燃煤性砷污染患者β2-MG检测及意义

我省部份地区煤砷污染严重 ,1993年周氏报道 ,含量在 10 0ｍｇ/ｋｇ[1] ,最高达 830 0ｍｇ/ｋｇ ,2 0 0 0年本省调查在病区煤砷含量平均为 397 2± 2 30 3(ｍｇ/ｋｇ) [2 ] 。煤通过燃烧污染空气和食物 ,从而引起燃煤性砷中毒。患者临床表现除皮肤特异性改变外 ,随着病情加重可出现肝、肾等重要脏器功能的严重损伤 ,甚至癌变。本文就部分砷中毒患者的血、尿 β2 —ＭＧ的检测结果进行分析 ,探讨其与砷中毒程度相关关系及损伤机理。1　对象与方法1 1　对象　本省地方性砷中毒 (以下简称地砷病 )高发区兴仁县交乐病区经临床确诊的燃煤性砷中…     

贵州省大面积实施地砷病综合防制干预健康教育效果分析

贵州省地砷病主要分布在兴仁县、兴义市、安龙县。现有病人乡镇数9个,行政村32个,直接暴露人口3.9554万人,8786户,地砷病患者2848人[1]。2005年贵州省利用2004年度中央财政专项资金在上述3县实施以健康教育为基础、禁止采用高砷煤和改良炉灶为主并辅以其他有效阻断砷污染的综合     

砷中毒的预防与治疗

1引起砷中毒的原因砷中毒是服用超标含砷的化合物所致。一段时间内饮用超标高砷水同样可以引起急性砷中毒。在我国存在砷中毒病区,其中包括饮水型（如新疆、内蒙、吉林、山西等省和自治区）、燃煤污染型（如贵州、陕西等省和自治区）和饮茶型砷中毒病区（如内蒙、西藏等省和自治区）,通过长期饮用含高浓度无机砷的水或燃用含高浓度无机砷的煤引起砷中毒。     

2013年吉林省饮水型地方性砷中毒监测情况分析

地方性砷中毒（简称地砷病）是严重危害群众身体健康的地方病,吉林省是地砷病病情较重的省份之一。随着近几年地方病防治项目的落实,地砷病病区和潜在病区实施了改水工程建设,越来越多的高深暴露人口能及时地停止饮用高砷水,群众饮用了符合国家标准的安全水。为动态监控改水工程落实的进度和质量,了解饮水型砷中毒病区潜在病区病情变化趋势,评价防治效果,科学、规范、有序地指导防治工作,按照《中央转移支付地方病防治项目方案》的要求,吉林省开展了监测工作。结果报告如下。     

贵州省燃煤污染型氟中毒重点病区流行因素变化研究

目的了解贵州省燃煤污染型氟中毒重点病区流行因素变化情况,为采取针对性的防治措施提供科学依据。方法以2000年全省流行病学调查结果为依据,分别在氟斑牙流行强度为较显著的病区（A类）和氟斑牙流行强度为中等的痛区（B类）,各抽取4个调查县。在A类病区调查县,每县抽取3个氟斑牙流行强度为较显著的病区乡,在B类病区调查县,每县抽取3个氟斑牙流行强度为中等的病区乡。在每个调查乡随机抽取3个病区村,每村随机抽取30户,入户回顾性调查上世纪50-90年代病区家庭地氟病流行因素,现况调查2007年病区家庭相同的地氟病流行因素。调查内容包括燃煤情况、燃煤方式、房屋结构、主食构成、食物干燥储存方法、食物加工前淘洗习惯。结果原煤仍然是病区的主要生活能源;敞灶燃煤率、玉米食用比例、玉米和辣椒的敞煤火干燥储存率、草房拥有率与时间呈反比,铁炉拥有率、铁炉烟囱出屋率、大米食用比例、砖混房拥有率、居厨分开率、玉米和辣椒加工前淘洗率与时间呈正比。结论通过多年的综合治理,导致燃煤型地氟痛发生的因素逐渐减弱,预防控制地氟病流行的相关措施和健康行为得到逐步落实和建立,但由于经济社会文化发展的不平衡及地理环境条件的差异,A类病区的变化滞后于B类病区。     

砷对机体抗氧化能力的影响及硒多糖的拮抗作用

地方性砷中毒 (简称地砷病 )是一种严重危害人体健康的地方病。山西是我国继新疆、内蒙之后发现的第 3个饮水型地砷病病区。 1994年在大同地区 5个县共查出病人 3 0 0 0余例 ,病区人口达 10 0多万人。目前有关砷中毒的毒作用机制还未有定论 ,其中的脂质过氧化学说近年来受到了一定关注。本研究对染砷大鼠和砷中毒病区人群的抗氧化能力进行测定 ,以探讨抗氧化作用在砷中毒发病中的意义 ;同时对硒多糖的拮抗效果进行了观察 ,为进一步探讨砷中毒的防治提供依据。1　材料与方法1 1　动物分组及染毒　选用山西医科大学动物中心提供的健康Ｗｉｓｔ…     

吉林省砷中毒病区高砷区改水降砷现况调查

1项目来源中国疾病预防控制中心地方病控制中心下发《关于开展全国砷中毒病区和高砷区改水降砷现况调查的通知》(中疾控地病发[2011]8号)。在全国开展地方性砷中毒病区和高砷区改水降砷防治措施落实现况调查,以便为国家制订地方     

煤烟污染型砷氟联合中毒

1987年作者发现,贵州省织金县坝子上村民组流行有一种以皮肤色素异常、皮肤过度角化、牙齿损害和骨关节功能障碍等为主要表现的疾病。1964年有关部门调查认为是烧某高砷煤引起的慢性砷中毒,但及时停用该煤后,病区的病情仍在不断加重和发展。为此作者于1988年再次对该村进行了流行病学调查。现将结果报告如下。基本情况调查点为织金县坝子上村民组,距县城50余公里,海拔810米,40户190人。对照点为织金县兴寨村,距县城7公里,海拔1100米,271户979人。两地均以煤为燃料,有敞灶烘烤大米、玉米、辣椒和取暖的习惯。1964年2月至1965年2月调查点曾烧过附近的北坡煤,在此前后均烧鼠场煤;对照点烧兴寨煤。两地附近无厂矿,也未用过含砷农药。     

燃煤型砷中毒流行因素的多变量分析

目的 探讨燃煤型砷中毒流行因素的作用。方法 用单因素及多因素非条件Ｌｏｇｉｓｔｉｃ回归模型对１５１例砷中毒患者和６９例对照的暴露因素进行了分析。结果 发现危险因素按作用大小依次是燃用高砷煤的年限,居室通风情况差,发砷及尿总砷负荷高,吸烟,氟中毒（ＯＲ〉１,Ｐ〈０．０５）;影响因素有文化程度和家庭经济状况（ＯＲ〈１,Ｐ〈０．０５）。结论 提示应采取综合措施来预防燃煤型砷中毒。     

2014年朔州市饮水型地方性砷中毒监测结果报告

<正>饮水型地方性砷中毒是由于长期饮用高砷水所致的是一种地方病,主要引起皮肤色素沉着、脱失、皮肤角化等皮肤改变,并且可引起远期危害,如内脏癌、心血管疾病等[1]。我市属饮水型地方性砷中毒重病区,通过多年的防治,特别是随着我国农村饮水安全工程规划的全面实施,病区防治措施已基本得到落实。为动态监控改水工程落实的进度和质量,了解饮水型砷中毒病区的病情变化趋势,评价防控措施效果,科学、规范、有序地指导防治工     

Urinary porphyrins as biomarkers for arsenic exposure among susceptible populations in Guizhou province, China

Coal is widely used in PR China. Unfortunately, coal from some areas in Guizhou Province contains elevated levels of arsenic. This has caused arsenicosis in individuals who use arsenic-contaminated coal for the purposes of heating, cooking and drying of food in poorly ventilated dwellings. The population at risk has been estimated to be approximately 200,000 people. Clinical symptoms of arsenicosis may include changes of skin pigmentation, hyperkeratosis of hand and feet, skin cancers, liver damage, persistent cough and chronic bronchitis. We analyzed the porphyrin excretion profile using a HPLC method in urine samples collected from 113 villagers who lived in Xing Ren district, a coal-borne arsenicosis endemic area and from 30 villagers from Xing Yi where arsenicosis is not prevalent. Urinary porphyrins were higher in the arsenic exposed group than those in the control group. The correlation between urinary arsenic and porphyrin concentrations demonstrated the effect of arsenic on heme biosynthesis resulting in increased porphyrin excretion. Both uroporphyrin and coproporphyrin III showed significant increases in the excretion profile of the younger age (<20 years) arsenic-exposed group, suggesting that porphyrins could be used as early warning biomarkers of chronic arsenic exposure in humans. Greater increases of urinary arsenic and porphyrins in women, children and older age groups who spend much of their time indoors suggest that they might be at a higher risk. Whether elevated porphyrins could predict adverse health effects associated with both cancer and non-cancer end-points in chronically arsenic-exposed populations need further investigation.     

Effect of environmental exposure of arsenic on cattle and poultry in nadia district, west bengal, India

A study was undertaken to evaluate an alternative source of arsenicosis in human food chain through livestock. Thirty milch cattle and 20 poultry birds along with their eggs were selected randomly from two endemic villages of Nadia district and one nonendemic villages of Hooghly district in West Bengal, India. Milk, feces, urine, and hair samples of cattle and feed materials, such as water and straw, were collected to analyze arsenic status. Arsenic concentration in egg yolk and albumen from poultry eggs and different poultry organs after culling was estimated. Distribution of arsenic in animal body indicates that major portion of arsenic was eliminated through feces, urine, and milk. Poultry egg yolk, albumen, and poultry products retain arsenic in all organs. Cows and poultry birds reared in endemic zone retain significantly higher concentration of arsenic. Consumption of egg, agricultural produces grown in contaminated soil, and milk might have produced arsenicosis and may be considered as alternative source of arsenic contamination.     

Changes in serum thioredoxin among individuals chronically exposed to arsenic in drinking water

It is well known that oxidative damage plays a key role in the development of chronic arsenicosis. There is a complex set of mechanisms of redox cycling in vivo to protect cells from the damage. In this study, we examined the differences in the levels of serum thioredoxin1 (TRX1) among individuals exposed to different levels of arsenic in drinking water and detected early biomarkers of arsenic poisoning before the appearance of skin lesions. A total of 157 subjects from endemic regions of China were selected and divided into arsenicosis group with skin lesions (total intake of arsenic: 8.68-45.71 mg-year) and non-arsenicosis group without skin lesions, which further divided into low (0.00-1.06 mg-year), medium (1.37-3.55 mg-year), and high (4.26-48.13 mg-year) arsenic exposure groups. Concentrations of serum TRX1 were analyzed by an ELISA method. Levels of water arsenic and urinary speciated arsenics, including inorganic arsenic (iAs), monomethylated arsenic (MMA), and dimethylated arsenic (DMA), were determined by hydride generation atomic absorption spectrometry. Our results showed that the levels of serum TRX1 in arsenicosis patients were significantly higher than that of the subjects who were chronically exposed to arsenic, but without skin lesions. A positive correlation was seen between the levels of serum TRX1 and the total water arsenic intake or the levels of urinary arsenic species. The results of this study indicate that arsenic exposure could significantly change the levels of human serum TRX1, which can be detected before arsenic-specific dermatological symptoms occur. This study provides further evidence on revealing the mechanism of arsenic toxicity.     

Arsenic contamination and arsenicosis in China

Arsenicosis is a serious environmental chemical disease in China mainly caused by drinking water from pump wells contaminated by high levels of arsenic. Chronic exposure of humans to high concentrations of arsenic in drinking water is associated with skin lesions, peripheral vascular disease, hypertension, blackfoot disease, and high risk of cancers. Lead by the Ministry of Health of China, we carried out a research about arsenicosis in China recently. Areas contaminated with arsenic from drinking water are determined by 10% pump well water sample method while areas from burning coal are determined by existing data. Two epidemic areas of Shanxi Province and Inner Mongolia are investigated for the distribution of pump wells containing high arsenic. Well water in all the investigated villages of Shanxi Province showed polluted by high arsenic, and the average rate of unsafe pump well water is 52%. In Inner Mongolia, the high percentage of pump wells containing elevated arsenic is found only in a few villages. The average rate of unsafe pump well water is 11%. From our research, we find that new endemic areas are continuously emerging in China. Up to now, epidemic areas of arsenicosis mainly involve eight provinces and 37 counties in China. In the affected areas, the discovery of wells and coal with high levels of arsenic is continuing sporadically, and a similar scattered distribution pattern of patients is also being observed.     

DNA hypermethylation of promoter of gene p53 and p16 in arsenic-exposed people with and without malignancy.

Chronic arsenic exposure is known to produce arsenicosis and cancer. To ascertain whether perturbation of methylation plays a role in such carcinogenesis, the degree of methylation of p53 and p16 gene in DNA obtained from blood samples of people chronically exposed to arsenic and skin cancer subjects was studied. Methylation-specific restriction endonuclease digestion followed by polymerase chain reaction (PCR) of gene p53 and bisulfite treatment followed by methylation-sensitive PCR of gene p16 have been carried out to analyze the methylation status of the samples studied. Significant DNA hypermethylation of promoter region of p53 gene was observed in DNA of arsenic-exposed people compared to control subjects. This hypermethylation showed a dose-response relationship. Further, hypermethylation of p53 gene was also observed in arsenic-induced skin cancer patients compared to subjects having skin cancer unrelated to arsenic, though not at significant level. However, a small subgroup of cases showed hypomethylation with high arsenic exposure. Significant hypermethylation of gene p16 was also observed in cases of arsenicosis exposed to high level of arsenic. In man, arsenic has the ability to alter DNA methylation patterns in gene p53 and p16, which are important in carcinogenesis.     

Structure-function alteration of hemoglobin in arsenicosis patients: a probable pathway to exert toxicity

Chronic arsenicosis, a major public health concern in India and Bangladesh, is mainly caused by ingestion of arsenic (As) contaminated ground water. Although this problem has been studied extensively, the mechanism of toxicity remains unknown. This paper investigates the process of trivalent arsenicals binding to hemoglobin (Hb) in chronic arsenicosis patients and consequent modification in the structure–function activity of Hb. In this work peroxidase activity, thermal denaturation profile, oxygen releasing capacity and hydrodynamic diameter have been evaluated for the Hb collected from subjects suffering with chronic arsenicosis. Increased peroxidative activity suggests altered oxidative status of Hb in the diseased state. The thermal denaturation profile indicates the Hb molecule to be more susceptible to unfolding in the pathologic state. The enhanced oxygen releasing capacity and significant reduction in hydrodynamic diameter of Hb is also observed in the diseased condition, suggesting conformational alterations in the Hb molecule. Finally, trivalent arsenic is found to bind with freshly isolated Hb from arsenicosis patients, binding affinity constant being 0.256 μM^?1. The binding is positively cooperative with a Hill coefficient of +2.961 and isosbestic points at specific wavelengths. Thus, our work explores the structure–function property of Hb in chronic arsenicosis subjects and reveals that the molecule is modified in such a way that comparatively weak binding with oxygen and strong binding with arsenic occur simultaneously. This association may play a crucial role in exerting the pathway for arsenic toxicity. Copyright © 2011 John Wiley & Sons, Ltd.     

Randomized placebo-controlled trial of 2,3-dimercapto-1-propanesulfonate (DMPS) in therapy of chronic arsenicosis due to drinking arsenic-contaminated water.

BACKGROUND: Chronic arsenic toxicity, producing various clinical manifestations, is currently epidemic in West Bengal, India, Bangladesh, and other regions of the world. 2,3-Dimercapto-1-propanesulfonate, a chelating agent, increases excretion of arsenic in urine to several times the prechelation concentration but the therapeutic efficacy of 2,3-dimercapto-1-propanesulfonate in the management of chronic arsenic toxicity has been incompletely evaluated. We investigated the clinical use of 2,3-dmercapto-1-propanesulfonate in such patients. METHODS: Twenty-one consecutive patients with chronic arsenicosis were individually randomized into 2 groups: 11 patients (9 males and 2 females, age 30.63+/-11.4 years) received 2,3-dimercapto-1-propanesulfonate 100-mg capsules 4 times a day for 1 week and repeated in the 3rd, 5th, and 7th week with no drug during the intervening period. The other 10 patients (5 males and 5 females, age 34.4+/-14.41 years) were given placebo capsules (resembling 2,3-dimercapto-1-propanesulfonate) in the same schedule. The consumption of arsenic-contaminated water was terminated by all 21 subjects. Initial and posttreatment urinary arsenic excretion was determined in all cases. Sequential excretion of urinary arsenic was determined during the treatment of 2 drug- and 1 placebo-treated cases. The clinical features were evaluated by an objective scoring system before and after treatment. Routine investigation including liver function test and skin biopsy were also done before and after the treatment. Drug-associated toxicity was tabulated. RESULTS: Therapy with 2,3-dimercapto-1-propanesulfonate caused significant improvement in the clinical condition of chronic arsenicosis patients as evidenced by significant reduction of total clinical scores from 8.90+/-2.84 to 3.27+/-1.73; p < 0.0001. Exposure cessation alone with placebo treatment also reduced clinical scores (8.50+/-1.96 to 5.40+/-2.12; p < 0.003), but the posttreatment total clinical score of 2,3-dimercapto-1-propanesulfonate-treated patients (3.27+/-1.73) was significantly lower than that of placebo-treated patients (5.40+/-2.12; p < 0.01). The most significant improvement was noted in regard to the clinical scores of weakness, pigmentation, and lung disease. No difference was noted between groups in the hematological and biochemical parameters (which were normal) and skin histology before and after treatment. No 2,3-dimercapto-1-propanesulfonate-related adverse effects were noted. Total urinary excretion of arsenic in 2,3-dimercapto-1-propanesulfonate-treated cases increased significantly following drug therapy, with no increase in placebo-treated cases. CONCLUSION: 2,3-Dimercapto-1-propanesulfonate treatment caused significant improvement in the clinical score of patients suffering from chronic arsenic toxicity. Increased urinary excretion of arsenic during the period of therapy is the possible cause of this improvement.     

An overview on chronic arsenism via drinking water in PR China

Chronic endemic arsenism via drinking water was first found in Taiwan in 1968, and reported in Xinjiang Province in mainland China in the 1980s. Arsenism has become one of the most serious endemic diseases in China in the last two decades. Up to now, the disease has been found in Inner Mongolia, Shanxi, Ningxia, Jilin and Qinghai provinces. According to the Chinese maximum limit standard of arsenic (As) in drinking water, over 2 millions people have been exposed to high arsenic and about 10,000 persons were diagnosed as arsenism patients. There are different As concentrations in the water of different sites, even in the same area. Most of the As concentrations range from 0.05 to 2.0mg/l. The incidence of arsenism increases as As concentrations in drinking water and the drinking time increase. The age distribution of patients with arsenism ranged from 3 to 80 years old with peak prevalence in adults. A dose-effect relationship between the status of arsenism and arsenic level and drinking time has been shown. New high-arsenic areas in China have been discovered during recent investigations. In order to reduce the adverse health effects of arsenism, the central and local governments of China have provided significant funds to change water levels of As and at the same time take general measures to "reduce arsenic intake, remove arsenic from the body and treat the patients". After the implementation of these control measures in certain regions, the clinical symptoms and signs of 30% of the patients were improved. There was no change in 52% of patients and only 18% of patients got worse. It is suggested that future work in the research and control of arsenism in China should include: (1) identify all the high arsenic areas in China, (2) study the association of arsenism with fluorosis, (3) determine individual susceptibility, (4) select biomarkers for diagnosis in the early stage of a arsenism, and (5) investigate the molecular mechanisms of carcinogenesis.     

Toxicology and Genetic Susceptibility of Drugs and Pollutant

S21Possibleinvolvementofhereditaryfactors intheriskmodulationofarseniasisintwoethnic clansexposedtoindoorcombustionofhigharse niccoal LINGuo Fang1,DUHui2,CHENJi Gang3,LU Hong Chao2,GUOWei Chao1,ZHANGXin Jiang4,SHENJian Hua1(1.ShanghaiInstituteforBiologicalSciences,Institute ofPlantPhysiologyandEcology,ChineseAcademyof Sciences,Shanghai200032,China;2.Prefecture CenterforDiseasePreventionandControl,Guiyang562400,China;3.MunicipalCenterforDiseasePre ventionandControl,Shang…     

Chronic arsenicosis in goats with special reference to its exposure, excretion and deposition in an arsenic contaminated zone

Thirty goats were selected randomly from a village of Nadia district, West Bengal according to the previous reports of human being suffering from chronic arsenicosis. Environmental samples viz. drinking water, rice plants and grass used for goat and biological samples viz. blood, urine, faeces, hair and meat were collected to evaluate the arsenic status. It was found that arsenic concentration in both environmental and biological samples was significantly (p<0.01) higher rather than respective samples on control zone. Bio-concentration factor (BCF) and bio-transfer factor (BTF) are indicated to evaluate the subclinical toxicity in goat as they do not exhibit clinical manifestation like human beings.