Abstract

A clinical study was made on 65 cases with the syndrome of arsenism and fluorosis (SAD) from March 1982 to August 1989. All the cases with this syndrome had drunk a well water containing arsenic 0.6 mg/L and fluorine 3.45 mg/L for a long period. The patients all had the clinical manifestations of both chronic arsenism and fluorosis. It was a kind of syndrome caused by the combined harmful effects of these two trace elements, arsenic and fluorine. Higher incidences of peripheral neuritis and cardiovascular changes were found in these patients than in that with single chronic arsenism or single fluorosis. The chief diagnostic criteria of the SAF were recommended as follows: (1) having drunk high arsenic and high fluorine water for a long period, (2) having the two principal symptoms of chronic arsenism or one of them, arsenic keratosis and/or arsenic dyspigmentation, (3) having the principal symptoms and/or signs of chronic fluorosis, clinical or roentgenographic manifestations of dental fluorosis and/or osteofluorosis. However, no final conclusion has yet been reached on the morbidity of both skin and visceral tumors in this series. The incidence of skin cancer was 7.7 percent and a patient [with] a grade II squamous cell carcinoma of esophagus was found.