Arsenic

Forms

Inorganic - most important commercially

Organic - Seafood, contaminated water/environment

Most toxic form

Inorganic Arsenic

• Arsenic trioxide

• Arsine gas

Organic is non-toxic! and found in seafood

IARC Classification

1 - Known human Carcinogen

• Skin

• Lung

• Bladder and Kidney

Chronic effects

Cancer

Hyperkeratosis

Sensory Peripheral neuropathy

Anaemia

Black foot disease/ peripheral vascular disease

Acute presentation and treatment

HISTORY OF EXPOSURE

GIT! ACUTE ABDOMEN, NAUSEA, VOMITING

RAPID PROGRESSION TO CARDIOVASCULAR COLLAPSE, HAEMOLYTIC ANEMIA

CLUES: SKIN CHANGES AND GARLIC ODOUR BREATH

TREATMENT INCLUDES BAL ( BAL CI IN ACUTE RENAL FAILURE - USE DMSA)

BIOLOGICAL MONITORING:

ACUTE EXPOSURE

ARSENIC CHRONIC EXPOSURE

URINE FOR recent, and biological monitoring of workplaces . 2-3 days

Blood- clinical setting for acute poisoning. Drops very quickly

HAIR AND NAILS FOR CHRONIC but not in occupational health se

ARSENIC NAILS

MEES LINES - TRANVERSE WHITE LINES ON NAILS ARTE PATHOGNOMIC

Sources

Mining (CU,ZN,PB),wood preservatives/pesticides, semiconductor, copper smelting, leather tanning

Urine for arsenic

Inorganic + mma + dma (i.e the toxic metabolites)

Request speciation as total is measured.

Organic As is non toxic

No seafood for 48 hours before test