Arsenic Exposure Profile, Urine

Arsenic poisoning of a chronic nature is often evidenced by cardiovascular abnormalities and neurological disorders. Acute exposures to high concentrations of arsenic may be evidenced by the following signs and symptoms:²

• Gastrointestinal: Severe abdominal pain, nausea and vomiting, bloody or rice-water diarrhea

• Cardiovascular and respiratory: Hypotension, shock, ventricular arrhythmia, congestive heart failure, pulmonary edema

• Neurologic: Light-headedness, headache, weakness, lethargy, delirium, encephalopathy, convulsions, coma, sensorimotor peripheral neuropathy

• Hepatic and renal: Elevated liver enzymes, hematuria, oliguria, proteinuria, acute tubular necrosis, renal cortical necrosis

• Hematologic: Anemia, leukopenia, thrombocytopenia, disseminated intravascular coagulation

• Other: Rhabdomyolysis, garlic odor on breath, delayed appearance of Mees lines

In acute arsenic poisoning, death is usually due to cardiovascular collapse and hypovolemic shock.

Generally, inorganic arsenic is associated with industry and has a higher rate of toxicity than does the organic arsenic that is usually associated with dietary intake.³ Urine offers the better medium for analyzing a chronic or prolonged arsenic exposure. Possible dietary or domestic sources of arsenic should be considered if urine concentrations remain above the norm.

Arsenic compounds in organic forms have numerous commercial applications (eg, arsenical pesticides, pharmaceuticals, ceramic glass industry, and metallurgy). Arsine gas may also be emitted as a byproduct of certain industries, such as metallurgy. Organic forms of arsenic are typically encountered from dietary intake. Biological Exposure Indices (BEI®) are reference values intended as guidelines for evaluation of occupational exposure. BEI® represent biological levels of chemicals that correspond to workers with inhalation exposure equivalent to the threshold limit value (TLV®) of the chemicals. TLVs refer to the airborne concentrations of substances and represent conditions under which it is believed that nearly all workers may be repeatedly exposed, day after day, without adverse health effects.⁴