Medical Problems Associated with Arsenic Exposure

Abstract

Chronic arsenicalism is a most uncommon occupational disease in the USA today. The syndrome has been well documented and does not present unusual diagnostic difficulties. The biologic half-life of As is less than 48 h in most persons and, once removed from exposure, the body burden drops rapidly. As is a marked irritant to surface tissues and appropriate protective devices must be employed to avoid skin problems. No effects on the nervous system, liver or kidneys have been observed in employees who may have been heavily exposed to airborne arsenic trioxide in the past. There is no evidence of systemic, arsenicalism in employees currently employed. Absorption of As may cause a relative neutropenia without a significant reduction of the total white blood cell count. The relationship between the concentration of As in the ambient air of the work space and the quantity of As excreted in the urine allows the use of urine As measurements for detecting undesirable personal hygiene practices or breakdowns in the protective measures used for controlling worker exposure. A biological monitoring program is recommended which includes urine As determinations for all workers exposed to As. The possibility of increased risk of respiratory cancer among employees exposed to arsenic trioxide and other smelter emissions requires a medical program aimed at the prevention and early detection of lung cancer among smelter workers. It is questionable, however, whether any need has been shown for special examinations related to lymphatic and hematopoietic cancer. The following program of medical surveillance for all employees exposed to more than 50 .mu.gm/m3 of As is recommended. A physical examination once every 2 yr for employees under age 50 and annually for those ages 50 and above. Such an examination would include ancillary laboratory examinations such as blood counts, blood chemistries, electrocardiography and respirometry where indicated. Annual examination by chest x-ray or its equivalent. Examination of the nasal septum every 6 mo. by a physician or other trained personnel.