	Acute: vomiting, abdominal pain, watery diarrhea; Chronic: thickened skin, darker skin, cancer
Causes	Arsenic
Diagnostic method	Urine, blood, or hair testing
Prevention	Drinking water without arsenic
Treatment	Dimercaptosuccinic acid, dimercaptopropane sulfonate
Frequency	>200 million

Arsenic poisoning (or arsenicosis) is a medical condition that occurs due to elevated levels of arsenic in the body.^[4] If arsenic poisoning occurs over a brief period of time, symptoms may include vomiting, abdominal pain, encephalopathy, and watery diarrhea that contains blood.^[1] Long-term exposure can result in thickening of the skin, darker skin, abdominal pain, diarrhea, heart disease, numbness, and cancer.^[1]

The most common reason for long-term exposure is contaminated drinking water.^[3] Groundwater most often becomes contaminated naturally; however, contamination may also occur from mining or agriculture.^[1] It may also be found in the soil and air.^[5] Recommended levels in water are less than 10–50 μg/L (10–50 parts per billion).^[1] Other routes of exposure include toxic waste sites and pseudo-medicine.^[1]^[3] Most cases of poisoning are accidental.^[1] Arsenic acts by changing the functioning of around 200 enzymes.^[1] Diagnosis is by testing the urine, blood, or hair.^[1]

Prevention is by using water that does not contain high levels of arsenic.^[1] This may be achieved by the use of special filters or using rainwater.^[1] There is not good evidence to support specific treatments for long-term poisoning.^[1] For acute poisonings treating dehydration is important.^[4] Dimercaptosuccinic acid or dimercaptopropane sulfonate may be used while dimercaprol (BAL) is not recommended.^[2] Hemodialysis may also be used.^[4]

Through drinking water, more than 200 million people globally are exposed to higher-than-safe levels of arsenic.^[3] The areas most affected are Bangladesh and West Bengal.^[3] Exposure is also more common in people of low income and minorities.^[6] Acute poisoning is uncommon.^[3] The toxicity of arsenic has been described as far back as 1500 BC in the Ebers papyrus.^[7]

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p Ratnaike RN (1 July 2003). "Acute and chronic arsenic toxicity". Postgraduate Medical Journal. 79 (933): 391–396. doi:10.1136/pmj.79.933.391. PMC 1742758. PMID 12897217.
^ ^a ^b Andersen O, Aaseth J (December 2016). "A review of pitfalls and progress in chelation treatment of metal poisonings". Journal of Trace Elements in Medicine and Biology. 38: 74–80. doi:10.1016/j.jtemb.2016.03.013. hdl:11250/2430866. PMID 27150911.
^ ^a ^b ^c ^d ^e ^f Naujokas MF, Anderson B, Ahsan H, Aposhian HV, Graziano JH, Thompson C, Suk WA (3 January 2013). "The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem". Environmental Health Perspectives. 121 (3): 295–302. doi:10.1289/ehp.1205875. PMC 3621177. PMID 23458756.
^ ^a ^b ^c Vahidnia A, van der Voet G, de Wolff F (1 October 2007). "Arsenic neurotoxicity A review". Human & Experimental Toxicology. 26 (10): 823–832. Bibcode:2007HETox..26..823V. doi:10.1177/0960327107084539. PMID 18025055. S2CID 24138885.
^ Hughes MF, Beck BD, Chen Y, Lewis AS, Thomas DJ (October 2011). "Arsenic exposure and toxicology: a historical perspective". Toxicological Sciences. 123 (2): 305–32. doi:10.1093/toxsci/kfr184. PMC 3179678. PMID 21750349.
^ Joca L, Sacks JD, Moore D, Lee JS, Sams R, Cowden J (2016). "Systematic review of differential inorganic arsenic exposure in minority, low-income, and indigenous populations in the United States". Environment International. 92–93: 707–15. Bibcode:2016EnInt..92..707J. doi:10.1016/j.envint.2016.01.011. PMID 26896853.
^ Howie F (2013). Care and Conservation of Geological Material. Routledge. p. 135. ISBN 978-1-135-38521-7. Archived from the original on 2017-09-10.

[Rat2003-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p Ratnaike RN (1 July 2003). "Acute and chronic arsenic toxicity". Postgraduate Medical Journal. 79 (933): 391–396. doi:10.1136/pmj.79.933.391. PMC 1742758. PMID 12897217.

[An2016-2] Andersen O, Aaseth J (December 2016). "A review of pitfalls and progress in chelation treatment of metal poisonings". Journal of Trace Elements in Medicine and Biology. 38: 74–80. doi:10.1016/j.jtemb.2016.03.013. hdl:11250/2430866. PMID 27150911.

[EH2013-3] ^ ^a ^b ^c ^d ^e ^f Naujokas MF, Anderson B, Ahsan H, Aposhian HV, Graziano JH, Thompson C, Suk WA (3 January 2013). "The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem". Environmental Health Perspectives. 121 (3): 295–302. doi:10.1289/ehp.1205875. PMC 3621177. PMID 23458756.

[Va2007-4] Vahidnia A, van der Voet G, de Wolff F (1 October 2007). "Arsenic neurotoxicity A review". Human & Experimental Toxicology. 26 (10): 823–832. Bibcode:2007HETox..26..823V. doi:10.1177/0960327107084539. PMID 18025055. S2CID 24138885.

[Hug2011-5] Hughes MF, Beck BD, Chen Y, Lewis AS, Thomas DJ (October 2011). "Arsenic exposure and toxicology: a historical perspective". Toxicological Sciences. 123 (2): 305–32. doi:10.1093/toxsci/kfr184. PMC 3179678. PMID 21750349.

[6] Joca L, Sacks JD, Moore D, Lee JS, Sams R, Cowden J (2016). "Systematic review of differential inorganic arsenic exposure in minority, low-income, and indigenous populations in the United States". Environment International. 92–93: 707–15. Bibcode:2016EnInt..92..707J. doi:10.1016/j.envint.2016.01.011. PMID 26896853.

[7] Howie F (2013). Care and Conservation of Geological Material. Routledge. p. 135. ISBN 978-1-135-38521-7. Archived from the original on 2017-09-10.

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