Effects of Selenium Supplementation on Arsenism: An Intervention Trial in Inner Mongolia

This paper reports the effects of a placebo-controlled Se-enriched yeast supplementation trial, conducted for 14 months, on arsenism in adult farmers living in a rural community in Inner Mongolia, China. The farmers had been naturally exposed to elevated concentrations of As in drinking water from tube-wells since 1983 but changed to arsenic-free drinking water when the trial began in June 1996. Blood and hair Se and As concentrations were analysed pre-intervention and at the end of the 3rd, 9th and 14th month, while skin lesions were assessed pre-intervention, as well as at the end of the 14th month, using the Arsenism Clinical Criteria established by the Ministry of Health, China. As the trial was a voluntary one, a number of farmers did not routinely have their blood and hair samples taken for analysis. Consequently, the data have been analysed in two categories. Fifty-four farmers from the Se-group and 29 from the placebo-group who were sampled on each occasion were considered as one group, which has been compared with the second group comprising up to a total of 100 farmers in the Se-group and 86 in the placebo-group. Results calculated for those farmers who were sampled on each occasion, showed that at the end of the trial, blood and hair Se concentrations of the Se-group increased from 0.130 to 0.186 µg ml^–1 and from 0.431 to 0.502 µg g^–1, respectively, while those of the placebo-groups remained constant. Blood and hair As concentrations of the Se-group decreased from 0.051 to 0.015 µg ml^–1 and from 2.57 to 0.680 µg g^–1, respectively, a greater reduction than those in the placebo-group that went from 0.064 to 0.024 µg ml^–1 and from 2.62 to 1.25 µg g^–1, respectively. When the data from all patients were examined, the analytical trends were similar. An evaluation of skin lesions in the category who were sampled for hair and blood on each occasion showed that 41.2% of hyperkeratosis, 50.0% of depigmentation and 44.7% of pigmentation in the Se-group improved one or more degrees, while those in the placebo-group improved by only 7.1, 12.0 and 6.7%, respectively. A total of 61.1% of the adults in Se-group improved in one or more type of skin lesion, but only 17.2% improved in the placebo-group. Comparable results were obtained when all the data from both categories of farmers were examined. Results from the trial showed that Se supplementation was more effective for the improvement of adults who were affected by double or triple skin lesions. In the placebo-group, most of the severely affected adults improved in only one kind of skin lesion, but in the Se-group, more adults improved in two or three kinds of skin lesions. Although the trial was limited by its relatively small size, the results have provided some evidence of the usefulness of Se supplementation for people affected by arsenism.