First aid for arsenic poisoning: symptoms, signs, treatment

Sources of influence

Arsenic is a naturally occurring element in the earth's crust and is widely distributed in the environment - in air, water and soil.
Its inorganic form is highly toxic. People are exposed to elevated concentrations of inorganic arsenic through contaminated drinking water, by using contaminated water for cooking and irrigating food crops, during industrial processes, and by eating contaminated foods and smoking tobacco.

Long-term exposure to arsenic in drinking water and food can lead to chronic arsenic poisoning. The most common consequences are skin lesions and skin cancer.

Drinking water and food

The greatest threat to human health is arsenic contained in groundwater. Inorganic arsenic occurs naturally in high concentrations in groundwater in a number of countries, including Argentina, Bangladesh, India, China, Mexico, the United States of America and Chile. Sources of exposure include drinking water, food crops irrigated with contaminated water, and food prepared with contaminated water.

Fish, shellfish, meat, poultry, dairy and grain products can also be dietary sources of arsenic, although the level of exposure to arsenic contained in such foods is generally much lower than the level of exposure to contaminated groundwater. In marine products, arsenic is mainly found in its less toxic organic form.

Industrial processes

Arsenic is used industrially as an alloying additive and in glass, dyes, textiles, paper, metal adhesives, wood preservatives, and ammunition production processes. Arsenic is also used in tanning processes and, to a limited extent, in the production of pesticides, feed additives and pharmaceuticals.

Tobacco

People who smoke tobacco may also be exposed to naturally occurring inorganic arsenic in tobacco because tobacco plants absorb a significant amount of arsenic naturally present in soil. In the past, levels of potential arsenic exposure were much higher because tobacco plants were commonly treated with an insecticide containing lead arsenate.

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Poisons and toxins are deposited in body tissues regardless of the use of the methods listed above for their removal. And you can get rid of these deposits only with the help of a special step in the rehabilitation program provided in our center.

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Health implications

Inorganic arsenic has been shown to be a carcinogen and is a major contaminant of drinking water globally. Arsenic also occurs in organic form. Inorganic arsenic compounds (like those found in water) are highly toxic, while organic arsenic compounds (like those found in seafood) are less harmful to health.

Acute consequences

Immediate symptoms of acute arsenic poisoning include vomiting, abdominal pain and diarrhea. They are followed by numbness and tingling in the limbs, muscle cramps and, in the most severe cases, death.

Long term impact

The first symptoms of long-term exposure to high levels of inorganic arsenic (eg, through drinking water or food) usually appear on the skin and include pigmentation changes, skin lesions, and roughening of the skin on the palms and soles (hyperkeratosis). These symptoms appear after exposure for at least five years and may be a warning sign of skin cancer.

In addition to skin cancer, long-term exposure to arsenic can also cause bladder and lung cancers. The International Agency for Research on Cancer (IARC) classifies arsenic and arsenic compounds as human carcinogens and also lists arsenic in drinking water as a human carcinogen.

Other negative health effects that may be associated with long-term inorganic arsenic use include effects on development, diabetes, lung disease, and cardiovascular disease. Arsenic-induced myocardial infarction, in particular, may be a significant cause of excess mortality. In China (Taiwan Province), arsenic exposure has been linked to “black leg disease,” which is a severe blood vessel disease that leads to gangrene. However, this disease is not observed in other parts of the world, so it is possible that malnutrition contributes to the development of this disease. Arsenic is also associated with adverse pregnancy outcomes and infant mortality, as well as health effects in children (1), and exposure in utero and early life is associated with increased mortality among youth due to various types of cancer, lung disease, heart attack, and kidney disease. insufficiency (2). Numerous studies have shown the negative effects of arsenic exposure on mental development, IQ, and memory (3).

Swallowed arsenic from a tooth

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Scale of the problem

Arsenic contamination of groundwater is widespread, and a number of areas have significant levels of arsenic contamination in drinking water. Today, at least 140 million people in 50 countries are known to drink water with arsenic concentrations above the WHO guideline level of 10 µg/liter (4).

After in the 1990s. In Bangladesh, widespread arsenic was found in well water, and the issue of arsenic exposure in that country has received a lot of attention. Since then, significant progress has been made, and the number of people exposed to arsenic levels above the Bangladesh Drinking Water Quality Standard has decreased by approximately 40%. Despite these efforts, it is estimated that in 2012, approximately 19 million and 39 million people in Bangladesh were exposed to arsenic levels above the national standard of 50 μg/liter and the WHO guideline of 10 μg/liter, respectively (5 ). In areas of Bangladesh where the problem is particularly acute, 21.4% of all deaths were caused by arsenic concentrations in drinking water greater than 10 µg/liter (6). A similar dose-response relationship was observed in other parts of Bangladesh: these results were combined with those of a national survey, and the combined analysis yielded an annual arsenic-related mortality rate of 43,000 (7). The US National Research Council has noted that lifetime consumption of drinking water containing 50 µg/liter arsenic (8) may be responsible for up to 1 in 100 additional cancer deaths.

Symptoms and signs caused by long-term exposure to elevated concentrations of inorganic arsenic vary between individuals, populations, and geographic areas. Therefore, there is no general definition of the disease caused by arsenic. This makes it difficult to estimate the burden of disease associated with arsenic.

There is also no method for distinguishing between cancers caused by arsenic and cancers caused by other factors. As a result, there is no reliable estimate of the extent of the problem worldwide.

In 2010, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) re-evaluated the health effects of arsenic exposure in the light of new evidence. JECFA concluded that for selected areas of the world where levels of inorganic arsenic in drinking water exceed 50-100 µg/litre, there is some evidence of adverse effects. For other areas where elevated levels of arsenic in water (10-50 µg/litre) are observed, the committee noted that while adverse effects may occur, the prevalence is low and would be difficult to detect in epidemiological studies.

First aid for poisoning

If you suspect arsenic poisoning through the mouth, you should immediately drink a glass of warm water in which three grams of citric acid or one tablespoon of vinegar is diluted.

It is recommended to drink plenty of fluids (the procedure helps not only to quickly remove the poison along with urine, but also fights dehydration of the body caused by vomiting and diarrhea); In no case should you fight vomiting and diarrhea; on the contrary, you need to promote the natural cleansing of the body by drinking warm milk. Taking adsorbents is not a very effective procedure, but in the absence of other means it helps to slightly reduce the dose of poison in the body. If arsenic gets on the skin, it is enough wash the body with warm water and soap, preventing the poison from being absorbed into the blood.

It is important to understand that in case of arsenic poisoning, emergency medical attention is needed. Toxicologists treat arsenic intoxication in the body.

Before treatment, laboratory tests are prescribed. Urine and blood tests can determine the amount of arsenic in the body. It is worth noting that in urine it should not exceed 100 mcg per 1 liter of urine, and in blood 30 mcg per 1 liter. There is also decreased hemoglobin and red blood cells in the blood, increased ESR, and increased protein levels in the urine.

After a few months, arsenic can be easily detected in the victim's hair and nails. There are special drugs that act as an antidote and are administered intramuscularly in a hospital setting; antidote and symptomatic therapy is also performed, and, if necessary, urgent resuscitation measures.

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Prevention and control

The first action for affected regions is to prevent further exposure to arsenic by ensuring safe water supplies for drinking, cooking, and irrigating food crops. There are a number of ways to reduce arsenic levels in drinking water.

Replacing sources with high concentrations of arsenic, such as groundwater, with microbiologically safe sources with low concentrations of arsenic, such as rainwater and treated surface water. Water with a low concentration of arsenic can be used for drinking, cooking and irrigation, while water with a high concentration of arsenic can be used for other purposes, such as washing and washing clothes.
Distinguishing between sources with high and low arsenic concentrations. For example, you can test water for arsenic levels and paint wells or hand pumps with different colors. When combined with effective health education, this can be an effective and inexpensive intervention to quickly reduce arsenic exposure.
Mixing water with low and high concentrations of arsenic to achieve acceptable arsenic levels.
Install arsenic removal systems—centralized or individual—and ensure proper disposal of removed arsenic. Technologies for arsenic removal include: oxidation, coagulation-precipitation, absorption, ion exchange and membrane technologies. There are a growing number of effective and low-cost options for eliminating arsenic from small and domestic water supplies, although there is still limited data on the extent to which such systems are used effectively over sustained periods of time.

Long-term interventions are needed to reduce workplace exposure to arsenic during manufacturing processes.

Health education and community involvement are key to ensuring successful interventions. It is important that community members understand the dangers of exposure to high concentrations of arsenic and know the sources of arsenic exposure, including arsenic contamination of food crops (eg, rice) from irrigation water and arsenic contamination of food from cooking water.

Monitoring of high-risk groups should also be conducted to detect early signs of arsenic poisoning, usually skin problems.