Contamination of Drinking-Water by Arsenic in Bangladesh: A Public Health Emergency (WHO, 2000, 16 p.): (introduction...)

Contamination of Drinking-Water by Arsenic in Bangladesh: A Public Health Emergency (WHO, 2000, 16 p.)

(introduction...)

Introduction

Extent of exposure in the population

Long-term health effects of exposure

(introduction...)

Skin lesions

Cancer

Classifying arsenic in drinking-water as a public health emergency

Emergency intervention programme

(introduction...)

Strategies to reduce exposure

Simple diagnosis in the field

Treatment

Ongoing monitoring

Lessons to be learned

Acknowledgements

R�sum� - Contamination de l'eau de boisson par de l'arsenic au Bangladesh: une urgence de sant� publique

Resumen - Contaminaci�n del agua de bebida con ars�nico en Bangladesh: una emergencia de salud p�blica

References

(introduction...)

Allan H. Smith,¹Elena O. Lingas,²& Mahfuzar Rahman³

¹Professor of Epidemiology, 140 Warren Hall, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA (email: [email protected]). Correspondence should be addressed to this author.
²Doctoral Research Student, School of Public Health, University of California, Berkeley, USA.
³International Fellow, Public Health Sciences Division, International Centre for Diarrheal Disease Research in Bangladesh, Dhaka, Bangladesh; Division of Occupational and Environmental Medicine, Faculty of Health Sciences, Linko¨ ping University, Sweden.
Ref. No. 00-0751

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 500 µg 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.

Keywords: Bangladesh; arsenic poisoning, prevention and control; arsenic poisoning, therapy; water pollution, chemical, prevention and control; water treatment; environmental monitoring.