Criteria for case definition of arsenicosis

Publisher Summary Despite the availability of a large number of reports of health effects of chronic arsenic (As) toxicity, no standard definition is available to characterize fully the clinical effects of chronic As exposure in man. Earlier reports mainly highlighted the effects of dermatological manifestations like pigmentation, keratosis, and skin cancer. Later on, various noncutaneous manifestations were also reported based on various clinical and epidemiological studies. However, only a small number of reports are based on valid As exposure data, blinding of cases and controls, total assessment of clinical effect, and correlation of these effects with As level in water, urine, hair, or nails, by estimation of As using sensitive techniques, like atomic absorption spectrophotometry (AAS) and neutron activation analysis (NAA). It was therefore felt necessary to develop a clinical case definition of arsenicosis on the basis of the review of the clinical data obtained by objective criteria and validated by testing of water and biological samples in cases of chronically As-exposed people. A minimum period of six months of ingestion of As is required for the diagnosis of arsenicosis.