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Arsenic, Antimony and Bismuth

Arsenic has a long history in therapeutic medicine and for many centuries has been an important pesticide and preservative. Arsenic is not a cumulative poison but a profound cause of circulatory disturbances such as Blackfoot disease and cancers including Bowen’s disease. Epidemiological evidence emphases that inorganic arsenic compounds are unequivocally carcinogenic in humans following ingestion or inhalation. Dermal absorption of arsenite or arsenates is low. Contaminated drinking water is the principal source of arsenic-related cancer and risks of lung and bladder cancer are proportional to the amount of inorganic arsenic absorbed into the body irrespective of whether it is inhaled or ingested. Cancer risk is determined by the socio-economic status of the population and patterns of exposure, nutrition and duration of exposure. Arsenic is cytotoxic, mutagenic and induces reactive oxygen species. Arsenic residues are methylated and excreted via the kidney. A safety threshold of 10 ppb arsenic in drinking water has been established to safeguard consumers against risks of skin, lung, kidney, bladder, nasal passages, liver and prostatic cancers. Arsenic-related skin cancer is more prevalent in areas of poor nutrition at exposures exceeding 50 mg l−1. Well-nourished people may safely tolerate arsenic at <400 μg l−1 without risk of cancers. Experimental animal studies provide evidence of the cytogenic and molecular genetic basis for arsenic-induced carcinogenesis. They demonstrate that pre- and perinatal arsenic exposure predisposes to cancer later in life.

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31 Oct 2013
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From the book series:
Issues in Toxicology