Background: Physicians and
epidemiologists frequently use case studies to illustrate aspects of a health
problem or as a starting point for research. By studying the particulars of a
given person’s story, they can find clues about the greater scientific mysteries
involved. In this exercise, you will essentially work backward from this
approach. Using the wide-ranging and factual information presented in the
article, Arsenic: In Search of an Antidote to a Global Poison, you can
choose from a variety of “characters” to develop into their own case study.
This is the type of research that authors of fiction do to create vivid and
accurate depictions of characters’ lives from worlds they may have never
actually experienced. The novel On the Beach by author Nevil Shute is a
well-known example of “environmental fiction” which uses as its backdrop
nuclear war. The nonfiction story The Hot Zone by Richard Preston is a
well-told, gripping story about the deadly Ebola virus. You may choose to write
about the arsenic in your own local environment, somewhere you have never
traveled before, or another setting that is of interest to you. You may search
for material by looking for local news on arsenic contamination, using the
article provided, other internet resources, or even interviewing local health
department officials.
About this assignment: For this
discussion board assignment you only need to post your case study, you do not
have to post additional responses to other student case studies (although you
may do so). You are encouraged to create a character based on your research.
Use details to create a plausible case study of an individual with arsenicosis.
Step 1: Read the article “Arsenic: In Search of an Antidote to a
Global Poison,” EHP Student Edition, September 2005, p. A379. As you read, be
sure to note signs and symptoms of arsenicosis (arsenic poisoning), sources,
possible sources of exposure, and standards for exposure.
Step 2: Based on your reading, create a profile of a fictional
person suffering from arsenicosis (arsenic poisoning). Use your imagination to
fill in the details of this individual’s case history, using the following
headings:
Background: Age, gender, physical description, place of residence,
etc.
Signs and Symptoms/Lab Results: Describe the hypothetical lab findings, and signs and
symptoms of arsenicosis as suffered by your fictional patient.
Environmental Findings: Where was the arsenic coming from and how does it get into
the body? Detail the source.
Treatment/Recommendations: How did health officials proceed or intervene?
Be creative, tell a story. Make sure
that your facts are plausible and consistent with your readings.
Step 3: Share your case study with your class via the class
discussion board.
Below is an example case study.
Background: Jacob Petersen is a fair-skinned man in his early 30s who
lives in a rural area of Washington State. He is a carpenter and built his own
cabin and does work for other people in the area. He moved with his wife, who
is a schoolteacher, into their newly built cabin about 10 months ago. The cabin
is supplied with water from a well on the property and is heated by a
woodstove. Mr. Petersen is an active person in generally good health taking no
medications. He has recently quit smoking but had smoked about 10 packs a year
for the previous 10 years. His wife, parents, and siblings are in good health.
Signs and Symptoms/Lab Results: Mr. Petersen came to his doctor complaining of tingling in
his hands and feet, spreading from his toes and fingers initially. Recently the
tingling has turned to numbness and weakness, especially when trying to grip
tools. His palms and the soles of his feet show dark and pale spots, and some
areas also have raised areas of thickened skin between 4 and 10 millimeters in
diameter. His reflexes also seem to be slightly weak, especially in the ankles.
Mr. Petersen’s urine test showed 6,000 micrograms of arsenic per deciliter
instead of the normal levels, which are usually below 50. His wife’s urine
contained 300 micrograms of arsenic per deciliter.
Environmental Findings: Interviews by health officials revealed that Mr. Petersen
had been bringing home scrap wood from his various job sites and burning it in
the woodstove of his cabin. This wood was often pressure-treated with chromated
copper arsenate (CCA), a wood preservative. The water in his well was also
found to have a level of arsenic at 250 micrograms per liter.
Treatment/Recommendations: Mr. Petersen was told to stop burning scrap wood in his
woodstove and to use caution when handling treated lumber. He was also urged to
get a filter for his well that would remove arsenic, and to change the filters
frequently. His wife was urged to avoid pregnancy until the arsenic had cleared
from their systems, approximately one year. Mr. Petersen was also urged to get
screened regularly for lung and/or skin cancer due to his elevated risk. Area
residents were also notified to test their wells for arsenic by local public
health officials.
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