Assessment of Arsenic Levels in Body Samples and Chronic Exposure in People Using Water with a High Concentration of Arsenic: a Field Study in Kutahya

  • Arikan, Inci (Department of Public Health, Medical Faculty, Dumlupinar University) ;
  • Namdar, Nazli Dizen (Department of Dermatology, Medical Faculty, Dumlupinar University) ;
  • Kahraman, Cuneyt (Department of Internal Medicine, Medical Faculty, Dumlupinar University) ;
  • Dagci, Merve (Department OF Chemistry, Faculty of Arts and Science, Dumlupinar University) ;
  • Ece, Ezgi (Department of Biology, Faculty of Arts and Science, Dumlupinar University)
  • Published : 2015.04.29


Objective: This study aimed to evaluate the prevalence of skin lesions, which is a health effect of chronic arsenic (As) exposure, and determine the hair/blood arsenic concentrations of people living in Kutahya villages who are using and drinking tap water with a high concentration of arsenic. Materials and Methods: A total of 303 people were included in the present cross-sectional study. A prepared questionnaire form was used to collect the participants' information and environmental history. Skin examination was performed on all participants. Hair, blood and water samples were analyzed using atomic absorption spectroscopy. The cumulative arsenic index (CAI) was calculated for all participants. Results: Villages were divided into two groups according to the arsenic level (<$20{\mu}g/L$, Group I; >$20{\mu}g/L$, Group II) in their water. The prevalence of skin lesions, hair and blood arsenic level, and CAI were found to be higher in the Group II participants. There was a positive association between body arsenic levels and CAI in the participants of each group. Conclusions: The number of skin lesions and arsenic concentrations in body samples were found to increase with the water arsenic level and exposure time. We hope that sharing this study's results with local administrators will help accelerate the rehabilitation of water sources in Kutahya.


Arsenic in water;arsenic in body samples;environmental exposure;field study;Turkey


Supported by : Research Foundation of Dumlupinar University


  1. Ahsan H, Perrin M, Rahman A, et al (2000). Associations between drinking water and urinary arsenic levels and skin lesions in Bangladesh. J Occup Environ Med, 42, 1195-201.
  2. Anetor JI, Wanibuchi V, Fukushima S (2007). Arsenic exposure and its health effects and risk of cancer in developing countries: micronutrients as host defence. Asian Pac J Cancer Prev, 8, 13-23.
  3. Anwar M (2005). Arsenic, cadmium and lead levels in hair and toenail samples in pakistan. Environ Sci, 12, 71-86.
  4. Argos M, Ahsan H, Graziano JH (2012). Arsenic and human health: epidemiologic progress and public health implications. Rev Environ Health, 27, 191-5.
  5. Calderon RL, Hudgens EE, Carty C, et al (2013). Biological and behavioral factors modify biomarkers of arsenic exposure in a U.S. population. Environ Res, 126, 134-44.
  6. Chhabra D, Oda K, Jagannath P (2012). Chronic heavy metal exposure and gallbladder cancer risk in India, a comparative study with Japan. Asian Pac J Cancer Prev, 13, 187-90.
  7. Cohen SM, Arnold LL, Eldan M, Lewis AS, Beck BD (2006). Methylated arsenicals: the implications of metabolism and carcinogenicity studies in rodents to human risk assessment. Crit Rev Toxicol, 36, 99-133.
  8. Dogan M, Dogan A (2007). Arsenic mineralization, source, distribution, and abundance in the Kutahya region of the western anatolia, Turkey. Environ Geochem Health, 29, 119-29.
  9. Dogan M, Dogan AU, Celebi C, Baris YI (2005). Geogenic arsenic and a survey of skin lesions in Emet Region of Kutahya, Turkey. Indoor-Built Environment, 14, 533-6.
  10. Fasinu PS, Orisakwe OE (2013). Heavy metal pollution in sub-saharan africa and possible implications in cancer epidemiology. Asian Pac J Cancer Prev, 14, 3393-402.
  11. Gunduz O, Simsek C, Hasozbek A (2010). Arsenic pollution in the groundwater of simav plain, Turkey: Its impact on water quality and human health. Water Air Soil Pollution, 205, 43-62.
  12. Gunduz O, Bakar C, Simsek C, et al (2014). Statistical analysis of death causes (2005-2010) in villages with high arsenic levels in drinking water supplies of simav plain, Turkey. Arch Environ Occup Health, 70, 35-46.
  13. Guo X, Liu Z, Huang C, et al (2006). Levels of arsenic in drinking water and cutaneous lesions in Inner Mongolia. J Health Popul Nutr, 24, 214-20.
  14. Hall M, Chen Y, Ahsan H, et al (2006). Blood arsenic as a biomarker of arsenic exposure: results from a prospective study. Toxicol, 225, 225-33.
  15. Huang L, Wu H, van der Kuijp TJ (2014). The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution. Int J Environ Health Res, 3, 1-21.
  16. Jarup L (2003). Hazards of heavy metal contamination. Br Med Bull, 68, 167-82.
  17. Jin-Yong Chung, Seung-Do Yu, Young-Seoub Hong (2014). Environmental source of arsenic exposure. J Prev Med Public Health, 47, 253-57.
  18. Katiyar S, Singh D (2014). Prevalence of arsenic exposure in population of Ballia district from drinking water and its correlation with blood arsenic level. J Environ Biol, 35, 589-94.
  19. Kazi TG, Arain MB, Baig JA, et al (2009). The correlation of arsenic levels in drinking water with the biological samples of skin disorders. Sci Total Environ, 407, 1019-26.
  20. Khan MMH, Sakauchi F, Sonoda T, Washio M, Mori M (2003). Magnitude of arsenic toxicity in tube-well drinking water in bangladesh and its adverse effects on human health including cancer: evidence from a review of the literature. Asian Pac J Cancer Prev, 4, 7-14.
  21. Li X, Li B, Xi S, et al (2013). Prolonged environmental exposure of arsenic through drinking water on the risk of hypertension and type 2 diabetes. Environ Sci Pollut Res, 20, 8151-61.
  22. Marchiset-Ferlay N, Savanovitch C, Sauvant-Rochat MP (2012). What is the best biomarker to assess arsenic exposure via drinking water? Environ Int, 39, 150-71.
  23. Mazumder DN, Deb D, Biswas A, et al (2014). Dietary arsenic exposure with low level of arsenic in drinking water and biomarker: a study in West Bengal. J Environ Sci Health A Tox Hazard Subst Environ Eng, 49, 555-64.
  24. Moseferi M. Yunesian M, Dastgiri S, Mesdaghinia A, Esmailnasab N (2008). Prevalence of skin lesions and exposure to arsenic in drinking water in Iran. Sci Total Environ, 390, 69-76.
  25. Naujokas MF, Anderson B, Ahsan H, et al (2013). The broad scope of health effects from chronic arsenic exposure: update on a worldwide public health problem. Environ Health Perspect, 121, 295-302.
  26. Rim KT (2013). Occupational cancers with chemical exposure and their prevention in Korea: a literature review. Asian Pac J Cancer Prev, 14, 3379-91.
  27. Rodrigues JL, Batista BL, Nunes JA, et al (2008). Evaluation of the use of human hair for biomonitoring the deficiency of essential and exposure to toxic elements. Sci Total Environ, 405, 370-6.
  28. Rodríguez-Lado L, Sun G, Berg M, et al (2013). Groundwater arsenic contamination throughout China. Science, 341, 866-68.
  29. Samanta G, Sharma R, Roychowdhury T, Chakraborti D (2004). Arsenic and other elements in hair, nails, and skin-scales of arsenic victims in West Bengal, India. Sci Total Environ, 326, 33-47.
  30. Sela H, Karpas Z, Cohen H, Tal A, Zeiri Y (2013). Trace element concentration in hair samples as an indicator of exposure of population in the Negev, Israel. Biol Trace Elem Res, 155, 209-20.
  31. Sinha D, Roy M, Dey S, Siddiqi M, Bhattacharya RK (2003). Modulation of arsenic induced cytotoxicity by tea. Asian Pac J Cancer Prev, 4, 233-7.
  32. Smith AH, Steinmaus CM (2009). Health effects of arsenic and chromium in drinking water: recent human findings. Annu Rev Public Health, 30, 107-22.
  33. Shankar S, Shanker U, Shikha (2014). Arsenic contamination of groundwater: a review of sources, prevalence, health risks, and strategies for mitigation. Sci World J, 2014, 304524.
  34. Udensi UK, Graham-Evans BE, Rogers CS, Isokpehi RD (2011). Cytotoxicity patterns of arsenic trioxide exposure on HaCaT keratinocytes. Clin Cosmet Investig Dermatol, 4, 183-90.
  35. Yoshida T, Yamauchi H, Fan Sun G (2004). Chronic health effects in people exposed to arsenic via the drinking water: dose-response relationships in review. Toxicol Appl Pharmacol, 198, 243-52.
  36. Zhang C, Mao G, He S, et al (2013). Relationship between long-term exposure to low-level arsenic in drinking water and the prevalence of abnormal blood pressure. J Hazard Mater, 262, 1154-58.

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