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Arsenic exposure and poisoning

Rose H Goldman, MD, MPH
Section Editor
Michele M Burns, MD, MPH
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Arsenic is a metalloid element. Acute high-dose exposure to arsenic can cause severe systemic toxicity and death. Lower dose chronic arsenic exposure can result in subacute toxicity that can include skin changes and skin cancer, peripheral sensorimotor neuropathy, diabetes mellitus, cardiovascular effects, peripheral vascular disease, hepatotoxicity and other conditions [1]. Latent, or long-term effects of arsenic exposure include an increased risk of cancers, even after exposure has ceased.

Clinicians may need to consider arsenic exposure in the emergency care setting when treating those suspected of acute poisoning or those who present with prolonged or intermittent gastrointestinal symptoms that are atypical for most viral and bacterial enteric illnesses [2]. In the office setting, clinicians may need to consider questions concerning chronic arsenic exposure in patients whose source of water is well water, exposure from food (particularly rice products), and in other environmental settings.


Overview — Arsenic is a naturally occurring element found in the earth's crust and within numerous ores. It is classed as a metalloid because it complexes with metals; it also reacts with other elements such as oxygen, hydrogen, chlorine, carbon, and sulfur. Elemental arsenic is rare, and the element exists more commonly as organic or inorganic compounds [2].

Arsenical compounds can be grouped as inorganic, organic, and arsine gas (AsH3), and they are further classified according to their valence states: elemental (0), arsenite (trivalent, +3), and arsenate (pentavalent, +5). Trivalent arsenic or arsenite compounds, both inorganic and organic, are considered the most toxic. However, other organic forms of arsenic, found in some fish and crustaceans, as well as other foods, consisting mostly of arsenobetaine (a trimethylated arsenic compound sometime called "fish arsenic") and arsenocholine, are excreted rapidly and are thought to be of negligible toxicity [2-4].

Human exposures can occur from natural sources, such as volcanic eruptions, and arsenic leaching from soil and rocks into drinking water. Exposure can also through inhalation, usually when workers are exposed to arsenic dusts as in smelting and refining [5].


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  1. Naujokas MF, Anderson B, Ahsan H, et al. The broad scope of health effects from chronic arsenic exposure: update on a worldwide public health problem. Environ Health Perspect 2013; 121:295.
  2. Mundy SW. Arsenic. In: Goldfrank's Toxicologic Emergencies, 10th ed, Hoffman RS, Lewin NA, Howland MA, et al (Eds), Mcgraw-Hill Education, New York 2015. p.1169.
  3. Agency for Toxic Substances and Disease Registry. Toxicological Profile for Arsenic. U.S. Department of Health & Human Services, Public Health Service 2007. Available at: www.atsdr.cdc.gov/toxprofiles/tp.asp?id=22&tid=3 (Accessed on October 11, 2011).
  4. Orloff K, Mistry K, Metcalf S. Biomonitoring for environmental exposures to arsenic. J Toxicol Environ Health B Crit Rev 2009; 12:509.
  5. US Environmental Protection Agency. Technology Transfer Network Air Toxics. Available at: www.epa.gov/ttn/atw/hlthef/arsenic.html (Accessed on May 01, 2016).
  6. Jackson BP, Taylor VF, Karagas MR, et al. Arsenic, organic foods, and brown rice syrup. Environ Health Perspect 2012; 120:623.
  7. Consumer Reports. Arsenic in your food. Available at: www.consumerreports.org/cro/magazine/2012/11/arsenic-in-your-food/index.htm (Accessed on April 24, 2016).
  8. Rose M, Lewis J, Langford N, et al. Arsenic in seaweed--forms, concentration and dietary exposure. Food Chem Toxicol 2007; 45:1263.
  9. Almela C, Clemente MJ, Vélez D, Montoro R. Total arsenic, inorganic arsenic, lead and cadmium contents in edible seaweed sold in Spain. Food Chem Toxicol 2006; 44:1901.
  10. Environmental Protection Agency. Arsenical Pesticides. In: Recognition and Management of Pesticide Poisonings, 6th ed. Washington, DC 2013. p. 277. Available at: https://www.epa.gov/pesticide-worker-safety/recognition-and-management-pesticide-poisonings (Accessed on April 24, 2016).
  11. Eisler R. Arsenic hazards to humans, plants, and animals from gold mining. Rev Environ Contam Toxicol 2004; 180:133.
  12. Saper RB, Kales SN, Paquin J, et al. Heavy metal content of ayurvedic herbal medicine products. JAMA 2004; 292:2868.
  13. Saper RB, Phillips RS, Sehgal A, et al. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA 2008; 300:915.
  14. Gerhardt RE, Crecelius EA, Hudson JB. Moonshine-related arsenic poisoning. Arch Intern Med 1980; 140:211.
  15. Lasky T, Sun W, Kadry A, Hoffman MK. Mean total arsenic concentrations in chicken 1989-2000 and estimated exposures for consumers of chicken. Environ Health Perspect 2004; 112:18.
  16. US Food and Drug Administration. Questions and Answers Regarding 3-Nitro (Roxarsone). www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm258313.htm (Accessed on April 01, 2016).
  17. Miller WH Jr, Schipper HM, Lee JS, et al. Mechanisms of action of arsenic trioxide. Cancer Res 2002; 62:3893.
  18. Soignet SL, Maslak P, Wang ZG, et al. Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide. N Engl J Med 1998; 339:1341.
  19. National Cancer Institute, NIH. Arsenic Trioxide, 2015. www.cancer.gov/about-cancer/treatment/drugs/arsenictrioxide (Accessed on April 24, 2016).
  20. National Research Council. Arsenic in Drinking Water, 2001 Update. National Academy Press; Washington, DC 2001.
  21. World Health Organization. Arsenic in drinking water: WHO Information Fact Sheet No 210. World Health Organization; 2001.
  22. US Environmental Protection Agency. Arsenic in Drinking Water. Available at: http://water.epa.gov/lawsregs/rulesregs/sdwa/arsenic/index.cfm (Accessed on April 24, 2016).
  23. Smith AH, Lingas EO, Rahman M. Contamination of drinking-water by arsenic in Bangladesh: a public health emergency. Bull World Health Organ 2000; 78:1093.
  24. Chakraborti D, Mukherjee SC, Pati S, et al. Arsenic groundwater contamination in Middle Ganga Plain, Bihar, India: a future danger? Environ Health Perspect 2003; 111:1194.
  25. Chowdhury UK, Biswas BK, Chowdhury TR, et al. Groundwater arsenic contamination in Bangladesh and West Bengal, India. Environ Health Perspect 2000; 108:393.
  26. Argos M, Kalra T, Rathouz PJ, et al. Arsenic exposure from drinking water, and all-cause and chronic-disease mortalities in Bangladesh (HEALS): a prospective cohort study. Lancet 2010; 376:252.
  27. WHO. Arsenic in Drinking Water: Background document for development of WHO Guidelines for Drinking-water Quality, 2011. www.who.int/water_sanitation_health/dwq/chemicals/arsenic.pdf (Accessed on April 24, 2016).
  28. Parvez F, Wasserman GA, Factor-Litvak P, et al. Arsenic exposure and motor function among children in Bangladesh. Environ Health Perspect 2011; 119:1665.
  29. Franzblau A, Lilis R. Acute arsenic intoxication from environmental arsenic exposure. Arch Environ Health 1989; 44:385.
  30. US Food and Drug Administration. Questions & Answers: Apple Juice and Arsenic. July 15, 2013. Available at: www.fda.gov/Food/ResourcesForYou/Consumers/ucm271595.htm (Accessed on April 24, 2016).
  31. ConsumerReports.org. Consumer Reports tests juices for arsenic and lead. November 30, 2011. Available at: http://news.consumerreports.org/safety/2011/11/consumer-reports-tests-juices-for-arsenic-and-lead.html (Accessed on April 24, 2016).
  32. US Food and Drug Administration. Arsenic in Apple Juice Analytical Results, 2005-2011 Toxic Elements Food and Foodware Program. Available at: www.fda.gov/food/foodborneillnesscontaminants/metals/ucm273328.htm (Accessed on April 24, 2016).
  33. Karagas MR, Punshon T, Sayarath V, et al. Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life. JAMA Pediatr 2016; 170:609.
  34. American Academy of Pediatrics. AAP Offers Advice For Parents Concerned About Arsenic in Food. Available at: https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Offers-Advice-For-Parents-Concerned-About-Arsenic-in-Food.aspx (Accessed on May 01, 2016).
  35. US Food and Drug Administration. FDA proposes limit for inorganic arsenic in infant rice cereal. Available at: www.fda.gov/newsevents/newsroom/pressannouncements/ucm493740.htm (Accessed on April 17, 2016).
  36. Bailey KA, Smith AH, Tokar EJ, et al. Mechanisms Underlying Latent Disease Risk Associated with Early-Life Arsenic Exposure: Current Research Trends and Scientific Gaps. Environ Health Perspect 2016; 124:170.
  37. Nachman KE, Baron PA, Raber G, et al. Roxarsone, inorganic arsenic, and other arsenic species in chicken: a U.S.-based market basket sample. Environ Health Perspect 2013; 121:818.
  38. EPA. Chromated Copper Arsenate (CCA). Available at: https://www.epa.gov/ingredients-used-pesticide-products/chromated-copper-arsenate-cca (Accessed on April 24, 2016).
  39. Windebank AJ. Arsenic. In: Experimental and Clinical Neurotoxicology, Spencer PS, Schaumburg HH (Eds), Oxford University Press, New York 2000. p.203.
  40. Fowler BA, Selene CH, Chou RJ, et al. Arsenic. In: Handbook on the Toxicology of Metals, 4th ed, Nordberg GF, Fowler BA, Nordberg M. (Eds), Academic Press, San Diego 2015. p.581.
  41. Lauwerys RR, Hoet P. Industrial Chemical Exposure - Guidelines for Biological Monitoring, Lewis Publishers, Boca Raton 2000.
  42. Aposhian H. Biochemical toxicology of arsenic. Rev Biochem Toxicol 1989; 10:265.
  43. Beckman KJ, Bauman JL, Pimental PA, et al. Arsenic-induced torsade de pointes. Crit Care Med 1991; 19:290.
  44. Danan M, Dally S, Conso F. Arsenic-induced encephalopathy. Neurology 1984; 34:1524.
  45. Lai MW, Boyer EW, Kleinman ME, et al. Acute arsenic poisoning in two siblings. Pediatrics 2005; 116:249.
  46. Feldman RG. Arsenic. In: Occupational and Environmental Neurotoxicology, Feldman RG (Ed), Lippincott-Raven, Philadelphia 1999.
  47. HEYMAN A, PFEIFFER JB Jr, WILLETT RW, TAYLOR HM. Peripheral neuropathy caused by arsenical intoxication; a study of 41 cases with observations on the effects of BAL (2, 3, dimercapto-propanol). N Engl J Med 1956; 254:401.
  48. Reynolds ES. An Account of the Epidemic Outbreak of Arsenical Poisoning occurring in Beer Drinkers in the North of England and the Midland Counties in 1900. Med Chir Trans 1901; 84:409.
  49. Chhuttani P, Chopra J. Arsenic Poisoning. In: Handbook of Clinical Neurology: Intoxication of the Nervous System, part I, Vinken P, Bruyn G (Eds), North Holland, Amsterdam 1979. Vol 36, p.199.
  50. Chhuttani PN, Chawla LS, Sharma TD. Arsenical neuropathy. Neurology 1967; 17:269.
  51. Mees R. The nails with arsenical polyneuritis. JAMA 1919; 72:1337.
  52. Aldrich C. Leuconychia striata arsenicalis transversus. Am J Med Sci 1904; 127:702.
  53. National Research Council. Arsenic in Drinking Water. National Academy Press; Wasthington, DC 1999.
  54. Uede K, Furukawa F. Skin manifestations in acute arsenic poisoning from the Wakayama curry-poisoning incident. Br J Dermatol 2003; 149:757.
  55. Ahsan H, Chen Y, Parvez F, et al. Arsenic exposure from drinking water and risk of premalignant skin lesions in Bangladesh: baseline results from the Health Effects of Arsenic Longitudinal Study. Am J Epidemiol 2006; 163:1138.
  56. Yu HS, Lee CH, Chen GS. Peripheral vascular diseases resulting from chronic arsenical poisoning. J Dermatol 2002; 29:123.
  57. Tseng WP. Effects and dose--response relationships of skin cancer and blackfoot disease with arsenic. Environ Health Perspect 1977; 19:109.
  58. Lin TH, Huang YL. Chemical speciation of arsenic in urine of patients with blackfoot disease. Biol Trace Elem Res 1995; 48:251.
  59. Lagerkvist BJ, Zetterlund B. Assessment of exposure to arsenic among smelter workers: a five-year follow-up. Am J Ind Med 1994; 25:477.
  60. Feldman RG, Niles CA, Kelly-Hayes M, et al. Peripheral neuropathy in arsenic smelter workers. Neurology 1979; 29:939.
  61. Morton WE, Caron GA. Encephalopathy: an uncommon manifestation of workplace arsenic poisoning? Am J Ind Med 1989; 15:1.
  62. Freeman JW, Couch JR. Prolonged encephalopathy with arsenic poisoning. Neurology 1978; 28:853.
  63. Beckett WS, Moore JL, Keogh JP, Bleecker ML. Acute encephalopathy due to occupational exposure to arsenic. Br J Ind Med 1986; 43:66.
  64. Rodríguez VM, Jiménez-Capdeville ME, Giordano M. The effects of arsenic exposure on the nervous system. Toxicol Lett 2003; 145:1.
  65. Cuzick J, Sasieni P, Evans S. Ingested arsenic, keratoses, and bladder cancer. Am J Epidemiol 1992; 136:417.
  66. Chiou HY, Hsueh YM, Liaw KF, et al. Incidence of internal cancers and ingested inorganic arsenic: a seven-year follow-up study in Taiwan. Cancer Res 1995; 55:1296.
  67. Marshall G, Ferreccio C, Yuan Y, et al. Fifty-year study of lung and bladder cancer mortality in Chile related to arsenic in drinking water. J Natl Cancer Inst 2007; 99:920.
  68. Huang CY, Chu JS, Pu YS, et al. Effect of urinary total arsenic level and estimated glomerular filtration rate on the risk of renal cell carcinoma in a low arsenic exposure area. J Urol 2011; 185:2040.
  69. Järup L. Hazards of heavy metal contamination. Br Med Bull 2003; 68:167.
  70. Chiou HY, Chiou ST, Hsu YH, et al. Incidence of transitional cell carcinoma and arsenic in drinking water: a follow-up study of 8,102 residents in an arseniasis-endemic area in northeastern Taiwan. Am J Epidemiol 2001; 153:411.
  71. Steinmaus C, Ferreccio C, Yuan Y, et al. Elevated lung cancer in younger adults and low concentrations of arsenic in water. Am J Epidemiol 2014; 180:1082.
  72. Ferreccio C, González C, Milosavjlevic V, et al. Lung cancer and arsenic concentrations in drinking water in Chile. Epidemiology 2000; 11:673.
  73. Chen CL, Hsu LI, Chiou HY, et al. Ingested arsenic, cigarette smoking, and lung cancer risk: a follow-up study in arseniasis-endemic areas in Taiwan. JAMA 2004; 292:2984.
  74. Chiu HF, Ho SC, Yang CY. Lung cancer mortality reduction after installation of tap-water supply system in an arseniasis-endemic area in Southwestern Taiwan. Lung Cancer 2004; 46:265.
  75. Guo HR. The lack of a specific association between arsenic in drinking water and hepatocellular carcinoma. J Hepatol 2003; 39:383.
  76. Ohnishi K, Yoshida H, Shigeno K, et al. Prolongation of the QT interval and ventricular tachycardia in patients treated with arsenic trioxide for acute promyelocytic leukemia. Ann Intern Med 2000; 133:881.
  77. Barbey JT, Pezzullo JC, Soignet SL. Effect of arsenic trioxide on QT interval in patients with advanced malignancies. J Clin Oncol 2003; 21:3609.
  78. Rahman M. Arsenic and hypertension in Bangladesh. Bull World Health Organ 2002; 80:173.
  79. Chen CJ, Hsueh YM, Lai MS, et al. Increased prevalence of hypertension and long-term arsenic exposure. Hypertension 1995; 25:53.
  80. Rahman M, Tondel M, Ahmad SA, et al. Hypertension and arsenic exposure in Bangladesh. Hypertension 1999; 33:74.
  81. Wang CH, Chen CL, Hsiao CK, et al. Increased risk of QT prolongation associated with atherosclerotic diseases in arseniasis-endemic area in southwestern coast of Taiwan. Toxicol Appl Pharmacol 2009; 239:320.
  82. Chen Y, Graziano JH, Parvez F, et al. Arsenic exposure from drinking water and mortality from cardiovascular disease in Bangladesh: prospective cohort study. BMJ 2011; 342:d2431.
  83. Moon KA, Guallar E, Umans JG, et al. Association between exposure to low to moderate arsenic levels and incident cardiovascular disease. A prospective cohort study. Ann Intern Med 2013; 159:649.
  84. Balakumar P, Kaur J. Arsenic exposure and cardiovascular disorders: an overview. Cardiovasc Toxicol 2009; 9:169.
  85. Navas-Acien A, Sharrett AR, Silbergeld EK, et al. Arsenic exposure and cardiovascular disease: a systematic review of the epidemiologic evidence. Am J Epidemiol 2005; 162:1037.
  86. Hernández-Zavala A, Del Razo LM, Aguilar C, et al. Alteration in bilirubin excretion in individuals chronically exposed to arsenic in Mexico. Toxicol Lett 1998; 99:79.
  87. Santra A, Das Gupta J, De BK, et al. Hepatic manifestations in chronic arsenic toxicity. Indian J Gastroenterol 1999; 18:152.
  88. Tseng CH, Tai TY, Chong CK, et al. Long-term arsenic exposure and incidence of non-insulin-dependent diabetes mellitus: a cohort study in arseniasis-hyperendemic villages in Taiwan. Environ Health Perspect 2000; 108:847.
  89. Navas-Acien A, Silbergeld EK, Pastor-Barriuso R, Guallar E. Arsenic exposure and prevalence of type 2 diabetes in US adults. JAMA 2008; 300:814.
  90. Rahman M, Tondel M, Ahmad SA, Axelson O. Diabetes mellitus associated with arsenic exposure in Bangladesh. Am J Epidemiol 1998; 148:198.
  91. Chen Y, Ahsan H, Slavkovich V, et al. No association between arsenic exposure from drinking water and diabetes mellitus: a cross-sectional study in Bangladesh. Environ Health Perspect 2010; 118:1299.
  92. von Ehrenstein OS, Mazumder DN, Yuan Y, et al. Decrements in lung function related to arsenic in drinking water in West Bengal, India. Am J Epidemiol 2005; 162:533.
  93. Parvez F, Chen Y, Brandt-Rauf PW, et al. A prospective study of respiratory symptoms associated with chronic arsenic exposure in Bangladesh: findings from the Health Effects of Arsenic Longitudinal Study (HEALS). Thorax 2010; 65:528.
  94. Ahmad SA, Sayed MH, Barua S, et al. Arsenic in drinking water and pregnancy outcomes. Environ Health Perspect 2001; 109:629.
  95. Hopenhayn-Rich C, Browning SR, Hertz-Picciotto I, et al. Chronic arsenic exposure and risk of infant mortality in two areas of Chile. Environ Health Perspect 2000; 108:667.
  96. Rahman A, Vahter M, Ekström EC, et al. Association of arsenic exposure during pregnancy with fetal loss and infant death: a cohort study in Bangladesh. Am J Epidemiol 2007; 165:1389.
  97. Farzan SF, Chen Y, Wu F, et al. Blood Pressure Changes in Relation to Arsenic Exposure in a U.S. Pregnancy Cohort. Environ Health Perspect 2015; 123:999.
  98. Farzan SF, Korrick S, Li Z, et al. In utero arsenic exposure and infant infection in a United States cohort: a prospective study. Environ Res 2013; 126:24.
  99. Concha G, Vogler G, Nermell B, Vahter M. Low-level arsenic excretion in breast milk of native Andean women exposed to high levels of arsenic in the drinking water. Int Arch Occup Environ Health 1998; 71:42.
  100. Sternowsky HJ, Moser B, Szadkowsky D. Arsenic in breast milk during the first 3 months of lactation. Int J Hyg Environ Health 2002; 205:405.
  101. American Academy of Pediatrics Council on Environmental Health. Children's unique vulnerabilities to environmental hazards. In: Pediatric Environmental Health, 3rd ed, Etzel RA (Ed), American Academy of Pediatrics, 2012. p.13.
  102. Quang LS, Woolf AD. Addressing specific populations: children's unique vulnerabilities to environmental exposures. Environ Epidem & Toxicol 2000; 2:79.
  103. Centers for Disease Control and Prevention. National Biomonitoring Program. Biomonitoring Summary. Arsenic. Available at: www.cdc.gov/biomonitoring/Arsenic_BiomonitoringSummary.html (Accessed on April 24, 2016).
  104. Kales SN, Huyck KL, Goldman RH. Elevated urine arsenic: un-speciated results lead to unnecessary concern and further evaluations. J Anal Toxicol 2006; 30:80.
  105. Steindel SJ, Howanitz PJ. The uncertainty of hair analysis for trace metals. JAMA 2001; 285:83.
  106. Seidel S, Kreutzer R, Smith D, et al. Assessment of commercial laboratories performing hair mineral analysis. JAMA 2001; 285:67.
  107. Center for Disease Control and Prevention. Fouth National Report on Human Exposure to Environmental Chemicals, Updated Tables, February 2015. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention 2015. http://www.cdc.gov/biomonitoring/pdf/FourthReport_UpdatedTables_Feb2015.pdf (Accessed on April 24, 2016).
  108. Reigart JR, Roberts JR. Arsenical Pesticides. In: Recognition and Management of Pesticide Poisonings, 5th ed, U.S. Environmental Protection Agency, Washington 1999. p.126. Available at: www.epa.gov/oppfead1/safety/healthcare/handbook/handbook.htm (Accessed on October 12, 2011).
  109. Kosnett MJ. Arsenic. In: Critical Care Toxicology: Diagnosis and Management of the Critically Poisoned Patient, Brent J, Wallace K, Burkhart KK, et al. (Eds), Mosby, Philadelphia 2004. p.799.
  110. Howland, MA. Dimercaprol (British Anti-Lewisite or BAL). In: Goldfrank's Toxicological Emergencies, Nelson, LS, Lewin, NA, Howland, MA, et al (Eds), McGraw-Hill, New York 2010.
  111. Guha Mazumder DN, De BK, Santra A, et al. Randomized placebo-controlled trial of 2,3-dimercapto-1-propanesulfonate (DMPS) in therapy of chronic arsenicosis due to drinking arsenic-contaminated water. J Toxicol Clin Toxicol 2001; 39:665.
  112. US Department of Labor. Occupational Safety and Health Administration. Available at: www.osha.gov/SLTC/arsenic/index.html (Accessed on May 01, 2016).
  113. National Institute of Occupational Safety and Health. NIOSH Pocket Guide to Chemical Hazards. Available at: www.cdc.gov/niosh/npg/npgd0038.html (Accessed on May 01, 2016).
  114. World Health Organization. Arsenic in Drinking Water. Available at: www.who.int/water_sanitation_health/dwq/arsenic/en (Accessed on May 01, 2016).
  115. National Research Council (NRC). Arsenic in Drinking Water, 2001 Update. National Academy Press, Washington, DC 2001. Available at: www.nap.edu/catalog/10194/arsenic-in-drinking-water-2001-update (Accessed on May 01, 2016).
  116. American Academy of Pediatrics. Arsenic in Food Products. Available at: www.aap.org/en-us/about-the-aap/aap-press-room/pages/Arsenic-in-Food-Products.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token (Accessed on May 01, 2016).
  117. Pediatric Environmental Health Specialty Units: Information on Arsenic in Food: Guidance for Parents and Families, October 2012. Available at: www.pehsu.net/Public_Arsenic_in_Food.html (Accessed on May 01, 2016).
  118. Peters HA, Croft WA, Woolson EA, et al. Seasonal arsenic exposure from burning chromium-copper-arsenate-treated wood. JAMA 1984; 251:2393.