Occupational disease according to bk 1108

Diseases caused by occupational exposure to arsenic or its compounds

Arsenic (As) is found in various minerals.

Arsenic is 3 or 5-valent in its compounds. Important compounds of the trivalent As are arsenic trioxide (arsenic - As2O3 -) and the arsenic acid (H3AsO3) with its salts (arsenites). Compounds of the 5-valent As are the arsenic acid (H3AsO4) and its salts, the arsenates (arseniates). Pure elemental arsenic does not cause any damage to health, but it easily oxidizes in air or in contact with sweat or saliva. All arsenic compounds are hazardous to health.

Sources of occupational hazards can be found today in semiconductor production. Other sources of danger are arsenic-containing paints and varnishes (ship floor coating). Arsenic can be found in raw materials in the pharmaceutical industry (Note: Salvarsan was the first (arsenic-containing) systemic therapeutic agent in the therapy of syphilis. Arsenic (Fowler's solution) was also present in the treatment of psoriasis vulgaris until 1966. Arsenic is also used in the chemical, ceramic and glass industries (e.g. also as a pickling agent in tanneries, furriers). The use of pesticides containing arsenic has been prohibited in Germany since 1942 (formerly a frequent source of chronic arsenic toxicity through arsenic residues in wine or wine products, e.g. in marc).

Uptake of arsenic: As and its compounds are mainly taken up in the form of dust, vapours or gas via the respiratory tract, but also via the gastrointestinal tract and possibly through the skin. It is excreted in urine, stool, sweat and through the lungs. It can accumulate in various organs, including the skin, hair and nails.

S.u. Arsenic intoxication

S.u. arsenic melanosis

see below arsenic keratoses

S.u. salvar sandstone dermatitis

The carcinogenicity of arsenic has been well studied. Even small amounts can fundamentally influence signal transduction in cells. Increased frequencies of chromosomal aberrations, changes in the degree of methylation of genes, interference with DNA repair mechanisms by inorganic arsenic compounds have been detected.

Latency periods for in situ carcinomas, invasive carcinomas and basal cell carcinomas can be expected after initial contact after 17-20 years.

1. Bauer A (2016) Skin cancer as an occupational disease. dermatologist 67: 884-890
2. Boffetta P et al (1997) Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons.Cancer Causes Control 8:444-472.
3. Lau AT et al (2004) Opposed arsenite-induced signaling pathways promote cell proliferation or apoptosis in cultured lung cells. Carcinogenesis 25:21-28 Letzel S et al (1998) Occupationally related tumors in tar refinery workers. J Am Acad Dermatol 39:712-720.
4. Leaflet on BK No. 2 of annex 1 of the 7th BKVO (Bek. des BMA of 19.05.1964, BArbBl Fachteil Arbeitsschutz 1964, 125f)