Table 5
General Health Information About Inorganic Arsenic
| What is inorganic arsenic? |
| In this chapter, "inorganic arsenic" means: |
| – |
The element arsenic; |
| – |
Arsenic-containing compounds that don't contain
the element carbon; |
| – |
Copper aceto-arsenite. |
| Arsine is a gaseous inorganic arsenic compound not
addressed by requirements in this chapter. It's addressed
in a separate chapter, Respiratory hazards, chapter 296-841 WAC. |
| How does inorganic arsenic get into my body? |
| Inorganic arsenic enters your body when you: |
| – |
Breath in (inhale) airborne particles such as dusts,
fume, sprays, or other aerosols that contain
inorganic arsenic. You will also inhale inorganic
arsenic particles when you smoke tobacco products
that have become contaminated from contact with
inorganic arsenic at work. Some compounds,
including arsenic trichloride, can be inhaled as a
vapor; |
| – |
Swallow (ingest) food, drink, cosmetics such as lip
balm, sweat and other substances that become
contaminated from contact with inorganic arsenic at
work. |
| Inorganic arsenic particles brought home on your
clothes, shoes, or body can be inhaled or ingested by
household members. |
| Some inorganic arsenic compounds enter your body
when eye or skin contact occurs. Arsenic trichloride is
one example of a compound that is readily absorbed
through the eyes and skin. |
| What happens after inorganic arsenic enters my body? |
| Once inorganic arsenic enters your body, some of it is
changed into a less harmful organic form by the liver.
Both the organic and inorganic forms leave your body in
urine. |
| Most of the arsenic will be gone within several days,
although some will remain in your body for several
months and even longer. |
| Why is medical monitoring necessary? |
| Although exposure to inorganic arsenic is associated
with various health effects, the most serious health
effects are lung and skin cancer. The medical monitoring
requirements in this chapter are established to minimize
your risk for these diseases. |
| To learn more about the medical monitoring process, see
Medical evaluation, WAC 296-848-30030. |
| What health effects and symptoms are linked with
exposure to inorganic arsenic? |
| Exposure to inorganic arsenic is associated with various
health effects ranging from temporary local effects such
as skin irritation to lasting systematic effects due to
gradual (chronic) or sudden (acute) poisoning. Such
effects should not occur if the requirements in this
chapter are followed. |
| Skin Health Effects: |
| Arsenic trioxide, arsenic trichloride, and other trivalent
compounds can cause skin irritation from direct contact. |
| – |
The following moist mucous membranes are most
sensitive to irritation: |
|
▪ |
Eye and inner eyelid (conjunctiva); |
|
▪ |
Linings inside the nose, mouth, and respiratory
system. |
| – |
Other sites most vulnerable irritation also include: |
|
▪ |
Eyelids; |
|
▪ |
Angles (the space between 2 planes) of the
ears, nose, and mouth; |
|
▪ |
Moist and macerated (softened by moisture)
areas of skin; |
|
▪ |
Wrists; |
|
▪ |
Genitalia, if personal hygiene is poor. |
| Inorganic arsenic is also capable of causing keratoses
(small corns or warts), especially on palms and soles. |
| Trivalent arsenic compounds are corrosive to skin: |
| – |
Brief contact won't cause irritation, but prolonged
contact causes localized engorgement (hyperemia)
which later forms vesicular (blister-like) or pustular
(pimple-like) eruptions. |
| – |
Exposure can create perforations (holes) in the nasal
septum (the tissue dividing the nasal cavity in half). |
| Arsenic trioxide and arsenic pentoxide exposure have
been linked to skin sensitization (acquired sensitivity or
allergy) and contact dermatitis (inflammation due to
allergic or irritant reaction). |
| Acute Poisoning Effects: |
| Acute poisoning is usually linked to ingestion, not
inhalation, of inorganic arsenic. Cases of acute
poisoning rarely occur in occupational settings and
inhalation-related cases are exceedingly rare. |
| When acute poisoning is due to ingestion, the following
gastrointestinal symptoms develop within 1/2 to 4 hours: |
| – |
Tightening (constriction) of the throat followed by
difficulty or inability to swallow (dysphagia), pain in
the region above the belly button (epigastric pain),
vomiting, and watery diarrhea. Blood may appear in
vomit and stools; |
| – |
Shock may develop due to severe fluid loss when
the amount of inorganic arsenic swallowed is
sufficiently high. Death can occur in 24 hours. |
| When acute poisoning is due to inhalation: |
| – |
The following symptoms develop first: |
|
▪ |
Cough; |
|
▪ |
Chest pain; |
|
▪ |
Shortness of breath (dyspnea); |
|
▪ |
Giddiness; |
|
▪ |
Headache; |
|
▪ |
Extreme general weakness. |
| – |
Gastrointestinal symptoms will follow. |
| Chronic Poisoning Effects: |
| Cases of chronic poisoning caused by ingestion are also
rare. Symptoms are: |
| – |
Weight loss; |
| – |
Nausea and diarrhea alternating with constipation; |
| – |
Skin pigmentation and eruptions; |
| – |
Hair loss; |
| – |
Numbness in hands and feet, "pins and needles"
sensation, muscle weakness, and other symptoms
resulting from peripheral neuritis; |
| – |
Horizontal white lines (striations) on fingernails and
toenails. |
| Inhalation of inorganic arsenic is the most common cause
of chronic poisoning in occupational settings.
Symptoms associated with this condition are divided into
3 phases. |
| – |
1st phase, earliest symptoms: |
|
▪ |
Weakness; |
|
▪ |
Loss of appetite; |
|
▪ |
Some nausea; |
|
▪ |
Occasional vomiting; |
|
▪ |
Sense of heaviness in the stomach; |
|
▪ |
Some diarrhea. |
| – |
2nd phase symptoms: |
|
▪ |
Inflammation of the eyes and inner eyelid
(conjunctivitis); |
|
▪ |
Inflammation, accompanied by an abundant
discharge from mucous membranes (a catarrhal
state) of the nose, larynx, and respiratory
passage; |
|
▪ |
Symptoms associated with the common cold
(Coryza), hoarseness, and mild
tracheobronchitis may occur; |
|
▪ |
Skin lesions are common (eczematoid and
allergic in type). Perforations (holes) in the
nasal septum (the tissue dividing the nasal
cavity in half) are the most typical lesions of
the upper respiratory tract. |
| – |
3rd phase symptoms (related to peripheral neuritis): |
|
▪ |
Numbness in hands and feet, "pins and
needles" sensation, muscle weakness. |
|
▪ |
In severe cases, motor paralyses occur:
Initially affecting the toe extensors and the
peronei (outer portion of the lower leg). |
|
▪ |
"Wrist drop" or "foot drop" (resulting from
paralysis of flexor muscles of feet and hands)
only occurs in the most severe cases. |