Arsenicosis

Arsenicosis

Arsenicosis, also known as chronic arsenic poisoning, is a medical condition caused by prolonged exposure to arsenic, a toxic metalloid. This condition is primarily associated with the consumption of arsenic-contaminated drinking water, but can also result from exposure to arsenic in food, air, or occupational settings. Arsenicosis is a significant public health issue in many parts of the world, particularly in regions where groundwater is naturally contaminated with high levels of arsenic.

Pathophysiology

Arsenic is a naturally occurring element that can exist in several chemical forms, including inorganic and organic compounds. Inorganic arsenic compounds, such as arsenite (As³⁺) and arsenate (As⁵⁺), are more toxic than organic forms. When ingested, arsenic is absorbed into the bloodstream and distributed throughout the body, where it can interfere with cellular metabolism and cause oxidative stress.

Chronic exposure to arsenic can lead to a variety of health effects, including skin lesions, peripheral neuropathy, and an increased risk of cancer. Arsenic is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), meaning it is a known human carcinogen.

Clinical Manifestations

The clinical manifestations of arsenicosis can vary depending on the level and duration of exposure. Common symptoms include:

• Skin changes: Hyperpigmentation, hypopigmentation, and keratosis, particularly on the palms and soles.
• Peripheral neuropathy: Numbness, tingling, and pain in the extremities.
• Gastrointestinal symptoms: Abdominal pain, diarrhea, and vomiting.
• Hematological effects: Anemia and leukopenia.
• Cardiovascular effects: Hypertension and cardiovascular disease.
• Cancer: Increased risk of skin, bladder, lung, and other cancers.

Diagnosis

Diagnosis of arsenicosis is based on clinical evaluation, history of exposure, and laboratory tests. Measurement of arsenic levels in urine is the most common method for assessing exposure. Hair and nail analysis can also be used to evaluate long-term exposure.

Treatment

The primary treatment for arsenicosis is the removal of the source of exposure. Chelation therapy with agents such as dimercaprol or succimer may be used in cases of acute poisoning, but its effectiveness in chronic arsenicosis is limited. Supportive care and management of symptoms are important aspects of treatment.

Prevention

Preventing arsenicosis involves reducing exposure to arsenic. This can be achieved by:

• Testing and treating drinking water: Identifying and mitigating arsenic contamination in water supplies.
• Public health education: Raising awareness about the risks of arsenic exposure and promoting safe water practices.
• Regulation and monitoring: Implementing policies to regulate arsenic levels in water, food, and the environment.

Epidemiology

Arsenicosis is a global health concern, with significant outbreaks reported in countries such as Bangladesh, India, China, and parts of South America. The World Health Organization (WHO) estimates that millions of people worldwide are exposed to unsafe levels of arsenic in drinking water.

Also see

• Arsenic poisoning
• Groundwater contamination
• Heavy metal toxicity
• Public health