Chronic Arsenic Poisoning Leading to Skin Malignancy in a Community

Abstract

AimTo elucidate the etiology of skin malignancy in people in the hamlet of Kiradalli, Yadgir District, Karnataka State, India, where many people experienced skin lesions that transformed into malignancy. MethodsA cross-sectional survey of the inhabitants of Kiradalli was performed by trained and supervised paramedics. Skin lesions were documented. Lesions with a high suspicion of malignancy underwent biopsy. Drinking water was analyzed at the Cochin University of Science and Technology for arsenic content. Blood of affected patients was sent for arsenic level estimation and compared to normal levels. The media and social activists were involved to highlight this community health issue to help provide an alternative source of water and to provide rehabilitation. ResultsForty-six people were found to have skin changes suspicious for arsenic keratosis. Ten cases of epidermal malignancy were noted. A prevalence of 2.38% for epidermal neoplasm and 10.9% for arsenic keratosis was documented. The arsenic level of the water was 0.483 mg/L—much higher than the permitted level. Arsenic in the blood of affected patients was high. ConclusionArsenic in the drinking water as a cause of skin cancer was established. The primary preventative measure to halt the development of new lesions was to provide safe drinking water for residents. The secondary preventative measure was to improve the prognosis of patients with malignant lesions by early diagnosis and treatment.