http://www.greencross.org.tw/toxin/heavy-metal/heavy_metal.htm<br />
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<b style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;"><a name="砷(Arsenic, As)">砷(Arsenic, As)</a></b><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-size:14px;"><span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">一、可能暴露的職業:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">農藥的製造及噴灑,砷的製造及生產、電子半導體的製造等的相關行業,氫化砷(AsH3)則易發生在電腦工業及金屬工業、中藥的砒霜等。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
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<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">二、急性中毒:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color:#FF0000;"><span style="font-family: 新細明體; line-height: 30px;">食入性中毒:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-family: 新細明體; line-height: 30px;">急性期會有噁心、嘔吐、腹痛、血便、休克、低血壓、溶血、大蒜、及金屬味、肝炎、黃疸、急性腎衰竭、昏迷、抽搐。亞急性期會有周邊神經炎、指甲上有Mee&#39;s line出現。</span></span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">吸入性中毒::</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">咳嗽、呼吸困難、胸痛、肺水腫、急性呼吸衰竭。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">氫化砷中毒:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">在高濃度暴露後2-4時發作,引起大量溶血,會有腹痛、血尿及黃疸(triad)的典型症狀,急性腎衰竭並不少見。。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
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<span style="color:#FF0000;"><span style="font-family: 新細明體; line-height: 30px;">三、慢性中毒:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-family: 新細明體; line-height: 30px;">A.皮膚:溼疹、角質化、皮膚癌、Boween&#39;s disease。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-family: 新細明體; line-height: 30px;">B.神經:中樞及周邊神經病變。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-family: 新細明體; line-height: 30px;">C.血液:貧血、血球稀少、白血病。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="font-family: 新細明體; line-height: 30px;">D.其他:周邊血管病變、四肢壞死(烏腳病Black foot disease)及肝功能異常。肺癌、肝癌及膀胱癌的機牽大幅上升。</span></span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
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<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">四、實驗室檢查:</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">24小時尿液的砷含量大於100ug/l(吃海產也會上升),但是慢性中毒者血中濃度往往正常或稍微偏高。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
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<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">五、診斷</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">A.血中濃度常不準確。在48小時內不吃富含砷的食物如海產,且尿中砷濃度大於150 ug/L或100ug/day。</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">B.改測尿液中的無機砷含量。其尿中三價砷(劇毒)及五價砷濃度大於50 ug/ g creatinine</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
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<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">六、治療</span><br style="color: rgb(0, 0, 0); font-family: 新細明體; font-size: medium; line-height: 30px;" />
<span style="color: rgb(0, 0, 0); font-family: 新細明體; line-height: 30px;">急性中毒--支持性治療及D-penicillamine, BAL,DMSA, DMPS等解毒劑。DMSA可改善慢性中毒症狀。</span></span>