Arsenic is commonly found in groundwater and can cause serious health effects. The document discusses arsenic's properties, major sources like groundwater, and health impacts like skin lesions and cancers. It also provides information on limits and standards, noting the WHO drinking water guideline of 10 μg/L, as well as strategies for control and prevention like installing arsenic removal systems and educating the public.

1. Arsenic
Prepared By Dr.Anees AlSaadi
Community Medicine Resident.
Nov. 2012
Poisoning
1

2. Napoléon Bonaparte.
August – May
Jane Austen
December – July
2

3. Simón José Antonio de la Santísima
Trinidad Bolívar y Palacios Ponte y
Blanco(24 July 1783 – 17 December
1830)
3

4. KING OF POISONS
AND
POISON OF KINGS
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5. • What Is Arsenic …? The Chemical And
Physical Properties.
• Where It Is Found ….?
• Burden of Arsenic Poisoning.
• Effect On The Health.
• Limits And Standards.
• Control And Prevention.
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6. What Is ARSENIC …?
Arsenic
(Metal)
Inorganic
Arsenic
Toxic
Environmental
Arsenate &
Arsenite
Organic
Arsenic
Non Toxic.
Sea Food
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7. ARSENIC
• Arsenic is typically
considered a heavy
metal.
• Ubiquitous in the
environment .
• allotropic forms:
– Alpha or yellow.
– Beta or black.
– Gamma or grey.
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8. Where It Is Found ….?
• Natural Activities.
• Soil, Air, Water, Food.
• Human Activities.
20th
14th
12th
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9. Where It Is Found ….?
Fruit sprays Sheep-dips
Weed-killers
Rat poisons
Fly papers
Calico printing
Taxidermy
Preserving timber
against white ants9

10. Where It Is Found ….?
Ground Water.
Antifungal wood
Preservatives.
 Cigarettes Smoking.
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11. Burden of Arsenic Poisoning.
• United States
–(AAPCC) & (NPDS) in 2010:
• 927 human exposures.
• The majority of the pesticide exposures occurred in
children 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 Poison
Control Centers' National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila). Dec 2011;49(10):910-41.
11

12. Burden of Arsenic Poisoning.
• International
–100 million people are at risk.
–In Bangladesh 95% of the water supply is
arsenic contaminated.
Ng JC, Moore MR. Arsenic in drinking water: a natural killer in Bangladesh and beyond. An urgent alternative watershed management
strategy is needed. Med J Aust. Dec 5-19 2005;183(11-12):562-3. 12

13. 13http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html
Nepal
Bhutan
Bangladesh
Burma
Thailand

14. Burden of Arsenic Poisoning.
• Mortality/Morbidity
– (AAPCC) & (NPDS), 6 individuals suffered major
effects and 3 died from exposure to nonpesticide
arsenic exposure in 2011.
Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Dart RC. 2010 Annual Report of the American Association of
Poison Control Centers' National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila). Dec 2011;49(10):910-41.
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15. Burden of Arsenic Poisoning.
• WHO estimated that arsenic contaminated
drinking water in Bangladesh alone was attributed
9,100 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.html
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16. Risk Factors
• Sex.
• Age
– Pesticides V.S Nonpesticide Arsenic Exposure.
• Occupation.
• Nutritional Deficiencies.
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17. Effect On Health.
History :
• Killing: Suicidal, Homicidal,
Malicious …ect.
• Occupational History.
History :
• Dietary, Nutritional
Habits, Alcohol.
• Ayurvedic Medicine
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18. Effect On Health.
Acute:
Shock like Picture.
Acute:
Cholera- like GE.
Acute:
Garlic smell.
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19. CHRONIC
• Classical Dermatitis.
– Hyperkeratosis.
– Dew drops on a dusty road.
• Mees lines on fingernails.
• Acute Hemolytic Anemia.
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20. CHRONIC • Peripheral neuropathy.
• Cardiac arrhythmias:
– Prolonged QT and VF.
• Hepatic and Renal Damage.
• Black foot disease.
• Cancers.
• Pregnancy.
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21. Limits And Standards.
10 μg/ L
10 μg/m3
http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 21

22. Limits And Standards.
5μg/m3
http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 22

23. Limits And Standards.
3.0 μg/kg
http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 23

24. Limits And Standards.
WHO
WHO
Tolerable
intake level
3.0 μg/kg
body weight
per day
Drinking
Water
10 μg/ L
Air
Can not be
Established
EPA & OSHA
OSHA
Water 10 μg/L
Air ( PEL) 10 μg/m3
Action
level
5μg/m3
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http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html
http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10024

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 Notification
http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10024 25

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. Control And Prevention
Long 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. • The Major Source Of Arsenic Is:
–Ground Water.
–Cigarettes Smoking.
–Pesticides.
–Volcanic eruptions.
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• The Major Source Of Arsenic Is:
–Ground Water.
–Cigarettes Smoking.
–Pesticides.
–Volcanic eruptions.

30. • The following is the most
common human health effect of
Arsenic:
–Hepatocellular Carcinoma.
–Skin Squamous Cell Carcinoma.
– Skin Melanoses and Keratosis.
–Black foot Disease.
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31. 31
• The following is the most
common human health effect of
Arsenic:
–Hepatocellular Carcinoma.
–Skin Squamous Cell Carcinoma.
– Skin Melanoses and Keratosis.
–Black foot Disease.

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.
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