Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-848 - Arsenic › Section 296-848-60010 - Health information about inorganic arsenic

Current through Register Vol. 24-14, July 15, 2024
(1) You must make this section
			 readily available to employees as required in Training, WAC
			 296-848-30005.
(2) You must provide this section
			 to the licensed health care professional (LHCP) as required in Step 4
			 of the medical evaluation process found in Medical evaluations, WAC
			 296-848-30030.
Table 5 General Health Information About
				Inorganic Arsenic
What is inorganic
						arsenic?
In this chapter, "inorganic arsenic"
						  means:
- The element arsenic;
- Arsenic-containing compounds that don't
						  contain the element carbon;
- Copper aceto-arsenite.
Arsine is a gaseous inorganic arsenic
						  compound not addressed by requirements in this chapter. It's
						  addressed in a separate chapter, Respiratory hazards, chapter 296-841
						  WA C.
How does inorganic arsenic
						get into my body?
Inorganic arsenic enters your body when
						  you:
- Breath in
(inhale)
airborne
						  particles such as dusts, fume, sprays, or other aerosols that contain
						  inorganic arsenic. You will also inhale inorganic arsenic particles
						  when you smoke tobacco products that have become contaminated from
						  contact with inorganic arsenic at work. Some compounds, including
						  arsenic trichloride, can be inhaled as a vapor;
- Swallow
(ingest)
food, drink,
						  cosmetics such as lip balm, sweat and other substances that become
						  contaminated from contact with inorganic arsenic at work.
Inorganic arsenic particles brought home on
						  your clothes, shoes, or body can be inhaled or ingested by household
						  members.
Some inorganic arsenic compounds enter your
						  body when
eye or skin contact
occurs. Arsenic
						  trichloride is one example of a compound that is readily
absorbed
through the eyes and skin.
What happens after inorganic
						arsenic enters my body?
Once inorganic arsenic enters your
						body, some of it is changed into a less harmful organic form by the
						liver. Both the organic and inorganic forms leave your body in urine.
Most of the arsenic will be gone
						within several days, although some will remain in your body for
						several months and even longer.
Why is medical monitoring
						necessary?
Although exposure to inorganic
						arsenic is associated with various health effects, the most serious
						health effects are
lung and skin cancer.
The medical
						monitoring requirements in this chapter are established to minimize
						your risk for these diseases.
To learn more about the medical
						monitoring process, see Medical evaluation, WAC
						296-848-30030.
What health effects and
						symptoms are linked with exposure to inorganic arsenic?
Exposure to inorganic arsenic is
						associated with various health effects ranging from
temporary
						local
effects such as skin irritation to
lasting
						systematic
effects due to gradual (chronic) or sudden (acute)
						poisoning. Such effects should not occur if the requirements in this
						chapter are followed.
Skin Health Effects:
Arsenic trioxide, arsenic
						trichloride, and other trivalent compounds can cause
skin
						irritation
from direct contact.
- The following moist mucous
						membranes are most sensitive to irritation:
* Eye and inner eyelid
						(conjunctiva);
* Linings inside the nose, mouth,
						and respiratory system.
- Other sites most vulnerable irritation also
						  include:
* Eyelids;
* Angles (the space between 2
						planes) of the ears, nose, and mouth;
* Moist and macerated (softened by
						moisture) areas of skin;
* Wrists;
* Genitalia, if personal hygiene is
						poor.
Inorganic arsenic is also capable
						of causing keratoses
(small corns or warts),
especially
						on palms and soles.
Trivalent arsenic compounds are
corrosive
to skin:
- Brief contact won't cause
						irritation, but prolonged contact causes localized engorgement
						(hyperemia) which later forms vesicular (blister-like) or pustular
						(pimple-like) eruptions.
- Exposure can create perforations
						(holes) in the nasal septum (the tissue dividing the nasal cavity in
						half).
Arsenic trioxide and arsenic
						pentoxide exposure have been linked to
skin
						sensitization
(acquired sensitivity or allergy)
and
						contact dermatitis
(inflammation due to allergic or irritant
						reaction).
Acute Poisoning
						Effects:
Acute poisoning is usually linked
						to ingestion, not inhalation, of inorganic arsenic. Cases of acute
						poisoning
rarely
occur in occupational settings and
						inhalation-related cases are exceedingly rare.
When acute poisoning is due to
ingestion,
the following gastrointestinal symptoms
						develop within 1/2 to 4 hours:
- Tightening (constriction) of the
						throat followed by difficulty or inability to swallow (dysphagia),
						pain in the region above the belly button (epigastric pain),
						vomiting, and watery diarrhea. Blood may appear in vomit and stools;
- Shock may develop due to severe
						fluid loss when the amount of inorganic arsenic swallowed is
						sufficiently high. Death can occur in 24 hours.
When acute poisoning is due to
						inhalation:
- The following symptoms develop
						first:
* Cough;
* Chest pain;
* Shortness of breath (dyspnea);
* Giddiness;
* Headache;
* Extreme general weakness.
- Gastrointestinal symptoms will
						follow.
Chronic Poisoning
						Effects:
Cases of chronic poisoning caused
						by
ingestion
are also rare. Symptoms are:
- Weight loss;
- Nausea and diarrhea alternating
						with constipation;
- Skin pigmentation and eruptions;
- Hair loss;
- Numbness in hands and feet, "pins
						and needles" sensation, muscle weakness, and other symptoms resulting
						from peripheral neuritis;
- Horizontal white lines
						(striations) on fingernails and toenails.
Inhalation
of
						inorganic arsenic is the most common cause of chronic poisoning in
						occupational settings. Symptoms associated with this condition are
						divided into 3 phases.
- 1st phase, earliest symptoms:
* Weakness;
* Loss of appetite;
* Some nausea;
* Occasional vomiting;
* Sense of heaviness in the
						stomach;
* Some diarrhea.
- 2nd phase symptoms:
* Inflammation of the eyes and inner eyelid
						  (conjunctivitis);
* Inflammation, accompanied by an abundant
						  discharge from mucous membranes (a catarrhal state) of the nose,
						  larynx, and respiratory passage;
* Symptoms associated with the common cold
						  (Coryza), hoarseness, and mild tracheobronchitis may
						  occur;
* Skin lesions are common
						(eczematoid and allergic in type). Perforations (holes) in the nasal
						septum (the tissue dividing the nasal cavity in half) are the most
						typical lesions of the upper respiratory tract.
- 3rd phase symptoms (related to peripheral
						  neuritis):
* Numbness in hands and feet, "pins
						and needles" sensation, muscle weakness.
* In severe cases, motor paralyses
						occur: Initially affecting the toe extensors and the peronei (outer
						portion of the lower leg).
* "Wrist drop" or "foot drop"
						(resulting from paralysis of flexor muscles of feet and hands)
only occurs in the most severe cases.
Statutory Authority:
				  RCW  49.17.010,
				  49.17.040,
				  49.17.050,
				  49.17.060. 07-03-153,
				  § 296-848-60010, filed 1/23/07, effective
				  6/1/07.