Populations have always been exposed to high arsenic levels in food, drinking water, wine, and other sources. Arsenic is found as inorganic and organic compounds. It is found naturally in rocks and soil worldwide, and industrial effluents contribute significant amounts. Arsenic is used in large quantities in the manufacture of glass to eliminate a green color caused by impurities of iron compounds. Arsenic is sometimes added to lead to harden it and is also used in the manufacture of such military poison gases as lewisite and adamsite. Until the introduction of penicillin, arsenic was of great importance in the treatment of syphilis. In other medicinal uses, it has been displaced by sulfa drugs or antibiotics. Lead arsenate, calcium arsenate, and Paris green are used extensively as insecticides. Arsenic is abundant in seafood, but in an organic form, arsenobetaine, that is not toxic and rapidly absorbed and excreted in the urine and bile.

Exposure to inorganic arsenic in drinking water is associated with health risks related to the duration and level of exposure, particularly above 300 ppb. Acute poisoning is associated with vomiting, bloody diarrhea, abnormal heart rhythm, esoph-ageal and abdominal pain, and sometimes death because of cardiopulmonary collapse. Classical syndromes of chronic arsenic exposure include hyperkeratosis, corns, and warts on the feet (blackfoot) and hands. Studies from Taiwan and Japan strongly suggest that high arsenic intake is associated with cancers of the bladder, kidney, lung, and liver, which may be dose-related. Arsenic may be an indirect carcinogen.

In contrast to adverse effects of arsenic, small amounts of the metal may be essential to the body. Approximately 10 to 50 ppb might be necessary to maintain homeostasis of the body. In laboratory animals, low levels of arsenic fail to support normal weight gain and decrease the ability to become pregnant. Also, arsenic (arsenic trioxide) has been used successfully to treat patients with acute promyelo-cytic leukemia (APL).

The EPA recently reduced the standards for arsenic in drinking water from 50 ppb to 10 ppb. This will impact significantly on municipalities, which must deal with the regulation and reduce arsenic in their drinking water.

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