The Relationship Between Exposure to Arsenic Concentrations in Drinking Water and the Development of Skin Lesions in Farmers from Inner Mongolia, China

Associations between the concentration of arsenic naturally occurring in drinking water and the development of skin lesions in people have been documented for some years at various locations around the world. Data on the exposure-response relationship between concentrations of arsenic in drinking water and prevalence of skin lesions in farmers from five locations in Inner Mongolia, China have been collected from the original publications and re-analysed together as a meta-study. The calculated data show a positive linear exposure-response relationship without a threshold. The reasons for this linear correlation are discussed and compared with the data from Xinjiang, another arsenism area located in a different geographical area of China. Here a different relationship was recorded that involved a threshold concentration before skin lesions developed. The significance of these two different exposure-response scenarios is discussed.     

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.     

Arsenism Clinical Stages and their Relation with Hair Arsenic Concentration of Residents of Bayinmaodao Rural District, Inner Mongolia, China

The clinical skin lesions of arsenism in men and women in Bayinmaodao rural district in Inner Mongolia, Peoples Republic of China, have been examined by doctors, and their hair and drinking water samples analysed for arsenic by hydride generation and ICP-AES. Altogether 311 arsenism patients with a 15.53% prevalence rate for the district were recorded. The disease prevalence rate was positively related to population, age, and their exposure to elevated arsenic concentrations in the drinking water from 1983 when new wells were dug and drinking of surface water was abandoned. Hyperkeratosis was the most serious skin lesion with the highest occurrence rate, then depigmentation and pigmentation in decreasing order. With increasing severity of the disease, ranging from skin lesion with single hyperkeratosis 1° to hyperkeratosis 3° with depigmentation 3° and pigmentation 3°, the results showed that arsenic concentrations in head hair had increased. Arsenic concentrations in hair were positively correlated with the arsenic concentrations in drinking water obtained from local wells.     

燃煤型砷中毒病区尿砷甲基化代谢和砷致皮肤损伤危险度的关系初探

砷中毒具有特异的皮肤损伤特征。为了研究燃煤型砷中毒病区高砷暴露、人体甲基化代谢能力与皮肤损伤患病风险之间的关系,在陕南典型燃煤型砷中毒村进行了皮肤损伤诊断和流行病学调查,采集尿样并分析总砷及形态砷含量,同时计算了用于表征人体砷甲基化代谢能力的指标包括尿中无机砷、一甲基砷和二甲基砷占总砷的百分含量(i As%、MMA%、DMA%),以及一甲基化率(PMI=MMA/i As)和二甲基化率(SMI=DMA/MMA)。Logistic回归分析结果表明:尿总砷含量(UTAs)是砷致皮肤损伤的危险因素(OR=1.038,95%CI:1.003~1.073),二甲基砷百分含量和SMI是皮肤损伤的保护因素(OR=0.883,95%CI:0.798~0.976;OR=0.724,95%CI:0.535~0.978);且砷致皮肤损伤的危险度随砷暴露水平的增高和甲基化能力的降低而增大。     

燃煤型砷中毒的最低有效累积暴露剂量初探

以陕南燃煤型砷中毒病区的5个自然村为调查采样点,通过现场流行病学调查和环境样品的分析测定,分析砷暴露人群的砷暴露途径,估算各暴露途径(呼吸、饮水和食物)的暴露剂量及对总暴露的贡献率,探讨引发燃煤型地方性砷中毒发病的最低有效暴露剂量。研究结果表明,除对照村外,采暖季各村的烤火间和卧室空气砷含量均有不同程度的超标,水和粮食未受燃煤砷污染。在采暖季,高砷煤燃烧污染的空气是人群砷暴露的主要来源;在非采暖季消化道砷暴露是各村的主要摄砷途径;表明消化道暴露对累积砷暴露的贡献不容忽视。结合问卷调查和流行病学调查结果,估算陕南病区引发燃煤型砷中毒的最低累积暴露剂量在1 712 mg左右。     

中国饮水型砷中毒区的水化学环境与砷中毒关系

中国各饮水型砷中毒区的水化学特点受沉积环境和气候因素所控制,砷中毒的流行和发病程度与其地下水的水化学环境、水中砷的形态和价态有密切联系。在实地考察监测和对台湾、新疆、内蒙古、山西、吉林饮水型砷中毒病区环境和地下水水化学特征总结的基础上,系统分析了饮水水源中总As、As(III)、甲基胂、腐植酸与砷中毒的关系,揭示了不同病区病情差异的原因。研究表明,除台湾外,各砷中毒区均分布在干旱半干旱区;各病区多分布在沉积盆地中心或平原内相对低洼的地带,饮用的地下水均取自中新生代地层;砷中毒病情不仅与总砷含量有明显的剂量-效应关系,还与As(III)和甲基胂的浓度直接相关。台湾、内蒙古和山西病区地下水为富含有机质的复杂还原环境,水中不仅As(III)含量高,且检出有机物、腐植酸和甲基胂,新疆和吉林病区地下水为以无机砷中As(V)为主的氧化环境,吉林病区未检测出甲基胂,这是新疆与吉林病区患病率较低的主要原因。研究成果可为区域防病改水、砷中毒的预报提供重要技术支撑。     

地方性砷中毒地区环境砷暴露健康风险研究进展

自然因素引起的环境高砷暴露及其健康效应,尤其是饮水型地方性砷中毒是砷污染健康风险评估的基础。总结地方性砷中毒在环境砷暴露的风险识别、暴露途径和暴露与健康效应关系研究中的作用基础上,指出了地方性砷中毒研究中仅强调了饮水污染,关注的暴露途径比较单一,因此,人体多途径联合砷暴露的健康风险评估过程存在较大的不确定性。我国是唯一存在饮水和燃煤2种自然环境高砷暴露的国家,是研究2种类型砷暴露异同的天然场地,然而目前环境高砷的暴露及其健康效应的研究均为独立研究,对燃煤型地方性砷中毒在呼吸链砷暴露风险评估中的作用重视不够。因此,通过开展两种环境砷暴露及其健康效应的综合比较研究,建立呼吸链暴露评估和暴露-健康效应模型,可以为人体多途径联合砷暴露的健康风险研究提供新的依据。     

硒酵母对地方性砷中毒病人排砷作用

观察了硒酵母治疗地方性砷中毒病人１４个月的排砷效果，结果显示，硒酵母治疗３个月后，治疗组发，血、尿砷的下降速度比对照组明显加快至１４个月，治疗组发、血尿砷分别下降７７．８％，８８．２％和７３．１％，与对照组相比，治疗组发砷和血砷的下降幅度明显增大。     

地方性砷中毒病区人发中微量元素的研究

通过对内蒙古临河市地方性砷中毒病区２７１个头发样品及环境样品测定结果表明：病区人群发中Ａｓ、Ｃｕ、Ｋ含量高于对照区,发Ｚｎ、Ｓｅ低于对照区。Ａｓ、Ｃｕ、Ｋ、Ｓｅ的变化与砷中毒的典型症状有一定相关性,发中Ｓｅ、Ｚｎ、Ｃｕ含量与发Ａｓ有等级相关（ｒ＝－０．９８８－０．７９４、０．７８３）。     

燃煤型砷中毒的最低有效累积暴露剂量初探

以陕南燃煤型砷中毒病区的5个自然村为调查采样点,通过现场流行病学调查和环境样品的分析测定,分析砷暴露人群的砷暴露途径,估算各暴露途径(呼吸、饮水和食物)的暴露剂量及对总暴露的贡献率,探讨引发燃煤型地方性砷中毒发病的最低有效暴露剂量。研究结果表明,除对照村外,采暖季各村的烤火间和卧室空气砷含量均有不同程度的超标,水和粮食未受燃煤砷污染。在采暖季,高砷煤燃烧污染的空气是人群砷暴露的主要来源;在非采暖季消化道砷暴露是各村的主要摄砷途径;提示消化道暴露对累积砷暴露的贡献不容忽视。结合问卷调查和流行病学调查结果,估算陕南病区引发燃煤型砷中毒的最低累积暴露剂量在1 712 mg左右。