The WHO guideline value for arsenic in drinking water is 10 µg/L; however, India's IS 10500 standard permits up to 50 µg/L as the permissible limit. Chronic arsenic exposure at levels >50 µg/L MOST characteristically causes which triad?

• A Lung fibrosis, peripheral neuropathy, and chronic liver disease
• B Melanosis, keratosis, and peripheral vascular disease (Blackfoot disease) ✓
• C Blue line on gums, colic, and wrist drop
• D Mottling of enamel, osteosclerosis, and genu valgum

Explanation

Chronic arsenicosis (endemic in West Bengal, Bangladesh) is characterized by: (1) melanosis — raindrop pigmentation on trunk; (2) palmar/plantar keratosis — arsenical keratosis; (3) peripheral vascular disease leading to Blackfoot disease (gangrene of lower extremities) seen in Taiwan. Internal cancers (lung, bladder, skin) also occur. The blue gum line, colic, and wrist drop describe lead poisoning. Mottled enamel and fluorosis describe fluoride toxicity.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.