Arsenic Poisoning

What is arsenic?

Arsenic is a naturally occurring element in the environment. Rock, soil, water, air, plants and animals all contain some level of arsenic. Arsenic combines with inorganic and organic substances to form many different compounds.

Inorganic compounds

Arsenic combines with oxygen, chlorine and sulfur to create inorganic arsenic compounds. These compounds may occur naturally in soil and rock. But they also occur due to agriculture and industrial processes, such as mining, smelting and manufacturing. Arsenic enters the air and land from wind-blown dust. It can get into groundwater from runoff and leaching. Inorganic arsenic compounds are highly toxic and have been linked to cancer.

Organic compounds

Arsenic in plants and animals combines with carbon and hydrogen to create organic arsenic compounds. Seafood such as fish and shellfish contain organic compounds. However, most of the arsenic in organic compounds is in a form that’s much less toxic than inorganic compounds. Organic compounds aren’t linked to cancer.

What is arsenic poisoning?

Arsenic poisoning occurs when you ingest or consume high levels of arsenic. It shares features of other heavy metal poisonings, including mercury and lead.

You can experience arsenic poisoning quickly, but long-term exposure to the element is more common. This may be through contaminated groundwater, air, soil or food. Arsenic poisoning occurs most often in major areas of agriculture and industrialization. Arsenic poisoning can cause serious complications and even death if not treated immediately.

Who does arsenic poisoning affect?

Arsenic poisoning affects at least 140 million people worldwide. This is due to contaminated drinking water. People in 50 countries are exposed to water that contains potentially dangerous levels of arsenic. These countries include:

• Bangladesh.
• India.
• China.
• Thailand.
• Chile.
• Mexico.
• United States.

What are the symptoms of arsenic poisoning?

You can show signs of arsenic poisoning within 30 minutes of high levels of exposure. Immediate symptoms of arsenic poisoning may include:

• Abdominal pain.
• Nausea and vomiting.
• Diarrhea.
• Cough.
• Chest pain.
• Shortness of breath (dyspnea).
• Sore throat (pharyngitis).
• Abnormal heart rhythm (arrhythmia).
• Low blood pressure (hypotension).
• “Pins and needles” feeling in your fingers and toes.
• Red, swollen skin.
• Garlic odor in your breath and body tissues.

Long-term exposure to arsenic may take years to develop and can cause more severe symptoms. Severe arsenic poisoning symptoms include:

• Skin pigmentation changes (darkening of your skin).
• Warts and lesions.
• Hard patches on the palms of your hands and soles of your feet (hyperkeratosis).
• White lines on your nails (Mees’ lines).
• Persistent sore throat.
• Constant digestive issues.

What causes arsenic poisoning?

Drinking contaminated water causes most cases of arsenic poisoning. In some areas of the world — including the United States — high levels of arsenic occur in drinking water. This is because arsenic that’s naturally present in the ground can leach into the water supply. Runoff from industrial plants can also contaminate groundwater.

You may also get arsenic poisoning when using contaminated water while preparing food. In addition, many crops are irrigated with contaminated water.

Eating contaminated food can also cause arsenic poisoning. Certain foods, including chicken, rice, fruit juice and some fish, may contain arsenic. This is due to its presence in the soil or water.

If you work in an industry that uses arsenic, you could get arsenic poisoning through repeated inhalation of arsenic particles in the air. Industries that use arsenic include:

• Pesticides and herbicides.
• Smelting and mining.
• Glass manufacturing.
• Semiconductor manufacturing.
• Woodworking and carpentry.

Other causes of arsenic poisoning include:

• Smoking tobacco.
• Breathing in smoke or dust from wood treated with arsenic.
• Contact with contaminated soil, dust or wood preserved with arsenic.

How is arsenic poisoning diagnosed?

Your healthcare provider may order a heavy metal test to diagnose arsenic poisoning. Using your urine (pee), this test can measure high levels of arsenic in your body after immediate exposure. Blood tests, as well as tests on your hair and fingernails, can measure long-term exposure to high levels of arsenic within six and 12 months. These tests are commonly used in areas where the risk of arsenic poisoning is higher.

How is arsenic poisoning treated?

Treating arsenic poisoning depends on the type of exposure and the severity of your condition. For immediate exposure, the first treatment for arsenic poisoning includes removing contaminated clothing. You’ll also want to rinse the arsenic off your skin.

Your healthcare provider may give you chelation therapy. This treatment uses certain chemicals to separate the arsenic from your blood proteins.

You may also receive bowel irrigation. With this treatment, a special solution flushes out the contents of your gastrointestinal tract. It removes the arsenic and prevents your gut from absorbing it.

Your provider will monitor your heart and kidney function. In addition, you may need oxygen, fluids, a blood transfusion, heart medication or medication to control seizures.

How can I prevent arsenic poisoning?

The best way to prevent arsenic poisoning is to ensure you’re drinking clean water. Also, confirm that all the food you eat is prepared with clean water. You may want to consider only drinking and using bottled water while traveling.

If you work in an industry that uses arsenic, wear a face mask to lessen your chances of accidentally inhaling arsenic particles. In addition, be sure to shower and change your clothes before going home. You could unintentionally carry the toxin home on your skin, hair or clothing.

When working with arsenic-treated wood, make sure to wear protective clothing, gloves and a dust mask. This can help reduce your exposure to sawdust.

What is the outlook (prognosis) if I have arsenic poisoning?

The prognosis for arsenic poisoning depends on the cause of exposure. This includes the type, the amount and the duration of the exposure. Long-term exposure can lead to many different illnesses and complications, including:

• Liver disease.
• Heart disease.
• Diabetes.
• Digestive system issues.
• Nervous system complications.
• Neurotoxicity.

Arsenic is a known carcinogen, which means it may cause cancer. The most common types of arsenic-related cancers include:

• Bladder cancer.
• Blood cancer.
• Cancers of the digestive system.
• Liver cancer.
• Lung cancer.
• Lymphoma.
• Kidney cancer.
• Prostate cancer.
• Skin cancer.

In pregnant people, arsenic poisoning can lead to complications during fetal development. Your baby may also have birth defects. In addition, developmental delays can occur in children who are frequently exposed to arsenic.

How fast can you die from arsenic poisoning?

Arsenic is very poisonous. Consumed in large amounts, it can cause death very quickly. Lethal doses resulting in death typically occur within one to four days of ingestion. Exposure in smaller amounts over a period of time can still cause serious complications.

Is arsenic in rat poison?

Rat poison — officially called rodenticide — historically contained heavy metals such as arsenic. It was used to control rodent populations, including rats. However, since the mid- to late-20th century, most rodenticides use anticoagulants instead. These anticoagulants stop normal blood clotting in rodents. While newer forms of rodenticide don’t contain arsenic, the anticoagulants in them can be just as toxic and life-threatening.

A note from Cleveland Clinic

Arsenic occurs naturally in the environment. But it can be dangerous if you’re exposed to high levels of the element. Long-term exposure can cause serious health complications including many different types of cancer. If you live or work near an area with high levels of arsenic, take steps to limit your exposure. This includes finding clean sources of drinking water. If you show any signs of arsenic poisoning, seek medical care right away. The sooner you receive treatment, the better your outlook.