A patient with arsenic intoxication should have a careful exposure history to try to identify the source of the heavy metal.
Industrial or hobby exposures:
(1) pottery
(2) smelting and casting
(3) colored glass
(4) production of pesticides (see below)
(5) electronics
(6) fossil fuel power plant
(7) treating metals (galvanizing, plating or etching)
(8) soldering or welding
Agriculture, forestry or gardening:
(1) insecticides
(2) herbicides
(3) fungicides
(4) algicides
(5) defoliant
Environmental:
(1) naturally contaminated ground water
(2) ground water contaminated by adjacent farms or industrial complexes
(3) contaminated air adjacent to an industrial complex
(4) burning, cutting or sanding wood treated with preservatives
Diet:
(1) shellfish
(2) seafish
Drugs of abuse:
(1) cocaine or opium (with an arsenical as an intentional or accidental contaminant)
(2) moonshine
Health-related:
(1) Chinese medicines
(2) folk medicines
(3) herbal cure-alls
(4) arsenic trichloride (Trisenox)
(5) Melarsoprol
If no source can be found, then intentional poisoning should be considered.
Specialty: Toxicology, Emergency Medicine, Critical Care