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Arsenic poisoning is a medical condition caused by elevated levels of arsenic in the body. The dominant basis of arsenic poisoning is from ground water that naturally contains high concentrations of arsenic. A 2007 study found that over 137 million people in more than 70 countries are probably affected by arsenic poisoning from drinking water.[1]
Contents  [hide] 
1 Signs and symptoms
1.1 Night blindness
2 Exposure modalities
2.1 Drinking water
2.2 Occupational exposures
2.3 Food
3 History
3.1 Notable cases
3.1.1 King Faisal the 1st of Iraq (King Faisal bin Al Husain)
3.1.2 Francesco I de' Medici, Grand Duke of Tuscany
3.1.3 George III of Great Britain
3.1.4 Napoleon Bonaparte
3.1.5 Simón Bolívar
3.1.6 Charles Francis Hall
3.1.7 Clare Boothe Luce
3.1.8 Emperor Guangxu
3.1.9 Phar Lap
4 Pathophysiology
5 Diagnosis
6 Treatment
6.1 Chelation
6.2 Mineral supplements
6.3 Nutritional intervention
7 See also
8 References
9 Further reading
10 External links
Signs and symptoms[edit]

Symptoms of arsenic poisoning begin with headaches, confusion, severe diarrhea, and drowsiness. As the poisoning develops, convulsions and changes in fingernail pigmentation called leukonychia may occur. When the poisoning becomes acute, symptoms may include diarrhea, vomiting, blood in the urine, cramping muscles, hair loss, stomach pain, and more convulsions. The organs of the body that are usually affected by arsenic poisoning are the lungs, skin, kidneys, and liver.[2] The final result of arsenic poisoning is coma to death.[citation needed]
Arsenic is related to heart disease[3] (hypertension related cardiovascular), cancer,[4] stroke[5] (cerebrovascular diseases), chronic lower respiratory diseases,[6] and diabetes.[7][8]
Night blindness[edit]
Chronic exposure to arsenic is related to vitamin A deficiency which is related to heart disease and night blindness.[9]
Inorganic arsenites (arsenic(III)) in drinking water have a much higher acute toxicity than organic arsenates (arsenic(V)).[10] The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg or 1 mg/kg/day.[11]
Exposure modalities[edit]

Drinking water[edit]
Main article: Arsenic contamination of groundwater
Chronic arsenic poisoning results from drinking contaminated well water over a long period of time. Many aquifers contain high concentration of arsenic salts.[12] The World Health Organization recommends a limit of 0.01 mg/L (10ppb) of arsenic in drinking water. This recommendation was established based on the limit of detection of available testing equipment at the time of publication of the WHO water quality guidelines.
More recent findings show that consumption of water with levels as low as 0.00017 mg/L (0.17ppb) over long periods of time can lead to arsenicosis. From a 1988 study in China, the US protection agency quantified the lifetime exposure of arsenic in drinking water at concentrations of 0.0017 mg/L, 0.00017 mg/L, and 0.000017 mg/L are associated with a lifetime skin cancer risk of 1 in 10,000, 1 in 100,000, and 1 in 1,000,000 respectively. The World Health Organization contends that a level of 0.01 mg/L poses a risk of 6 in 10000 chance of lifetime skin cancer risk and contends that this level of risk is acceptable.[13]
One of the worst incidents of arsenic poisoning via well water occurred in Bangladesh,called by the World Health Organization the "largest mass poisoning of a population in history."[14]
Mining techniques such as hydraulic fracturing may mobilize arsenic in groundwater and aquifers due to enhanced methane transport and resulting changes in redox conditions,[15] and inject fluid containing additional arsenic.[16]
Occupational exposures[edit]
Main article: Arsenic#Applications
Because of its high toxicity, arsenic is little used in the Western world, although in Asia is still a popular pesticide. Arsenic is mainly encountered occupationally in the smelting of zinc and copper ores.
It has been found that rice is particularly susceptible to accumulation of arsenic from soil.[17] Rice grown in US has an average 260 ppb of arsenic according to a study, but U.S. arsenic intake remains far below WHO recommended limits.[18] China has set a standard for arsenic limits in food (150 ppb),[19] as levels in rice exceed those in water.[20]
In the United States, levels of arsenic that are above natural levels, but still well below danger levels set in federal safety standards, have been detected in commercially grown chickens.[21] The source of the arsenic appears to be the feed additives roxarsone and nitarsone, which are used to increase weight and skin coloring of the poultry.[22]

In addition to its presence as a poison, for centuries arsenic was used medicinally. It has been used for over 2,400 years as a part of traditional Chinese medicine.[23] In the western world, arsenic compounds, such as salvarsan, were used extensively to treat syphilis before penicillin was introduced. It was eventually replaced as a therapeutic agent by sulfa drugs and then by other antibiotics. Arsenic was also an ingredient in many tonics (or "patent medicines").
In addition, during the Elizabethan era, some women used a mixture of vinegar, chalk, and arsenic applied topically to whiten their skin. This use of arsenic was intended to prevent aging and creasing of the skin, but some arsenic was inevitably absorbed into the blood stream.[citation needed]
Some pigments, most notably the popular Emerald Green (known also under several other names), were based on arsenic compounds. Overexposure to these pigments was a frequent cause of accidental poisoning of artists and craftsmen.
Arsenic became a favored method for murder of the Middle Ages and Renaissance, particularly among ruling classes in Italy allegedly. Because the symptoms are similar to those of cholera, which was common at the time, arsenic poisoning often went undetected.[24]:63 By the 19th century, it had acquired the nickname "inheritance powder," perhaps because impatient heirs were known or suspected to use it to ensure or accelerate their inheritances.[24]:21
In ancient Korea, and particularly in Joseon Dynasty, arsenic-sulfur compounds have been used as a major ingredient of sayak (사약; 賜藥), which was a poison cocktail used in capital punishment of high-profile political figures and members of the royal family.[25]  Due to social and political prominence of the condemned, many of these events were well-documented, often in the Annals of Joseon Dynasty; they are sometimes portrayed in historical television miniseries because of their dramatic nature.[26][dead link]

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