6 - Health effects of chronic arsenic toxicity

Abstract

Chronic arsenic toxicity is associated with various clinical manifestations known as arsenicosis. Pigmentation and keratosis are the specific skin lesion characteristics of chronic arsenic toxicity. Arsenicosis is also associated with various systemic manifestations over and above skin lesions, important ones being chronic lung diseases such as chronic bronchitis, chronic obstructive pulmonary disease, and bronchiectasis, liver diseases such as noncirrhotic portal fibrosis, polyneuropathy, and cerebrovascular disease, peripheral vascular disease, hypertension, and ischemic heart disease, diabetes mellitus, nonpitting edema of the limbs, weakness, and anemia, congestion of eyes, pterygium and cataract, and erectile dysfunction. Cancer of the skin, lung, and urinary bladder are important cancers associated with chronic arsenic toxicity. Treatment of arsenicosis is unsatisfactory and is mostly symptomatic. Stoppage of drinking of arsenic-contaminated water is the mainstay of the management of arsenicosis as specific chelation therapy has limited value. Early skin cancer, detectable by regular active surveillance, is curable.