The Relationship Between Arsenic Exposure And Skin Lesions In Endemic Arsenicosis Area Of Shanxi Province, China

Objective: To investigate the level of arsenic in environmental media and foodstuffs including vegetables in water-born endemic arsenism area of Shanyin county,Shanxi province. The intake of inorganic arsenic through drinking water and diets ofpeople in this area is calculated to assess the risk of arsenic on people healthy andinvestigate the relationship between arsenic in drinking water and skin lesions. And wepreliminarily studied the relationship between MPO (-463G/A) and skin lesions ofarsenic poisoning.Methods: According to Diagnosis Standard for Endemic Arsenism(WS/T211-2001), and the investigate results of investigations in2006,2008and in2010of our study group, totally277people from17counties in this area were choosen forsurvey. The content of arsenic in drinking water, glutinous broom corn and foxtail milletwere quantitatively determined by ICP-MS. The level of arsenic in soil and potato weremeasured by Atomic Fluorescence Spectrometer (AFS).93people from47family werechoosen according to arsenic level (≤10μg/L,10～50μg/L,50～200μg/L,>200μg/L).Their oral mucosa were Collected, polymerase chain reaction-restriction feagmentlength polymorphism technique was used to detect polymorphism ofMPO-463G/A.Investigated and tested results were input into Excel and analyzed withSpss.Results:1. The level of environment media: In this study,140water samples werecollected.Arsenic concentration in drinking water was1.19-720μg/L, the median valuewas74.56μg/L, and the ratio of As level higher than the chinese standards for drinkingwater (50μg/L) was70%(98/140). The level of arsenic in food stuffs were0.03-4.58mg/kg, the median value of arsenic was0.78mg/kg, and there were96.05%(73/76) of arsenic exceeded0.2mg/kg. Arsenic concentration in soil and vegetable was3.99-15.61mg/kg and0-0.5mg/kg, respectively. The median water arsenic concentration86.57μg/L in arsenism patient, the median7.1μg/L in non-arsenic poisoning, there wassignificant differences in water arsenic concentration between arsenism patient and non-arsenic poisoning (P<0.05). Arsenic concentration in food of arsenism patient andnon-arsenic poisoning，the difference was not statistically significant（P>0.05）.2. Estimate inorganic arsenic exposure in the environmental media：Predictedinorganic arsenic intake from food and vegetable is modeled with the equivalent intakefrom drinking water for a typical Chinese diet. The water and grain arsenic level of74.56μg/L and0.78mg/kg would equate to118.35%and73%of the MTDI.Dailyconsumption of grain with a total arsenic level of0.17mg/kg would be equivalent to adrinking water arsenic level of10μg/L.3. The relationship between arsenic in drinking water and skin lesions The waterAs concentrations was divided into three groups,≤10μg/L,10～50μg/L and>50μg/L, ascompared with arsenic level (≤10μg/L) in drinking water, the OR values forhyperkeratosis,hyerpigmentation, hypopigmention,total skin lesions was1.07，2.83；1.22，2.07；1.26，4.55；2.37，16.61；respectively. Further,Spearman correlation testshowed that the severity of skin lesions was associated with the increasing of As contentin water.4. The relationship between myeloperoxidase genetic polymorphiism with arsenicpoisoning The genotype frequency of MPO-463G/A at GG,GA site was66.6(32/48),33.33(16/48) in case group and5.78(26/45),42.22(19/45) in contralgroup,respectively.The difference between the two groups was not significant（χ2=0.782，P>0.05）. The relationship between polymorphism of MPO-463G/A andthe risk of arsenic poisoning was not find in this study（ORadj=1.539，95%CI：0.648-3.655).The result on adjusted risk estimates for joint effect of arsenic exposureand susceptible genotypes，subjects exposed to high levels of arsenic （> the mediancut-off118.52μg/L）and carrying the MPO genotype，the joint effects of arsenicexposure and susceptible genotypes correlation was statistically significant.Conclusion：（1）. As levels in drinking water and foodstuffs were both high inwater-born endemic arsenism area of Shanxi province.The low level of arsenic invegetable and soil was detected.（2）. Inorganic arsenic exposure to the residents washigh in this district.The As concentrations in foods could not be ignored,especially inLow levels of arsenic(≤50μg/L).（3）. Arsenic in drinking water has been considered asa risk factor of arsenic poisoning.The degree of skin lessions increased,as the arsenic in drinking water increased（.4）. Genetic polymorphism of MPO-463G/A was not found tohave relationship with arsenic poisoning.