Abstract
Correlations between the concentrations of arsenic in scalp hair and in drinking water as well as in blood and/or urine have been reported. These correlations clearly show exposure–absorption–excretion relationships. In addition, arsenic metabolites such as monomethylarsonic acid and dimethylarsinic acid have been identified and quantified in these tissues and fluids, leaving little doubt that elevated levels of arsenic in the hair can reflect systemic arsenic intoxication. Consequently, hair analysis has potential merit as a screening procedure for poisoning by arsenic. However, questions regarding the exogenous versus the endogenous deposition of arsenic in the hair, and uncertainties about the normal level of arsenic in the hair remain unresolved. Pending their resolution, the determination of arsenic in hair should remain a screening tool, and clinical signs and symptoms should be employed to complete the diagnosis of arsenic poisoning.
Highlights
Since the middle of the 20th Century, the determination of trace element levels in human scalp hair has become increasingly popular for monitoring environmental exposures, evaluating heavy metal poisonings, assessing nutritional status, and diagnosing diseases
Before trace element levels in scalp hair can become an acceptable diagnostic indicator of mineral metabolism, additional work is required in four specific areas: (1) normal values showing narrow ranges must be established, (2) sample collection and sample preparation must be standardized, (3) trace elements incorporated into the hair from within the body must be differentiated from contamination by external sources, and (4) standard reference materials must become available to allow laboratories to establish quality assurance programs.”
The inability to distinguish between exogenous and endogenous deposition is one of the most compelling reasons to reject hair analysis as an indicator of the arsenic body burden. It is for this reason the authors concluded: “The arsenic concentration in urine seems to be a better marker of individual arsenic exposure than concentrations in drinking water and hair.”
Summary
Since the middle of the 20th Century, the determination of trace element levels in human scalp hair has become increasingly popular for monitoring environmental exposures, evaluating heavy metal poisonings, assessing nutritional status, and diagnosing diseases. Blood and urine analysis are the more traditional approaches to testing trace element levels in the human body, but the bio-kinetics as well as changing external factors often lead to fluctuating trace element concentrations in blood and urine. On the other hand, is considered by some to be a metabolic end product providing a more permanent record of the trace elements associated with health and disease and of trace elements assimilated from the environment
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