Both acute and chronic health effects of inorganic arsenic (Asi) on human beings involve several organ systems. In recent decades, emerging epidemics of arseniasis resulting from environmental and occupational exposures have been reported in Asia. There are four sources of As exposure including well water, coal burning, mining and smelting, and geothermal drilling. The endemic areas of arseniasis through drinking high-As well water are located in Bangladesh, Xingjiang, Inner Mongolia and Shaanxi of China, West Bengal of India, and southwestern and northeastern Taiwan. The endemic area of coal burning-related arseniasis is located in Guizhou of China, while those of industrial arseniasis are located in Yunnan of China, Toroku, Matsuo and Nakajo of Japan, Mindanao of Phillipines, and Ronpibool of Thailand. Clinical manifestations of arseniasis include skin hyperpigmentation and depigmentation, palmoplantal hyperkeratosis, dermatitis, gastroenteritis, bronchitis, peripheral polyneuritis and polyneuropathy, hepatopathy, conjunctivitis, lens opacity, diabetes mellitus, mental retardation, ischemic heart disease, electrocardiographic abnormality, cerebrovascular accident, peripheral vascular disease and limb gangrene, microcirculation abnormality, hypertension, and cancers of the skin and various internal organs. The clinical manifestations vary with the source and duration of As exposure, while nutritional status and As methylation capability may be involved in the determination of individual susceptibility to arseniasis.
