{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:44:35Z","timestamp":1787060675432,"version":"build-2736575974"},"reference-count":18,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>As a result of population growth and the development of tube wells, humans\u2019 exposure to arsenic has increased over the past few decades. The natural course of organ damage secondary to arsenic exposure is not yet well understood. In Toroku, Japan, an arsenic mine was intermittently operated from 1920 to 1962, and residents were exposed to high concentrations of arsenic. In this paper, we analyzed 190 consecutive residents for whom detailed records of neurological symptoms and findings were obtained from 1974 to 2005. All participants were interviewed regarding the presence of general, skin, hearing, respiratory, and neurological symptoms. Neurological symptoms were classified into extremity numbness or pain, constipation, dyshidrosis, sensory loss, and muscle atrophy. Superficial and vibratory sensation was also evaluated. More than 80% of participants experienced extremity numbness, and numbness was the most common neurological symptom. Numbness was associated with superficial sensory disturbance, and was correlated with the subsequent development of other neurological symptoms, including autonomic and motor symptoms. No previous studies have investigated the natural course of chronic arsenic intoxication; thus, these data serve as a guide for detecting early symptoms due to arsenic exposure.<\/jats:p>","DOI":"10.3390\/ijerph182010749","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T21:36:15Z","timestamp":1634160975000},"page":"10749","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Detailed Analysis of Neurological Symptoms and Sensory Disturbances Due to Chronic Arsenic Exposure in Toroku, Japan"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5097-6317","authenticated-orcid":false,"given":"Takashi","family":"Sugiyama","sequence":"first","affiliation":[{"name":"Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1302-4151","authenticated-orcid":false,"given":"Nobuyuki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chiyoda Hospital, Miyazaki 883-0064, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Ebihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ebihara General Hospital, Miyazaki 884-0006, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Mochizuki","sequence":"additional","affiliation":[{"name":"Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/jcb.26234","article-title":"Prevalence of exposure of heavy metals and their impact on health consequences","volume":"119","author":"Rehman","year":"2018","journal-title":"J. Cell. Biochem."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ecoenv.2014.10.009","article-title":"Arsenic contamination, consequences and remediation techniques: A review","volume":"112","author":"Singh","year":"2015","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1093\/toxsci\/kfr184","article-title":"Arsenic exposure and toxicology: A historical perspective","volume":"123","author":"Hughes","year":"2011","journal-title":"Toxicol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mochizuki, H. (2019). Arsenic Neurotoxicity in Humans. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20143418"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jns.2015.12.020","article-title":"Prolonged central sensory conduction time in patients with chronic arsenic exposure","volume":"361","author":"Mochizuki","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_6","unstructured":"Miyazaki Prefecture (1972). Toroku Chiku no Kougai ni Kakawaru Shakaiigakutekityousaseiseki, Miyazaki Prefecture. (In Japanese)."},{"key":"ref_7","unstructured":"Japan Federation of Bar Associations (1975). Closed Mine Pollution Report, Japan Federation of Bar Associations. (In Japanese)."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00244-018-0544-8","article-title":"Clinical Symptoms, Neurological Signs, and Electrophysiological Findings in Surviving Residents with Probable Arsenic Exposure in Toroku, Japan","volume":"75","author":"Ishii","year":"2018","journal-title":"Arch. Environ. Contam. Toxicol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transpl."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.kjms.2011.05.003","article-title":"Chronic arsenic toxicity: Studies in West Bengal, India","volume":"27","author":"Dasgupta","year":"2011","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12199-019-0781-0","article-title":"Peripheral neuropathy induced by drinking water contaminated with low-dose arsenic in Myanmar","volume":"24","author":"Mochizuki","year":"2019","journal-title":"Environ. Health Prev. Med."},{"key":"ref_13","first-page":"436","article-title":"Chronic arsenic toxicity & human health","volume":"128","year":"2008","journal-title":"Indian J. Med. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1081\/ESE-120016887","article-title":"Neuropathy in arsenic toxicity from groundwater arsenic contamination in West Bengal, India","volume":"38","author":"Mukherjee","year":"2003","journal-title":"J. Environ. Sci. Health A Tox. Hazard. Subst. Environ. Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1081\/CLT-100108509","article-title":"Chronic arsenic toxicity in Bangladesh and West Bengal, India\u2014A review and commentary","volume":"39","author":"Rahman","year":"2001","journal-title":"J. Toxicol. Clin. Toxicol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9492","DOI":"10.1007\/s11356-016-6149-8","article-title":"Arsenic contamination of groundwater and its induced health effects in Shahpur block, Bhojpur district, Bihar state, India: Risk evaluation","volume":"23","author":"Chakraborti","year":"2016","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2188\/jea.16.207","article-title":"Arsenic in drinking water and peripheral nerve conduction velocity among residents of a chronically arsenic-affected area in Inner Mongolia","volume":"16","author":"Fujino","year":"2006","journal-title":"J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12995-021-00302-6","article-title":"The impact of chronic co-exposure to different heavy metals on small fibers of peripheral nerves. A study of metal industry workers","volume":"16","author":"Koszewicz","year":"2021","journal-title":"J. Occup. Med. Toxicol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/20\/10749\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:12:44Z","timestamp":1760166764000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/20\/10749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,13]]},"references-count":18,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["ijerph182010749"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182010749","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,13]]}}}