Nutritional deficiency and arsenical manifestations: a perspective study in an arsenic-endemic region of West Bengal, India.

Abstract: The exposure to low or high concentrations of arsenic (As), either due to the direct consumption of As contaminated drinking water, or indirectly through daily intake of As contaminated food may be fatal to the human health. Arsenic contamination in drinking water threatens more than 150 millions peoples all over the world. Around 110 millions of those peoples live in 10 countries in South and South-East Asia: Bangladesh, Cambodia, China, India, Laos, Myanmar, Nepal, Pakistan, Taiwan and Vietnam. Therefore, treatment of As contaminated water and soil could be the only effective option to minimize the health hazard. Therefore, keeping in view the above facts, an attempt has been made in this paper to review As contamination, its effect on human health and various conventional and advance technologies which are being used for the removal of As from soil and water.

Abstract: Arsenic (As) is a toxic metalloid found to be an important groundwater contaminant of mainly natural geogenic origin worldwide particularly in large deltas and along major rivers in poor regions of South- and East-Asia. Excessive and long-term human intake of toxic inorganic As with food and water is causing arsenicosis, which is disfiguring, disabling, and leading to potentially fatal diseases like skin- and internal cancers. It is estimated that more than 100 million people mainly in developing countries are at risk. The arsenicosis situation in affected countries has been named the largest chemical threat to public health ever experienced and arsenicosis is spreading to regions where near-sterile well water loaded with As has replaced microbial suspect surface water containing lower As concentrations. This review provides an overview of the state of the art knowledge on the water and food As intake and exposure, and how the As chemistry in water and food may influence chosen mitigation strategies. Although reports on severe health effects from exposure to As in water are abundant there are several weak points in our knowledge on causes and prevalence of arsenicosis in order to devise effective mitigation. The main mitigation strategies focus on drinking water based on exploration of As-free water and As removal from extracted water, whereas mitigation strategies on cooking water and reducing exposure through food are quite often overlooked. The experiences of adopted low cost methods for lowering the human intake of As in rural areas are critically evaluated in terms of public acceptance, sustainability and impact on arsenicosis.

Abstract: This paper reviews how active research in West Bengal has unmasked the endemic arsenism that has detrimental effects on the health of millions of people and their offspring. It documents how the pathways of exposure to this toxin/poison have been greatly expanded through intensive application of groundwater in agriculture in the region within the Green Revolution framework. A goal of this paper is to compare and contrast the similarities and differences in arsenic occurrence in West Bengal with those of other parts of the world and assess the unique socio-cultural factors that determine the risks of exposure to arsenic in local groundwater. Successful intervention options are also critically reviewed with emphasis on integrative strategies that ensure safe water to the population, proper nutrition, and effective ways to reduce the transfer of arsenic from soil to crops. While no universal model may be suited for the vast areas of the world affected with by natural contamination of groundwater with arsenic, we have emphasized community-specific sustainable options that can be adapted. Disseminating scientifically correct information among the population coupled with increased community level participation and education are recognized as necessary adjuncts for an engineering intervention to be successful and sustainable.

Abstract: More than 200 million people in 70 countries are exposed to arsenic through drinking water. Chronic exposure to this metalloid has been associated with the onset of many diseases, including cancer. Epidemiological evidence supports its carcinogenic potential, however, detailed molecular mechanisms remain to be elucidated. Despite the global magnitude of this problem, not all individuals face the same risk. Susceptibility to the toxic effects of arsenic is influenced by alterations in genes involved in arsenic metabolism, as well as biological factors, such as age, gender and nutrition. Moreover, chronic arsenic exposure results in several genotoxic and epigenetic alterations tightly associated with the arsenic biotransformation process, resulting in an increased cancer risk. In this review, we: 1) review the roles of inter-individual DNA-level variations influencing the susceptibility to arsenic-induced carcinogenesis; 2) discuss the contribution of arsenic biotransformation to cancer initiation; 3) provide insights into emerging research areas and the challenges in the field; and 4) compile a resource of publicly available arsenic-related DNA-level variations, transcriptome and methylation data. Understanding the molecular mechanisms of arsenic exposure and its subsequent health effects will support efforts to reduce the worldwide health burden and encourage the development of strategies for managing arsenic-related diseases in the era of personalized medicine.

Abstract: Background Infantile beriberi (thiamine deficiency) occurs mainly in infants breastfed by mothers with inadequate intake of thiamine, typically among vulnerable populations. We describe possible and probable cases of infantile thiamine deficiency in northern Laos. Methodology/Principal Findings Three surveys were conducted in Luang Namtha Province. First, we performed a retrospective survey of all infants with a diagnosis of thiamine deficiency admitted to the 5 hospitals in the province (2007–2009). Second, we prospectively recorded all infants with cardiac failure at Luang Namtha Hospital. Third, we further investigated all mothers with infants (1–6 months) living in 22 villages of the thiamine deficiency patients’ origin. We performed a cross-sectional survey of all mothers and infants using a pre-tested questionnaire, physical examination and squat test. Infant mortality was estimated by verbal autopsy. From March to June 2010, four suspected infants with thiamine deficiency were admitted to Luang Namtha Provincial hospital. All recovered after parenteral thiamine injection. Between 2007 and 2009, 54 infants with possible/probable thiamine deficiency were diagnosed with acute severe cardiac failure, 49 (90.2%) were cured after parenteral thiamine; three died (5.6%). In the 22 villages, of 468 live born infants, 50 (10.6%, 95% CI: 8.0–13.8) died during the first year. A peak of mortality (36 deaths) was reported between 1 and 3 months. Verbal autopsy suggested that 17 deaths (3.6%) were due to suspected infantile thiamine deficiency. Of 127 mothers, 60 (47.2%) reported edema and paresthesia as well as a positive squat test during pregnancy; 125 (98.4%) respected post-partum food avoidance and all ate polished rice. Of 127 infants, 2 (1.6%) had probable thiamine deficiency, and 8 (6.8%) possible thiamine deficiency. Conclusion Thiamine deficiency may be a major cause of infant mortality among ethnic groups in northern Laos. Mothers’ and children’s symptoms are compatible with thiamine deficiency. The severity of this nutritional situation requires urgent attention in Laos.

Abstract: Arsenic in drinking water: not just a problem for Bangladesh D. van Halem, S. A. Bakker, G. L. Amy, and J. C. van Dijk Delft University of Technology, Faculty of Civil Engineering and Geosciences, Stevinweg 1, 2628 CN Delft, The Netherlands UNESCO-IHE, Westvest 7, 2611 AX Delft, The Netherlands Received: 11 December 2008 – Accepted: 15 February 2009 – Published: 26 February 2009 Correspondence to: D. van Halem (d.vanhalem@tudelft.nl) Published by Copernicus Publications on behalf of the Delft University of Technology.

Abstract: The value of research on health effects of ingested inorganic arsenic. Human oral exposure to inorganic arsenic. Nationwide and California arsenic occurrence studies. Dietary intake and hazards of arsenic. Determination of total arsenic and arsenic compounds in drinking water. Sources and pathways of arsenic in Southwest England: health implications. Exposure assessment for arsenic concentrations from electric power stations. Ischemic heart disease induced by ingested inorganic arsenic. Urinary excretion of arsenic species in a human population chronically exposed to arsenic via drinking water: a pilot study. Long-term follow-up of patients treated with medicinal arsenic. Epidemiological study designs to address potential high bladder cancer risks from arsenic in drinking water. Arsenic in drinking water and urinary cancers. Arsenic in drinking water and cancers: a brief descriptive review of Taiwan studies. Review of health assessments for US/Canada populations exposed to arsenic in drinking water. Assessment of the dose response for internal cancers and arsenic in drinking water in the blackfoot disease endemic region of Taiwan. Species differences in the metabolism of arsenic. Inorganic arsenic metabolism in humans. Genotoxicity of arsenic and its methylated metabolites. Arsenic essentiality studies and factors affecting its importance. A physiologically based pharmacokinetic model for ingested arsenic. Overview of a physiologically based pharmacokinetic model for the four major arsenic species in mammals. Water utility regulatory and research projects on arsenic. The use of site-specific studies to assess arsenic health risk at superfund site. The process for setting drinking water regulations under the Safe Drinking Water Act. Arsenic in the Canadian general environment: evaluation of risks to health. Impacts of a stringent arsenic drinking water regulation on the western USA. Arsenic in drinking water: health effects and regulatory issues in California. Regulating arsenic in Nevada drinking water supplies: past problems, future challenges. The water utility perspective on arsenic regulation. Derivation of the inorganic arsenic reference dose. Arsenic and human health: some persisting scientific issues.