title: The broad scope of health effects from chronic arsenic exposure: update on a worldwide public health problem.
abstract: BACKGROUND
  Concerns for arsenic exposure are not limited to toxic waste sites and massive poisoning events. Chronic exposure continues to be a major public health problem worldwide, affecting hundreds of millions of persons.
  
  
  OBJECTIVE
  We reviewed recent information on worldwide concerns for arsenic exposures and public health to heighten awareness of the current scope of arsenic exposure and health outcomes and the importance of reducing exposure, particularly during pregnancy and early life.
  
  
  METHODS
  We synthesized the large body of current research pertaining to arsenic exposure and health outcomes with an emphasis on recent publications.
  
  
  CONCLUSIONS
  Locations of high arsenic exposure via drinking water span from Bangladesh, Chile, and Taiwan to the United States. The U.S. Environmental Protection Agency maximum contaminant level (MCL) in drinking water is 10 µg/L; however, concentrations of > 3,000 µg/L have been found in wells in the United States. In addition, exposure through diet is of growing concern. Knowledge of the scope of arsenic-associated health effects has broadened; arsenic leaves essentially no bodily system untouched. Arsenic is a known carcinogen associated with skin, lung, bladder, kidney, and liver cancer. Dermatological, developmental, neurological, respiratory, cardiovascular, immunological, and endocrine effects are also evident. Most remarkably, early-life exposure may be related to increased risks for several types of cancer and other diseases during adulthood.
  
  
  CONCLUSIONS
  These data call for heightened awareness of arsenic-related pathologies in broader contexts than previously perceived. Testing foods and drinking water for arsenic, including individual private wells, should be a top priority to reduce exposure, particularly for pregnant women and children, given the potential for life-long effects of developmental exposure.
authors: MDB Inc., Durham, North Carolina 27713, USA. naujokasmf@niehs.nih.gov
authors: Marisa F
authors: MF
authors: Naujokas
authors: Beth
authors: B
authors: Anderson
authors: Habibul
authors: H
authors: Ahsan
authors: H Vasken
authors: HV
authors: Aposhian
authors: Joseph H
authors: JH
authors: Graziano
authors: Claudia
authors: C
authors: Thompson
authors: William A
authors: WA
authors: Suk
mesh_terms: D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D060766:Drinking Water / Q000737:chemistry*; D004785:Environmental Pollutants / Q000032:analysis / Q000633:toxicity*; D006801:Humans; D011634:Public Health; D014481:United States; D014484:United States Environmental Protection Agency
chemical_list: D060766:Drinking Water; D004785:Environmental Pollutants; D001151:Arsenic