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Recent evidence suggests that the development of skin lesions from arsenic exposure may be mediated by increases in the expression of various growth factors, including transforming growth factor-alpha (TGFα). To investigate this association in humans, levels of total urinary arsenic and urinary TGFα were determined in 41 individuals with and without arsenic-associated skin lesions from Bangladesh who have chronic exposure to arsenic in their drinking water. After adjusting for age and sex, total urinary arsenic was found to be correlated with urinary TGFα (R 2 = 0.37; p < 0.0001), particularly in those individuals with arsenic-associated skin lesions (R 2 = 0.70; p < 0.0001). Stratification of the cohort into quartiles based on urinary TGFα levels demonstrated a trend of increasing odds ratios for the presence of arsenic-associated skin lesions with increasing urinary TGFα, although this was not significant (p = 0.15). These results suggest that urinary TGFα may be a useful biomarker for the epidermal effects of arsenic exposure. [ABSTRACT FROM AUTHOR]