10 THINGS YOU NEED TO KNOW ABOUT ARSENIC POISONING 1. Arsenic is found in some rat poisons and it can kill you! 2. Arsenic can cause cancer (especially bladder and lung cancer) in very small quantities. 3. The health impacts of long-term arsenic exposure may not show up for years. 4. Arsenic occurs naturally in some regions in the United States and some areas have high amounts in drinking water. 1 5. Old mining areas can concentrate Arsenic in spoil piles. (see satellite photo right) 6. Safer limits for Arsenic in public systems for drinking water were only implemented in 2006 after millions of people had already been exposed 7. The new Arsenic limits do not protect the millions of people with private wells. 8. Have your wells tested for Arsenic or find out the history of your public water system Arsenic exposure. 9. If wooden deck or playground equipment was installed before 2004, it should be tested for Arsenic. 10. If you suspect Arsenic exposure, tell your doctor and possibly have hair or urine tested. 2 History of Arsenic o Arsenic has been used as a poison for centuries and has been suspected in the death or murders of the Medici’s, King George III of England, Napoleon and Simon Bolivar to name but a few. o o While recognized as a powerful poison, it was not known just how toxic and deadly arsenic could be in minute quantities until this millennium. o o After World War II, the global and US consensus for Arsenic in drinking water was believed to be safe below 50 parts per billion. o o About 2000, evidence began to mount from Bangladesh, Chile, Taiwan and China that smaller concentrations could cause cancer. o o Chronic conditions like skin and bladder cancer were on the rise even in areas where the average arsenic concentrations were between 10 and 50 ppb. o o In 2001, the US drinking water standard for Arsenic was lowered from 50 ppb to 10 ppb. o o . A 2007 study found that over 137 million people in more than 70 countries are probably affected by arsenic poisoning of drinking water.[1] 3 Arsenic Occurence According to the EPA Arsenic: Is a semi-metal element. It is odorless and tasteless. It enters drinking water supplies from natural deposits in the earth It is concentrated by agricultural and industrial practices. Humans increase the level of available arsenic through burning of fossil fuels, oil sands, gold and base metal mining, agricultural pesticides and additives, burning of waste. 4 Arsenic Regulations Maximum Contaminant Level or MCL: The new drinking water standard 0.010 mg/L (milligrams per liter) is the same as: 0.01 ppm (parts per million) and, 10 ppb (parts per billion) set in 2001 10 μg/L (micrograms per liter). EPA goal is set at 0 ppm. o This drinking water standard impacted 4,100 public water systems that served 13 million people. o The EPA estimated in 2001 that the 10 ppb standard would prevent approximately 2.3 to 5.5 deaths from bladder cancer and 4.6 to 27.5 deaths from lung cancer each year in the United States. 5 DRINKING WATER SOURCES Public Water Systems Given until 2006 to meet the new limit, Could apply for nine years worth of “compliance extensions” Could give them until 2015 to incorporate new technology Private Water Wells Used by 40 million Americans Not protected by the new national standard May have high levels of arsenic. 6 7 In the US, California, Texas, Michigan, and Arizona top the list of U.S. states with the number of public water systems in violation of the federal standard for arsenic. Joining these states are, New Mexico, Idaho, Nevada, and Illinois at the top of the list of states with more than 30,000 people potentially affected by high arsenic levels. http://www.circleofblue.org/waternews/2011/world/infographic-an-elemental-concern-arsenic-in-drinking-water/ 8 9 ARSENIC HOT SPOTS IN US PUBLIC WATER SYSTEMS The previous standard for drinking water, established in 1942 was 50 parts per billion but many areas exceeded this limit. At that level, the National Academy of Sciences found in 1999, people have a 1-in-100 chance of getting cancer from the arsenic over a lifetime of exposure above 50 ppb. Arsenic is classified as a "known human carcinogen" by the U.S. EPA and the World Health Organization, and children are at greater risk from arsenic than adults because they are less able to metabolize the metal (NRC 1999). 10 ARSENIC EXPOSURE SYMPTOMS Acute Symptoms -High dose, short term, exposure to Arsenic will cause coma or death! - Low dose long term exposure to Arsenic in water includes non-cancer effects such as thickening and discoloration of the skin, development of white crescent-moon marks on the fingernails, skin lesions, as well as others listed below:. Nausea Vomiting Stomach pain Diarrhea Kidney damage Diabetes Liver damage Abnormal heart rhythm Birth defects Spontaneous abortions Cardiovascular Reproductive disease problems Darkening of the skin Lower IQ levels in children 11 Partial paralysis Blindness Low platelet count Numbness of hands and feet Damage to blood Decreased red vessels blood cell count Decreased white “corns” or “warts” blood cell count on the palms, soles and torso Sensation of pins and Thickening, needles in redness, hands and feet itching, rash (neuropathy) or swelling of the skin Inhalation effects: loss of appetite, nausea, and diarrhea. 'pins and needles' tingling in the palms, or cramps in calf muscles Heat and irritation in throat and stomach, a garlic odor on breath, or a metallic taste in the mouth vomiting, purging 12 neurological effects including restlessness, chronic headaches, apathy, fainting, dizziness, delirium, somnolence, convulsions or coma. 13 Chronic Symptoms Arsenic has been linked to several cancers and has also recently been linked to higher occurrences of Type II diabetes. Arsenic in drinking water may also compromise immune function. Long term arsenic toxicity and arsenic poisoning increases the risk of several cancers including: Skin cancer Lung cancer Liver cancer Bladder cancer Kidney cancer Nasal passage cancer Prostate cancer Chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases including: Atherosclerosis High blood pressure Stroke and Heart attack Impaired electrical Peripheral vascular Impaired small blood conduction in the disease (aka vessel heart peripheral artery circulation disease) 14 Diagnosis Urine 1. Most reliable simple test for arsenic exposure 2. Reliable only for a few days 3. D Hair/Finger Nails 1. Measures exposure to high levels of arsenic over the past 6-12 months. 2. Hair samples may give falsely elevated results for years. 3. Can determine if you have been exposed to above-average levels of arsenic. 4. They cannot predict whether the arsenic levels in your body will affect your health. If needed, your doctor has additional tests that can be performed to check arsenic levels in your body Information excerpted from Toxicological Profile for Arsenic August 2007 Agency for Toxic Substances and Disease Registry 15 What’s New? Arsenic Linked to Diabetes - 13 Million Americans Are Exposed to Dangerous Levels of Arsenic Through Drinking Water Participants in a Johns Hopkins study with type 2 diabetes in 2003-2004 had a 26% higher level of total arsenic in their urine than those without the disease. Reported in the 2008 Journal of the American Medical Association (2008;300(7):814- 822). abstract available at http://jama.ama-assn.org/content/300/7/814.short http://diabetes.webmd.com/news/20080819/arsenic-linked-to-diabetes Source -WEBMD- DIABETES Arsenic in drinking water may also compromise immune function "Scientists link influenza A (H1N1) susceptibility to common levels of arsenic exposure". http://www.eurekalert.org/pub_releases/2009-05/mbl-sli052009.php.. 16 Regional Distribution Generalized map of Groundwater Arsenic in North America 17 Is There Arsenic in Your Water? 18 US Map of Arsenic in Wells (red> 10ppb) The USGS has determined that approximately 10% of the 18,000 samples exceeded the National standard of 10 ppb. Highest Arsenic Levels Most places with the highest arsenic levels are in the West, Fallon, Nev., tested levels of more than 100 parts per billion. In Fallon, the childhood leukemia rate is 40 times the national average, Albuquerque New Mexico is said to have the highest arsenic levels of any major American city's drinking water. 19 The map above shows that historical, Arsenic poisoning cases by state have tended to mimic the higher concentrations of Arsenic in drinking water. 20 FACTS ABOUT BLADDER CANCER There is an undeniable link between bladder cancer and Arsenic exposure. Bladder cancer is the sixth most common form of cancer in the United States the fourth most common cancer among men the ninth most common among women 4 times more common among men than women incidence rate among whites is twice that of blacks in the US mortality rates for Hispanics and Asians are about ½ those for whites and blacks risk of bladder cancer increases with age. incidence rates are highest in industrialized countries (United States, Canada, France, Denmark, Italy and Spain). 21 What is in dispute is the dose vs. exposure time necessary to trigger the cancer response. Since the evidence indicates that there is generally at least a ten year lag time between exposure and mortality from the disease, precise estimates are difficult. Over a decade many people have moved residences and the sources and concentration of arsenic may have changed. It is for these reasons that we have adopted a regional approach to compare potential sources of arsenic with the known incidence of bladder cancers in males in the US.