Document YjepZEVRbKLea23KB056R2VmN

40 OCCUPATIONAL TUMORS AND ALLIED DISEASES water. The classical, but apparently not unique example of an endemic en vironmental contact with arsenic (present in the drinking water) is presented by the Reichenstein disease, which was observed among the inhabitants of the city of Reichenstein in Silesia. The district of Reichenstein has been for the last 900 years the site of intensive mining activities (gold and silver ores and since 1698 also arsenic ores). During these centuries large spoil banks containing arsenic wastes ac cumulated in the neighborhood of the mine shafts. As the spring water coming from the nearby mountains ran through this area, arsenic was dissolved in it. Similarly, the underground water, from which most of the drinking water supply was obtained formerly, contained considerable amounts of arsenic (10 to 15 mgm. per liter, or about 10 times the minimal toxic dose). The arsenic content of this underground water was especially high wherever connections between the underground water and the water in the mine pits existed. In addition to this environmental exposure from the consumption of arsenic containing drinking water, there also existed an occupational type of contact for individuals employed in the construction trades, as the arsenic spoils in this region were used for building material and the preparation of mortar. Chronic arsenicism with its neuritic, gastro-intestinal, hepatic and cutaneous manifesta tions was a disease commonly observed among the inhabitants of Reichenstein for many centuries up to rather recent times. The first description of this important and interesting public health problem was rendered by Geyer in 1898, who mentioned that a high incidence of malignant tumors was observed among the inhabitants of this region. Geyer noted especially the occurrence of arsenical keratoses and epitheliomas. This observation was confirmed by several local physicians (Habel; Jahn; Wilde). A comprehensive report on the Reichenstein disease was published in 1937 by Kathe, in which the various aspects of this disorder were discussed in detail. Since the town was provided with a new and adequate water supply in 1928, through which the arsenic content of the water was lowered to a maximum of 0.015 mgm. per liter, it must be expected that this interesting source of endemic arsenicism will grad ually lose most of its practical importance and will become a matter of past history (Gottron). Recent reports from Argentina indicate that similar conditions as those observed in the Reichenstein district seem to exist in certain parts of Argentina. The drinking water in these parts contains appreciable amounts of arsenic and the occurrence of arsenical keratoses and epitheliomas among the inhabitants has been observed (Seminario and Alvarado; Fernandez} Corbella; Garcia and Ruiz} Alvarez). In a recent communication from this country, Arguello stated that 39 out of 323 cases of skin cancer treated at his clinic were of environmental arsenic origin, coming from a region in which chronic poisoning was endemic on account of the high arsenic content of the drinking water and the foodstuffs raised there.