2004—2008年江苏省饮水型地方性砷中毒流行病学调查

目的了解江苏省高砷水源分布和地方性砷中毒（简称地砷病）病情。方法在全省重点可疑地区进行高砷水源筛查,对6个市、20个县（市、区）进行水样采集和水砷含量检测,对水砷含量≥0．05mg／L的村进行地砷病病情调查,依据《地方性砷中毒诊断标准》进行地砷病诊断。结果2004—2008年全省高砷水源筛查共调查1934个村,发现超标村37个;共采集水样40060份,检测出超标水样427份。高砷村分布在沿淮河和洪泽湖周边的淮安XY、JH、HZ、宿迁SH及靠近安徽的徐州SN5个县。2008年地砷病病情调查显示,患者总检出率7．42％,轻度及以上检出率2．70％,病情较轻。结论江苏省的高砷区主要呈沿淮河与洪泽湖周边及靠近安徽分布,地砷病病情虽较轻,但防治工作仍不能忽视,建议进一步加强水砷筛查、病情调查、健康教育和监测工作。     

2019年河南省饮水型地方性砷中毒监测结果分析

目的了解河南省饮水型地方性砷中毒防治进展, 为如期实现消除高砷危害目标提供科学依据。方法 2019年7-8月, 按照《饮水型地方性砷中毒监测方案》, 对河南省已查明的6个县的26个高砷村进行普查, 了解高砷村改水及改水工程运转情况, 测定居民户饮用水砷含量, 同时调查高砷村常住人口砷中毒病情状况。结果全省26个高砷村已全部改水, 改水率为100.00%;在26个高砷村共调查18个改水工程, 全部正常运转;采集水样26份, 水砷含量均< 0.01 mg/L, 符合生活饮用水卫生标准;未发现地方性砷中毒病例。结论河南省饮水型地方性砷中毒得到有效控制, 今后应继续巩固防治成果。     

安徽省地方性砷中毒病区调查

目的了解安徽省是否存在水源性高砷区及地方性砷中毒区,为地方性砷中毒防治提供依据。方法根据安徽省生活饮用水质抽样普查工作的结果,选定天长市、五河县、砀山县为地方性砷中毒重点调查县。采取分阶段随机抽样方法,每县随机选取15个调查点(自然村)调查水砷含量。对饮水水砷含量超标的调查点进行砷中毒病情现场调查,调查居民超标水井饮用年限、皮肤角化、皮肤脱色、皮肤色沉情况,并检测其家中饮用水水砷、水氟含量及尿砷等。结果共计检测水砷450份,其中15份水砷超标(>0.05mg/L)。对水砷超标较高的五河县临北乡官塘铺行政村宣滩自然村调查,初步诊断发现地方性砷中毒可疑14人,轻度5人。结论安徽省境内发现水源性高砷区和地方性砷中毒病区存在。并发现有疑似及轻度病人存在。在发现高砷区中不存在高氟水源和地氟病病区。应尽快在高砷区开展改水降砷及地方性砷中毒的监测工作。     

2004-2008年江苏省饮水型地方性砷中毒流行病学调查

目的 了解江苏省高砷水源分布和地方性砷中毒(简称地砷病)病情.方法 在全省重点可疑地区进行高砷水源筛查,对6个市、20个县(市、区)进行水样采集和水砷含量检测,对水砷含量≥0.05 mg/L的村进行地砷病病情调查,依据<地方性砷中毒诊断标准>进行地砷病诊断.结果 2004-2008年全省高砷水源筛查共调查1 934个村...     

沈丘县高砷水源筛查结果分析

目的筛查地处淮河流域的河南省沈丘县高砷水源,为砷中毒防治提供依据。方法以淮河支流沙河为轴心,沿河80个自然村居民饮用水为筛查对象,采用原子荧光分光光度法测定水砷含量。结果检测20个分散供水(井深50米)村500份水样、60个深水井集中供水自然村19处水源水,分散供水水砷范围为:0.001~0.054 mg/L,共检出水砷在0.01~0.05 mg/L水样30个,占6.00%,未检出水砷0.05 mg/L水样,20个村水砷含量均≤0.01mg/L;19处集中供水水样砷含量范围为:0.001~0.006 mg/L。结论河南省沈丘县无砷超标水源,以村为单位,无分散供水砷污染(以水砷0.01 mg/L计),沈丘县无砷中毒防治任务。     

四川省金川县饮水型砷中毒流行病学调查

目的　了解金川县砷中毒的病情及流行特征 ,查明引起砷中毒的高砷来源。方法　对经检测饮水砷含量超标的村进行病情调查 ,同时对该村的地理、地貌、饮用水源及环境中砷污染情况进行调查 ,测定内环境和外环境介质中砷含量。结果　饮水砷含量检测有 3个共饮泉水源超标 ,最高饮水砷含量达 0 2 87mg/L ,超标 5倍多 ;共调查 375人 ,查出患者 6 2人 ,患病率为 16 5 3% ,其中年龄最小 11岁 ,最大 83岁。结论　四川省存在地方性砷中毒。共饮泉水中砷含量超标是引起该病流行的主要因素。由于没有其他环境砷污染 ,水砷含量高是自然形成的 ,因此属于饮水型地方性砷中毒     

甘肃省高砷饮用水源筛查及砷中毒调查

目的 了解甘肃省居民饮用水含砷量分布及饮高砷水人群受威胁情况,为科学防治饮水型地方性砷中毒提供依据.方法 于2005-2011年,按照全国饮用水高砷水源筛查方案,选择13个市(州)42个县进行饮水砷含量筛查,对检出高砷水源的地区人群进行受危害情况调查.结果 筛查范围覆盖全省13个市(州)的42个县(区),筛查454个乡1 596个村约177.1万人.采集水样24 965件,筛查出水砷含量＞0.05 mg/L的超标水样181件,超标率为0.73％;其中,水砷在＞0.05～0.2 mg/L的占90.61％(164/181),＞0.2～0.5 mg/L的占5.52％ (10/181),＞0.5～1.04 mg/L的占3.87％(7/181).砷含量超标水源主要分布在夏河、合作、舟曲、环县、徽县、成县、天祝、漳县、两当、临潭10个县的58个村,约有4.6万人受到砷中毒威胁.在调查的8 489名居民中共检出砷中毒患者157例.确定出饮水型砷中毒病区12个,其中,重病区、中病区各1个,轻病区10个,以夏河县病情最重,患病率达49％.结论 甘肃省饮水高砷区分布范围较广,砷中毒受威胁人口多,局部地区病情严重.     

2006～2008年陕西省汉中市饮水性砷中毒流行病学调查

目的了解2006～2008年汉中市沿汉江流域地区及分布有高砷石煤的镇巴县高砷水源分布和地方性砷中毒(简称地砷病)现状。方法根据国家和陕西省项目技术方案确定的选点原则,在汉中市沿汉江流域选择宁强、略阳、勉县、洋县、西乡5县及分布有高砷石煤的镇巴县共15个乡(镇)的25个自然村进行居民饮用水源水砷筛查检测,对水砷含量≥0.05 mg/L的村进行地砷病线索调查,对水砷含量≥0.15 mg/L的村进行地砷病病情普查,普查率不低于90%。地砷病诊断按照《地方性砷中毒诊断标准》(WS/T211-2001)进行。结果共检测水样616份,水砷超过国家标准(0.05 mg/L)水样7份,超标率1.14%。超标水样均分布于勉县温泉镇郭家湾村,属于温泉分布区所在地,水砷最高含量0.11 mg/L。超标水源暴露人口970人,暴露率9.84%。地砷病总检出率3.16%(25/791)。其中轻度9例(占36%),中度14例(占56%),重度2例(占8%);年龄52～88岁之间,平均65.56岁;暴露时间52～88年之间,平均65.16年;男性检出率为6.25%(24/384),女性为0.25%(1/407),男性明显高于女性。临床以单纯皮肤色素脱失居多,占76%(19/25),色素脱失与色素沉着并存次之,占24%(6/25),合并有肢端麻木达40%(10/25),未检出皮肤角化、鲍文氏病及皮肤癌病例。在镇巴县燃煤型砷中毒病区未检出水砷含量超标水样。结论汉中市沿汉江流域的勉县温泉地区水砷含量超标,属于地砷病病区,并与地方性氟中毒病区并存,建议开展氟砷联合中毒研究。     

阿坝州水砷调查

目的 为了解阿坝州高砷水源存在和分布范围,为进一步调查和掌握全州地方性砷中毒病情提供线索和依据.方法 每个县按东、西、南、北、中方位各选1个乡进行调查,水样现场采用快速水砷半定量测定试剂盒进行筛查.结果 共调查50个乡267个村,水样2 462份,现场采用快速水砷半定量测定试剂盒进行筛查共有29份水样超标.结论 从松潘、九寨沟、小金等县高砷水资料发现,一般有矿的地区很可能有高砷水存在,这为今后调查高砷水源提供参考.     

2012年平罗县饮水型地方性砷中毒调查

为了解平罗县饮水型地方性砷中毒情况,于2012年对3个被列为国家级监测点的病区村(A、B、C)进行砷中毒患病调查;每村采集30名以往暴露过高砷水的成人(年龄在15～78岁,不足30人时,可补充检测疑似患者、正常人)尿样;并于枯水期采集1份末梢水水样,按照相应国标监测尿砷、水砷含量. 三个监测点由2个改水工程覆盖(B村2009年3月改水,A、C村2008年5月改水),改水工程运转正常且3个村水砷含量(＜0.01～0.024 mg/L)均合格.共检查46人,未发现砷中毒患者;仅在C村检出4例可疑病例,占11.43％(4/35).尿砷含量在0.001～0.055 mg/L,中位数为0.008 mg/L,几何均值为0.009 mg/L.见表1.     

Fighting arsenic at the grassroots: experience of BRAC's community awareness initiative in Bangladesh

The study evaluates the arsenic mitigation project of BRAC in raising awareness of arsenic poisoning in rural communities in Bangladesh. Data came from selected project villages in south-western Bangladesh. Comparison villages were also selected from the same region. A total of 1240 randomly selected adults were interviewed in May 2000. Findings reveal that the mitigation project played a significant, positive role in raising awareness of the safe water options, signs of arsenicosis, mode of transmission and the type of treatment. Testing tube-well water for arsenic created curiosity, innovation and interest in the community, and the water treatment plant became a symbol of the arsenic campaign. The study concludes that the behavioural change aspects of the arsenic mitigation project have the potential to significantly improve the level of understanding about arsenic contamination in the traditional communities.     

Associations between arsenic in drinking water and pterygium in southwestern Taiwan

BACKGROUND: Pterygium is a fibrovascular growth of the bulbar conjunctiva and underlying subconjunctival tissue that may cause blindness. The mechanism of pterygium formation is not yet fully understood, but pterygium has some tumorlike features. OBJECTIVES: The objective of this study was to evaluate the association between arsenic exposure through drinking water and the occurrence of pterygium in southwestern Taiwan. METHODS: We recruited participants > 40 years of age from three villages in the arseniasis-endemic area in southwestern Taiwan (exposure villages) and four neighboring nonendemic villages (comparison villages). Each participant received an eye examination and a questionnaire interview. Photographs taken of both eyes were later graded by an ophthalmologist to determine pterygium status. RESULTS: We included 223 participants from the exposure villages and 160 from the comparison villages. The prevalence of pterygium was higher in the exposure villages across all age groups in both sexes and increased with cumulative arsenic exposure. We found a significant association between cumulative arsenic exposure and the prevalence of pterygium. After adjusting for age, sex, working under sunlight, and working in sandy environments, we found that cumulative arsenic exposure of 0.1-15.0 mg/L-year and > or = 15.1 mg/L-year were associated with increased risks of developing pterygium. The adjusted odds ratios were 2.04 [95% confidence interval (CI), 1.04-3.99] and 2.88 (95% CI, 1.42-5.83), respectively. CONCLUSIONS: Chronic exposure to arsenic in drinking water was related to the occurrence of pterygium, and the association was still observed after adjusting for exposures to sunlight and sandy environments.     

2011-2012年江苏省高砷地区饮水型地方性砷中毒监测结果

目的了解江苏省高砷地区饮水型砷中毒的病情现状,为进一步制定防治策略提供依据。方法 2011-2012年监测高砷地区改水工程进度,并在所有改水工程中随机选择11个监测其运行情况;从高砷区中选择2个自然村作为监测点,对连续居住半年以上的居民按照地方性砷中毒诊断标准(WS/T211-2001)进行砷中毒病情调查,同时采集监测点水样,测定饮水含砷量。结果 2011年完成改水工程11个,改水率29.73%,累计完成改水工程29个,累计改水率78.37%;2012年完成改水工程8个,改水率21.62%,累计完成改水工程37个,累计改水率100.00%。2011年11个改水工程均正常运转,其中10个水砷含量合格,合格率为90.91%。2012年11个改水工程均正常运转,水砷含量全部合格。2011年共调查307人,砷中毒9例,检出率为2.93%,均为轻度病例,可疑病例7例(占2.28%);2012年共调查353人,无中毒病例,可疑病例10例(占2.83%)。两年均未发现皮肤癌病例。结论江苏省高砷地区的改水工作基本完成,改水工程正常运转,可疑病人检出率稍有升高,需尽快采取相关措施。     

The relationship of arsenic levels in drinking water and the prevalence rate of skin lesions in Bangladesh.

To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1,481 subjects [Greater/equal to] 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation). Individual exposure assessment could only be estimated by present levels and in terms of a dose index, i.e., arsenic levels divided by individual body weight. Arsenic water concentrations ranged from 10 to 2,040 microg/L, and the crude overall prevalence rate for skin lesions was 29/100. After age adjustment to the world population the prevalence rate was 30. 1/100 and 26.5/100 for males and females, respectively. There was a significant trend for the prevalence rate both in relation to exposure levels and to dose index (p < 0.05), regardless of sex. This study shows a higher prevalence rate of arsenic skin lesions in males than females, with clear dose-response relationship. The overall high prevalence rate in the studied villages is an alarming sign of arsenic exposure and requires an urgent remedy.     

应用10％抽样法判定高砷暴露区的研究

目的　研究以 10 %抽样率检测井水中砷浓度判定高砷暴露区 (村、屯 )的方法是否具有代表性。方法　选择山西、内蒙 31个已确定的高砷暴露村 ,应用现场快速检测试剂盒对压把井井水中砷浓度进行测定。根据各村水井分布图 ,按东、南、西、北、中将每村划分为 5个区 ,应用盲法在每个区中随机抽样。以水砷浓度 >0 .0 5 mg/ L作为超标井 ,计算抽样超标率。与实际超标率进行比较 ,评价 10 %抽样法对实际检出率的代表性。结果　在水井实际超标率不低于 5 %的情况下 ,10 %抽样法检出率与实际检出率之间差异无显著性 ,可以较好的代表实际检出率。而在实际超标率低于 5 %时 ,此方法对实际情况的代表性较差。结论　 10 %抽样法在实际超标率 >5 %时可以较好的　　　　　　代表实际情况     

石门雄黄矿地区居民砷暴露研究

目的：研究砷污染地区居民砷暴露水平的分布特征。方法：分析污染区和对照区环境样品和居民头发砷含量。结果：污染区三个村土壤砷含量８４．１７～２９６．１９ｍｇ／ｋｇ。河水砷含量达０．５～１４．５ｍｇ／Ｌ，井水、自来水、食物含砷量一般符合国家卫生标准。砷摄入量１９５～１１２９μｇ／ｄ。居民头发砷含量中位数为０．９７２～２．４５９μｇ／ｇ。发砷值随年龄增加而增加。结论：石门雄黄矿附近地区河水砷污染严重，以河水为饮用水源的居民砷暴露水平达到甚至超过国内外重大慢性砷中毒案例的暴露水平，应引起重视     

甘肃省合作市水源水含砷情况调查及对人群的影响

目的 调查甘肃省合作市水源水含砷情况及对人群的影响.方法 通过合作市7个乡、12个行政村、162个自然村进行的193份饮水水源样本的筛查和地砷病病情普查工作.按照《甘肃省地方病防治项目实施方案》和《甘肃省高砷区普查方案》的技术要求进行.凡筛查确定的高砷水源的自然村,以该自然村为中心采集全部饮用水源检测砷含量.结果 发现超标水样分布在合作市的4个乡的11个自然村,超标水样13份,占6.7%.在高砷区小学生、成年人中发现患皮肤疣状物者较多,其表面干燥、皲裂、出血.高砷水源区与低砷水源区人群尿砷水平比较,差异有统计学意义（P＜0.05）.结论 在少数民族聚居地区发现高砷水源的分布和地方性砷中毒疑似病人,为今后进行地方性砷中毒病区的确定和病人的确诊,以及病区改水驱砷等综合治理措施提供科学依据.     

Status of groundwater arsenic contamination and human suffering in a Gram Panchayet (cluster of villages) in Murshidabad, one of the nine arsenic affected districts in West Bengal, India

A detailed study was carried out in a cluster of villages known as Sagarpara Gram Panchayet (GP), covering an area of 20 km2 and population of 24,419 to determine the status of groundwater arsenic contamination and related health effects. The arsenic analysis of all hand tubewells (n = 565) in working condition showed, 86.2% and 58.8% of them had arsenic above 10, and 50 microgl(-1), respectively. The groundwater samples from all 21 villages in Sagarpara GP contained arsenic above 50 microgl(-1). In our preliminary clinical survey across the 21 villages, 3,302 villagers were examined and 679 among them (20.6%) were registered with arsenical skin lesions. A total of 850 biological samples (hair, nail and urine) were analysed from the affected villages and, on average, 85% of them contained arsenic above the normal level. Thus, many people of Sagarpara might be sub-clinically affected. Our data was compared with the international one to estimate population in Sagarpara GP at risk from arsenical skin lesions and cancer. Proper watershed management and economical utilization of available surface water resources along with the villagers' participation is urgently required to combat the present arsenic crisis.     

Dose-response relation between arsenic concentration in well water and mortality from cancers and vascular diseases

Age-adjusted mortality rates were analyzed to examine the dose-response relation between ingested arsenic levels and risk of cancers and vascular diseases among residents in the endemic area of blackfoot disease, a unique peripheral vascular disease associated with long-term exposure to high-arsenic artesian well water and confined to the southwestern coast of Taiwan. The arsenic levels in well water determined in 1964-1966 were available in 42 villages of the study area, while mortality and population data during 1973-1986 were obtained from the local household registration offices and Taiwan Provincial Department of Health. Age-adjusted mortality rates from various cancers and vascular diseases by sex were calculated using the 1976 world population as the standard population. A significant dose-response relation was observed between arsenic levels in well water and cancers of the bladder, kidney, skin, and lung in both males and females, and cancers of the prostate and liver in males. However, there was no association for cancers of the nasopharynx, esophagus, stomach, colon, and uterine cervix, and for leukemia. Arsenic levels in well water were also associated with peripheral vascular diseases and cardiovascular diseases in a dose-response pattern, but not with cerebrovascular accidents. The dual effect of arsenic on carcinogenesis and arteriosclerosis and the interrelation between these two pathogenic mechanisms deserve more intensive study.     

Community wells to mitigate the arsenic crisis in Bangladesh

OBJECTIVE: To monitor the effectiveness of deep community wells in reducing exposure to elevated levels of arsenic in groundwater pumped from shallower aquifers. METHODS: Six community wells ranging in depth from 60 m to 140 m were installed in villages where very few of the wells already present produced safe water. By means of flow meters and interviews with villagers carrying water from the community wells, a study was made of the extent to which these were used during one year. The results were compared with household and well data obtained during a previous survey in the same area. FINDINGS: The mean arsenic concentration in water pumped from wells already in use in the villages where the community wells, were installed was 180 +/- 140 micrograms/l (n = 956). Monthly sampling for 4-11 months showed that arsenic levels in groundwater from five of the six newly installed wells were consistently within the WHO guideline value of 10 micrograms/l for drinking-water. One of these wells met the Bangladesh standard of 50 micrograms/l arsenic but failed to meet the WHO guideline values for manganese and uranium in drinking-water. The community wells were very popular. Many women walked hundreds of metres each day to fetch water from them. On average, 2200 litres were hand-pumped daily from each community well, regardless of the season. CONCLUSION: A single community well can meet the needs of some 500 people residing within a radius of 150 m of it in a densely populated village. Properly monitored community wells should become more prominent in campaigns to reduce arsenic exposure in Bangladesh. Between 8000 and 10,000 deep community wells are needed to provide safe water for the four to five million people living in the most severely affected parts of the country.