Arsenic exposure can occur due to ingestion of contaminated water or occupational and environmental settings.
Contamination of drinking water by naturally occurring arsenic is the main source of exposure to arsenic and affecrs an estimated hundred million people worldwide.
Hotspots of arsenic exposure have been identified in Bangladesh, Thailand, Taiwan, and northern Chile.
In the US elevated levels of arsenic in groundwater is found in northern New England and the south west.
Arsenic exposure associated with working coal, gold, zinc, cobalt mines, in contact with pressure-treated wood, assembly of computer chips, manufacture and use of arsenic containing pesticides, and ingestion of contaminated shellfish or seaweed.
Affects almost all organ systems.
Associated with abnormal porphyrin metabolism, portal hypertension, peripheral neuropathy, peripheral vascular disease, cardiovascular diseases, and diabetes.
Dose response associations have been noted between arsenic exposure and coronary artery disease, peripheral arterial disease, and type two diabetes.
There is a weak association between arsenic exposure and rate of stroke.
Associated with skin changes including basal cell carcinoma, squamous cell carcinoma and Merkel cell carcinoma.
Blood levels may be elevated, but because it is quickly metabolized test can produce normal results if a patient has not been recently exposed.
Causes tissue damage and accelerated atherogenesis through oxidative and inflammatory mechanisms.
Hair testing can identify arsenic exposure.
Exposure linked to the development of type 2 diabetes (Navas-Acien).
3.6 fold increase in the odds of developing diabetes in patients with the highest total urinary arsenic levels as compared to those with the lowest urinary arsenic concentrations.
Associated with renal cell in transitional cell carcinomas.
Chelating agents maybe used in the treatment of acute arsenic poisoning.
Management for chronic arsenic poisoning includes the avoidance of further contact with the agent.