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Jūsų pirštas tarsi laižo akumuliatorių. Kisinas E. The higher Spirit, the more harmonious the Body Curiously, the behavioural changes were no longer present at 8 and 12 weeks of exposure, which may suggest an adaptive response.
Although arsenic metal has a limited solubility, it is not completely inert when immersed in water or biological fluids see sections on Water solubility and Toxicokineticsso that dissolved ionic species predominantly As III may be released from the metal.
Following a conservative approach, the toxicity of arsenic metal is therefore considered to be determined by the release of soluble inorganic species trivalent arsenites and pentavalent arsenates which do not differ substantially in potency and may be interconverted both in the environment and in the body. Consequently, it is justified to apply read across to soluble inorganic arsenic compounds to evaluate the systemic effects, including repeated dose toxicity, of arsenic metal. General remarks A large number of investigations in animals and humans on the toxic effects of inorganic arsenic compounds following repeated exposure are available, and these have been reviewed on several occasions by renowned scientific organizations.
Instead, an overview of available investigations is presented below. When evaluating the results of the animal and human studies, it is important to remember that there are considerable differences in arsenic biotransformation between species and between individuals of a same species see section on Toxicokinetics.
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Also, a number of aspects raise issues regarding the jei patinimas sąnarių of some studies for quantifying, comparing and interpreting results, especially regarding relevance to humans and risk assessment.
It is generally considered that trivalent arsenic compounds are more toxic than the pentavalent forms, at least at high doses. However, the difference is difficult to quantify since a conversion between trivalent and pentavalent arsenic can occur after the substance has entered the kaip veikia artritą bendrų sąnarių akivaizdžių ATSDR, Furthermore, exposure via the oral and inhalation routes is the most relevant for hazard and risk assessment of inorganic arsenic compounds.
Dermal absorption is low see section on Toxicokineticsso that no significant systemic exposure is expected via this route. The following paragraphs summarise the data available on the inhalation and oral toxicity of inorganic arsenic compounds.
Data on humans is presented first, followed by studies conducted in animals. Inhalation exposure Effects in humans Respiratory effects: Workers exposed to arsenic dusts in air often experience irritation to the mucous membranes of the nose and throat, which may lead to laryngitis, bronchitis or rhinitis, and very high exposures characteristic of workplace exposures in the past can cause perforation of the nasal septum.
However, there have been few systematic investigations of respiratory effects in humans exposed to arsenic. None are considered to be conclusive with regard to the relationship between inhaled inorganic arsenic and respiratory disease ATSDR, Cardiovascular effects: There is some evidence from epidemiological studies that inhaled inorganic arsenic can produce effects on the cardiovascular system, but such effects resulting from oral exposure are better characterized Swollen painful joint little finger, Gastrointestinal effects: Several case studies have reported nausea, vomiting and diarrhoea in workers with acute arsenic poisoning following occupational inhalation exposure.
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Such effects are a common feature of oral ingestion of high doses of arsenic but exposure levels have not been reliably estimated for any of these cases ATSDR, Neurological effects: There is evidence from epidemiological studies that inhaled inorganic arsenic can produce neurological effects. However, the exposure levels were difficult to quantify. Dermal effects: Dermatitis has frequently been observed in industrial workers exposed to inorganic arsenic in the air, with the highest rates occurring in workers with the greatest arsenic exposure.
However, limited quantitative information is available regarding the levels that produce such dermatitis and co-exposure to other substances in the workplace by the dermal route makes a dose-response analysis difficult. The highest arsenic exposures 0. Other organ systems: There is no reliable evidence in humans that inhaled inorganic arsenic produces effects on other important organ systems such as liver, kidneys or the haematological, immunological and musculoskeletal systems.
Since this sort of response is produced by a number of respirable particulate materials, it is likely that the inflammatory response was not specifically due to arsenic. Immunological effects: Female mice exposed to arsenic trioxide aerosol for 3 hours showed a concentration-related decrease in pulmonary bactericidal activity, presumably as a result of injury to alveolar macrophages, and a corresponding concentration-related increase in susceptibility to introduced respiratory bacterial pathogens Aranyi et al.
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Other organ systems: There is no reliable evidence in animals that inhaled inorganic arsenic produces swollen painful joint little finger on other important organ systems such as liver, kidneys, skin or the haematological, immunological, cardiovascular and musculoskeletal systems ATSDR, Oral toxicity Effects in humans There is a large body of studies in humans and animals on the toxic effects of ingested arsenic. In humans, most cases result from accidental, suicidal, varžtas sąnarių or medicinal ingestion of arsenic-containing powders or solutions, or from consumption of contaminated food and drinking water.
In many cases, the exact chemical form of arsenic is not known; however, it is presumed that the most likely forms are either pentavalent arsenate, trivalent arsenite or a mixture of both. Respiratory effects: Bronchitis and sequelae bronchiectasis, bronchopneumonia have been observed in patients and at autopsy swollen painful joint little finger some chronic poisoning cases Guha Mazumder et al.
Bronchopneumonia secondary to arsenic-induced bronchitis was considered to be the cause of death in one young child after several years of exposure to an average dose of 0.
Although in general respiratory effects have not been widely associated with repeated oral ingestion of low arsenic doses, a few studies have reported minor respiratory symptoms, such as cough, sputum, rhinorrhoea and sore throat in people with repeated oral exposure to 0. Arsenic in water samples was measured by atomic absorption spectroscopy.
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The prevalence of respiratory symptoms was documented via a structured, validated questionnaire. Pulmonary function test PFT was assessed by portable spirometer. Compared with controls, the arsenic-exposed subjects had a higher prevalence of upper and lower respiratory symptoms, dyspnoea, asthma, eye irritation and headache. Also, A positive association was observed between arsenic concentration in drinking water and the prevalence of respiratory symptoms, while a negative association existed between arsenic level and spirometric parameters.
Based on the study results, the study author suggested that even low-level arsenic exposure has deleterious respiratory effects Das et al. To evaluate the chronic effects of arsenic poisoning due to consumption of contaminated groundwater, a non-randomized, controlled, cross-sectional, observational study was carried out in the Arsenic Clinic, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, over a period of 1 year and 4 months.
Special investigations included routine parameters and organ-specific tests.
Arsenic levels in drinking water, hair and nails were measured. Twenty-five non-smoking healthy controls were evaluated. Murshidabad and districts adjacent to Kolkata, West Bengal, were mostly affected. Middle-aged males were the main sufferers. Restrictive abnormality in spirometry [11 Based on the study results, the author concluded that mucocutaneous and nail lesions, hepatomegaly and restrictive change in spirometry were the common and significant findings in the study Ghosh, Cardiovascular effects: A number of studies in humans indicate that arsenic ingestion may lead to serious effects on the cardiovascular system.
Characteristic effects on the heart from both acute and long-term exposure include altered myocardial depolarization prolonged QT interval, nonspecific ST segment changes and cardiac arrhythmia Cullen et al. A significant dose-related increase in the prevalence of cardiac electrophysiological abnormalities was observed in residents of Inner Mongolia, China; the incidences of QT prolongation were observed in 3. The disease is characterised by a progressive loss of circulation in the hands and feet, leading ultimately to necrosis and gangrene Chen et al.
Despite other factors being suspected of playing a role in the etiology of this disease Ko, ; Lu et al. Arsenic exposure in Taiwan has also been associated with an increased incidence of cerebrovascular and microvascular diseases Chiou et al. Wang et al.
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Studies in Chile indicate that ingestion of 0. Autopsy of five children from this region who died of apparent arsenic toxicity showed a marked thickening of small and medium sized arteries in tissues throughout the body, especially the heart Rosenberg, In addition, cardiac failure, arterial hypotension, myocardial necrosis, and thrombosis have been observed in children who died from chronic arsenic ingestion Zaldívar,as well as adults chronically exposed to arsenic Dueñas et al.
Likewise, thickening and vascular occlusion of blood vessels were noted in German vintners exposed to arsenical pesticides in wine and in adults who drank arsenic-contaminated drinking water Roth ; Zaldívar and Guillier, Similarly, Lewis et al.
Limitations in the study included lack of evaluation of smoking as a confounder and of other dietary sources of arsenic, and the lack of a dose-response for hypertensive heart disease. Another ecological study Engel and Smith found significant increases in deaths from arteriosclerosis, aortic aneurysm, and all other diseases of the arteries, arterioles, and capillaries among U.
In a prospective cohort epidemiology study, the risk of young adult mortality due to high chronic exposure to arsenic through years of drinking arsenic-contaminated water was evaluated. Age, sex, educational attainment and SES were adjusted during the analysis.
In this year closed-cohort study —all young-adult deaths were captured through verbal autopsy using International Classification of Diseases ICD to define the causes.
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Girls had higher values of cumulative arsenic exposure via tube well water than boys median: The study concluded that higher gydymas sąnarių vaikams of, and chronic exposure to, arsenic in drinking water, increased the mortality risk among the young adults, regardless swollen painful joint little finger gender Rahman et al.
Gastrointestinal effects: Clinical signs such as gastrointestinal irritation, including nausea, vomiting, diarrhoea and abdominal pain are often observed in individuals with longer-term, low exposure to arsenic e. These symptoms generally decline within a short time after exposure ceases.
More severe symptoms hematemesis, hemoperitoneum, gastrointestinal hemorrhage and necrosis have been reported in individuals with long-term ingestion of swollen painful joint little finger. Haematological effects: Anaemia and leukopenia are common effects of arsenic poisoning in humans and have been reported following intermediate Franzblau and Lilis, ; Heyman et al.
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These may be due to direct cytotoxic or haemolytic effect on blood cells Armstrong et al. However, haematological effects are not observed in all cases of arsenic exposure EPA, b; Harrington et al. Hepatic effects: A number of studies in humans exposed to inorganic arsenic by the oral route have noted signs or symptoms of hepatic injury.
Clinical examination often revealed that the liver was swollen and tender Chakraborty and Saha, ; Franklin et al. These effects are most often observed after repeated exposure to doses of 0. Histological examination of the livers of persons chronically exposed to arsenic revealed a consistent finding of portal tract fibrosis Guha Mazumder, ; Guha Mazumder et al.
Cirrhosis has also been reported at increased frequency in arsenic-exposed individuals Tsai et al. Several researchers consider that these hepatic effects are secondary to damage to hepatic blood vessel damage Morris et al. Dermal effects: One of the most common, characteristic, effects of arsenic ingestion is a pattern of skin changes that include generalized hyperkeratosis and formation of hyperkeratotic warts or corns on the palms and soles, along with areas of hyperpigmentation interspersed with small areas of hypopigmentation on the face, neck and back.
These and other dermal effects have been noted in a large majority of human studies involving repeated oral exposure e.
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In cases of low-level chronic exposure usually from waterthese skin lesions appear to be the most sensitive indication of exposure, so this endpoint is considered to be the most appropriate basis for establishing a chronic oral MRL.
This is supported by the finding that other effects hepatic injury, vascular disease and neurological changes also appear to have similar thresholds. Numerous studies in humans have reported dermal effects at chronic dose levels generally ranging from about 0.
Another large study reported increased incidence of skin lesions associated with estimated doses of 0. Several epidemiological studies of moderately sized populations 20— people exposed to arsenic through drinking water detected no swollen painful joint little finger or other effects at average chronic doses of 0. Neurological effects: A large number of epidemiological studies and case reports indicate that ingestion of inorganic arsenic can cause injury to the nervous system.
Repeated exposure to low levels 0. Neurological effects were not generally found in populations chronically exposed to doses of 0. There is emerging evidence suggesting that exposure to arsenic may be associated with intellectual deficits in children. For example, Wasserman et al. After adjustment for confounding factors, a dose-related inverse effect of arsenic exposure was seen on both performance and Full-Scale subset scores.
A study of children age 5—15 years from West Bengal, India, found significant associations between urinary arsenic concentrations and reductions in scores of tests of vocabulary, object assembly and picture completion. In this cohort, the average lifetime peak arsenic concentration in well water was 0. Furthermore, using peak arsenic as a continuous variable in the regression models also did not support an adverse effect on the tests results ATSDR, Renal effects: Most case studies of chronic arsenic toxicity do not report clinical signs of significant renal injury, even when other systems are severely impaired e.
Other organ systems: No reliable studies of musculoskeletal or immunological effects in humans after oral exposure to inorganic arsenicals have been reported ATSDR, Effects in animals Respiratory effects: There are only few data regarding respiratory effects in animals following oral exposure to inorganic arsenic.