Talk:Arsenic poisoning

Arsenic also causes injury to peripheral nerve fibers resulting in loss of sensation, numbness and sometimes pain.

General ToDo
I will get onto these if there is no objection

1. Update image to something clinical

2. Speficic clinical details of presentation of acute toxicity. The article is currently too focused on chronic exposure and biochem.

3. Remove spurious famous references. The possibility of poisoning should not be included, specific mortalities in various areas should be.

4. Replace country specific material with summaries.

5. Replace multiple references to diagnostic/treatment techniques with guideline summary from, say 3, countries (likely East China, AUS/UK/US and India).

6. Include any unmentioned pertinent information from: http://emedicine.medscape.com/article/812953-clinical#a0217

--Millionmice (talk) 06:25, 12 August 2011 (UTC)

Toxicity
2nd paragraph of Toxicity section is highly biased and should be removed. The author seeks to create the "suspicion" described in sentence 1 using misleading citations. See my comments in italic below

Arsenic is suspiciously [suspicious according to whom?] related to the first five leading causes of non accidental death in the United States. Bringing the total to one million five hundred twenty five thousand six hundred seventy five (1,525,675) related mortalities. EPA efforts are underway to reduce drinking water exposure to zero. [8] Lead causes of mortality in the world are all related ''[related how? cause, correlation, coincidence?]'' to Arsenic. These are [9] Heart disease [10] (hypertension related cardiovascular), Cancer, [11] stroke [12] (cerebrovascular diseases) Chronic lower respiratory diseases, [13] and Diabetes. These diseases are all related to the alteration of voltage dependent potassium channels. [for which there are other causes unrelated to arsenic][citation needed] Researchers, led by Ana Navas-Acien, MD, PhD, of the Johns Hopkins Bloomberg School of Health, studied 788 adults who had their urine tested for arsenic exposure in the 2003-2004 National Health and Nutrition Examination Survey. Participants with type 2 diabetes had a 26% higher level of total arsenic in their urine than those without the disease. Diabetes is also related to alteration of voltage dependent potassium channels due in part to the function of insulin and potassium in the cellular metabolism of glucose.[citation needed][what is the relationship?] Due to the regular appearance of Arsenic in public drinking water supplies, it is likely that Arsenic plays a part in about thirty percent of total all cause mortality in America.[citation needed] Arsenic prevalence in the water has been related to the occurrence of hypertension, erectile dysfunction and related conditions.[citation needed]

Misc
Under "Notables", why is there no mention of the mass poisoning at Gustav Adolf Lutheran Church in New Sweden, Maine, in April of 2003? It's the subject of Christine Ellen Young's book "A Bitter Brew". Jeanie821 14:55, 3 March 2007 (UTC)Jeanie


 * There's no mention probably because no one has added it yet (so feel free :) Just be sure to reference your sources, e.g.  -- Limulus 04:09, 5 March 2007 (UTC)

does anyone now anything about arsenic
 * please see Arsenic......WBardwin 02:17, 11 November 2005 (UTC)

From the article:

''Also, eating food with sulphur such as eggs and onions help to neutralize arsenic in a natural, nonchemical way. '' (emphasis mine)

What is this supposed to mean? Is it somehow identifying chemical with unnatural? Or is it simply a clumsy way of saying that eggs and onions, two natural products, neutralise arsenic in a nonchemical (physical, physiological) way? I suspect the most likely answer is the first, so I have taken the freedom to correct it. If anyone disagrees, please answer.--Daniel Medina 00:19, 6 January 2006 (UTC)

Mean Lethal Dose
Would someone mind updating the mean lethal dose? The page that it sources is not active anymore. —Preceding unsigned comment added by 216.56.4.76 (talk) 22:21, 4 December 2008 (UTC)

What idiot...
Who is going around talking about arsenic killing by stomach disruption? You really can't believe that. Overdoing arsenic will lead to vomiting and perhaps this is where the myth was first perpetuated. Arsenic kills by multi-system organ failure. It's absorption is gastric and excretion is renal. Which is why the test for arsenic poisoning is examination of urine.Angrynight 16:50, 21 February 2006 (UTC)


 * Please don't call people idiots who don't know as much as you. Try and be civil, even if you're annoyed. Thanks. --Singkong2005 16:35, 30 April 2006 (UTC)

Medicinal use of arsenic
not even a single line is here indicating the medicinal use of this important element. http://scifun.chem.wisc.edu/chemweek/arsenic/arsenic.html —Preceding unsigned comment added by Adilkhan1234 (talk • contribs) 08:05, 10 August 2010 (UTC)
 * 
 * 

From Talk:Arsenicosis (merged to this page)
''I merged the two articles. There were just a few talk page comments at Talk:Arsenicosis, which have been copied to this section:''


 * Previous deletion debate

i was under the impression that WHO documents are in the public domain, as is the case with US document publications. Sorry if I am wrong, and will rewrite the article. thanks. vogon77 20:38, Oct 7, 2004 (UTC)

arsenic poisoning
Is this another word for arsenic poisoning, or is it a particular type of arsenic poisoning? If the former, this should be merged with the arsenic poisoning article. If the latter, the article should make that more clear. --Alynna 22:51, 5 December 2005 (UTC)
 * Okay, according to arsenic poisoning it's "chronic low-level arsenic poisoning". I will update the article accordingly. --Alynna 01:18, 18 January 2006 (UTC)

Bangladesh
The issue of Arsenic poisoning from groundwater in Bangladesh needs to be addressed properly in one place. Info already on Wikipedia includes:


 * A reference in Bangladesh: Nickson, R, McArthur, J & Burgess, W, et al. (1998), "Arsenic poisoning of Bangladesh groundwater", Nature, no. 6700, pp. 338.
 * A section about the problem in Arsenic.

Relevant articles include: Arsenic, Borehole, Bangladesh - these should be linked appropriately.
 * I agree and the text already in the article should state when it happened so people can look for better resources. It's important whether this happened before or after the WHO report. 108.18.136.147 (talk) 01:12, 20 April 2015 (UTC)

stricter USA arsenic norm questioned by experts
The article says that the WHO approved safe limit in water is 0.01 mg/L. Experts question this, and say that up to 100 ppb is safe (which by my calculation is 0.1 mg/L, 10 times the WHO level ), according to these links:
 * USA: stricter arsenic norm unnecessary and harmful for the poor, say experts
 * EPA arsenic rule set too low, study claims

It's claimed that a stricter guideline (in the USA) is unnecessary and harmful for the poor. (I'm not agreeing - it's just a bit of info that may be revelant.) --Singkong2005 17:18, 30 April 2006 (UTC)

Studies of a medicine called "Fowler's Solution" which is essentially "medicinal arsenic" showed that long term use produced a few cases of bladder cancer (a side effect of chronic exposure) in the UK. When the individuals who used this substance had their urine tested it was estimated that they had the equivalent of a lifetime exposure of 0.025 mg/L (25 ppb) (Hassam, 2009; cited at http://www.physics.harvard.edu/~wilson/arsenic/arsenic_project_introduction.html) Googoodal (talk) 23:29, 13 November 2009 (UTC)

How long does arsenic take to kill a person?
How long does arsenic take to kill a person through steady poisoning, and in what amounts? The section on Charles Francis Hall makes mention of the length of time, but not the amounts required. The article also mentions assassinations, but doesn't go into any detail. I'm not interested in murder, but I am interested in the process.

I have a related question: more than once I've read a mystery story (from authors ranging from Dorothy Sayers to Dashiell Hammett) where the murderer desensitizes him/herself to arsenic by taking increasingly large doses, so that he can partake of the food lethal for the victim. Is that medically possible? Is there any documented case where that actually happened (or has been suspected)? 89.102.137.191 15:06, 25 June 2006 (UTC)

Napoleon -- Anon contribution
The info below moved here for a more specific source (publication, date, etc.) as well as format compatibility. Anyone have more information? WBardwin 06:50, 9 July 2006 (UTC)


 * IT IS NOW KNOWN THAT NAPOLEON WAS POISONED WITH RAT POISON AS CONFIRMED BY PASCAL KINTZ, PRESIDENT OF THE INTERNATIONAL FORENSIC TOXICOLOGY SOCIETY WITH NEW METHODOLOGY CONFIRMING THAT IN THE MEDULLA OF THE HAIR SHAFT THERE WAS ORGANIC ARSENIC, THE MOST TOXIC NOT OCCURING IN NATURE AND BY NECESSITY WAS CONSUMED AND CARRIED BY THE BLOOD TO THE HAIR SHAFT. (contributed by 64.12.116.9, 17:14, 8 July 2006)

Take it easy! (Writing with capital letters only is the Internet equivalent of screaming or at least raising your voice.) There are still considerable errors in the paragraph about the poisoning of Napoléon I Bonaparte. His five years of illness could not have been due to the mouldy wallpapers in his bedroom and living room. These wallpapers where put up three years after he fell ill so the timing does not fit. Although there where several other possible sources in the environment the age structure of the twelve poisoned people speaks against environmental poisoning. Hair samples taken from Napoléon at different times have been measured to have different arsenic contents. The hair samples taken after his death has an arsenic content about 40 times what is considered normal today. His dead body was placed in a fourfold coffin which was in turn placed in a stone vault for 19 years. As such his corpse was never in contact with the soil. Furthermore, Napoléon was buried without a single hair on his head. All had been shaved off the day after he died. This was done by Jean Abram Noverraz who had previously been his personal servant.

Anyway, the poisoning theory does not state that Napoléon died from arsenic poisoning. The last five years of his life he was repeatedly poisoned with arsenic. The doses where large enough to make him ill but not enough to kill him. During a period of almost six weeks before he died he was also poisoned with antimony. Yet he never swallowed any lethal dose of it. The last days before he died he was given a drink seasoned with bitter almonds. Although bitter almonds contain prussic acid the amount he was given was not enough to kill him by itself. However, the combination of prussic acid and calomel was lethal. I have written a summary of the present-day state of knowledge on the issue witch can be found here. I don't give myself out of being an expert, I am just a sceptic who can’t help being fascinated by him. As long as you refrain from ad hominem attacks I will do my best to answer any questions about it.

That Napoléon had been poisoned to death was first found out by Sten Forshufvud. He was not only a dentist but also a toxicologist. Although he had no formal qualifications as an historian he was supported by the two professional historians Ben Weider and David Geoffrey Chandler. As experts on Napoléon these would not have accepted a description differing radically from the conclusions they had drawn themselves without having very good reasons for it. In order to convince Ben and David Sten had to explain to them how he thought. If Sten had been a crackpot they would not have been convinced. Why? Because crackpot ideas are so studded by logical fallacies that someone trained to think logically would certainly spot at least some of them. David and especially Ben also had the opportunity to check if the contemporary eyewitness accounts really said what Sten claimed that they said. Ben did in fact work a lot with Sten on the cause of Napoléon’s death. Furthermore, Ben survived Sten by 23 years and continued to pursue the issue as long as he lived. Please note that adherence to the poisoning theory does not depend on your personal approach to the victim. Sten was an admirer of Napoléon. Ben also had a positive view of him although the word “admirer” may be an exaggeration. David considered Napoléon to have been “a great bad man” and I agree with him.

2010-12-29 Lena Synnerholm, Märsta, Sweden.

The latest version of my summary can now be found here.

2014-01-11 Lena Synnerholm, Märsta, Sweden.

Removed text
I've just removed the following text from the 'Treatment' section:
 * If modest amounts of arsenic is ingested, it is suggested that 5 charcoal tablets be ingested immediately in order to help soak up the arsenic and then pass it through your system naturally. Eating food with sulphur, such as eggs and onions, can also help to neutralize arsenic. 

I don't know what the medical advice is for arsenic poisoning but in the activated carbon article it specifically states that it is bad at absorbing arsenic, which indicates to me that this advice is wrong. If it is wrong, then it could actually be dangerous to include it in the article (although it would be stupid to get medical advice from Wikipedia there are stupid people in the world). I thought it best to remove it just in case rather than waiting for references. --82.47.198.253 16:13, 30 August 2006 (UTC)

Dioxin
Dioxin doesn't contain Asenic - why is it mentioned here at all?

How does it work?
What is the method by which Arsenic poisons? What bodily/cellular processes are distrupted and how? I think there should be a section in the article for this. Ranunculoid 19:46, 4 August 2007 (UTC)

Biochemistry of Arsenic Poisoning needs to be included
Arsenic disrupts the glycolysis pathway in cells. Arsenic binds to Glyceraldehyde-3-phosphate to make 1-arseno-3-phosphoglycerate. Then, 1-arseno-3-phosphoglycerate is converted to 3-phosphoglycerate.

These reactions bypass the step in glycolysis using Phosphoglycerate Kinase (PK). Since PK is an important enzyme in glycolysis for substrate-level phosphorylation of ADP to ATP, Arsenic Poisoning thus results in a loss of 2 ATP molecules from each Glucose and thus no net ATP production in glycolysis.

Please do not use my text above as a Wikipedia entry. I've typed it out here off the top of my head and without a source. I just thought I'd be lazy and provide it as a springboard for someone else to do the legwork. It is, however, factually accurate and available in any introductory biochemistry text and numerous journal articles.

thats quite esoteric. Arsenate which is the +5 valence state of arsenic is chemically similar to phosphate essential to cellular mechanisms thus it interferes with the ATP ADP process. The cellular response is usually to reduce the arsenic to + 3 valence state (arsenite) and extrude the chemical from the cell. Arsenite can also be taken up by the cell with water since it is soluble. One cellular defense mechanism methylates the arsenic as it reduces from As(V) which helps to decrease the toxicity. —Preceding unsigned comment added by 138.250.27.43 (talk) 15:53, 9 January 2008 (UTC)

Units and values
The use of ppm, ppb, mg/L, WHO limits, US limits, and other numbers concerning toxicity all need to be rectified and verified. The current material is not consistent and seems to have errors. Also, ppb might be a bad choice in terminology because of the "billion" ambiguity. Snezzy 11:07, 17 October 2007 (UTC)

Arsenic Toxicity
This section first states that the LD50 for arsenic is 15-30mg/kg and then goes on to say in the next sentence that this works out to be about 53g for a 70kg human.
 * 70 x 15mg = 1050mg = ~1g
 * 70 x 30mg = 2100mg = ~2g

Something is amiss here!

CrackDragon (talk) 17:31, 11 February 2009 (UTC)

Arsenic lakes
There are some lakes (US) that have a naturally lethally high concentration of Arsenic. I don't know the names, but maybe the fact would be worth mentioning here. 71.236.26.74 (talk) 22:24, 6 July 2009 (UTC)

Toxicity
The article reads: "The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg or 1 mg/kg/day." This raises a number of questions: First, I suppose the 1 mg/kg/day figure is "mg of arsenic per kg of body weight", that should probably be stated in the article. Also the per day bit is not completely clear to me, is this the minimum amount that would not be metabolised in a day or is there something more to this figure? If it can be related to the first figures then that suggests that the per day dose would not kill you for at least 70 days. Speaking of which, the first figures "70 to 200 mg" are not stated as per kg, but if they are not then it seems to me those figurese or the 1 mg/kg/day must be wrong. -- Qha (talk) 21:58, 13 September 2009 (UTC)

Lethal, sub-lethal and chronic poisoning
I think it is important to point out the differences between lethal, sub-lethal and chronic arsenic poisoning. These can be described as different levels of poisoning as the amounts absorbed at a time is the highest in lethal poisoning, a little less in sub-lethal poisoning, and even less in chronic poisoning. The most important differences are these:

¤ Lethal poisoning kills in 12 – 18 hours. As the name suggest it is almost always deadly. (Please correct me if my information on this is outdated.) ¤ Sub-lethal poisoning can kill after two to ten days but is not necessary deadly. If the victim survives the first ten days he or she will recover during a period of several weeks. ¤ Chronic poisoning is deadly unless the source of arsenic is found and eliminated in time. I am not sure how long it takes to die from it but my educated guess is that the time is measured in years.

The three levels of poisoning have different sets of symptoms. However, there is some overlapping between the symptoms of lethal and sub-lethal poisoning and between the symptoms of sub-lethal and chronic poisoning. Furthermore, people recovering from sub-lethal poisoning shows the symptoms of chronic poisoning. This has lead to confusion between chronic poisoning and the after-effects of sub-lethal poisoning. To find the right cause it is necessary carefully trace the development of the patient’s symptoms over time. Finally, ignorance about the differences between lethal and sub-lethal poisoning can mislead people to dismiss arsenic poisoning altogether because the victim did not die from it. Fuzzy ideas about arsenic levels probably contribute to this.

2012-08-01 Lena Synnerholm, Märsta, Sweden.

English, please
Is this too much to ask that at least first paragraph would be understandable to common Joe? --89.72.209.44 (talk) 17:31, 6 December 2010 (UTC)

Yes, that is reasonable. Any chemists out there, we laymen would be thankful if someone would translate that first paragraph, especially the second sentence, to simpler terminology, even if some of the meaning is lost. Wikipedia is intended for everyone to use, after all, and the paragraph is singularly opaque. - Lord Vargonius (talk) 02:07, 21 September 2011 (UTC)

Usability of this section
Really??? You couldn't make this harder to read or use?? 00:22, 21 December 2010 (UTC) — Preceding unsigned comment added by Mloyd01 (talk • contribs)

Safer To Buy Rice From China Than The United States?
According to Wikipedia => Seems China set a standard limit of 150 ppb of Arsenic in rice; but there is no standard whatsoever for the level of Arsenic in rice (260 ppb/aver) bought in the United States - is this correct? - and ok? - in any case - Enjoy! :) Drbogdan (talk) 19:14, 24 September 2012 (UTC)

Expansion
The following points regarding arsenic poisoning may be incorporated into the article after proper paraphrasing and adding appropriate references: heart a. Neuropathy (motor & sensory), optic Neuritis b. Iron dialysed or fresh hydrated ferric oxide c. Cholera** ( Rice water stool )  D ip ta ns hu Talk 08:01, 31 May 2014 (UTC)
 * Aphrodisiac, found in Ashes n charred bones
 * Aldrich Mee’s lines ( leuchoparonychia ) on nails
 * Rain drop pigmentation of skin
 * Red velvety appearance of stomach mucosa Subendocardial hg. Of
 * calcium sodium Edetate is antidote
 * White arsenic - Arsenious oxide
 * Arsenious trioxide resembles Addison’s disease
 * Black foot disease
 * BAL is antidote ( c/I in café Cadmium & Ferrum poisoning )
 * Marsh test
 * Measels like rashes
 * Alkali is contraindicated
 * Reinsch test
 * Retards decomposition (Carbolic acid, Organophosphorus, Strychnine( Nux Vomica, Endrin, Dhatura, Arsenic, Zinc Chloride)
 * Rigor mortis lasts longer than usual*
 * Sankhya or Somalkar is white arsenic
 * Schele’s green (copper arsenate)
 * paris green ( copper acetoarsenate )
 * Hyperkeratosis & Hyper pigmentation of palm & soles
 * deposited in Hair after 1 week
 * These idea seem attractive, especially if strong sources are cited per WP:MEDRS. --Smokefoot (talk) 10:04, 31 May 2014 (UTC)

Duplication
Not sure why we have "There is also a link to cardiovascular" and than in the next sentence " Arsenic is related to heart disease"

And than "Skin effects can include skin cancer in the long-term but often prior to skin cancer are different skin lesions...Other effects may include darkening of skin and thickening of skin"

Followed by "This can include skin cancer in the long-term but often prior to skin cancer are different skin lesions[10]. Common dermal effects include hyperpigmentation (darkening of skin) and hyperkeratosis (thickening of skin)."

Doc James (talk · contribs · email) 01:22, 30 March 2018 (UTC)

"Almost clinical description"
Committee on Medical and Biologic Effects of Environmental Pollutants. Arsenic : Medical and Biologic Effects of Environmental Pollutants. Washington, D.C.: National Academy of Sciences, 1977, 1.

Presumably this source meets MEDRS, as the National Research Council's Division of Medical Sciences would choose an authorship committee composed entirely of scholars familiar with the subject, and ''This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The work on which this publication is based was performed pursuant to Contract No. 68-02-1226 with the Environmental Protection Agency.'' EPA prefers peer-reviewed scholarly work for its contracts, I would expect, and the authors review existing studies; not being familiar with the literature, I'm not clear whether to class this more as a secondary or tertiary source, but it's definitely not primary. To me it seems a "systematic review" from File:Research design and evidence - Capho.svg.

In the cited page of this source (the first page of the introduction), the authors describe the conclusion of Madame Bovary as "an almost clinical description of acute arsenic poisoning". Is there an appropriate place for introducing a short reference to the eighth chapter (where the title character experiences the poisoning), basically for the purpose of suggesting that the reader consult this chapter for a non-technical description of acute poisoning? Not suggesting that we create an "in popular culture" section! Such sections are pretty much always worthless. Rather, either we should introduce it to provide a more thorough description than would be appropriate for an encyclopedia article, or we should avoid introducing it because we shouldn't point readers to specific non-technical documents. Nyttend backup (talk) 13:34, 15 November 2018 (UTC)

Better images
I've just added a better image to the lead to show that this is not a "historical problem" but still very much current today. I am actually baffled that I can't find more images for this in Wikimedia Commons, given that millions of people are or were affected by it e.g. in Bangladesh, see: https://en.wikipedia.org/wiki/Water_supply_and_sanitation_in_Bangladesh#Arsenic_contamination_of_groundwater Maybe there are other keywords that I haven't tried yet in my search? EMsmile (talk) 10:59, 24 October 2023 (UTC)