Abstract: 【Abstract】 Objective To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province. Methods A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years （except pregnant women） were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions. Results A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 （69.2%, 95% CI: 66.5%, 72.0%） presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median (Q1, Q3) arsenic levels were 0.31 （0.14, 0.74） μg/g in hair samples （n = 1 079） , 0.84 （0.67, 1.10） μg/L in blood samples （n =1 091）, and 60.31 （41.71, 91.52） μg/L in urine samples （n =1 092）. Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions （adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively）. Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions （adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively）. The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without （adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039）. Conclusion Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.

Key words: Arsenic poisoning, Skin manifestations, Prevalence, Environmental exposure, Occupational exposure, Age factors, Arsenic exposure, Arsenic-related skin lesions