{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:05Z","timestamp":1787028365205,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2004,9,30]],"date-time":"2004-09-30T00:00:00Z","timestamp":1096502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study conducted in Bangladesh reports the relationship of clinical complications with nutritional status and the prevalence of leukopenia among arsenic exposed patients living in the rural villages. A total of 115 exposed individuals diagnosed as arsenicosis patients were randomly selected from four known arsenic endemic villages, and age-matched 120 unexposed subjects were enrolled in the study program. The duration of arsenic exposure in about 37% of the patients was at least 10 yrs, while the population mean and range were 7.6 \u00b1 5.2 yrs, and 1 \u2013 25 yrs, respectively. The mean arsenic concentrations in the drinking water for the exposed and unexposed (control) population were 218.1 \u03bcg\/L and 11.3 \u03bcg\/L, respectively. The spot urine sample of the arsenicosis patients contained an average of 234.6 \u03bcg\/L arsenic. Although very few patients showed elevated WBC count, 16% had leukopenia (below normal count), and the whole population had significantly low WBC count than the control subjects. Prevalences of neutropenia and lymphocytosis were observed in patients with chronic exposure to high levels of arsenic in water. The body mass index was found to be lower than 18.5, the cut-off point for malnutrition (underweight), in about 28% of the arsenicosis cases compared to 15% of the controls. The monthly income and total calorie consumption per day showed the patients were underprivileged than the controls. Arsenical symptoms and complications were more severe in the nutritionally vulnerable (underweight) patients than the overweight ones. Also, the incidences of leukopenia and anaemia were more common in the female patients who were underweight. The findings of this research demonstrate that the poor nutritional status of patients increases the complications of chronic arsenic toxicity; suggest the possibility of other sources of arsenic contamination different from drinking water in the study area; and establish a higher prevalence of leukopenia and lymphocytosis in arsenicosis patients.<\/jats:p>","DOI":"10.3390\/ijerph2004020074","type":"journal-article","created":{"date-parts":[[2008,10,25]],"date-time":"2008-10-25T13:52:15Z","timestamp":1224942735000},"page":"74-82","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Association of Clinical Complications with Nutritional Status and the Prevalence of Leukopenia among Arsenic Patients in Bangladesh"],"prefix":"10.3390","volume":"1","author":[{"given":"Laila  N.","family":"Islam","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka-1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AHM  Nurun","family":"Nabi","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka-1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M  Mahfuzur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka-1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monsur  A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka-1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azizul  I.","family":"Kazi","sequence":"additional","affiliation":[{"name":"Bangladesh Council of Scientific and Industrial Research (BCSIR), Mirpur Road, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2004,9,30]]},"reference":[{"key":"ref_1","first-page":"683","article-title":"Chronic arsenic toxicity in Bangladesh and West Bengal, India \u2013 A review and commentary","volume":"39","author":"Rahman","year":"2001","journal-title":"Clin. Toxicol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1006\/taap.2001.9152","article-title":"Differential effects of trivalent and pentavalent arsenicals on cell proliferation and cytokine secretion in normal human epidermal keratinocytes","volume":"172","author":"Vega","year":"2001","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1289\/ehp.99107727","article-title":"The relationship of arsenic levels in drinking water and the prevalence rate of skin lesions in Bangladesh","volume":"107","author":"Tondel","year":"1999","journal-title":"Environ. Health Perspect."},{"key":"ref_4","first-page":"645","article-title":"Ground water arsenic contamination and sufferings of people in West Bengal, India and Bangladesh","volume":"Vol. 10","author":"Roussel","year":"2000","journal-title":"Trace Elements in Man and Animals"},{"key":"ref_5","unstructured":"Nriagu, J.O. (1994). Arsenic in the Environment. Part II: Human Health and Ecosystem Effects, John Wiley & Sons, Inc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1600-0773.2001.890101.x","article-title":"Role of metabolism in arsenic toxicity","volume":"89","author":"Vahter","year":"2001","journal-title":"Pharmacol Toxicol."},{"key":"ref_7","unstructured":"(1999). National Academy Press."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1080\/00039896.1984.10545849","article-title":"Outbreak of fatal arsenic poisoning caused by contaminated drinking water","volume":"39","author":"Armstrong","year":"1984","journal-title":"Arch. Environ. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"424","DOI":"10.5694\/j.1326-5377.1975.tb105939.x","article-title":"Arsenic poisoning from anti-asthmatic herbal preparations","volume":"2","author":"Tay","year":"1975","journal-title":"Med. J. Aus."},{"key":"ref_10","first-page":"515","article-title":"Megaloblastic, dyserythropoietic anemia following arsenic ingestion","volume":"10","author":"Lerman","year":"1980","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/oxfordjournals.aje.a112635","article-title":"A survey of a population exposed to high concentrations of arsenic in well water in Fairbanks, Alaska","volume":"108","author":"Harrington","year":"1978","journal-title":"Am. J. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3109\/15563657909010601","article-title":"Arsenic exposure in multiple environmental media in children near a smelter","volume":"14","author":"Morse","year":"1979","journal-title":"Clin. Toxicol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/ajh.2830360415","article-title":"Arsenic intoxication presenting as a myelodysplastic syndrome: A case report","volume":"36","author":"Rezuke","year":"1991","journal-title":"Am. J. Hematol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3109\/08923979909052758","article-title":"Sodium arsenite reduces proliferation of human activated T-cells by inhibition of the secretion of interleukin-2","volume":"21","author":"Vega","year":"1999","journal-title":"Immunopharmacol. Immunotoxicol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1046\/j.1523-1747.2002.00475.x","article-title":"Arsenic induces tumor necrosis factor alpha release and tumor necrosis factor receptor 1 signaling in T helper cell apoptosis","volume":"119","author":"Yu","year":"2002","journal-title":"J. Invest. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1021\/tx9701384","article-title":"Inorganic and methylated arsenic compounds induce death in murine macrophages via different mechanisms","volume":"11","author":"Sakurai","year":"1998","journal-title":"Chem. Res. Toxicol."},{"key":"ref_17","unstructured":"Nriagu, J. O. (1994). Arsenic in the Environment. Part II: Human Health and Ecosystem Effects, John Wiley & Sons, Inc."},{"key":"ref_18","unstructured":"Nriagu, J. O. (1994). Arsenic in the environment. Part II: Human Health and Ecosystem Effects, John Wiley & Sons, Inc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/bjc.1995.22","article-title":"Multiple risk factors associated with arsenic induced skin cancer: effects of chronic liver disease and malnutritional status","volume":"71","author":"Hsueh","year":"1995","journal-title":"Br. J. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1093\/ije\/27.5.871","article-title":"Arsenic levels in drinking water and the prevalence of skin lesions in West Bengal, India","volume":"27","author":"Mazumder","year":"1998","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/0960312042000209516","article-title":"Association between nutritional status and arsenicosis due to chronic arsenic exposure in Bangladesh","volume":"14","author":"Milton","year":"2004","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1080\/09603120220129346","article-title":"Respiratory effects and arsenic contaminated well water in Bangladesh","volume":"12","author":"Milton","year":"2002","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1161\/01.ATV.16.4.504","article-title":"Dose response relationships between ischemic heart disease mortality and long-term arsenic exposure","volume":"16","author":"Chen","year":"1996","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1093\/ije\/29.6.1047","article-title":"Arsenic in drinking water and the prevalence of respiratory effects in West Bengal, India","volume":"29","author":"Mazumder","year":"2000","journal-title":"Int. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1080\/009841098159213","article-title":"Arsenic toxicity in human erythrocytes: characterization of morphologic changes and determination of the mechanism of damage","volume":"53","author":"Winski","year":"1998","journal-title":"J. Toxicol. Environ. Health"},{"key":"ref_26","first-page":"171","article-title":"Urinary uroporphyrin as an indicator of arsenic exposure in rats","volume":"26","author":"Martinez","year":"1983","journal-title":"Proc. West. Pharmacol. Soc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/0009-2797(94)03601-4","article-title":"Alterations in heme biosynthetic pathway from the III - V semiconductor metal, indium arsenide (In As)","volume":"93","author":"Conner","year":"1995","journal-title":"Chem. Biol. Interact."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1182\/blood.V45.2.241.241","article-title":"Arsenic intoxication as a cause of megaloblastic anemia","volume":"45","author":"Westhoff","year":"1975","journal-title":"Blood"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1182\/blood.V53.5.820.820","article-title":"Arsenic-induced bone marrow toxicity: Ultrastructural and electron\u2013probe analysis","volume":"53","author":"Feussner","year":"1979","journal-title":"Blood"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/0378-4274(87)90165-2","article-title":"Effects of low dietary intake of methionine, choline or proteins on the biotransformation of arsenite in the rabbits","volume":"37","author":"Vahter","year":"1987","journal-title":"Toxicol. Lett."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1093\/oxfordjournals.aje.a116797","article-title":"Arsenic ingestion and internal cancers: a review [letter]","volume":"138","author":"Engel","year":"1993","journal-title":"Am. J. Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1289\/ehp.6841","article-title":"Nutritional factors and susceptibility to arsenic-caused skin lesions in West Bengal, India","volume":"112","author":"Mitra","year":"2002","journal-title":"Environ. Health Perspect."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/1\/2\/74\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:26:16Z","timestamp":1760221576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/1\/2\/74"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,9,30]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2004,9]]}},"alternative-id":["ijerph2004020074"],"URL":"https:\/\/doi.org\/10.3390\/ijerph2004020074","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,9,30]]}}}