Academic journal article Environmental Health Perspectives

The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem

Academic journal article Environmental Health Perspectives

The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem

Article excerpt

BACKGROUND: Concerns for arsenic exposure are not limited to toxic waste sites and massive poisoning events. Chronic exposure continues to be a major public health problem worldwide, affecting hundreds of millions of persons.

OBJECTIVES: We reviewed recent information on worldwide concerns for arsenic exposures and public health to heighten awareness of the current scope of arsenic exposure and health outcomes and the importance of reducing exposure, particularly during pregnancy and early life.

METHODS: We synthesized the large body of current research pertaining to arsenic exposure and health outcomes with an emphasis on recent publications.

DISCUSSION: Locations of high arsenic exposure via drinking water span from Bangladesh, Chile, and Taiwan to the United States. The U.S. Environmental Protection Agency maximum contaminant level (MCL) in drinking water is 10 [micro]g/L; however, concentrations of > 3,000 [micro]g/L have been found in wells in the United States. In addition, exposure through diet is of growing concern. Knowledge of the scope of arsenic-associated health effects has broadened; arsenic leaves essentially no bodily system untouched. Arsenic is a known carcinogen associated with skin, lung, bladder, kidney, and liver cancer. Dermatological, developmental, neurological, respiratory, cardiovascular, immunological, and endocrine effects are also evident. Most remarkably, early-life exposure may be related to increased risks for several types of cancer and other diseases during adulthood.

CONCLUSIONS: These data call for heightened awareness of arsenic-related pathologies in broader contexts than previously perceived. Testing foods and drinking water for arsenic, including individual private wells, should be a top priority to reduce exposure, particularly for pregnant women and children, given the potential for life-long effects of developmental exposure.

KEY WORDS: arsenic, arsenic health effects, cancer, chronic arsenic exposure, development, drinking water, skin lesions. Environ Health Perspect 121:295-302 (2013). [Online 3 January 2013]

Ongoing exposures to toxic chemicals such as arsenic continue to pose a significant threat to public health. The World Health Organization (WHO) estimates that > 200 million persons worldwide might be chronically exposed to arsenic in drinking water at concentrations above the WHO safety standard of 10 [micro]g/L (WHO 2008) (Table 1). Arsenic is a metalloid element that is encountered primarily as arsenical compounds. Within these compounds, arsenic occurs in different valence states, the most common of which are [As.sup.III] (arsenites) and [As.sup.V] (arsenates). Arsenic in drinking water is typically found in the inorganic form, either as [As.sup.III] or [As.sup.V], whereas arsenic in food is found in the organic and inorganic forms, depending on the specific food [Agency for Toxic Substances and Disease Registry (ATSDR) 2007; European Food Safety Authority (EFSA) 2009] Sources of arsenic contamination include natural deposits as well as anthropogenic sources such as mining and electronics manufacturing processes and metal smelting (ATSDR 2007).

Table 1. Arsenic exposure concerns worldwide.

Country     Estimated        Arsenic         References
             exposed     concentration in
            population    drinking water
            (millions)        (pg/L)

Argentina          2.0       < 1 to 7,550  Bates et al.
                                           2004; Moore
                                           et al. 2004;
                                           Steinmaus et
                                           al. 2010

Bangladesh       35-77          < 10 to >  Kinniburgh
                                    2,500  and Smedley

Chile (b)          0.4         600 to 800  Ferreccio et
                                           al. … 
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