A French maid, a promiscuous husband, and an angry wife -- the first arsenic poisoning patient that Dr. Michael Harbut saw in his Michigan practice was, in his words, the victim of a "classic love triangle."
"But that's the exception rather than the rule," said Harbut, chief of the Center for Occupational and Environmental Medicine at the Wayne State University School of Medicine.
While arsenic has been famously slipped into the food or drink of unsuspecting spouses and royalty for centuries, today it's more likely to be fed to poultry, applied to crops, leached from pressure-treated wood, puffed into the air by coal-fired power plants and drilled free from bedrock.
As a result, experts warn that many people are unwittingly exposed to small amounts every day. Each exposure may not be acutely deadly, or even noticeably harmful, but the sum of tiny doses over time may take a toll on the body -- potentially triggering or exacerbating disease, said Harbut.
The consequences can run the gamut of today's major health concerns, including cancer, diabetes and heart disease.
"Arsenic is quite remarkable in how many things it can do and how many systems in the body it seems to perturb in subtle ways," said Joshua Hamilton, senior scientist at the Marine Biological Laboratory in Woods Hole, Mass., adding that arsenic tends to do its damage slowly and quietly, without raising a typical doctor's suspicions.
Particularly vulnerable are young kids. Low-level exposures in the womb and during childhood can set the stage for problems later in life, Hamilton said.
In September, Consumer Reports released a study that found detectable levels of arsenic in a childhood staple, rice, sold in U.S. supermarkets.
The news, which came less than a year after a similar report uncovered fruit juices contaminated with arsenic, left some parents frightened and frustrated.
"Oh great, another contaminated thing," said Diana Chaplin of New York City, who has now stopped feeding rice to her two-year-old son, Elliot. "This is something I thought was okay, and now it's not okay."
Carla Daniels, a spokesperson with the U.S. FDA, told The Huffington Post that the agency is now testing rice samples to "determine what limits or other steps" they might take. "We are working as hard and as fast as we can," she said.
Despite the fact that arsenic consistently ranks at the top of federal government lists of environmental chemicals of concern to human health, no standards yet exist for arsenic levels in food.
"There needs to be regulations on arsenic in food -- in particular, baby rice," said Allan Smith, director of the Arsenic Health Effects Research Program at the University of California, Berkeley.
But not everyone believes there is reason to panic.
"The U.S. rice industry does not believe that the levels of arsenic found in rice and rice products pose a threat to human health," said Stacy Fitzgerald-Redd, a spokesperson for the industry group USA Rice Federation, which has not taken a position on the potential regulation of arsenic in rice.
While Fitzgeral-Redd said that the industry "is committed to responsibly examining the issue" and supports the FDA effort, she pointed out that in Japan, where rice consumption is far greater than in the U.S., overall disease rates are lower.
This "obscures the point," said Hamilton. "There might be a contribution of arsenic to disease risk," he said, "but it might be masked by an otherwise healthy population" that consumes a lot of fish and little red meat.
Eating rice or drinking juice aren't the only ways one might be exposed to arsenic. Playground equipment and meats can be mediums, and drinking water has long been a recognized source.
In fact, the EPA regulates arsenic in drinking water. For people using private wells, however, the only way to know if dangerous amounts of arsenic are flowing into their homes is to have the water tested.
Due to its natural presence in bedrock, a little arsenic in soil and water is to be expected, especially when stirred up by the drilling of a well. "But just because it's natural doesn't mean it's not bad," said Harbut. "Asbestos and gasoline are also natural."
Then there are the unnatural sources. About 1.6 million tons of arsenic have been enlisted for agricultural and industrial purposes in the U.S. since 1910, according to Consumer Reports. Much of the arsenic used is of the less toxic organic form. However, as Hamilton said, "every organic form can be broken down by micro-organisms" and potentially released as the more harmful inorganic arsenic.
Once arsenic is in the environment, it's tough to eliminate. Rice grown in Louisiana, Texas and Arkansas, for example, where arsenical pesticides were once heavily used on cotton, contains higher concentrations of the chemical element than rice grown elsewhere.
"You think organic brown rice is so healthy," said Chaplin, the New York mom. "But even if it's organically grown, the soil is still contaminated." Chaplin said she continues to eat the occasional helping of rice, but now rinses the rice longer and cooks it in extra water, like you would pasta, to help reduce the arsenic residues.
While the lists of sources and health effects lengthen, some researchers emphasize that there is no need for alarm over arsenic, at least not for the average American.
Relative to the high rates of disease he's found in exposed Chilean and Bangladeshi populations, Smith said that typical exposures in the U.S. are very low and "not of concern."
Hamilton disagreed, and pointed back to the emerging knowledge of arsenic's low-dose effects. His research has suggested that exposures to arsenic at EPA's current drinking water standard of 10 parts per billion was enough to disrupt hormones in mice. The same hormones play roles in a variety of human conditions -- from cancer and heart disease to reproductive problems and cognitive deficits in children.
As Harbut, who suggested that even lower levels could cause harm, succinctly put it: "Arsenic is bad. Duh."
