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February 1, 1985

Arsenic Exposure-Reply

Author Affiliations

University of Wisconsin Center for Health Sciences University Hospital and Clinics Madison

JAMA. 1985;253(5):634. doi:10.1001/jama.1985.03350290036014

In Reply.—  The letter of Horvath and colleagues highlights our observation that burning CCA-treated wood liberates to the air ash and dust of the metals arsenic-V, copper, and chrome.1 The recurring (seasonal) alopecia that appeared in all eight family members during the cold winter months made us suspect that arsenic or thallium could be the causative agent for the hair loss, skin rashes, bleeding, gastrointestinal tract distress, severe respiratory tract illness (that led to tracheostomy in the youngest child), and blackouts.The chronic low-level exposure rather than an acute exposure as in criminal cases of poisoning did not produce Mees' lines in the nails. Moreover, the fact that the arsenic was in the penta form meant that the effect of the arsenic was not lethal (as would have been possible had the arsenic been in the trivalent form). Since arsenic reacts rapidly in vivo with the sulfhydryl pool, urinary