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. 1999 Apr;56(4):277–281. doi: 10.1136/oem.56.4.277

Relations between exposure to arsenic, skin lesions, and glucosuria

M Rahman, M Tondel, I A Chowdhury, O Axelson
PMCID: PMC1757723  PMID: 10450246

Abstract

OBJECTIVES: Exposure to arsenic causes keratosis, hyperpigmentation, and hypopigmentation and seemingly also diabetes mellitus, at least in subjects with skin lesions. Here we evaluate the relations of arsenical skin lesions and glucosuria as a proxy for diabetes mellitus. METHODS: Through existing measurements of arsenic in drinking water in Bangladesh, wells with and without arsenic contamination were identified. Based on a questionnaire, 1595 subjects > or = 30 years of age were interviewed; 1481 had a history of drinking water contaminated with arsenic whereas 114 had not. Time weighted mean arsenic concentrations and mg-years/l of exposure to arsenic were estimated based on the history of consumption of well water and current arsenic concentrations. Urine samples from the study subjects were tested by means of a glucometric strip. People with positive tests were considered to be cases of glucosuria. RESULTS: A total of 430 (29%) of the exposed people were found to have skin lesions. Corresponding to drinking water with < 0.5, 0.5-1.0, and > 1.0 mg/l of arsenic, and with the 114 unexposed subjects as the reference, the prevalence ratios for glucosuria, as adjusted for age and sex, were 0.8, 1.4, and 1.4 for those without skin lesions, and 1.1, 2.2, and 2.6 for those with skin lesions. Taking exposure as < 1.0, 1.0-5.0, > 5.0-10.0 and > 10.0 mg- years/l of exposure to arsenic the prevalence ratios, similarly adjusted, were 0.4, 0.9, 1.2, and 1.7 for those without and 0.8, 1.7, 2.1, and 2.9 for those with skin lesions. All series of risk estimates were significant for trend, (p < 0.01). CONCLUSIONS: The results suggest that skin lesions and diabetes mellitus, as here indicated by glucosuria, are largely independent effects of exposure to arsenic although glucosuria had some tendency to be associated with skin lesions. Importantly, however, glucosuria (diabetes mellitus) may occur independently of skin lesions.

 

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Selected References

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  1. Bagla P., Kaiser J. India's spreading health crisis draws global arsenic experts. Science. 1996 Oct 11;274(5285):174–175. doi: 10.1126/science.274.5285.174. [DOI] [PubMed] [Google Scholar]
  2. Boquist L., Boquist S., Ericsson I. Structural beta-cell changes and transient hyperglycemia in mice treated with compounds inducing inhibited citric acid cycle enzyme activity. Diabetes. 1988 Jan;37(1):89–98. doi: 10.2337/diab.37.1.89. [DOI] [PubMed] [Google Scholar]
  3. Borgoño J. M., Vicent P., Venturino H., Infante A. Arsenic in the drinking water of the city of Antofagasta: epidemiological and clinical study before and after the installation of a treatment plant. Environ Health Perspect. 1977 Aug;19:103–105. doi: 10.1289/ehp.19-1637404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Foy H. M., Tarmapai S., Eamchan P., Metdilogkul O. Chronic arsenic poisoning from well water in a mining area in Thailand. Asia Pac J Public Health. 1992;6(3):150–152. doi: 10.1177/101053959200600306. [DOI] [PubMed] [Google Scholar]
  5. Gerhardt R. E., Hudson J. B., Rao R. N., Sobel R. E. Chronic renal insufficiency from cortical necrosis induced by arsenic poisoning. Arch Intern Med. 1978 Aug;138(8):1267–1269. [PubMed] [Google Scholar]
  6. Guha Mazumder D. N., Chakraborty A. K., Ghose A., Gupta J. D., Chakraborty D. P., Dey S. B., Chattopadhyay N. Chronic arsenic toxicity from drinking tubewell water in rural West Bengal. Bull World Health Organ. 1988;66(4):499–506. [PMC free article] [PubMed] [Google Scholar]
  7. Harrington J. M., Middaugh J. P., Morse D. L., Housworth J. A survey of a population exposed to high concentrations of arsenic in well water in Fairbanks, Alaska. Am J Epidemiol. 1978 Nov;108(5):377–385. doi: 10.1093/oxfordjournals.aje.a112635. [DOI] [PubMed] [Google Scholar]
  8. Kawaguchi I. [Studies on As2O3-induced hyperglycemia (author's transl)]. Nihon Yakurigaku Zasshi. 1981 Sep;78(3):213–222. [PubMed] [Google Scholar]
  9. Lai M. S., Hsueh Y. M., Chen C. J., Shyu M. P., Chen S. Y., Kuo T. L., Wu M. M., Tai T. Y. Ingested inorganic arsenic and prevalence of diabetes mellitus. Am J Epidemiol. 1994 Mar 1;139(5):484–492. doi: 10.1093/oxfordjournals.aje.a117031. [DOI] [PubMed] [Google Scholar]
  10. Mazumder D. N., Das Gupta J., Chakraborty A. K., Chatterjee A., Das D., Chakraborti D. Environmental pollution and chronic arsenicosis in south Calcutta. Bull World Health Organ. 1992;70(4):481–485. [PMC free article] [PubMed] [Google Scholar]
  11. Rahman M., Axelson O. Diabetes mellitus and arsenic exposure: a second look at case-control data from a Swedish copper smelter. Occup Environ Med. 1995 Nov;52(11):773–774. doi: 10.1136/oem.52.11.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rahman M., Tondel M., Ahmad S. A., Axelson O. Diabetes mellitus associated with arsenic exposure in Bangladesh. Am J Epidemiol. 1998 Jul 15;148(2):198–203. doi: 10.1093/oxfordjournals.aje.a009624. [DOI] [PubMed] [Google Scholar]
  13. Rahman M., Wingren G., Axelson O. Diabetes mellitus among Swedish art glass workers--an effect of arsenic exposure? Scand J Work Environ Health. 1996 Apr;22(2):146–149. doi: 10.5271/sjweh.123. [DOI] [PubMed] [Google Scholar]
  14. Ross R. The pathogenesis of atherosclerosis--an update. N Engl J Med. 1986 Feb 20;314(8):488–500. doi: 10.1056/NEJM198602203140806. [DOI] [PubMed] [Google Scholar]
  15. Tseng W. P., Chu H. M., How S. W., Fong J. M., Lin C. S., Yeh S. Prevalence of skin cancer in an endemic area of chronic arsenicism in Taiwan. J Natl Cancer Inst. 1968 Mar;40(3):453–463. [PubMed] [Google Scholar]
  16. Tseng W. P. Effects and dose--response relationships of skin cancer and blackfoot disease with arsenic. Environ Health Perspect. 1977 Aug;19:109–119. doi: 10.1289/ehp.7719109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Yeh S. Skin cancer in chronic arsenicism. Hum Pathol. 1973 Dec;4(4):469–485. doi: 10.1016/s0046-8177(73)80060-7. [DOI] [PubMed] [Google Scholar]
  18. Zaldívar R. Arsenic contamination of drinking water and foodstuffs causing endemic chronic poisoning. Beitr Pathol. 1974 Apr;151(4):384–400. doi: 10.1016/s0005-8165(74)80047-8. [DOI] [PubMed] [Google Scholar]

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