Arsenic

Two types 1) Inorganic & 2) Organic For both the Biological Half life in blood is 60 hours. It is rapidly eliminated through urine either unchanged or after biotransformation. Toxicity differs in different compounds of Arsenic. Acute Toxicity:- Inorganic Arsenic toxicity mimic the signs & symptoms of acute diarrhoeas (Cholera). Acute Toxicity may be due to ingestion deliberately or accidently through contaminated food or drinks. Presenting Symptoms:- 1) Abdominal Pain 2) Profound vomiting 3) Rice Water Stools 4) Dehydration 5) Shock 6) Followed by Stupor, Coma, Convulsions & Death Mechanism:- The underlying lesions are due to dilation & increased permeability of small blood vessels of the gut& elsewhere. Mainly seen in Inorganic Arsenic. Chronic Toxicity:- A) Skin:- 1) Eczematous or Follicular Dermatitis 2) Ulceration 3) Hyperkeratosis of Palms & Soles 4) Rain Drop Hyper Pigmentation of skin 5) Skin Cancers of 3 Types:- a) Basal Cell Carcinoma b) Squamous Cell Carcinoma c) Bowens Disease (Form of Sq. Cell Ca seen in HIV +ve, As & Huma Papilloma Virus) B) CNS:- 1) Peripheral Neuropathy of mixed Sensory Motor type, caused by interference in Glycolysis within the neurons. 2)Parasthesia 3) Loss of Vibration sensation 4) Pain & Burning Sensation in the Limbs especially in the calf muscles, followed by Muscle Weakness 5) Acute Encephalopathy C) Liver:-1) Liver Enlargement 2) Liver cirrhosis Both of these are due to inhibition of enzymes concerned with intracellular respiration D) Blood:- Megaloblastic Anaemia:- Arsenic interferes with SH Group enzymes responsible for Heam Synthesis. E) Respiratory System:- 1) Perforation of Nasal Cartilaginous Septum, due to Inflammation & Erosive lesions of nasal mucosa. It is painless & may occur within short duration of exposure. 2) Bronchitis 3) Pneumonitis 4) Carcinoma of Lung F) Arsine Gas (AsH3):- Colourless gas which is odourless in low concentration, but in increased concentration smell like garlic. It is formed whenever Arsenic comes in contact with Nascent Oxygen (Freshly prepared Oxygen) As + 3H = AsH3 Areas responsible are 1) Electronic, Quartz (Watch Making) Industries which produces semiconductors. 2) Metal Smelting 3) Galvanizing Toxicity(Mainly Acute):- 1) Nausea, Vomiting, Headache 2) Abdominal Pain 3) Haemolytic Jaundice :- Commonest cause of Occupational Jaundice. Abdominal Pain & Jaundice occur typically within 24 to 48 hours. 4) Anuric or Oliguric Renal failure, usually appears within 72 hours. 5) Hepatic failure 6) Haemoglobinurea Treatment:1)Exchange Blood Transfusion 2) In mild cases of Haemoglobinurea:- Forced Diuresis.

Chronic Cases of Arsine Gas Poisoning:- History of Occupation where Cyanide is Extracted e.g. Cyanide Extraction of Gold & Zinc Smelting. It causes 1) Severe Anaemia 2) Mild increase in Serum Bilirubin Level. Bio-monitoring of Arsenic:1) TWA of Airborne Concentration should not exceed 50 MicroGm/M3 2) Urinary Arsenic Concentration should not exceed 50 MicroGm/M3 3) The Drinking Water Concentration Should not exceed 0.01 Mg/lit