Arsenic

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Arsenic History and Poisoning with list of medical effects.

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  • According to the American Association of Poison Control Centers' (AAPCC) National Poisoning Data System (NPDS),
  • Arsenic

    1. 1. ArsenicPrepared By Dr.Anees AlSaadiCommunity Medicine Resident.Nov. 2012Poisoning1
    2. 2. Napoléon Bonaparte.August – MayJane AustenDecember – July2
    3. 3. Simón José Antonio de la SantísimaTrinidad Bolívar y Palacios Ponte yBlanco(24 July 1783 – 17 December1830)3
    4. 4. KING OF POISONSANDPOISON OF KINGS4
    5. 5. • What Is Arsenic …? The Chemical AndPhysical Properties.• Where It Is Found ….?• Burden of Arsenic Poisoning.• Effect On The Health.• Limits And Standards.• Control And Prevention.5
    6. 6. What Is ARSENIC …?Arsenic(Metal)InorganicArsenicToxicEnvironmentalArsenate &ArseniteOrganicArsenicNon Toxic.Sea Food6
    7. 7. ARSENIC• Arsenic is typicallyconsidered a heavymetal.• Ubiquitous in theenvironment .• allotropic forms:– Alpha or yellow.– Beta or black.– Gamma or grey.7
    8. 8. Where It Is Found ….?• Natural Activities.• Soil, Air, Water, Food.• Human Activities.20th14th12th8
    9. 9. Where It Is Found ….?Fruit sprays Sheep-dipsWeed-killersRat poisonsFly papersCalico printingTaxidermyPreserving timberagainst white ants9
    10. 10. Where It Is Found ….?Ground Water.Antifungal woodPreservatives. Cigarettes Smoking.10
    11. 11. Burden of Arsenic Poisoning.• United States–(AAPCC) & (NPDS) in 2010:• 927 human exposures.• The majority of the pesticide exposures occurred inchildren younger than 5 years (43 [65%] of 67).Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Dart RC. 2010 Annual Report of the American Association of PoisonControl Centers National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila). Dec 2011;49(10):910-41.11
    12. 12. Burden of Arsenic Poisoning.• International–100 million people are at risk.–In Bangladesh 95% of the water supply isarsenic contaminated.Ng JC, Moore MR. Arsenic in drinking water: a natural killer in Bangladesh and beyond. An urgent alternative watershed managementstrategy is needed. Med J Aust. Dec 5-19 2005;183(11-12):562-3. 12
    13. 13. 13http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.htmlNepalBhutanBangladeshBurmaThailand
    14. 14. Burden of Arsenic Poisoning.• Mortality/Morbidity– (AAPCC) & (NPDS), 6 individuals suffered majoreffects and 3 died from exposure to nonpesticidearsenic exposure in 2011.Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Dart RC. 2010 Annual Report of the American Association ofPoison Control Centers National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila). Dec 2011;49(10):910-41.14
    15. 15. Burden of Arsenic Poisoning.• WHO estimated that arsenic contaminateddrinking water in Bangladesh alone was attributed9,100 deaths and 125000 (DALYs) in 2001.WHO. Arsenic. Geneva , world health organization press; 2010: available from:http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html15
    16. 16. Risk Factors• Sex.• Age– Pesticides V.S Nonpesticide Arsenic Exposure.• Occupation.• Nutritional Deficiencies.16
    17. 17. Effect On Health.History :• Killing: Suicidal, Homicidal,Malicious …ect.• Occupational History.History :• Dietary, NutritionalHabits, Alcohol.• Ayurvedic Medicine17
    18. 18. Effect On Health.Acute:Shock like Picture.Acute:Cholera- like GE.Acute:Garlic smell.18
    19. 19. CHRONIC• Classical Dermatitis.– Hyperkeratosis.– Dew drops on a dusty road.• Mees lines on fingernails.• Acute Hemolytic Anemia.19
    20. 20. CHRONIC • Peripheral neuropathy.• Cardiac arrhythmias:– Prolonged QT and VF.• Hepatic and Renal Damage.• Black foot disease.• Cancers.• Pregnancy.20
    21. 21. Limits And Standards.10 μg/ L10 μg/m3http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 21
    22. 22. Limits And Standards.5μg/m3http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 22
    23. 23. Limits And Standards.3.0 μg/kghttp://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 23
    24. 24. Limits And Standards.WHOWHOTolerableintake level3.0 μg/kgbody weightper dayDrinkingWater10 μg/ LAirCan not beEstablishedEPA & OSHAOSHAWater 10 μg/LAir ( PEL) 10 μg/m3Actionlevel5μg/m324http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.htmlhttp://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10024
    25. 25. Action Level (5 µg/m3) at least 30 days/year:Medical Examination.Protective Clothing And EquipmentHygiene Facilities And PracticesSigns And LabelsObservation Of Monitoring Access To RecordsTraining And Notificationhttp://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10024 25
    26. 26. Control And Prevention.Emergency• Pond –sand filter.• Dug wells.• Deep hand tube wells.• Rainwater harvesting.http://www.who.int/water_sanitation_health/dwq/wsh0306/en/index3.html 26
    27. 27. Control And PreventionLong term• Drinking water arsenic concentration below 10μg/L.– Rain water collection.– Regular testing of water.– Installing arsenic removal system.• Occupational exposure to low level.• Public awareness and education.• Monitor high risk population for early signs.http://www.who.int/water_sanitation_health/dwq/wsh0306/en/index3.html 27
    28. 28. • The Major Source Of Arsenic Is:–Ground Water.–Cigarettes Smoking.–Pesticides.–Volcanic eruptions.28
    29. 29. 29• The Major Source Of Arsenic Is:–Ground Water.–Cigarettes Smoking.–Pesticides.–Volcanic eruptions.
    30. 30. • The following is the mostcommon human health effect ofArsenic:–Hepatocellular Carcinoma.–Skin Squamous Cell Carcinoma.– Skin Melanoses and Keratosis.–Black foot Disease.30
    31. 31. 31• The following is the mostcommon human health effect ofArsenic:–Hepatocellular Carcinoma.–Skin Squamous Cell Carcinoma.– Skin Melanoses and Keratosis.–Black foot Disease.
    32. 32. Summary• Inorganic Arsenic is the toxic form.• Underground Drinking water is the major source.• Acute and Chronic health Effect mainly on the skin,respiratory and CNS.• Known Carcinogenic.• 10μg/L level in drinking water.• Prevention and Control.32
    33. 33. 33

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