3. Environmental exposures  Cancer risks:  Tobacco smoke  Radon in homes  Arsenic

4. Lifetime risks of dying from cancer due to environmental exposures  Tobacco smoke:  Low exposure = 4/1000  High exposure = 10/1000  Radon in homes:  Average exposure = 3/1000  High exposure = 20/1000  Arsenic in drinking water:  U.S. estimated average = 1/1000  U.S. water standard = 21/1000

5. ARSINIC  Organic form  Inorganic forms  More toxic

6. Drinking water contaminated with Arsenic  Skin  Lung  Liver  Kidney  Other organs

7. SKIN CANCER  First described in 1888 in patients treated with arsenical mixtures for skin conditions  Arsenic from water supplies and drugs is known to cause skin cancer  Prevalence among highly exposed males aged >60 reached 25%

8. Liver cancer  Liver Cancer  Angiosarcoma  Supported by a series of case reports  Winegrowers in Germany  Taiwan

9. Lung Cancer  Ingestion:  Water supplies  Comparable to tobacco smoke and radon  Inhalation:  Smelters

10. Kidney and Bladder Cancer  There is a clear relationship between arsenic water levels and bladder and kidney cancer

11. CONCLUSION  Results from epidemiological studies, showed persuasive evidence that inorganic arsenic is a cause of human cancer at several sites.  There is strong evidence supporting a causal relationship between ingested arsenic and cancer of skin, liver, lung cancer.  There is some evidence from Taiwan supporting a causal relationship between ingested arsenic and cancer of kidney and bladder cancer. Arsenic is a human carcinogen

12. Is Arsenic Useful?  Industry  Medicine  Leukemia (Arsenic Trioxide, Trisenox)  Autoimmune diseases