Arsenic

Arsenic History and Poisoning with list of medical effects.

1. A rsenic Prepared By Dr.Anees AlSaadi Community Medicine Resident . Nov. 2012 P oisoning 1

2. Napoléon Bonaparte . 15 August 1769 – 5 May 1821 Jane Austen 16 December 1775 – 18 July 1817 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 4

5. OBJECTIVES 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 . 5

6. What Is ARSENIC …? Arsenic (Metal) Inorganic Arsenic Toxic Environmental Arsenate & Arsenite Organic Arsenic Non Toxic. Sea Food 6

7. ARSENIC Arsenic is typically considered a heavy metal. Ubiquitous in the environment . ③allotropic forms : Alpha or yellow. Beta or black. Gamma or grey. 7

8. Where It Is Found ….? Natural Activities. Soil, Air, Water, Food. Human Activities. 20 th 14 th 12 th 8

9. Where It Is Found ….? Fruit sprays Sheep-dips Weed-killers Rat poisons Fly papers Calico printing Taxidermy Preserving timber against white ants 9

10. Where It Is Found ….? Ground Water. Antifungal wood Preservatives. Cigarettes Smoking. 10

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. 13 http://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. 14

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 15

16. Risk Factors Sex. Age Pesticides V.S Nonpesticide Arsenic Exposure. Occupation. Nutritional Deficiencies. 16

17. Effect On Health. 17

18. Effect On Health. 18

19. CHRONIC Classical Dermatitis. Hyperkeratosis. Dew drops on a dusty road. Mees lines on fingernails. Acute Hemolytic Anemia. 19

20. CHRONIC Peripheral neuropathy . Cardiac arrhythmias: Prolonged QT and VF. Hepatic and Renal Damage . Black foot disease. Cancers. Pregnancy. 20

21. Limits And Standards . 10 μ g/ L 10 μ g/m 3 http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 21

22. Limits And Standards . 5 μ g/m 3 http://www.who.int/ipcs/assessment/public_health/arsenic/en/index.html 22

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

24. Limits And Standards . WHO EPA & OSHA 24 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/m 3 ) 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 10 μ g/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. 28

29. 29 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. 30

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. 10 μ g/L level in drinking water. Prevention and Control. 32

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