Comments
With chronic exposure in the occupational setting, skin lesions and peripheral neuropathy are the most common adverse effects. Patchy hyperpigmentation, "raindrops on a dusty road," is the classic skin lesion of chronic arsenic exposure. Other adverse effects include anemia, leukopenia, thrombocytopenia, eosinophilia, and liver injury. [ATSDR Case Studies: Arsenic Toxicity] At this time, 90% of arsenic is used as chromated copper arsenate (CCA) to preserve wood (pressure-treated wood). Arsenic exposure occurs when workers sand or burn this wood. Arsenic is used as an alloy in lead-acid batteries. Inorganic arsenic is no longer used in agriculture in the USA. Organic arsenic pesticides (cacodylic acid, disodium methylarsenate, and monosodium methylarsenate) are used on cotton. Eating fish also exposes humans to the less harmful organic form of arsenic, called "fish arsenic." 80% of drinking water in the USA has less than 2 ppb of arsenic, but 2% exceeds 20 ppb. [ATSDR ToxProfiles] Chronic arsenic poisoning has been reported in China from burning arsenic-rich coal in homes. [Environ Health Perspect 2002;110(2):119-22] After repeated ingestion of 0.04 mg/kg/day, victims have GI distress and blood changes within weeks to months and peripheral neuropathy within months to years. [Olson, p. 141]
Diagnostic
Urine arsenic; (Instruct patients not to eat seafood, kelp, or algae during the 48 hours preceding the urine test; seafood may contain organic arsenics that are of low toxicity and rapidly excreted in the urine.)