Reduction in urinary arsenic levels in response to arsenic mitigation efforts in Araihazar, Bangladesh.

Chen, Yu

van Geen, Alexander

Graziano, Joseph H

Pfaff, Alexander

Madajewicz, Malgosia

Parvez, Faruque

Hussain, AZM Iftekhar

Slavkovich, Vesna

Islam, Tariqul

Ahsan, Habibul

United States

2016-08-30T01:40:04Z

2007-06

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.

https://www.ncbi.nlm.nih.gov/pubmed/17589600

0091-6765

https://hdl.handle.net/10161/12706

eng

Environmental Health Perspectives

Environ Health Perspect

10.1289/ehp.9833

Adolescent

Adult

Aged

Arsenic

Arsenic Poisoning

Bangladesh

Environmental Exposure

Female

Health Education

Humans

Interviews as Topic

Male

Middle Aged

Water Pollutants, Chemical

Water Supply

Reduction in urinary arsenic levels in response to arsenic mitigation efforts in Araihazar, Bangladesh.

Journal article

https://www.ncbi.nlm.nih.gov/pubmed/17589600

917

923

6

Duke

Duke Population Research Center

Duke Population Research Institute

Economics

Sanford School of Public Policy

Trinity College of Arts & Sciences

Published

115