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1.
BACKGROUND: There is a need to identify and evaluate an effective mitigation program for arsenic exposure from drinking water in Bangladesh. OBJECTIVE: We evaluated the effectiveness of a multifaceted mitigation program to reduce As exposure among 11,746 individuals in a prospective cohort study initiated in 2000 in Araihazar, Bangladesh, by interviewing participants and measuring changes in urinary As levels. METHODS: The interventions included a) person-to-person reporting of well test results and health education; b) well labeling and village-level health education; and c) installations of 50 deep, low-As community wells in villages with the highest As exposure. RESULTS: Two years after these interventions, 58% of the 6,512 participants with unsafe wells (As >/=50 microg) at baseline had responded by switching to other wells. Well labeling and village-level health education was positively related to switching to safe wells (As < 50 mug/L) among participants with unsafe wells [rate ratio (RR) = 1.84; 95% confidence interval (CI), 1.60-2.11] and inversely related to any well switching among those with safe wells (RR = 0.80; 95% CI, 0.66-0.98). The urinary As level in participants who switched to a well identified as safe (< 50 microg As/L) dropped from an average of 375 microg As/g creatinine to 200 microg As/g creatinine, a 46% reduction toward the average urinary As content of 136 microg As/g creatinine for participants that used safe wells throughout. Urinary As reduction was positively related to educational attainment, body mass index, never-smoking, absence of skin lesions, and time since switching (p for trend < 0.05). CONCLUSIONS: Our study shows that testing of wells and informing households of the consequences of As exposure, combined with installation of deep community wells where most needed, can effectively address the continuing public health emergency from arsenic in drinking water in Bangladesh.  相似文献   

2.
Exposure to arsenic has long been known to have neurologic consequences in adults, but to date there are no well-controlled studies in children. We report results of a cross-sectional investigation of intellectual function in 201 children 10 years of age whose parents participate in our ongoing prospective cohort study examining health effects of As exposure in 12,000 residents of Araihazar, Bangladesh. Water As and manganese concentrations of tube wells at each child's home were obtained by surveying all wells in the study region. Children and mothers came to our field clinic, where children received a medical examination in which weight, height, and head circumference were measured. Children's intellectual function on tests drawn from the Wechsler Intelligence Scale for Children, version III, was assessed by summing weighted items across domains to create Verbal, Performance, and Full-Scale raw scores. Children provided urine specimens for measuring urinary As and creatinine and were asked to provide blood samples for measuring blood lead and hemoglobin concentrations. Exposure to As from drinking water was associated with reduced intellectual function after adjustment for sociodemographic covariates and water Mn. Water As was associated with reduced intellectual function, in a dose-response manner, such that children with water As levels > 50 microg/L achieved significantly lower Performance and Full-Scale scores than did children with water As levels < 5.5 microg/L. The association was generally stronger for well-water As than for urinary As.  相似文献   

3.
BACKGROUND: We recently reported results of a cross-sectional investigation of intellectual function in 10-year-olds in Bangladesh, who had been exposed to arsenic from drinking water in their home wells. OBJECTIVES: We present results of a similar investigation of 301 randomly selected 6-year-olds whose parents participated in our ongoing prospective study of the health effects of As exposure in 12,000 residents of Araihazar, Bangladesh. METHODS: Water As and manganese concentrations of tube wells at each home were obtained by surveying all study region wells. Children and mothers were first visited at home, where the quality of home stimulation was measured, and then seen in our field clinic, where children received a medical examination wherein weight, height, and head circumference were assessed. We assessed children's intellectual function using subtests drawn from the Wechsler Preschool and Primary Scale of Intelligence, version III, by summing weighted items across domains to create Verbal, Performance, Processing Speed, and Full-Scale raw scores. Children provided urine specimens for measuring urinary As and were asked to provide blood samples for blood lead measurements. RESULTS: Exposure to As from drinking water was associated with reduced intellectual function before and after adjusting for water Mn, for blood lead levels, and for sociodemographic features known to contribute to intellectual function. With covariate adjustment, water As remained significantly negatively associated with both Performance and Processing Speed raw scores; associations were less strong than in our previously studied 10-year-olds. CONCLUSION: This second cross-sectional study of As exposure expands our concerns about As neurotoxicity to a younger age group.  相似文献   

4.
The provision of alternative water sources is the principal arsenic mitigation strategy in Bangladesh, but can lead to risk substitution. A study of arsenic mitigation options was undertaken to assess water quality and sanitary condition and to estimate the burden of disease associated with each technology in disability-adjusted life years (DALYs). Dugwells and pond-sand filters showed heavy microbial contamination in both dry and monsoon seasons, and the estimated burden of disease was high. Rainwater was of good quality in the monsoon but deteriorated in the dry season. Deep tubewells showed microbial contamination in the monsoon but not in the dry season and was the only technology to approach the World Health Organization's reference level of risk of 10-6 DALYs. A few dugwells and one pond-sand filter showed arsenic in excess of 50 microg/L. The findings suggest that deep tubewells and rainwater harvesting provide safer water than dugwells and pond-sand filters and should be the preferred options.  相似文献   

5.
目的 探讨环氧合酶-2(COX-2)在亚砷酸钠诱导小鼠小胶质细胞活化中的作用及机制。 方法 建立慢性小鼠饮水砷暴露模型,将20只C57BL/6J雄性小鼠随机分为对照组(自来水)和砷暴露组(50 mg/L NaAsO2),连续自由饮水暴露12周。Morris水迷宫实验检测小鼠学习记忆能力;苏木精-伊红染色和透射电镜观察海马区神经元病理变化及超微结构改变;免疫荧光检测海马区离子钙结合配适分子-1(IBA-1)表达;蛋白印迹法(WB)检测海马区IBA-1、COX-2、核因子κB p65(NF-κB p65)蛋白表达;酶联免疫吸附法(ELISA)检测海马区白细胞介素-6(IL-6)和肿瘤坏死因子α(TNF-α)表达。 结果 与对照组小鼠[逃避潜伏期(29.01 ± 18.10)s、有效停留距离(11.78 ± 1.25)cm]比较,砷暴露组小鼠逃避潜伏期[(50.79 ± 12.30)s]延长,有效停留距离明显缩短[(9.34 ± 2.34)cm](P < 0.05);砷暴露组小鼠海马区出现细胞排列紊乱、水肿、皱缩等病理改变,荧光显微镜下IBA-1绿色荧光表达增多。与对照组[IBA-1(0.75 ± 0.13)、NF-κB p65(0.86 ± 0.14)、COX-2(0.74 ± 0.12)表达水平及IL-6(43.37 ± 1.11)pg/mL、TNF-α(198.46 ± 9.93)pg/mL含量]比较,砷暴露组小鼠海马IBA-1(1.01 ± 0.12)、NF-κBp65(1.23 ± 0.11)、COX-2(1.14 ± 0.13)表达水平及IL-6和TNF-α含量[分别为(93.61 ± 3.18)、(604.00 ± 25.02)pg/mL]明显升高,差异均具有统计学意义(P < 0.05)。 结论 慢性砷暴露导致小鼠学习记忆损伤机制可能与小胶质细胞活化,激活NF-κB上调COX-2分泌促炎性细胞因子,促进神经炎症有关。  相似文献   

6.
In the context of arsenic contamination of groundwater in Bangladesh, this paper analyses rural people's preferences for arsenic-free drinking water options. A particular focus is on rural households' willingness to pay for piped water supply which can provide a sustainable solution to the arsenic problem, and how the preference for piped water supply compares with that for various other household/community-based arsenic mitigation technologies. The analysis is based on data collected in a survey of over 2700 households in rural Bangladesh. Six arsenic mitigation technologies were selected for the study: three-kolshi (pitcher) method, activated alumina method (household-based and community-based), dugwell, pond sand filter and deep tubewell (handpump). The survey results indicate that, after taking into consideration the initial and recurring costs, convenience, associated risks and the advantages and disadvantages of each selected technology, the preference of the rural people is overwhelmingly in favor of deep tubewells, followed by the three-kolshi method. The analysis reveals a strong demand for piped water in both arsenic-affected and arsenic-free rural areas, and scope of adequate cost recovery. Between piped water and other arsenic mitigation technologies, the preference of the rural people is found to be predominantly in favor of the former.  相似文献   

7.
The Bangladesh Arsenic Mitigation and Water Supply Program (BAMWSP) has compiled field-kit measurements of the arsenic content of groundwater for nearly five million wells. By comparing the spatial distribution of arsenic inferred from these field-kit measurements with geo-referenced laboratory data in a portion of Araihazar upazila, it is shown here that the BAMWSP data could be used for targeting safe aquifers for the installation of community wells in many villages of Bangladesh. Recent experiences with mobile-phone technology to access and update the BAMWSP data in the field are also described. It is shown that the technology, without guaranteeing success, could optimize interventions by guiding the choice of the drilling method that is likely to reach a safe aquifer and identifying those villages where exploratory drilling is needed.  相似文献   

8.
Many interventions have been advocated to mitigate the impact of arsenic contamination of drinking water in Bangladesh. However, there are few data on the true magnitude of arsenic-related disease in Bangladesh nationally. There has also been little consideration given to possible adverse effects of such interventions, in particular, diarrheal disease. The purpose of this study was to estimate and compare the likely impacts of arsenic mitigation interventions on both arsenic-related disease and water-borne infectious disease. We found that arsenic-related disease currently results in 9,136 deaths per year and 174,174 disability-adjusted life years (DALYs; undiscounted) lost per year in those exposed to arsenic concentrations > 50 microg/L. This constitutes 0.3% of the total disease burden in Bangladesh in terms of undiscounted DALYs. We found intervention to be of overall benefit in reducing disease burden in most scenarios examined, but the concomitant increase in water-related infectious disease significantly reduced the potential benefits gained from intervention. A minimum reduction in arsenic-related DALYs of 77% was necessary before intervention achieved any reduction in net disease burden. This is assuming that interventions were provided to those exposed to > 50 microg/L and would concomitantly result in a 20% increase in water-related infectious disease in those without access to adequate sanitation. Intervention appears to be justified for those populations exposed to high levels of arsenic, but it must be based on exposure levels and on the effectiveness of interventions not only in reducing arsenic but in minimizing risk of water-related infections. Key words: arsenic/adverse effects, Bangladesh, burden of disease, diarrhea, risk assessment, water pollutants, water supply.  相似文献   

9.
Arsenic contamination of shallow groundwater in Bangladesh is a major public health problem; the main response to date has been installing alternative water supplies. A survey of the functional status of a statistically representative sample of water supplies was undertaken in 2005 to assess whether these provide a sustainable water supply to arsenic-affected communities. A questionnaire was administered in communities containing a total 1060 water supplies. Eight percent of water supplies could not be located and only 64% of those located were working at the time of the survey. When weighted for the numbers of different technologies across the country, the results indicate 76% of alternative water supplies would be working. Water supplies working at the time of the survey often broke down. Community contributions were found to be important in determining whether a water supply would be functional. Recommendations are made for revisions of the current mitigation strategy.  相似文献   

10.
11.
Exposure to manganese via inhalation has long been known to elicit neurotoxicity in adults, but little is known about possible consequences of exposure via drinking water. In this study, we report results of a cross-sectional investigation of intellectual function in 142 10-year-old children in Araihazar, Bangladesh, who had been consuming tube-well water with an average concentration of 793 microg Mn/L and 3 microg arsenic/L. Children and mothers came to our field clinic, where children received a medical examination in which weight, height, and head circumference were measured. Children's intellectual function was assessed on tests drawn from the Wechsler Intelligence Scale for Children, version III, by summing weighted items across domains to create Verbal, Performance, and Full-Scale raw scores. Children provided urine specimens for measuring urinary As and creatinine and were asked to provide blood samples for measuring blood lead, As, Mn, and hemoglobin concentrations. After adjustment for sociodemographic covariates, water Mn was associated with reduced Full-Scale, Performance, and Verbal raw scores, in a dose-response fashion; the low level of As in water had no effect. In the United States, roughly 6% of domestic household wells have Mn concentrations that exceed 300 microg Mn/L, the current U.S. Environmental Protection Agency lifetime health advisory level. We conclude that in both Bangladesh and the United States, some children are at risk for Mn-induced neurotoxicity.  相似文献   

12.
Arsenic problems have been observed in several countries around the world. The challenges of arsenic mitigation are more difficult for developing and poor countries due to resource and other limitations. Bangladesh is experiencing the worst arsenic problem in the world, as about 30 million people are possibly drinking arsenic contaminated water. Lack of knowledge has hampered the mitigation initiatives. This paper presents experience gained during an action research on water supply in arsenic mitigation in rural Singair, Bangladesh. The mitigation has been implemented there through integrated research and development of appropriate water supply options and its use through community participation. Political leaders and women played key roles in the success of the mitigation. More than one option for safe water has been developed and/or identified. The main recommendations include: integration of screening of tubewells and supply of safe water, research on technological and social aspects, community, women and local government participation, education and training of all stakeholders, immediate and appropriate use of the available knowledge, links between intermediate/immediate and long term investment, effective coordination and immediate attention by health, nutrition, agriculture, education, and other programs to this arsenic issue.  相似文献   

13.
A supply of safe drinking water is a recognized global concern. The arsenic contamination of groundwater in Bangladesh and other countries has furthered this concern. Lack of appropriate water options is one of the main barriers to the supply of safe drinking water for 30-60 million people who are exposed to the risk of drinking arsenic-contaminated water in Bangladesh. This paper describes the experience from a water supply programme for arsenic mitigation based on demand and participation of 30,000 rural people in Srinagar, a subdistrict of Bangladesh. About 85% of the 912 tubewell water samples tested had an arsenic content higher than 0.05 mg/l. The project promoted 11 options including groundwater, surface-water and rainwater-harvesting household-based options as well as community managed technologies. Most people, particularly women, wanted piped water, and hand-operated deep tubewells were also requested. Four cluster-based motorized piped water systems, 20 home-based arsenic-removal options (two types) and an arsenic-removal filter plant were installed. The public contributed about 49, 25 and 20% of the installation costs of piped water, home-based options and filter options, respectively, and 100% of all operation and maintenance costs. The household options and filter plant were abandoned within a few weeks. Reportedly, those options required too much attention, discharged small volumes of water at low rates, were difficult to maintain, and discharged poor-quality water. The proportion of families (54%) that drank arsenic-contaminated water during the final survey was significantly lower than in the baseline survey (87%). For arsenic-affected areas, it is recommended that a cluster-based piped water system be given proper consideration when selecting appropriate water options rather than household-based options or the development of new low-cost options.  相似文献   

14.
OBJECTIVES: To identify socioeconomic, demographic and environmental factors that predict undernutrition in adults in a Dhaka slum population. DESIGN: A panel survey, conducted between 1995 and 1997. A random sample of households was selected. Socioeconomic, demographic and environmental variables were collected monthly by questionnaire and nutritional status was assessed. SETTING: Dhaka slums in Bangladesh. SUBJECTS: A total of 1097 adults surveyed during September-December 1996. MAIN OUTCOME MEASURES: Body mass index (BMI) less than 18.5 kg/m(2). RESULTS: There was a sex difference with female subjects having a significant odds ratio for low BMI compared with male subjects (P<0.03). There was no difference by age for males, but there was a difference by age for female subjects, with women aged 30-39 and 40-49 years having the worst BMI (P<0.04; P<0.04). The Beri Bahd area of residence had the worst BMI (P<0.001). Deficit situation as the self-reported financial situation had the worst BMI (P<0.03). Casual wage workers, unskilled and dependent self-employed individuals had the worst BMI (P<0.005; P<0.003). Not being involved in credit organizations and NGO credit organizations was associated with worst BMI (P<0.008; P<0.03). Those households that had an income of 2000-2499 Taka had the worst BMI (P<0.07). Households with a floor area of 5 m(2) or more per consumption unit had the best BMI (P<0.01). Households without electricity had the worst BMI (P<0.007). Households with tube well water had the worst BMI compared with those with tap water (P<0.001). CONCLUSIONS: Under nutrition was related to demographic, economic, social and environmental factors.  相似文献   

15.
A national drinking water quality survey conducted in 2009 furnished data that were used to make an updated estimate of chronic arsenic exposure in Bangladesh. About 20 million and 45 million people were found to be exposed to concentrations above the national standard of 50 µg/L and the World Health Organization’s guideline value of 10 µg/L, respectively. From the updated exposure data and all-cause mortality hazard ratios based on local epidemiological studies, it was estimated that arsenic exposures to concentrations > 50 µg/L and 10–50 µg/L account for an annual 24 000 and perhaps as many as 19 000 adult deaths in the country, respectively. Exposure varies widely in the 64 districts; among adults, arsenic-related deaths account for 0–15% of all deaths. An arsenic-related mortality rate of 1 in every 16 adult deaths could represent an economic burden of 13 billion United States dollars (US$) in lost productivity alone over the next 20 years. Arsenic mitigation should follow a two-tiered approach: (i) prioritizing provision of safe water to an estimated 5 million people exposed to > 200 µg/L arsenic, and (ii) building local arsenic testing capacity. The effectiveness of such an approach was demonstrated during the United Nations Children’s Fund 2006–2011 country programme, which provided safe water to arsenic-contaminated areas at a cost of US$ 11 per capita. National scale-up of such an approach would cost a few hundred million US dollars but would improve the health and productivity of the population, especially in future generations.  相似文献   

16.
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.  相似文献   

17.
18.
Besides its toxicity, groundwater arsenic contamination creates widespread social problems for its victims and their families in Bangladesh. There is, for instance, a tendency to ostracise arsenic-affected people, arsenicosis being thought of as a contagious disease. Within the community, arsenic-affected people are barred from social activities and often face rejection, even by their immediate family members. Women with visible arsenicosis symptoms are unable to get married and some affected housewives are divorced by their husbands. Children with symptoms are not sent to school in an effort to hide the problem. This paper employs mainly qualitative methods to interpret people's understandings about the toxic impact of groundwater arsenic poisoning on their social lives. Arsenic-affected patients in southwest Bangladesh were asked to determine their 'own priorities' in measuring arsenic toxicity on their social activities and to explore their perceptions about their own survival strategies. We found that patients' experiences reveal severe negative social impacts, and a sharp difference of perceptions about arsenic and social issues between arsenicosis patients and unaffected people.  相似文献   

19.
Based on several surveys during 1997-2005 and visits of a medical team to Eruani village, Laksham upazila, Comilla district, Bangladesh, the arsenic contamination situation and consequent clinical manifestations of arsenicosis among the villagers, including dermatology, neuropathy, and obstetric outcome, are reported here. Analysis of biological samples from patients and non-patients showed high body burden of arsenic. Even after eight years of known exposure, village children were still drinking arsenic-contaminated water, and many of them had arsenical skin lesions. There were social problems due to the symptoms of arsenicosis. The last survey established that there is a lack of proper awareness among villagers about different aspects of arsenic toxicity. The viability of different options of safe water, such as dugwells, deep tubewells, rainwater harvesting, and surface water with watershed management in the village, was studied. Finally, based on 19 years of field experience, it was felt that, for any successful mitigation programme, emphasis should be given to creating awareness among villagers about the arsenic problem, role of arsenic-free water, better nutrition from local fruits and vegetables, and, above all, active participation of women along with others in the struggle against the arsenic menace.  相似文献   

20.
Groundwater arsenic contamination in Bangladesh and West Bengal, India   总被引:23,自引:0,他引:23       下载免费PDF全文
Nine districts in West Bengal, India, and 42 districts in Bangladesh have arsenic levels in groundwater above the World Health Organization maximum permissible limit of 50 microg/L. The area and population of the 42 districts in Bangladesh and the 9 districts in West Bengal are 92,106 km(2) and 79.9 million and 38,865 km(2) and 42.7 million, respectively. In our preliminary study, we have identified 985 arsenic-affected villages in 69 police stations/blocks of nine arsenic-affected districts in West Bengal. In Bangladesh, we have identified 492 affected villages in 141 police stations/blocks of 42 affected districts. To date, we have collected 10,991 water samples from 42 arsenic-affected districts in Bangladesh for analysis, 58,166 water samples from nine arsenic-affected districts in West Bengal. Of the water samples that we analyzed, 59 and 34%, respectively, contained arsenic levels above 50 microg/L. Thousands of hair, nail, and urine samples from people living in arsenic-affected villages have been analyzed to date; Bangladesh and West Bengal, 93 and 77% samples, on an average, contained arsenic above the normal/toxic level. We surveyed 27 of 42 districts in Bangladesh for arsenic patients; we identified patients with arsenical skin lesions in 25 districts. In West Bengal, we identified patients with lesions in seven of nine districts. We examined people from the affected villages at random for arsenical dermatologic features (11,180 and 29,035 from Bangladesh and West Bengal, respectively); 24.47 and 15.02% of those examined, respectively, had skin lesions. After 10 years of study in West Bengal and 5 in Bangladesh, we feel that we have seen only the tip of iceberg.  相似文献   

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