Internal organ damage in arsenic hydrogen intoxication

Abstract

Arsenic hydrogen is a colorless gas. It enters the body through the respiratory system, without irritating the mucous membranes of the upper respiratory tract. It is a poison with a primary hemolytic effect. In the body, arsenic hydrogen is oxidized to arsenic and excreted from the body mainly through the kidneys and intestines. The consequence of rapid and massive hemolysis is anemia, hypoxia, damage to parenchymal organs (kidneys, liver), nervous and cardiovascular system. In addition to hemolysis, a significant role is played by the direct toxic effect of arsenic, which is formed during the oxidation of arsenic hydrogen, on the organs and tissues of the body. The development of acute and chronic poisoning with arsenic hydrogen is possible. Acute poisoning causes mild, moderate and severe intoxication. Chronic intoxication with arsenic hydrogen is very rare. Moderate anemia, which does not have clear clinical manifestations of hemolysis, is characteristic. Urgent hospitalization, rest, fluid intake in large quantities are necessary. Antidotes for arsenic hydrogen poisoning are unithiol and sodium thiosulfate. Prolonged inhalations of oxygen are indicated. In the absence of severe kidney damage, diuretics are used. In renal failure, hemodialysis is performed. In severe cases, an exchange transfusion is possible. The presence of a characteristic clinical picture of the disease, along with anamnesis data and an increased urine arsenic level, allows you to establish the correct diagnosis. After severe acute and significant chronic intoxications, a patient is released from work with arsenic hydrogen and other toxic substances. He is referred to the medical and social expert commission to establish a disability group due to an occupational disease. Prevention of arsenic hydrogen poisoning in industrial conditions should be reduced to careful control over the use of purer metals and acids that do not contain arsenic, the installation of effective local and general ventilation. Constant sanitary and hygienic control over the release of arsenic hydrogen into the air of working premises is necessary.