Definition

Arsenic toxicity is exposure to toxic amounts of arsenic. Arsenic is a naturally occurring element in the earth’s crust. It has no smell or taste. If you suspect you have been exposed to arsenic, contact your doctor right away.

There are 2 primary forms of arsenic:

• Inorganic arsenic—Arsenic combined with hydrogen, oxygen, chlorine, or sulfur. Found in the environment, sometimes as a gas.
• Organic arsenic—Arsenic combined with carbon and hydrogen. Found in animals and plants.

Inorganic arsenic is much more harmful than organic arsenic.

Causes

Arsenic occurs naturally in soil and minerals, and may enter the air, water, and soil. It is also used:

• To preserve or pressure-treat wood—this use is being phased out except for specific applications such as railroad ties and utility poles, but old stocks may still be around and pose a risk
• As an ingredient in pesticides
• To produce glass
• In copper and other metal manufacturing
• In the electronics industry
• In medicine

Arsenic toxicity may occur when a person is exposed to toxic amounts of arsenic by:

• Breathing air containing arsenic
• Eating food contaminated with arsenic
• Drinking water contaminated with arsenic
• Living in areas with high natural levels of arsenic
• Working in a job that involves arsenic

Arsenic Can Be Inhaled into the Lungs Copyright © Nucleus Medical Media, Inc.

Risk Factors

Some people are more likely to be exposed to arsenic, but it can occur in anyone. Factors that may increase your chance of arsenic exposure include:

• Occupational exposure:
  • Companies that preserve wood with arsenic
  • The metal manufacturing industry
  • The glass production industry
  • The electronic industry
  • Other industries that use arsenic
• Living in an area with high natural levels of arsenic

In addition, children may be more susceptible than adults to the health effects of arsenic. There is some evidence that arsenic exposure may harm pregnant women and their unborn babies.

Symptoms

Ingesting high levels of arsenic can result in death. Arsenic has also been linked to increased risks of cancer of the lung, skin, bladder, liver, kidney, and prostate.

Symptoms of acute arsenic exposure generally occur within 30-60 minutes after ingestion. These may include:

• Gastrointestinal symptoms, such as:
  • Metallic or garlic taste in the mouth
  • Headache
  • Vomiting, possibly with blood
  • Watery diarrhea
  • Abdominal pain
• Paralytic symptoms, such as:
  • Cardiovascular system shutdown
  • Central nervous system (the brain and spinal cord) slows down
  • Death, which can occur in hours

Symptoms of chronic arsenic exposure include:

• Recurring diarrhea
• Thickening of skin
• Discoloration of skin
• Small corns or warts on the palms, soles, and torso
• Nausea
• Abnormal heart rhythm
• Numbness in hands and feet
• Partial paralysis
• Blindness
• Drowsiness
• Seizures

In addition, people exposed to arsenic may be at a greater risk of developing heart disease.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It can be difficult to make a diagnosis of arsenic poisoning because symptoms are so varied. If you have concerns about arsenic causing symptoms in yourself or a family member, talk to your doctor.

Your bodily fluids and tissues may be tested. This can be done with:

• Blood tests
• Urine tests
• Hair or fingernail analysis

Treatment

There is no effective treatment for arsenic toxicity. There is increasing evidence that chelation therapy may benefit some people who were poisoned with arsenic. Chelation therapy involves putting a chemical called a chelating agent into the bloodstream. The chelating agent combines with a toxin to help remove it from the body. Chelating agents may be given by pill or by injection.

If chelation is not indicated or is ineffective, your treatment will be designed to help manage and control your symptoms. Treatment may include IV hydration, for example.

Prevention

To help reduce your chances of getting arsenic toxicity:

• If you work with arsenic-treated wood at home, wear a dust mask, gloves, and protective clothing. Do not burn any wood that has been treated with arsenic compounds.
• If you live in an area with high natural levels of arsenic, use cleaner sources of water and limit contact with soil. If you have well water, have it tested for a variety of contaminants, including arsenic.