In 1921 in Chicago, Otylia “Tillie” Kupczyk asked her landlord if she might store a casket in their apartment building’s basement. Tillie had bought the casket on sale, and she had a feeling she would need it soon for her third husband, Frank. She had premonitions he was about to die and she wanted to be prepared. Frank indeed fell ill and died, just like Tillie’s previous two husbands. Tillie promptly cashed her life insurance check and looked for a new man to marry. It didn’t take her long. She met Joseph Klimek at Frank’s funeral in April, and they wed in July.
By November 1922, Tillie had a fresh insurance policy on Joseph’s life. After he became violently sick, physicians discovered trace amounts of arsenic in his stomach. Police immediately suspected his wife had poisoned his food. When it became apparent Joseph would survive the arsenic attempt, police turned their attention to Tillie’s deceased husbands. They exhumed Frank’s body, tested the tissue and also found it tainted with arsenic. Within six months, a jury sentenced Tillie Klimek to life in prison. She died in an Illinois penitentiary in 1936 from natural causes.
Arsenic might seem like a poison from the past, especially since it was mystery writer Agatha Christie’s favorite way to kill a character. But arsenic is a naturally occurring chemical element. Problematically, it shows up in groundwater, sometimes from natural causes, but also from human activities like mining or pesticide use. And an estimated 300 million people worldwide are at-risk for arsenic poisoning from their water supply, including 2.1 million Americans in 25 U.S. states. That means arsenic poisoning persists and it continues to be a fatal, not a fictional, problem.
Understanding Arsenic
Arsenic, which straddles the line between metals and nonmetals on the periodic table, is heavier than iron, nickel and manganese. It naturally occurs in minerals, and it has many industrial uses, such as alloys for lead that are used in ammunition or car batteries.
There are two types of arsenic: inorganic, which is found in drinking water, soils and sediments, as well as rice and some fruit juices. At high levels, inorganic arsenic is lethal to humans. The second type, organic, is seen in seafood and is not toxic to people.
Inorganic arsenic from contaminated groundwater can be found in most North and South American countries, Asia, the Mediterranean, and Australia. It is not widespread in Africa, Eastern Europe, and most of the Middle East. Beyond that, high levels are naturally present in the groundwater of a number of countries, including China, India, Mexicao and the U.S. In states such as Minnesota, 10 percent of private wells have arsenic levels of 10 µg/L (micrograms per liter) or higher, which is the maximum limit set by the Environmental Protection Agency.
Depending on how much a person consumes, they are at risk for the effects of either acute or chronic poisoning. Both types are typically fatal; the World Health Organization estimates that sustained exposure to arsenic at concentrations greater than 500 µg/L can cause chronic poisoning in one in 10 adults.
Acute Incidents
You may associate arsenic poisoning with sudden deaths in 20th-century detective novels, but humans have had a far longer history with it than that. From the Roman Empire through the Middle Ages to the Renaissance, the "king of poisons" was deployed for sinister means thanks to its lack of color, odor or taste when mixed with food and drink.
Today, acute poisoning can happen accidentally when a person ingests something tainted with an insecticide or pesticide containing arsenic. In rare instances, it is used to commit suicide. Acute poisoning occurs with as little as 100 mg, and can kill in as short as 24 hours. The process begins after the poison is ingested. It is absorbed by the small intestine, and the victim typically experiences gastrointestinal pain, vomiting and bloody diarrhea.
In past centuries, its symptoms resembled cholera, which helped poisoners escape scrutiny. In the 1860s, for example, English serial killer Mary Ann Cotton used arsenic to murder 21 people, including three husbands and 12 of her children and step-children. For years, cholera or “gastric fever” were blamed until authorities realized otherwise.
Acute arsenic victims typically die from massive fluid loss, but some experience renal failure, pulmonary edema, seizures or cardiomyopathy. Similar to chronic poisoning, no system in the body is spared from the toxin.
Chronic Cases
Whereas acute poisoning is agonizing but relatively quick, chronic arsenic poisoning can lead to years of suffering. It typically occurs when a person unknowingly drinks tainted water on a daily basis. Arsenic is a classified carcinogen, and the long-term effects are referred to as arsenicosis.
The first symptoms of arsenicosis often show up in the skin. A person might experience hyperpigmentation in a raindrop pattern on their extremities as well as their tongue. Overtime, they endure a keratosis of the hands and feet in which the skin hardens and forms nodules that grow. People with arsenicosis have also experienced blackfoot disease, a peripheral vascular disease that starts with numbness or feelings of cold in the hands or feet. The disease progresses to ulcers or gangrene, and can lead to amputation.
Scientists have studied arsenicosis and found that the symptoms vary, which can make diagnosis difficult. In a hospital-based study of clinical features of arsenicosis in West Bengal, all 156 cases showed pigmentation. Almost 77 percent had an enlarged liver; 70 percent weakness; other common ailments included cough, pain in abdomen, burning of the eyes. In other studies, however, lung disease has been the predominant symptom.
In the long term, arsenic’s chronic risks have been linked to various types of cancers. Studies from arsenic poisoning in Chile and Argentina found a casual relationship with bladder, lung and liver cancers.
Currently, there is no proven cure for chronic arsenicosis. Although some remedies may provide improvement, a person may never fully recover. It’s why arsenic remains one of the World Health Organization’s top ten chemicals of major public health concern.
