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INDUSTRIAL & ENVIRONMENTAL TOXICOLOGY
Prepared By: Wan Noorhidayat bt Wan Jusoh 141931 Nur Fadhilah binti Rosli 141466 Lecturer: Associate Prof. Dr. Mohd Yusoff Adon
Bachelor of Science Environmental & Occupational Health
The element arsenic itself is not soluble in water. with a valency of 5. it is usually undetectable if present in food. Most of inorganic and organic arsenic compounds are white or colorless powders that do not evaporate. Although EPA has not classify arsine for carcinogenicity but the arsenic itself widely known as the carcinogenic agents. The elemental arsenic is known ordinarily a steel grey metal which usually found in the environment combined with other elements. The dominant forms are arsenite. Arsine is a gas consisting of arsenic and hydrogen. Thus. such as hydrogen. Form Common valence states Chemical Formula As0 As3+ As5+ As3(CH3)2AsO(OH) CH3AsO(ONa)2 C7H9AsN2O4 H3AsO4 Na2HAsO4 NaAsO2 Name metalloid arsenic such as arsenites such as arsenates such as arsine gas cacodylic acid (dimethylarsinic acid) disodium methylarsenate (DSMA) carbasone arsenic acid disodium arsenate sodium arsenite Examples of organic arsenicals Examples of inorganic arsenicals Inorganic arsenic exists in four main chemical forms known as valency or oxidation states.000 tonnes per . They have no smell. and sulfur called inorganic arsenic while the other arsenic which combined with carbon and hydrogen is referred to as organic arsenic. Arsenic in combination with other elements (as salts) has a wide range of solubilities depending on the surrounding acidity and the presence of other chemicals. The arsenic which combined with elements such as oxygen. water and land through wind-blown dust and water run-off. Arsenic can be found naturally on earth in small concentrations. It is known that can extremely toxic to humans. Arsenic in the atmosphere comes from various sources: vulcanoes release about 3000 tonnes per year and microorganisms release volatile methylarsines to the extent of 20. and arsenate. or air. chlorine. water. It occurs in soil and minerals and it may enter air. and most have no special taste. with a valency of 3.Arsenic is an element that is widely distributed in the earth’s crust. Arsenic in the organic forms is usually less harmful than the inorganic forms. Valency is a measure of the ability of a compound to combine with other elements.
although the necessary intake may be as low as 0. but the negative site to it is that arsenic pollution becomes a wider issue because it easily spreads. (As(0)) normally occurs as the α-crystalline metallic form. Arsenic appears in Group 15 (V) of the periodic table. Arsenic is a component that is extremely hard to convert to water-soluble or volatile products. The fact that arsenic is naturally a fairly a mobile component. The melting point for arsenic is 817 °C and the boiling point for arsenic is 614°C. Despite its notoriety as a deadly poison. below nitrogen and phosphorus. Arsenic cannot be mobilized easily when it is immobile. The β-form is a dark gray amorphous solid. In compounds. Its position in the periodic table is shown at right. naturally immobile arsenics have also mobilized and can now be found on many more places than where they existed naturally.000 tonnes of arsenic per year are released by the burning of fossil fuels.92. black and grey. but human activity is responsible for much more: 80. Due to human activities.year. and maybe even for humans. Other allotropic forms of arsenic may also exist.0 Physical and chemical properties Arsenic is a chemical element that has the symbol As and atomic number 33. which is a steel gray and brittle solid. arsenic . it is frequently referred to as a metal.01 mg/day. mainly through mining and smelting. A rock containing an extremely high amount of 2. arsenic is an essential trace element for some animals. the stable form is a silvergray. Its Ionic Charge is (3-). Arsenic appears in three allotropic forms: yellow. having both properties of a metal and a nonmetal. which is also referred to as metallic arsenic. however. brittle crystalline solid. basically means that large concentrations are not likely to appear on one specific site. Arsenic is classified chemically as a metalloid. This is a good thing. Its Atomic Mass is 74. Elemental arsenic.
amorphous or vitreous forms. arsenic acid and sodium arsenate. powder. and arsenobetaine. and organic. Arsenic compounds can be categorized as inorganic. concentrations may be higher in certain areas as a result of weathering and anthropogenic activities including metal mining and smelting. water and air. compounds with an arsenic-carbon bond. There are many arsenic compounds of environmental importance. soil. fossil fuel combustion and pesticide use. Representative organic compounds are monomethyl-. They usually occur in trace quantities in all rock. +3. 3. dimethyl. and +5. The non metallic form is less reactive but will dissolve when heated with strong oxidizing acids and alkalis.0 Occupational Industrial Usage . However. -3. which has a garlic odor. tarnishes and when heated it rapidly oxidizes to arsenic trioxide. compounds without an arsenic-carbon bond. The metallic form is brittle. arsenic trichloride. Pentavalent ones include arsenic pentoxide.and trimethylarsine.typically exists in one of three oxidation states. Arsenic and its compounds occur in crystalline. Arsenic and its compounds are poisonous. arsenic trisulphide and sodium arsenite. Inorganic compounds include the trivalent arsenic trioxide.
and wood preservatives. ii. herbicides and other agricultural products using arsenic preparations and industrial or agricultural workers using them. lead.0 Classification 5. Various metallurgical or industrial activities like the electrolysis of copper. Main occupational exposures as summarized are the following: i. Workers engaged in the manufacturing of pesticides. vi. and nickel. or cadmium. Arsenic in wood processing plants. where arsenic is present as a contaminant or by-product of ores containing lead. iv. silver and zinc ores. with arsenic as a contaminant. gold.0 Occupational Exposure Limit (TLV/PEL) . including use as a semiconductor and infrared detector. Workers (mainly roaster workers) engaged in the smelting industries: copper.Occupational exposures to arsenic can be encountered in smelting and also in the manufacture of various pesticides. iii. Arsenic as desiccant or defoliant for the preparation of cotton fields for harvesting. 4. pigments. Arsine is used in the microelectronics industry and in semiconductor manufacture. gold. zinc. v. cobalt. glass. A more recently developed use of gallium arsenide occurs in various types of electronics manufacturing. paints.
liver. Chronic health effects are characterized by prolonged or repeated exposures over many days. nervous system.01 miligrams of arsenic per cubic meter of air (mg/m³) as a time-weighted average (TWA) over an 8-hour work shift. Acute health effects are often reversible. sore throat. Normally. Acute health effects are characterized by sudden and severe exposure and rapid absorption of the substance. months or years. Chronic health effects are often irreversible. inhalation and skin absorption Corrosive Short-term inhalation may cause cough. diarrhea and abdominal pain Inorganic arsenic is irritant to the eye and skin Following long-term ingestion the lungs. 6.0 Health Effects The symptoms of the adverse health effects can be divided up into the acute health effects and the chronic effects. a single large exposure is involved. The NIOSH recommended exposure limit (REL) for arsenic and all its inorganic compounds is 0.1 Acute Health Effects .002 mg/m³ as a ceiling concentration determined in any 15-minute sampling period. Symptoms may not be immediately apparent. The National Institute for Occupational Safety and Health (NIOSH) recommends that arsenic and all its inorganic compounds be controlled and handled as potential human carcinogens in the workplace and that exposure be minimized to the lowest feasible limit. Health Effect characteristics of Arsenic: • • • • • • • • Toxic by ingestion. kidneys or stomach may be affected Long-term inhalation may cause inflammation of the eyes and nose Inorganic arsenic compounds have mutagenic potential and human carcinogen 6. The American Conference of Governmental Industrial Hygienist (ACGIH) threshold limit value (TLV) for soluble arsenic compounds is 0.2 mg/m³ as a TWA for a normal 8-hour workday and a 40-hour workweek. breathlessness and wheezing Short-term ingestion causes sickness.The current Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for inorganic arsenic (except arsine) is 0.
jaundice. a) Ingestion Ingestion of large doses of arsenic may lead to acute symptoms within 30-60 min. and oliguria should strongly suggest arsine exposure. vomiting. and facial edema may be present. b) Inhalation In inhalation route (respiratory tract) Arsenic compounds are irritant to the upper airways. muscle cramps. and chest tightness. A dose of 120 mg arsenic trioxide may be fatal. Gastrointestinal symptoms caused by paralysis of the capillary control in the intestinal tract may include profuse watery diarrhea and may lead to a decrease in blood volume. Exposure to 10 ppm rapidly causes delirium. after the initial gastrointestinal problems. weakness and delirium. An acute gastrointestinal syndrome is the most common presentation of acute arsenic poisoning characterised by a metallic or garlic-like taste associated with dry mouth. Other complaints include headache. and copious blood-tinged diarrhea. Violent vomiting may ensue and may eventually lead to haematemesis. respiratory failure. coma. Thus. nausea. rhabdomyolysis and multi-organ failure may occur. Central Nervous System findings may include headaches. coma and circulatory collapse precede death. effects may be delayed when the arsenic is taken with food. Features include cough. burning lips and dysphagia. Physical examination may reveal bronzing of the skin and hepatosplenomegaly. sore throat. Seizures. The triad of abdominal pain. Cold. The lower extremities usually are more affected than the upper. and death. lowered blood pressure and electrolyte imbalance. c) Dermal/Ocular Exposure . and death. pulmonary oedema and respiratory failure. Motor involvement extending to total paralysis also may occur. Acute exposure to arsine results in intravascular hemolysis. breathlessness.Symptoms of acute arsenic poisoning may develop minutes to hours after ingestion and consists of nausea. Persons who recover may develop delayed peripheral neuropathy. presenting after several weeks as symmetric distal sensory loss. clammy skin. failure of vital cardiovascular and brain functions. abdominal pain. including renal failure. Liver enlargement and oliguria also may occur. The acute health effects differ according to the target organs and routes of exposure of the compound. Features of systemic toxicity may also occur. wheeze.
vomiting Summary of Arsenic Chronic Effects a) Gastrointestinal. pain. peripheral vascular disease. ("Blackfoot disease"). Dermal lesions. lacrimation. Most human arsenic exposure occurs from consumption of drinking water containing high amounts of inorganic Arsenic. altered haem metabolism Proximal tubule degeneration. papillary and cortical necrosis Diarrhoea. and Renal Effects Gastrointestinal effects are seen primarily after arsenic ingestion. skin cancer Peripheral vascular disease. cirrhosis. System or Organ Respiratory Tract Dermal Vascular Haematological Neurological Reproductive Liver Kidneys Gastrointestinal Effect Inflammation and tracheobronchitis Hyperkeratosis. kidney. conjunctivitis and corneal damage may occur after exposure to dusts or vapours containing inorganic arsenic. are the most commonly observed symptoms. liver. and lung). 6.2 Chronic Health Effects Chronic arsenic (As) poisoning has become a worldwide public health issue. In ocular exposure. Signs of chronic toxicity may be difficult to diagnose: a number of body systems may be affected and to different extents. skin cancer. Signs of chronic arsenicalism. warts. hypigmentation (Melanosis). cancers of internal organs (bladder. congenital malformation Hepatomegaly. hypertensive heart disease. and less often after inhalation or dermal absorption. peripheral neuropathy. angiosarcoma. blepharospasm. . encephalopathy Spontaneous abortion.For dermal exposure. Arsenic compounds such as trivalent arsenic compounds are well absorbed through the skin and may lead to features of systemic toxicity. myocardial injury Bone marrow depression (resulting in leucopenia and anaemia) Peripheral neuropathy. and alterations in gastrointestinal function (non-cirrhotic hypertension). and hyperkeratosis (thickening of the skin) of the palms and soles. such as hyperpigmentation (Melanosis). Hepatic. including pigmentation and development of keratoses. Arsenic trioxide is irritant to the skin and mucous membranes.
Raynaud's phenomenon and acrocyanosis resulted from contamination of the city's drinking water supply in Antofagasta. b) Cardiovascular Effects Long-term ingestion of arsenic in drinking water has resulted in pronounced peripheral vascular changes.820 ppb). a rare form of cancer. Peripheral neuropathy is a common complication of arsenic poisoning.The gastrointestinal (GI) effects of arsenic generally result from exposure via ingestion. The fundamental GI lesion appears to be increased permeability of the small blood vessels. Case reports have also linked chronic high-level arsenic exposure with hepatic angiosarcoma. Autopsies of Antofagasta children who died of arsenic toxicity revealed fibrous thickening of small and medium arteries and myocardial hypertrophy. Chile. known as Blackfoot disease. Epidemiological evidence indicates that chronic arsenic exposure is associated with vasospasm and peripheral vascular insufficiency. The classic finding is a peripheral neuropathy involving sensory and motor nerves in a symmetrical. Glomerular damage can result in proteinuria. investigators believe other vasoactive substances found in the water may have been contributory. as well as abnormal electrocardiographs (ECGs). at arsenic concentrations ranging from 20 to 400 ppb. or direct effects of arsenic on tubule cells. have been noted in vineyard workers exposed to arsenical pesticides. hemoglobinuric or myoglobinuric tubular injury. However. GI effects may also occur after heavy exposure by other routes. Gangrene of the extremities. Persons with Blackfoot disease also had a higher incidence of arsenic-induced skin cancers. where the prevalence of the disease increased with increasing age and wellwater arsenic concentration (10 to 1. Extensive inflammation and necrosis of the mucosa and submucosa of the stomach and intestine may occur and progress to perforation of the gut wall. with bloody diarrhea as a presenting symptom. The kidney is not a major target organ for chronic toxicity. has been associated with drinking arsenic-contaminated well water in Taiwan. leading to peripheral neuropathy. Chronic arsenic ingestion may lead to cirrhotic portal hypertension. The actual cause of injury may be hypotensive shock. A hemorrhagic gastroenteritis may develop. . Similar vascular disorders. c) Neurologic Effects Arsenic-exposed patients develop destruction of axonal cylinders. Arsenic is capable of causing chronic renal insufficiency from cortical necrosis has also been reported. leading to fluid loss and hypotension. however.
arsenical keratoses show little cellular atypia and may remain morphologically benign for decades. and abdomen. and skin cancer. Pigment changes have been observed in populations chronically consuming drinking water containing 400 ppb or more arsenic. Recovery from neuropathy induced by chronic exposure to arsenic compounds is generally slow. Arsenical hyperkeratosis occurs most frequently on the palms and soles. and other brain damage. a pathologic hallmark of chronic exposure. Patchy hyperpigmentation. back. Onset may begin within 24 to 72 hours following acute poisoning. e) Respiratory Effects . and groin. and complete recovery may not occur. Follow-up studies of Japanese children who chronically consumed arsenic-contaminated milk revealed an increased incidence of severe hearing loss. d) Dermal Effects Pigment changes and palmoplantar hyperkeratosis are characteristic of chronic arsenic exposure and benign arsenical keratoses may progress to malignancy. but occurs particularly on the eyelids. particularly painful dysesthesia. which is an in situ squamous cell carcinoma discussed in Carcinogenic Effects. hyperkeratosis. the pigmentation extends broadly over the chest. cells develop marked atypia (precancerous) and appear indistinguishable from Bowen disease.stocking-glove distribution. The classic appearance of the dark brown patches with scattered pale spots is sometimes described as "raindrops on a dusty road. Sensory effects. epilepsy. nipples. Subclinical neuropathy. temples. The types of skin lesions occurring most frequently in arsenic-exposed humans are hyperpigmentation. sometimes taking years. axillae. 0.4 to 1 cm in diameter. mental retardation. whereas ascending weakness and paralysis may predominate in more severe poisoning. has been described in chronically exposed individuals. but it more often develops slowly as a result of chronic exposure. In other cases. Hearing loss as a sequela of acute or chronic arsenic intoxication has not been confirmed by other case reports or epidemiologic studies. defined by the presence of abnormal nerve conduction with no clinical complaints or symptoms." In severe cases. may be found anywhere on the body. Encephalopathy has been reported after both acute and chronic exposures. The neuropathy is primarily due to destruction of axonal cylinders (axonopathy). neck. occur earlier and may predominate in moderate poisoning. In most cases. Nerve conduction and electromyography studies can document severity and progression. Keratoses usually appear as small corn-like elevations.
Smelter workers are however. an almost ten-fold increase in the incidence of lung cancer was found in workers most heavily exposed to arsenic. exposed to other factors in the working environment. and thus it is difficult to assess the role of arsenic in the etiology of these effects. A study of women working at or living near a copper smelter where ambient arsenic levels were elevated reported increased frequencies of spontaneous abortions and congenital malformations. A number of studies have shown good correlations between occupational exposure to arsenic and cancer in workers in such environments as copper smelting plants. and the excess lung cancer . selenium. cadmium. Lung cancer has been associated with chronic arsenic exposure in smelter workers and pesticide workers. Smelter workers experiencing prolonged exposures to high concentrations of airborne arsenic at levels rarely found today had inflammatory and erosive lesions of the respiratory mucosa. and sulfur dioxide were also present. including lead. including nasal septum perforation. and are often accompanied by thrombocytopenia and mild eosinophilia.Inhalation of high concentrations of arsenic compounds produces irritation of the respiratory mucosa. nickel. and basophilic stippling may be noted on peripheral blood smears. An attempt was made to control for exposure to sulphur dioxide. Chronic inhalation of inorganic arsenic can cause cancer in humans. h) Carcinogenic Effects IARC have classified inorganic arsenic as a known human carcinogen. lead. The anemia may be normocytic or macrocytic. copper. It is readily transferred across the placenta. However. In one study. antimony and bismuth in one case-control study. The frequency of all malformations was twice the expected rate and the frequency of multiple malformations was increased fivefold. and concentrations in human cord blood are similar to those in maternal blood. g) Reproductive Effects Increased frequency of spontaneous abortions and congenital malformations has been linked to arsenic exposure. f) Hematopoietic Effects Bone marrow depression may result from acute or chronic arsenic intoxication. a number of other chemicals. some of which may be carcinogenic. Arsenic is a reproductive toxicant and a teratogen. Anemia and leukopenia are common in chronic arsenic toxicity.
However. and soles. contaminated water. in the most recent IARC review in 2004 there was considered to be sufficient evidence in humans that arsenic in drinking-water causes cancers of the urinary bladder. squamous cell carcinomas. atrophic. palms. Smoking habits have also been considered in two studies and could not account for the excess of lung cancer noted. j) Lung Cancer . Most of the Taiwanese who developed skin cancer in association with ingestion of arsenic-contaminated drinking water had multiple cancer types. and are often indistinguishable from Bowen disease by clinical examination. which may ultimately become invasive.remained. in order of decreasing frequency. Arsenic-induced skin cancer is frequently characterized by lesions over the entire body. lung and skin only. it may be difficult to distinguish other arsenic-induced skin lesions from those induced by other causes. Long-term ingestion of drinking water contaminated with inorganic arsenic has been causally linked to an increased risk of a number of other cancers . Arsenical basal cell carcinomas most often arise from normal tissue. they may vary in size from 1 millimeter to >10 centimeters. relative excess of adenocarcinomas and a slight excess of oat-cell cancers were seen among smelter workers. The superficial spreading lesions are red. Arsenic-associated squamous cell carcinomas are distinguished from UV-induced squamous cell carcinomas by their tendency to occur on the extremities (especially palms and soles) and trunk rather than on sunexposed areas such as the head and neck." Seventy-two percent of the Taiwanese with skin cancer also had hyperkeratosis. scaly. and frequently occur on the trunk. are almost always multiple. were intraepidermal carcinomas (Bowen disease). Some hyperkeratinized lesions can develop into intraepidermal carcinoma. The lesions are sharply demarcated round or irregular plaques that tend to enlarge. The most commonly reported types. and the workplace. basal cell carcinomas. However. i) Skin Cancer Latency for skin cancer associated with ingestion of arsenic may be 3 to 4 decades. and "combined forms. An increased risk of skin cancer in humans is associated with chronic exposure to inorganic arsenic in medication. mostly in unexposed areas such as the trunk. and 90% had hyperpigmentation. whereas the noncarcinogenic skin effects typically develop several years after exposure. a significant. With regard to histological type of lung cancer. More than one type of skin cancer may occur in a patient.
It is assumed. Inorganic arsenic is a known human carcinogen which acts via a genotoxic mechanism. more toxic than pentavalent arsenic. A higher risk of lung cancer was found among workers exposed predominantly to arsenic trioxide in smelters and to pentavalent arsenical pesticides in other settings. Neither concomitant exposure to sulfur dioxide nor cigarette smokes was determined to be essential cofactors in these studies. in general. depending on duration and intensity of exposure. There is sufficient evidence that chronic exposure to inorganic arsenic in drinking water causes non-melanoma skin cancers and an increased risk of bladder and lung cancers in humans. An association between lung cancer and occupational exposure to inorganic arsenic has been confirmed in several epidemiologic studies. . Trivalent arsenic is. that there is no threshold for such effects and that risk management measures should ensure that exposures are as low as reasonably practical. there is a systematic gradient in lung cancer mortality rates. therefore.In arsenic-exposed workers. Summary of Health Effects Single doses of inorganic arsenic may be highly toxic by ingestion and inhalation (70180 mg orally has been fatal).
In the periphery. biological effect monitoring.The effects of inorganic arsenic on the vascular periphery are well documented. both motor and sensory neurones are affected. expired air or any combination of these to evaluate exposure and health risk compared to an appropriate reference. excreta. Other toxic effects associated with chronic exposure to inorganic arsenic include liver injury. Inorganic arsenic may cause irritation of the mucous membranes leading to conjunctivitis and pharyngitis and rhinitis after inhalation. Longterm ingestion of contaminated drinking water may lead to. enquires about symptoms of occupational poisoning or occupational disease and review of records and occupational history. Biological monitoring is a measurement and assessment of agents or their metabolites either in tissues. Characteristic dermal lesions after chronic oral or inhalation exposure may include hyper pigmentation and hyperkeratosis. There is limited data from epidemiology to suggest that inorganic arsenic may be a human developmental toxicant. Raynaud's phenomenon and acrocyanosis and progression to endarteritis obliterans and gangrene of the lower extremities ("Black foot disease"). Chronic exposure to inorganic arsenic compounds may lead to peripheral and central neurotoxicity. anaemia and leucopenia may occur together with disturbances in haem synthesis. cardiovascular disease and diabetes mellitus. Skin irritation and allergic contact dermatitis may occur after exposure to inorganic arsenic compounds. Early events may include paresthesiae followed by muscle weakness. 7. While medical surveillance means the . secreta. Haematologically. Health surveillance means any examination and investigations which may be necessary to detect exposure levels and early biological effects and responses. Administration of high doses of inorganic arsenic by oral. intraperitoneal or intravenous routes may cause embryolethality or foetal malformations in laboratory animals. medical surveillance. and includes biological monitoring.0 Health Surveillance Health surveillance can be divided into biological monitoring and medical surveillance. but it is not possible to draw any definitive conclusions. An increased incidence of cardiovascular disease has also been noted.
Franzblau and Lilis 1989). Long after urine levels have returned to baseline. Normal total urinary arsenic values are <50 µg arsenic per liter (As/L) in the absence of consumption of seafood in the past 48 hours. Consumption of medicines containing arsenic is associated with blood values of 100–250 µg /L. Milham and Strong 1974. 1990. and measurement of arsenic levels in these tissues may be a useful indicator of past exposures. For this reason. while blood levels in acutely toxic and fatal cases may be 1. Hindmarsh and McCurdy 1986. the arsenic content of hair and nails may be the only clue of arsenic exposure. de Peyster and Silvers 1995. Person must not consume any seafood for 1 or 2 days before sampling. Valentine et al.000 µg /L or higher (Driesback 1980). 1996.monitoring of a person for the purpose of identifying changes in health status due to occupational exposure to chemicals hazardous to health.g. and nails have all been investigated and used as biological indicators of exposure to arsenic. Vahter 1983). 7. Typical values in nonexposed individuals are <1 µg /L (Heydorn 1970. 1981b.1 Biological Monitoring Arsenic levels in blood. 1979. 1986. EPA 1977a. and this approach has proved useful in identifying above-average exposures in populations living near industrial point sources of arsenic (e. because arsenic in blood more rapidly undergone the absorption process. this due to that the sea food have high concentration of organoarsenicals. Most arsenic that is absorbed from the lungs or the gastrointestinal tract is excreted in the urine. measurement of urinary arsenic levels is generally accepted as the most reliable indicator of recent arsenic exposure. 1979). Karagas et al. Bencko 2005. Bencko et al. Valentine et al. The best specimen is a 24 hour urine collection. . Other than that. where if that person does so consume may affect the result of the test. the test are measure the arsenic level in whole blood volume where actual test must measure the arsenic level in red blood cell only. Milham and Strong 1974.. 1990). hair. mainly within 1–2 days. Since arsenic is cleared from blood within a few hours (Tam et al. values in excess of 200 µg As/L are considered abnormal (ATSDR 2000a). Blood test for arsenic level are less efficient compare to urine test. measurements of blood arsenic reflect exposures only within the very recent past. Polissar et al. These values may increase from several-fold to over 100-fold following arsenic exposure (Agahian et al. 1979b. Arsenic tends to accumulate in hair and nails. Normal levels in hair and nails are 1 ppm or less (Choucair and Ajax 1988. urine.
1989) and remain elevated for 6–12 months (Choucair and Ajax 1988). Fish and shellfish contain very large amounts of organically bound arsenic and these are readily absorbed from the GIT and quickly excreted in the urine. medicines taken. alanine and aspartate transaminases and gamma-glutamyl transpeptidase) Skin Nasal septum. Regular self-inspection of skin by workers is appropriate. Ensure that worker avoids seafood for three days prior to urine collection. liver function tests (Serum bilirubin. previous job. 7. lungs and lymph nodes. However. Full-sized chest x-ray examination (at pre-employment examination only). b) Periodic Medical Examination for Inorganic Arsenic: Done annually. a) Pre-Placement Medical Examinations for Inorganic Arsenic: Clinical examination & baseline data with particular emphasis on the: Nervous system Liver. (hyperpigmentation and thickening). caution must be exercised in using the arsenic content of these specimens to diagnose arsenic intoxication. Estimation of urinary arsenic content in an early morning urine specimen (with creatinine correction). Minimum exposure levels that produce measurable increases in arsenic levels in hair and nails have not been precisely defined.2 Medical Surveillance Any occupational exposure to arsenic and its compounds > 50% PEL or possibility of excessive absorption. alcohol consumption. . Detect early skin changes. because the arsenic content of hair and nails may be increased by external contamination.Yamauchi et al. History of smoking. alkaline phosphatase.
Hematological systems . gamma-glutamyl transpeptidase) Renal -Urine dipstick examination for protein and blood. serum transaminases e. try to eliminate anything that in the workplace that use arsenic so that the workers are not expose to the arsenic. tool. Renal function tests. process. Estimation of urinary arsenic content in an early morning urine specimen (with creatinine correction). For example. 8. alkaline phosphatase. . liver function tests (Serum bilirubin. 8. d) Periodic Medical Examination for Arsine Annually as for pre-employment.Hemoglobin estimation and peripheral blood film examination to look for basophilic stippling. we can use hierarchy of control. or substance is perhaps the best way of protecting workers.0 Prevention And Control In order to prevent and control the hazard from the arsenic.g. SGPT. Ensure that the worker avoids seafood for 3 days prior to urine collection as it may contain arsenic. which getting rid of any hazardous job. To exclude workers with cardiac or renal disease and those with hypersensitivity to hemolytic agents. machine.c) Pre-Placement Medical Examinations for Arsine: Clinical examination & baseline data with particular emphasis on the: Liver. SGOT.1 Hierarchy of Control Firstly is the elimination step.
frequency and severity of exposure to hazardous chemical. adjust and wear the PPE.gov/csem/arsenic/physiologic_effects. For example. and know the proper care. if possible. as well as respirators.pdf The Risk Assessment Information System: Toxicity Summary for Arsenic http://rais. we can use the engineering control. useful life and disposal of PPE. how to properly put on. Engineering control means structural changes to the environment or process to interrupt the path between the person and the hazard.0 References [online: 04 April 2009] i) Toxicological Profile for Arsenic: August 2007. Other than that. The employer must provide the PPE to their workers. Employers are required to train each employee who must use PPE.shtml ii) Case Studies in Environmental Medicine (CSEM): Arsenic Toxicity Physiologic Effects http://www. modified or create work environment that decrease the level or risk to get the arsenic hazardous effect. 0. reductions in time spent in arsenic-exposed work areas and alternate work will reduce the exposure to hazard.gov/toxprofiles/tp2. Employees must be trained to know when PPE is necessary.Secondly.cdc. we also can use substitution which means replace hazardous chemical with something less dangerous.01 mg/m³ of air as a time-weighted average (TWA) over an 8-hour work shift. safety hoods to protect the head and neck. For example. 9. The other example such as the enclosure of work operations and local exhaust so that the arsenic concentration in the workplace air is under level of which may produce effect. For example.cdc.atsdr. shoe covers. goggles. the limitations of the PPE.atsdr.html . take off. try to substitute the arsenic usage in the company with other chemical that less hazardous or not hazardous at all. what PPE is necessary. maintenance. The last step in hierarchy of control is by using personal protective equipment (PPE).ornl. gloves. Thirdly. Fourthly is administrative control which includes changes in work procedures with the goal of reducing the duration. http://www. The examples of PPE such as protective clothing.gov/tox/profiles/arsenic.
txt Toxicity arsenic http://emedicine.com/diseases/arsenic.gov/csem/arsenic/clinical_evaluation.ca.gov/SLTC/arsenic/index.pdf .knowledgebank.oehha.iii) Chronic Toxicity Summary: Arsenic And Arsenic Compounds http://www.swcp.htm Arsenic toxicity http://pages.pdf viii) Case Studies in Environmental Medicine (CSEM): Arsenic Toxicity Clinical Evaluation: History and Physical Evaluation http://www.manbir-online.gov/air/chronic_rels/pdf/arsenics.html ix) Safety and Health Topics: Arsenic http://www.pdf iv) v) vi) vii) Arsenic Toxicity http://www.oehha.osha.com/~tanman/ho/ArsenicToxicity.cdc.atsdr.irri.html x) Arsenic toxicity http://www.medscape.com/article/812953-overview Evidence On Developmental And Reproductive Toxicity Of Inorganic Arsenic http://www.gov/Prop65/pdf/AS-HID.ca.org/wheat/factsheets/arsenic %20toxicity.
irri.v) vi) vii) Arsenic toxicity http://pages.medscape.html ix) Safety and Health Topics: Arsenic http://www.html x) Arsenic toxicity http://www.oehha.org/wheat/factsheets/arsenic %20toxicity.gov/Prop65/pdf/AS-HID.knowledgebank.com/~tanman/ho/ArsenicToxicity.cdc.gov/csem/arsenic/clinical_evaluation.txt Toxicity arsenic http://emedicine.pdf .ca.gov/SLTC/arsenic/index.osha.swcp.atsdr.com/article/812953-overview Evidence On Developmental And Reproductive Toxicity Of Inorganic Arsenic http://www.pdf viii) Case Studies in Environmental Medicine (CSEM): Arsenic Toxicity Clinical Evaluation: History and Physical Evaluation http://www.
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