Arsenic poisoning is a global health issue affecting millions of people worldwide through environmental and occupational exposure, as well as intentional suicide and homicide attempts. This recommendation is based on several reports of worker exposure to arsine resulting in severe toxic effects or death. The aluminum ladder reacted with the sodium arsenite, liberating arsine. Overview and Key Difference 2. Arsine, the most toxic form of arsenic, is often produced from the reduction of inorganic arsenic salts with the use of acids and metal cofactors such as zinc. Conrad, M.E., R.M. Inorganic arsenic exposure of humans, by the inhalation route, has been shown to be strongly associated with lung cancer, while ingestion of inorganic arsenic by humans has been linked to a form of skin cancer and also to bladder, liver, and lung cancer. Hydrogen arsenide. Anthony Robbins, M.D. Although arsenic homicides commonly receive media publicity, the primary source of arsenic toxicity to the general population is by contaminated water, soil and food products. Subsequently, arsine was generated by a reaction between the acid cleaner and the aluminum which had arsenic impurities. Director, Current Intelligence Bulletin 32: Arsine (Arsenic Hydride) Poisining in the Workplace pdf icon[PDF – 699 KB], Centers for Disease Control and Prevention. [Arsenic poisoning]. The toxicity of arsine for mice was found to reach, under certain conditions, a surprisingly high figure compared with that of arsenites, the mosttoxic arsenic-containing compoundslikely to be formedin the reaction with the erythrocytes. DePalma, A.E. -, Yunus FM, Khan S, Chowdhury P, Milton AH, Hussain S, Rahman M. A Review of Groundwater Arsenic Contamination in Bangladesh: The Millennium Development Goal Era and Beyond. Elkins, H.B., and J.P. Fahy: Arsine Poisoning from Aluminum Tank Cleaning. Epub 2014 Sep 11. 2007 May;23(4):183-208. doi: 10.1177/0748233707076810. Dermatitis may be observed after chronic ingestion but the typical signs include increased pigmentation, and thickening of the skin on the palms and soles of the feet. As a result of inorganic arsenic's direct toxicity to the epithelial cells of the gastrointestinal tract and its systemic enzyme inhibition, profound gastroenteritis, sometimes with hemorrhage, can occur within minutes to hours after ingestion. However, in relation to the degree of blood destruction, the degree of known disability experienced by the victims of chronic arsine poisoning was less than expected.8, Chronic Arsenic Toxicity – Since inorganic arsenic is needed to generate arsine, prolonged exposures to low levels of arsine are likely to occur under conditions where workers are also exposed to inorganic arsenic. Arsenic toxicity is a global health problem affecting many millions of people. A detailed history to determine the exposure includes the following: 1. Arsine (arsenic hydride) poisoning in the workplace. 1979 Oct;40(10):A56-61. Skin cancer has long been considered a consequence of arsenic exposure, however multiple cancers of the internal organs have also been reported.3. Arsine may be accidentally formed by the reaction of arsenic impurities in commercial acids stored in metal tanks, so that a test should be made for arsine before entry is made into such vessels. Invariably, there was an acid medium where metal was present (e.g., dross residues galvanized implements, aluminum tanks or implements) thereby creating the key ingredients necessary for arsine formation. TABLE 3. -, Carlin DJ, Naujokas MF, Bradham KD, Cowden J, Heacock M, Henry HF, Lee JS, Thomas DJ, Thompson C, Tokar EJ, Waalkes MP, Birnbaum LS, Suk WA. A worker was poisoned during reclamation of metal from flue dust obtained from blast furnaces. Arsine is a gas consisting of arsenic and hydrogen. Thirteen workers were poisoned (3 died) during the purification of lead alloys. Two years before, arsenic had been used in the vat as an insecticide. J Prev Med Public Health. J. Pharmacol. Lead alloys in car batteries contain antimony as a hardener, with arsenic and silver added to inhibit corrosion. Arsine formation and industrial exposure depends on the occurrence and distribution of inorganic arsenic compounds and processes that can promote the conversion of inorganic arsenic (7440382)) compounds to arsine. HHS ... Arsenic (As) toxicity is a global phenomenon, and it is continuously threatening human life. Registered trademark information is not included in these files. Ley: Arsine Poisoning. Parish, G.G., R. Glass, and R. Kimbrough: Acute Arsine Poisoning in Two Workers Cleaning a Clogged Drain. Cone: Arsine, Stibine and Hydrogen Sulfide. The mechanism of arsine (AsH 3) toxicity is not completely understood, but hemoglobin (Hb) has long been recognized as a necessary component of the overall mechanism of AsH 3-induced hemolysis.In this study, the role of Hb in AsH 3-induced hemolysis was investigated.The purpose was to determine whether exposure to AsH 3 altered the structure of the heme or globin … Rev Environ Contam Toxicol. Initial symptoms of arsine poisoning are headache, malaise, weakness, dizziness difficult breathing, abdominal pain, nausea, and vomiting, which are usually first noticed 2 to 24 hours after exposure. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Whenever the possibility exists for either gas being generated, such as when working with metals (crude, drosses, or implements made of metal) care should be taken to assure that arsenic and antimony do not react with any sources of fresh hydrogen. Probably because of this instability fewer cases of stibine poisoning have been reported.22 Stibine can evolve when certain alloys containing antimony (Sb) are treated with acid and subjected to electrolytic action, when certain antimony compounds are treated with steam, or whenever nascent hydrogen comes in contact with metallic antimony or with a soluble antimony compound. Indian J Dermatol Venereol Leprol. Arsine was generated by reducing arsenic trioxide with NaBH₄. Het is een hemolytisch gif dat onder andere de rode bloedcellen aantast. The exposed victims experienced shortness of breath on exertion, and a general feeling of weakness. In industrial settings arsine poisoning generally results from the accidental formation of arsine gas. Abstract. Arsine is similar to a gas called stibine, which is formed when the metal antimony comes in contact with an acid. [emergency.cdc.gov] Three months later he again had aplastic anemia, and the urine once more contained considerable amounts of arsenic. Arsenic as a solute is nearly tasteless and can present in contaminated drinking water; it is also documented as a method of intentional homicide and suicide. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Arsine fumes were generated by moisture reacting with aluminum arsenide in metal dross. From 1928 to 1974 an additional 207 cases were reported, of which 51 (25%) were fatal.1, Acute Arsine Toxicity – Arsine is the most acutely toxic form of arsenic and one of the major industrial causes of sudden extensive hemolysis (destruction of red blood cells). Smalley, P.N. However, arsenic is a widespread element, and therefore unidentified exposures can occur in unsuspected work situations. This flammable, pyrophoric, and highly toxic pnictogen hydride gas is one of the simplest compounds of arsenic. Ind, G. Kazantzis, and R. Owens: Arsine Poisoning: Massive Hemolysis with Minimal Impairment of Renal Function. Health effects of chronic arsenic exposure. Arsine: Human health aspects. The main route of exposure is by inhalation, although poisoning after skin contact has also been described. Rothwell, S.S. Polack, and D.W. Stewart: Chronic Arsine Poisoning Among Workers Employed in the Cyanide Extraction of Gold: A Report of Fourteen Cases. Decreased numbers of red and white blood were reported in cases of chronic intoxication but these changes also regressed after arsenic ingestion ended. The Mean Lethal Dose (MLD) is unknown for man, but in small mammals it is about 0.5 mg/kg body weight.6, The characteristic features of acute arsine poisoning are abdominal paint bloody urine, and jaundice (yellow discoloration of the skin). Two workers were poisoned while cleaning an aluminum trailer tank with a phosphoric acid solution. Inorganic arsenic is found in nature at low levels mostly compounded with oxygen, chlorine, and sulfur. The National Institute for Occupational Safety and Health (NIOSH) recommends that appropriate work practices be implemented to reduce the risk of worker exposure to arsine (AsH3) gas, There is a high potential for the generation of arsine gas when inorganic arsenic is exposed to nascent (freshly formed) hydrogen. TABLE 2. CAS number: 7784-42-1 NIOSH REL: 0.002 mg/m3 15-minute CEILING; NIOSH considers arsine to be a potential occupational carcinogen as defined by the OSHA carcinogen policy [29 CFR 1990]. When the scrap mixture is in the molten state, calcium arsenide is formed. 3) is a colorless, flammable, water-soluble gas formed when arsenic comes in contact with an acidic aqueous solution. Treatment of arsine poisoning should include: (a) immediate blood exchange transfusion to replace the destroyed red blood cells, and also to remove arsenic and the hemoglobin-arsine complex; (b) the administration of therapeutic amounts of dimercaprol (BAL); and (c) dialysis should be started if the patient has suffered kidney damage. It has a garlic-like odor. Brit. An unusual bronze discoloration of the skin can often be observed accompanying the jaundice. NIOSH RTECS Number: CG6475000 COVID-19 is an emerging, rapidly evolving situation. Shindler: Arsine Hemolysis. Arsine is … Stibine (SbH3; hydrogen antimonide; antimony hydride; antimony trihydride)- Antimony (Sb) can be converted to stibine by a similar series of reactions required to convert arsenic to arsine. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Toxicol Ind Health. Mazey, and J.E. Arsine causes massive hemolysis and results in anemia, jaundice, and hemoglobinuric renal failure. Exchange transfusions lower blood arsenic levels, but dialysis, though it may be life-saving, does not remove arsenic from the patient. In one report of chronic arsine poisoning, it was noted that arsine in very small concentrations appeared to exert a cumulative, damaging effect. Two workers were poisoned after a commercial drain cleaner was added to a drain which contained water and arsenic residues. In the event arsine and/or stibine is generated, immediate steps should be taken to remove workers from the contaminated environment. Reed: Industrial Arsine Poisoning: Report of Three Cases. Subsequently the mixture of water and sodium arsenite under these conditions led to the generation of arsine. In light of the serious and accidental nature of exposure to arsine and/or stibine, NIOSH recommends that steps be taken to prevent exposure to these gases. Stibine equals or surpasses arsine in toxicity, and causes a specific toxic action which closely resembles that of arsine.21 Although stibine is chemically similar to arsine, it is less stable. TABLE 1. When stibine enters the bloodstream, it reacts with the hemoglobin of red blood cells, leading to destruction of the cells.21 Stibine exerts a direct effect on the brain tissue cells, leading to various degrees of degeneration.23 Victims of stibine poisoning have experienced marked weakness headache, nausea, severe abdominal and lower back pain, and blood in the urine. Bulmer, F.M.R., H.E. The tank had been used 6 months previously for the transport of a 42% solution of sodium arsenite (weed killer). Male 5-week-old Hos:HR-1 hairless mice were subjected to a single percutaneous exposure or whole-body inhalation exposure of ca. Petronella, D.R. Pinto, S.S., S.J. Arsenic and Environmental Health: State of the Science and Future Research Opportunities. It is soluble in water, and slightly soluble in alcohol and alkalies. Arsenic usually exists as a metalloid in room temperature, while arsine is a gas that is flammable and toxic. A more recent area of concern involves the recycling of batteries. It is extremely toxic to humans, with headaches, vomiting, and abdominal pains occurring within a few hours of exposure. Although arsenic causes toxicity, it can also play a protective role. : Personal communication, Lead Industries Association, New York, New York (June 14 and August 2, 1976). Arsine is a gaseous chemical compound that originates from the combination of arsenic and hydrogen atoms. | Arsine toxicity is different from arsenic toxicity. Mechanism. 2014 Sep;47(5):253-7. doi: 10.3961/jpmph.14.036. Arsine binds to the haemoglobin of red blood cells, causing them to be destroyed by the body. General toxicity Arsine Arsine primarily targets the erythrocyte (red blood cell) and rapidly induces intravascular haemolysis. Identified in 1775, arsine is a highly poisonous, colorless, nonirritating gas with a mild garlic odor. Arsine is an inorganic compound with the formula AsH3. Therefore, similar work practices should be implemented to reduce the risk of worker exposure to stibine. The manufacturer had added sodium arsenite and aniline hydrochloride to the acid to act as inhibitors to the corrosive action of the acid. These symptoms are similar to those caused by arsine toxicity.24. Ores contaminated with arsenic can liberate arsine when treated with acid.1 Arsine is commercially produced for use in organic synthesis, and the processing of solid state electronic components. Once arsine is inhaled, it breaks down, releasing inorganic arsenic into the blood stream. Ptitsa: Pathomorphological Characterization of Cerebrum of Rabbits during Antimony Hydride Poisoning. 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