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From April 1 st , 2016, to March 31 st,  2017, 48 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 57,570 patient-periods (Table 1). Participating units reported 127 VARBSIs in 120 patients. Patient-periods involving a fistula account for % of patient-periods. The VARBSI incidence rate is  cases per 100 patient-periods for patients with an arteriovenous (AV) fistula,  for patients with a synthetic fistula (graft),  for patients with a tunneled catheter and  for patients with a non-tunneled catheter. In 2016–2017, incidence rates for tunneled and non-tunneled catheters have significantly decreased compared to rates for 2012-2016 (p < ) while rates for AV fistulas and grafts have remained stable. Since 2015-2016, three HD units joined the surveillance. Data were extracted on May 5 th , 2017.

Two arsenic pigments have been widely used since their discovery – Paris Green and Scheele's Green . After the toxicity of arsenic became widely known, these chemicals were used less often as pigments and more often as insecticides. In the 1860s, an arsenic byproduct of dye production, London Purple was widely used. This was a solid mixture of arsenic trioxide, aniline, lime, and ferrous oxide, insoluble in water and very toxic by inhalation or ingestion [45] But it was later replaced with Paris Green, another arsenic-based dye. [46] With better understanding of the toxicology mechanism, two other compounds were used starting in the 1890s. [47] Arsenite of lime and arsenate of lead were used widely as insecticides until the discovery of DDT in 1942. [48] [49] [50]

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