The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem

Marisa F. Naujokas,¹ Beth Anderson,² Habibul Ahsan,^3,4,5 H. Vasken Aposhian,⁶ Joseph H. Graziano,⁷ Claudia Thompson,⁸ and William A. Suk²

¹MDB Inc., Durham, North Carolina, USA; ²Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA; ³Department of Health Studies, ⁴Department of Human Genetics, and ⁵Department of Medicine, The University of Chicago, Chicago, Illinois, USA; ⁶Department of Molecular and Cellular Biology, University of Arizona, Tucson, Arizona, USA; ⁷Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA; ⁸Susceptibility and Population Health Branch, Superfund Research Program, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA

Abstract

Background: Concerns for arsenic exposure are not limited to toxic waste sites and massive poisoning events. Chronic exposure continues to be a major public health problem worldwide, affecting hundreds of millions of persons.

Objectives: We reviewed recent information on worldwide concerns for arsenic exposures and public health to heighten awareness of the current scope of arsenic exposure and health outcomes and the importance of reducing exposure, particularly during pregnancy and early life.

Methods: We synthesized the large body of current research pertaining to arsenic exposure and health outcomes with an emphasis on recent publications.

Discussion: Locations of high arsenic exposure via drinking water span from Bangladesh, Chile, and Taiwan to the United States. The U.S. Environmental Protection Agency maximum contaminant level (MCL) in drinking water is 10 µg/L; however, concentrations of > 3,000 µg/L have been found in wells in the United States. In addition, exposure through diet is of growing concern. Knowledge of the scope of arsenic-associated health effects has broadened; arsenic leaves essentially no bodily system untouched. Arsenic is a known carcinogen associated with skin, lung, bladder, kidney, and liver cancer. Dermatological, developmental, neurological, respiratory, cardiovascular, immunological, and endocrine effects are also evident. Most remarkably, early-life exposure may be related to increased risks for several types of cancer and other diseases during adulthood.

Conclusions: These data call for heightened awareness of arsenic-related pathologies in broader contexts than previously perceived. Testing foods and drinking water for arsenic, including individual private wells, should be a top priority to reduce exposure, particularly for pregnant women and children, given the potential for life-long effects of developmental exposure.

Key words: arsenic, arsenic health effects, cancer, chronic arsenic exposure, development, drinking water, skin lesions.

Environ Health Perspect 121:295–302 (2013). http://dx.doi.org/10.1289/ehp.1205875 [Online 3 January 2013]

Address correspondence to M. Naujokas, MDB Inc., 2525 Meridian Corporate Center, Suite 50, Durham, North Carolina 27713 USA. Telephone: (919) 794-4700. E-mail: naujokasmf@niehs.nih.gov

M.F.N. is supported through a contract with the National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) (contract GS-OOF-0001S, Health and Human Services order CR700013). H.A. is supported by National Institutes of Health and NIEHS SRP grants P42ES10349, RO1CA107431, and RO1CA102484. J.G. is supported by NIEHS SRP grant P42ES10349.

The authors declare they have no actual or potential competing financial interests.

Received 8 August 2012; Accepted 21 December 2012; Online 3 January 2013.