Arsenic in drinking water and the prevalence of respiratory effects in West Bengal, India
01 Dec 2000-International Journal of Epidemiology (Oxford University Press)-Vol. 29, Iss: 6, pp 1047-1052
TL;DR: Evidence is added that long-term ingestion of inorganic arsenic can cause respiratory effects by participants with arsenic-induced skin lesions who also had high levels of arsenic in their current drinking water source compared with individuals who had normal skin and were exposed to low levels.
Abstract: Background A large population in West Bengal, India has been exposed to naturally occurring inorganic arsenic through their drinking water. A cross-sectional survey involving 7683 participants of all ages was conducted in an arsenic-affected region between April 1995 and March 1996. The main focus of the study was skin keratoses and pigmentation alterations, two characteristic signs of ingested inorganic arsenic. Strong exposure-response gradients were found for these skin lesions. The study also collected limited information concerning respiratory system signs and symptoms, which we report here because increasing evidence suggests that arsenic ingestion also causes pulmonary effects. Methods Participants were clinically examined and interviewed, and the arsenic content in their current primary drinking water source was measured. There were few smokers and analyses were confined to non-smokers (N = 6864 participants). Results Among both males and females, the prevalence of cough, shortness of breath, and chest sounds (crepitations and/or rhonchi) in the lungs rose with increasing arsenic concentrations in drinking water. These respiratory effects were most pronounced in individuals with high arsenic water concentrations who also had skin lesions. Prevalence odds ratio (POR) estimates were markedly increased for participants with arsenic-induced skin lesions who also had high levels of arsenic in their current drinking water source (>500 μg/l) compared with individuals who had normal skin and were exposed to low levels of arsenic (,50 μg/l). In participants with skin lesions, the age-adjusted POR estimates for cough were 7.8 for females (95% CI : 3.1‐19.5) and 5.0 for males (95% CI : 2.6‐9.9); for chest sounds POR for females was 9.6 (95% CI : 4.0‐22.9) and for males 6.9 (95% CI : 3.1‐15.0). The POR for shortness of breath in females was 23.2 (95% CI : 5.8‐92.8) and in males 3.7 (95% CI : 1.3‐10.6). Conclusion These results add to evidence that long-term ingestion of inorganic arsenic can cause respiratory effects.
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TL;DR: This review deals with environmental origin, occurrence, episodes, and impact on human health of arsenic, a metalloid occurs naturally, being the 20th most abundant element in the earth's crust.
3,166 citations
TL;DR: The experience in Bangladesh shows that groundwater sources throughout the world that are used for drinking-water should be tested for arsenic, and the fundamental intervention is the identification and provision of arsenic-free drinking water.
Abstract: The contamination of groundwater by arsenic in Bangladesh is the largest poisoning of a population in history, with millions of people exposed. This paper describes the history of the discovery of arsenic in drinking-water in Bangladesh and recommends intervention strategies. Tube-wells were installed to provide ‘‘pure water’’ to prevent morbidity and mortality from gastrointestinal disease. The water from the millions of tube-wells that were installed was not tested for arsenic contamination. Studies in other countries where the population has had long-term exposure to arsenic in groundwater indicate that 1 in 10 people who drink water containing 500mg of arsenic per litre may ultimately die from cancers caused by arsenic, including lung, bladder and skin cancers. The rapid allocation of funding and prompt expansion of current interventions to address this contamination should be facilitated. The fundamental intervention is the identification and provision of arsenic-free drinking water. Arsenic is rapidly excreted in urine, and for early or mild cases, no specific treatment is required. Community education and participation are essential to ensure that interventions are successful; these should be coupled with follow-up monitoring to confirm that exposure has ended. Taken together with the discovery of arsenic in groundwater in other countries, the experience in Bangladesh shows that groundwater sources throughout the world that are used for drinking-water should be tested for arsenic.
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TL;DR: This paper provides a comprehensive ecological and health risk assessment on the heavy metals in soils in Chinese industrial and agricultural regions and thus provides insights for the policymakers regarding exposure reduction and management.
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TL;DR: The mode of action of arsenic for its disease endpoints is currently under study, and two key areas are the interaction of trivalent arsenicals with sulfur in proteins and the ability of arsenic to generate oxidative stress.
1,007 citations
Cites background from "Arsenic in drinking water and the p..."
...…et al., 2001, 2004; Steinmaus et al., 2003), skin lesions (Ahsan et al., 2006; Haque et al., 2003; McCarty et al., 2006), respiratory diseases (Mazumder et al., 2000; Parvez et al., 2010; von Ehrenstein et al., 2005), and cardiovascular effects (Mumford et al., 2007; Rahman et al., 1999), at…...
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..., 2006), respiratory diseases (Mazumder et al., 2000; Parvez et al., 2010; von Ehrenstein et al., 2005), and cardiovascular effects (Mumford et al....
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TL;DR: There are no evidence based treatment regimens to treat chronic arsenic poisoning but antioxidants have been advocated, though benefit is not proven, and there is increasing emphasis on using alternative supplies of water.
Abstract: Arsenic toxicity is a global health problem affecting many millions of people. Contamination is caused by arsenic from natural geological sources leaching into aquifers, contaminating drinking water and may also occur from mining and other industrial processes. Arsenic is present as a contaminant in many traditional remedies. Arsenic trioxide is now used to treat acute promyelocytic leukaemia. Absorption occurs predominantly from ingestion from the small intestine, though minimal absorption occurs from skin contact and inhalation. Arsenic exerts its toxicity by inactivating up to 200 enzymes, especially those involved in cellular energy pathways and DNA synthesis and repair. Acute arsenic poisoning is associated initially with nausea, vomiting, abdominal pain, and severe diarrhoea. Encephalopathy and peripheral neuropathy are reported. Chronic arsenic toxicity results in multisystem disease. Arsenic is a well documented human carcinogen affecting numerous organs. There are no evidence based treatment regimens to treat chronic arsenic poisoning but antioxidants have been advocated, though benefit is not proven. The focus of management is to reduce arsenic ingestion from drinking water and there is increasing emphasis on using alternative supplies of water.
944 citations
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