Water Qual Expo Health (2009) 1: 5–21 DOI 10.1007/s12403-008-0002-3
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation in West Bengal, India and Bangladesh Bhaskar Das · Mohammad Mahmudur Rahman · Bishwajit Nayak · Arup Pal · Uttam Kumar Chowdhury · Subhas Chandra Mukherjee · Khitish Chandra Saha · Shyamapada Pati · Quazi Quamruzzaman · Dipankar Chakraborti
Received: 21 October 2008 / Accepted: 11 December 2008 / Published online: 20 January 2009 © Springer Science+Business Media B.V. 2009
Abstract Since 1988, water samples from 140,150 tubewells were analyzed for arsenic (As) in all 19 districts of West Bengal. In 9 districts, As has been found above the national standard (50 µg/L) and in 5 districts, between 10 and 50 µg/L. From Bangladesh, 50,515 tube-well water samples were analyzed from all 64 districts. Arsenic was present above 10 µg/L in 60 districts and in 50 districts, above 50 µg/L. Other than urine As speciation, 39,000 biological samples were analyzed from both patients and non-patients, 83% of the samples had As above normal level. Arsenical skin lesions were identified in 13,118 people, screening 114,841 from West Bengal and Bangladesh. About 6.1% of 5,000 children in Bangladesh and 1.7% of 14,000 in West
Electronic supplementary material The online version of this article (http://dx.doi.org/10.1007/s12403-008-0002-3) contains supplementary material, which is available to authorized users. B. Das · M.M. Rahman · B. Nayak · A. Pal · U.K. Chowdhury · D. Chakraborti () School of Environmental Studies, Jadavpur University, Kolkata 700 032, India e-mail:
[email protected] S.C. Mukherjee Department of Neurology, Medical College & Hospital, Kolkata, India K.C. Saha School of Tropical Medicine, Kolkata, India S. Pati Department of Obstetrics and Gynaecology, Institute of Post Graduate Medical Education and Research, S.S.K.M. Hospital, Kolkata, India Q. Quamruzzaman Dhaka Community Hospital, Dhaka, Bangladesh
Bengal were found to have arsenical skin lesions. Arsenic neuropathy, obstetric outcome and As in foodstuffs were also studied. Proper watershed management and community participation are needed to mitigate this alarming situation. Keywords Arsenic in ground water · Arsenic in biological samples · Arsenical skin lesions · Arsenic neuropathy · Obstetric outcome · Arsenic in children · Arsenic in food chain · An approach for mitigation
Introduction Arsenic contamination of ground water and its impact on human health have already been reported from several Asian countries (Mukherjee et al. 2006; Smedley and Kinniburgh 2002). The magnitude is severe in Bangladesh followed by West Bengal of India. Arsenic contamination of ground water in Chandigarh and some areas of Punjab in India were reported in 1976 (Datta 1976). The first As-contamination report in the lower Ganga plain of West Bengal was published in 1984 (Garai et al. 1984). In 1992, As in ground water in the Padma-Meghna-Brahmaputra plain of Bangladesh was first identified (Dhar et al. 1997) and further reported in the International Arsenic Conference in Calcutta in February 1995 (International Arsenic Conference 1995; Chakraborti et al. 2002). In 2001, groundwater As-contamination in the Terai region of Nepal was also reported (Shrestha et al. 2003). In June 2002, As-contamination in the middle Ganga plain of Bihar was detected (Chakraborti et al. 2003). During 2003–2004, As-contamination in Uttar Pradesh, Jharkhand and Assam states in India was revealed (Chakraborti et al. 2004). In 2006, As was detected in the ground water of Manipur, one of the 7 North Eastern Hill states of India (Chakraborti et al. 2008a). Based on the survey over
6
the last 20 years in the Ganga-Meghna-Brahmaputra (GMB) plain (an area of 5,69,749 km2 with a population of over 500 million), it is expected that the ground water of some parts in all states (Uttar Pradesh, Bihar, Jharkhand, West Bengal, Arunachal Pradesh and Assam) in the Ganga-Brahmaputra plain of India and six out of seven North Eastern Hill states (except the Mizoram) in India will be As-affected. Even we anticipate from our last 20 years arsenic experience in GMB plain and North Eastern Hill states that the flood plains of the country Bhutan on the foothill of Himalaya would be arsenic-affected. Padma-Meghna-Brahmaputra plain in Bangladesh is considered worst affected in world’s As scenario (Smith et al. 2000). Arsenic survey in the villages of West Bengal by School of Environmental Studies (SOES) started in early 1988. At that time, 22 affected villages in 12 blocks/Police stations (PSs) of 5 districts were known. The present results indicated that 3417 affected villages in 111 blocks of 9 highly affected districts are arsenic-contaminated. Although arsenic groundwater contamination in Bangladesh was identified in 1992 (Dhar et al. 1997), detailed survey on Ascontamination in Bangladesh was initiated in 1996. At that time there was information on 3 affected villages in 2 PSs of 2 districts (Dhar et al. 1997). Current findings showed that 2000 affected villages in 189 PSs of 50 affected districts are arsenic-contaminated. There is an increasing number of Asaffected villages with every new survey. After surveying for more than 20 years in the villages of West Bengal and 10 years in Bangladesh, we feel that we have seen only the tip of the iceberg of this calamity. This paper reports the results on groundwater As-contamination and its health effects in the state West Bengal of India and country Bangladesh, based on analytical, clinical and epidemiological surveys in As-affected areas of the GMB plain and an approach for mitigation.
Materials and methods Instrumentation Flow injection hydride generation atomic absorption spectrometry (FI-HG-AAS) method was used for As analysis. Details of the instrumentation and the flow injection system have already been described elsewhere (Chatterjee et al. 1995; Samanta et al. 1999). Details of the method and the operating condition of the instrument (Table 1) are given in Electronic Supplementary Material (ESM). Sample Collection, Digestion and Analysis Hand tube-well water, hair, nail, skin-scale and urine samples were analyzed for As by the FI-HG-AAS method. For
B. Das et al.
urine samples, only inorganic arsenic and its metabolites together [arsenite, As (III); arsenate, As (V); monomethyl arsonic acid, MMA (V) and dimethyl arsenic acid, DMA (V)] were measured with no chemical treatment. Under the experimental conditions of FI-HG-AAS, arsenobetaine and arsenocholine do not produce a signal (Chatterjee et al. 1995). For hair, nail, skin-scale samples, total arsenic was determined after digestion. The modes of water and biological samples collection, the digestion procedures for hair, nail and skin scale and the analytical procedures were reported earlier (Chatterjee et al. 1995; Das et al. 1995; Samanta et al. 1999). Arsenic species [As (III), As (V), MMA (V) and DMA (V)] in urine were measured by high performance liquid chromatography inductively coupled plasma mass spectrometry (HPLC-ICP-MS). The details of the instrument and the speciation method were reported earlier (Chowdhury et al. 2003). Quality Assurance and Quality Control Program For quality control, inter-laboratory tests were performed for water and hair samples as reported in earlier publications (Samanta et al. 1999; Rahman et al. 2002). USEPA water standard (USEPA Environmental Monitoring and Support Laboratory, Cincinnati, Ohio) and biological standard reference materials (SRM GBW 07601 human hair from the Institute of Geophysical and Geochemical Exploration, Lang fang, China, Mussel tissue CRM 278 and National Institute of Standard and Technology (NIST) urine SRM 2670) were also analyzed for As and have been reported elsewhere (Samanta et al. 1999; Rahman et al. 2002; Chowdhury et al. 2003). Screening of Villagers for Arsenic-Related Diseases Normally before visiting villages with our medical team for arsenicosis patient screening, we collected and analyzed hand tube-well water samples from those villages. Samples were collected beforehand by our expert field workers, who also made a rough estimation of the families that could be suffering from arsenical skin lesions. Our medical team examined those who visited our camps. Experienced dermatologists (K.C. Saha and R.N. Dutta) working with us for many years, recorded the signs and symptoms of arsenical skin lesions. Neurological involvement due to As toxicity and obstetric outcome were also studied by neurologist (S.C. Mukherjee) and gynecologist (S. Pati), respectively, working with us for several years. The neurological symptoms were examined according to the procedure of Mukherjee et al. (2003). The detail procedure for obstetric study was reported earlier (Chakraborti et al. 2003). Additionally, some other common symptoms were also observed in the As-affected villages of Bangladesh and West Bengal
62
Standard deviation
% of samples having As above
e For
is no normal value for skin scale in literature
hair, this is the % of samples above the toxic level of 1000 µg/kg
d There
level of As in nail ranges from 430 to 1080 µg/kg (Ioanid et al. 1961)
excretion of As in urine ranges from 5 to 40 µg per 1.5 L (per day) (Farmer and Johnson 1990)
c Normal
–
4,750
15,510
1,280
4,460
6,820
230
level of As in hair ranges from 80 to 250 µg/kg; 1000 µg/kg is an indication of toxicity (Arnold et al. 1990)
89
268
3,147
10
115
180
11,000
(µg/kg)
b Normal
84
3,980
44,890
380
3,870
4,560
8,665
(µg/kg)
a Normal
normal/toxic levelse
20,340 1,550
Maximum
1,320 180
Minimum
1,480
Median
8,400
Mean
(µg/kg)
(µg/kg)
83
3,330
28,060
280
2,340
3,390
4,536
(µg/kg)
haira
As in
scaled
nailb
haira
in urinec
Bangladesh As in skin
As in
As metabolites
As in
West Bengal
No. of observations
Parameters
93
7,630
79,490
260
6,400
8,570
4,471
(µg/kg)
nailb
As in
Table 1 Arsenic in hair, nail, urine (metabolites) and skin scale collected from the As-affected areas of West Bengal and Bangladesh (Chakraborti et al. 2004)
As in
95
410
3,086
24
115.78
280
1,586
(µg/kg)
urinec
As in skin
–
9,790
53,390
600
4,800
5,730
705
(µg/kg)
scaled
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation 7
8
(Mukherjee et al. 2005). In few cases, we had been to the respective houses to examine subjects. We had no bar on age of the subjects we examined. Biological samples such as hair, nail, skin scales and urine samples were collected from them immediately after the clinical examination. We collected biological samples from both patients and nonpatients from affected villages.
Results and Discussion Arsenic Contamination in Ground Water of West Bengal and Bangladesh During last 20 years, 140,150 hand tube-well water samples were analyzed for As in all 19 districts of West Bengal. 48.1% of hand tube-wells had As above 10 µg/L, 23.8% had above 50 µg/L and 3.3% had above 300 µg/L, the concentration predicting overt arsenical skin lesions (Rahman et al. 2001). A total of 187 (0.13%) hand tube-wells were found highly contaminated (As > 1000 µg/L). The maximum As concentration (3700 µg/L) was found in Ramnagar village of GP Ramnagar II, Baruipur block, in South 24 Parganas district. This tube-well was a private one and all the nine members of the owners’ family had arsenical skin lesions, seven of them with severe arsenical skin lesions already died and 4 of them from cancer. Based on As concentrations, West Bengal was classified into three zones: highly affected 9 districts (mainly in eastern side of Bhagirathi River) where more than 300 µg/L of As was found in tube-wells; mildly affected 5 districts (in northern part) where As in tube-wells was mostly below 50 µg/L (a few above 50 µg/L but none above 100 µg/L) and As-safe ( 50 µg/L) showed that 48.5% of the analyzed samples had As above 10 µg/L and 31% above 50 µg/L. Arsenic concentration above 1000 µg/L has been detected in 274 tube-wells. The maximum concentration detected in a tube-well was 4730 µg/L. The comparative bar diagram distribution of total water samples from 19 districts of West Bengal and 64 districts of Bangladesh against As concentration ranges is presented in Fig. 3. From the overall results it appears that higher As concentration is more in Bangladesh hand tube-wells than in West Bengal. British Geological Survey (BGS) and the Department of Public Health Engineering (DPHE) reported that 46 and 27% of the 3534 analyzed tube-wells exceeded 10 and 50 µg/L of As, respectively (BGS-DPHE 2001). Based on their study, BGS and DPHE (2001) reported that 57 million and 35 million people could be drinking As-contaminated water above 10 µg/L and 50 µg/L, respectively. Half of the 6500 tube-wells sampled in Araihazar PS of Bangladesh analyzed in 2000–2001, contained As above 10 µg/L and one quarter contained As above 50 µg/L (Van Geen et al. 2007). The results of As in hand tube-well water samples from Bangladesh analyzed by different organizations such as Bangladesh Arsenic Mitigation and Water Supply Project (BAMWSP), DPHE/UNICEF, DANIDA, the Water and Sanitation Partnership, World Vision International and the Asia Arsenic Network (AAN) are maintained by the National Arsenic Mitigation Information Centre (NAMIC) and the data showed that 1.4 million (30%) were found to have arsenic above 50 µg/L out of 4.8 million tube-wells tested from Bangladesh (Johnston and Sarker 2007). Nationwide about 20% of the shallow tube-wells are contaminated and more than 8000 villages where 80% of the tube-wells are contaminated (UNICEF 2008). It is noteworthy that most of the hand tube-wells were tested using field kits. Arsenic Concentration in Biological Samples and Subclinically Affected People in West Bengal and Bangladesh In our study, 8400 hair, 8665 nails, 11,000 urine and 230 skin-scale samples were analyzed from As-affected areas of West Bengal and 4536 hair, 4471 nail, 1586 urine and 705 skin-scale samples from As-affected villages of Bangladesh (Chakraborti et al. 2004). About half of these biological samples were collected from people with arsenical skin lesions, and the rest from non-patients who lived in the Asaffected villages (skin scale is only from those having keratosis). Table 1 shows the statistical representation of As in
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation
9
Fig. 1 Groundwater As-contamination status in all 19 districts of West Bengal
biological samples from West Bengal and Bangladesh. The normal level of As in hair ranges from 80 to 250 µg/kg, and 1000 µg/kg is an indication of toxicity (Arnold et al. 1990). The normal level of As in nail ranges from 430 to 1080 µg/kg (Ioanid et al. 1961), and the normal excretion level of As in urine ranges from 5 to 40 µg per 1.5 L per day (Farmer and Johnson 1990). There is no normal value for skin scale in literature. Analyses of these samples showed that 62, 84 and 89% of hair, nail and urine samples, respectively, in West Bengal and 83, 93 and 95% of hair, nail and urine samples, respectively, in Bangladesh, had As levels above the normal levels/toxic levels for hair. From the results of biological samples, it appears that many villagers may not be affected by arsenical skin lesions but have elevated levels of As in hair and nails, and thus could be subclinically affected.
Speciation of As in Urine in Adults and Children In general, inorganic As and its metabolites in human urine contain 10–30% inorganic As, 10–20% MMA and 60–80% DMA (Hopenhayn-Rich et al. 1993; IARC 2004). A few studies (Aposhian et al. 2000; Mandal et al. 2001) indicated presence of more toxic and unstable arsenic species, MMA (III) and DMA (III) in urine. These results questioned whether methylation is really a detoxification process. In Bangladesh, As speciation study was conducted in 42 exposed subjects (range of As in their drinking water was 118– 620 µg/L) in Datterhat village of Madaripur district. The results indicated that total As excretion per kg body weight is higher for children than adults (Chowdhury et al. 2003). The percentage of inorganic As, MMA and DMA in human urine
10
Fig. 2 Status of As contamination of ground water in all 64 districts of Bangladesh
B. Das et al.
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation
11
Fig. 3 Comparative bar diagram distribution of As in water samples analyzed from West Bengal and Bangladesh against different As concentration ranges
in our study was 17, 14 and 69%, respectively. The result also indicated that the first methylation step of the metabolic pathway is more active in adults than in children, but the second methylation step is more active in children than in adults compared to the non-exposed subjects (Chowdhury et al. 2003). From West Bengal, 54 urine samples were collected from the exposed subjects in the Murshidabad district (Chakraborti et al. 2004). Subjects were exposed to As from their drinking water (range 118–1003 µg/L). Similar finding was observed as we reported in the Bangladesh study (Chowdhury et al. 2003). Based on the study conducted from Haziganj PS of Chandpur district in Bangladesh, Alauddin et al. (2003) reported that As (III) is the major species present in urine of a group of exposed people and the amounts of both MMA and DMA are very low compared to the reports available in the literature. The explanation of such high percentage of As (III) in urine was thought to be due to poor methylation capacity of the studied subjects. A recent study investigated the effect of fasting on the pattern of urinary As excretion by determining total and speciated As in urine samples from a group of 29 unexposed volunteers at the beginning of the fasting and at the end of approximately 12 h of fasting period (Brima et al. 2007). The study concluded that fasting for a period of 12 h results in a significant increase in the percentage of urinary As as methylarsonate. The study also suggested that metabolism of As is changed by fasting (Brima et al. 2007). Li et al. (2008) reported that the average proportions of inorganic As, MMA and DMA in urine in gestational week-8 were 15, 11, and 74%, respectively, based on their study among 442 women from Matlab PS of Bangladesh. The study also reported that overall As methylation in women in early pregnancy was remarkably efficient (Li et al. 2008).
Arsenical Skin Lesions The common dermatological features of As toxicity observed in people of West Bengal and Bangladesh are given in ESM. In the preliminary survey, 96,000 people (including children) were randomly examined from highly arsenic-affected districts of West Bengal and 9356 people had arsenical skin symptoms (Chakraborti et al. 2008b). In Bangladesh, 18,841 people were examined from 260 villages of 31 As-contaminated districts. Arsenical dermatological symptoms were observed in 3762 subjects (Chakraborti et al. 2004). A series of studies reported the association between As in drinking water and the prevalence of skin lesions from Asaffected areas of Bangladesh and West Bengal (Chakraborty and Saha 1987; Tondel et al. 1999; Guha Mazumder et al. 1998; Ahsan et al. 2000). Guha Mazumder et al. (1998) reported the association between As exposure and skin keratosis and hyper-pigmentation among 7683 subjects from both high (As > 800 µg/L) and low (As < 50 µg/L) Asexposed areas of West Bengal. The study demonstrated clear exposure–response relationships between the prevalence of skin lesions and both arsenic levels in water and dose per body weight (Guha Mazumder et al. 1998). In a crosssectional study conducted from Matlab PS of Bangladesh, it was reported that 1682 individuals with arsenical skin lesions were identified out of 166,934 people screened (Hore et al. 2007). Tondel et al. (1999) examined 1481 people from four villages of Bangladesh and 430 were found to have arsenical skin lesions. In a study conducted from West Bengal, it was reported that the minimum As level in drinking water that caused arsenical skin lesions was 200 µg/L (Chakraborty and Saha 1987). From the field experience in West Bengal and in Bangladesh, analyzing water, hair, nails, urine and screening about 115,000 people for arsenical skin
12
symptoms and registering more than 13,000 patients with various types of arsenical skin lesions, it was reported that consumption of drinking water with more than 300 µg/L of As for couple of years may cause arsenical skin lesions (Chakraborti et al. 2004). However, several factors, such as concentration of As in drinking water, volume of water consumed, duration of exposure and nutritional status, may influence the appearance of arsenical skin lesions (Rahman et al. 2003). Although in the villages of Bangladesh and West Bengal more than 13,000 people were identified with arsenical skin symptoms, many are still unexplored. The probable causes behind this, as revealed during our discussion with the villagers in the affected villages, were: (i) the villagers often consider the arsenical skin lesions as contagious and affected people are afraid of isolation once others would come to know of their ailment, (ii) young girls and women of conservative families do not want to be examined, (iii) people are frustrated and feel that there is no cure for the disease, (iv) people who are weak and suffering extensively could not travel long distance to come to our camp, and (v) normally we visit the villages during the day, when most of the men are working in the fields and several young boys and girls are in schools. Detail screening of patient identification is necessary with experience dermatologists in all As-contaminated villages of West Bengal and Bangladesh. Arsenic Neuropathy In this study, neurological involvement due to chronic arsenic toxicity was also carried out in As-affected villages of West Bengal and Bangladesh (Mukherjee et al. 2003, 2005; Ahamed et al. 2006a; SOES 2008). The neurological study was conducted among 700 patients (398 males and 302 females) in three districts (Nadia, Murshidabad and Burdwan) of West Bengal with an age range of 11–79 years. The patients were divided into two groups based on the time span of onset of toxic manifestations following As exposure (Mukherjee et al. 2003). Most of the cases in Group 1 were chronically affected while the patients in Group 2 developed both neuropathy and dermopathy sub-acutely within 4–5 months of exposure. All these patients had arsenical skin lesions, positive biomarkers and an identified source of As-contaminated drinking water. Peripheral neuropathy was observed in 42% of the 662 patients in Group 1 and 86% of the 38 patients in Group 2. Paresthesias and pains in the distal parts of extremities were much higher in incidence in Group 2 (73.7 and 23.7% respectively) than in Group 1 (27.2 and 11.5%). Sensory neuropathy was diagnosed in 34.9% of patients in Group 1 and 76.3% in Group 2. Sensorimotor effects were observed in 7.5% of Group 1 and 10.5% of Group 2 subjects (Chakraborti et al. 2004). Nerve conduction and electromyographic studies revealed dysfunction
B. Das et al.
of the sensory and motor nerves. The proportion of patients with dysfunction varied from 29 to 45% for sensory nerves and 16 to 23% for motor nerve, depending on the degree of clinical neuropathies. Basu et al. (1996) reported a sensory predominant distal polyneuropathy in eight arsenicosis patients exposed to As-contaminated water (range: 200– 2000 µg/L) from West Bengal. Guha Mazumder et al. (1997) investigated neuronal involvement among 29 subjects from West Bengal of India. The results showed that abnormal electromyographic findings in 10 and altered nerve conduction velocity and electromyographic in 11 subjects (Guha Mazumder et al. 1997). In Bangladesh, the neurological involvement due to chronic As toxicity was studied in the Eruani village. Altogether, 166 subjects (104 females and 62 males) were found as neuropathy patients. The range of As in their drinking water was 300–1584 µg/L. Neuropathies from As toxicity were recorded in 100 (60%) subjects out of 166 (Ahamed et al. 2006a). The majority of the examined subjects presented with sensory features of distal paresthesias (57%), limb pains (18.7%) and distal hypesthesias (47%) that outnumbered motor features of distal limb weakness and atrophy. Hafeman et al. (2005) examined the association between As exposure and peripheral neuropathy in 137 Bangladeshi subjects, chronically exposed to As in drinking water. The study reported that increased As exposure, as measured by both cumulative and urinary measures, was associated with evidence of subclinical sensory neuropathy (Hafeman et al. 2005). Wasserman et al. (2004) reported children’s intellectual function decrease with increasing As exposure, based on their study from Araihazar PS of Bangladesh. Chronic As Toxicity and Obstetric Outcome The association between As exposure via drinking water and the obstetric outcome in women of West Bengal and Bangladesh has been reported in several our publications (Chakraborti et al. 2003; Mukherjee et al. 2005; Ahamed et al. 2006a; SOES 2008). The obstetric outcomes such as spontaneous abortion, stillbirth, preterm birth, low birth weight and neonatal death were investigated for both exposed and non-exposed women. In West Bengal, the obstetric study was conducted in 18 exposed women from the Murshidabad district. Subjects were grouped into Group A (200–400 µg/L) and Group B (401–1474 µg/L) according to As levels in their drinking water. In our study, we have not found any change in preterm birth and low birth weight with increase in As exposure but spontaneous abortion increased with increases of As and stillbirths decreased with increasing As concentration (Chakraborti et al. 2004). In our Bangladesh study, the subjects were also categorized into Group A and Group B according to low (201– 500 µg/L) and high levels (501–1200 µg/L) of As. Rates
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation
of stillbirths and spontaneous abortions increased in the exposed group compared to the non-exposed group (Ahamed et al. 2006a). A high incidence of preterm birth and neonatal death was observed in Group B. However, more studies are needed to establish the correlation between As exposure and obstetric outcome. Ahmad et al. (2001) investigated the association between As exposure and pregnancy outcome among women exposed to contaminated water (average As level in drinking water was 240 µg/L) from Bangladesh. The pregnancy outcomes were compared with women exposed to low concentration of As (As < 20 µg/L). The results showed that the rates of spontaneous abortions, stillbirths and preterm births were higher in high exposed group compared to the low exposed group. Milton et al. (2005) reported excessive risks for spontaneous abortion and stillbirth among the subjects in Bangladesh who were exposed to high concentrations of As in drinking water. Rahman et al. (2007) recently reported the dose response relationship between As exposure (As content in drinking water was 239 µg/L) and the risk of infant death. In West Bengal, pregnancy outcomes and the rate of infant mortality were investigated by Ehrenstein et al. (2006). Altogether, 202 women were involved in this study and they were exposed to As-contaminated water above 200 µg/L. The study showed that high concentration of As in drinking water during pregnancy increases the risk of stillbirth. Other Multi-systemic Common Presenting Features The following features were also commonly noticed from the As-affected areas of West Bengal and Bangladesh where people were drinking arsenic-contaminated ground water and suffering from arsenical skin lesions (Mukherjee et al. 2005): a) Skin itching to sun rays, burning and watering of eyes, weight loss, loss of appetite, weakness, lethargy and easily fatigued limited the physical activities and working capacities. b) Chronic respiratory complaints were also common. Chronic cough with or without expectoration was evident in more than 50%. As reported by the villagers, the unique sound of “cough of arsenicosis” from adjacent village homes at night was reported to create an unusual atmosphere. The cough may be painful and sputum may contain blood to be misdiagnosed as pulmonary tuberculosis. In late stages, shortness of breath predominates. c) Gastrointestinal symptoms of anorexia, nausea, dyspepsia, altered taste, pain in abdomen, enlarged liver and spleen, and ascites (collection of fluid in abdomen) were also observed in more than 50% patients. d) Moderate to severe anemia was evident in nearly 30% of cases. e) Conjunctival congestion, leg edema were less common and found in 10% of the cases.
13
Arsenic-Affected Children Infants and children are often considered more susceptible to adverse effect of toxic substance than adults (NRC 1993). Chronic As toxicity due to consumption of As-contaminated water causes significant morbidity in children in different parts of the world (Guha Mazumder 2007). From our field experience in West Bengal and in Bangladesh, it was observed that normally children under 11 years of age do not show arsenical skin lesions although their biological samples such as hair, nail, urine may contain elevated level of As (Chakraborti et al. 2004). However, exceptions are noticed when As concentration in water consumed by the children is very high (≥1000 µg/L) or when As concentration is low (around 500 µg/L) but the children suffer from malnutrition (Rahman et al. 2001). In As-affected areas of Bangladesh, arsenical skin lesions were found in 6.1% of children (out of 5000 screened) while in West Bengal, only 1.7% of the children (out of 14,000 screened) were detected (Chakraborti et al. 2004). In our study, it was observed that children of As-contaminated areas of Bangladesh are more affected than those in West Bengal (Rahman et al. 2001). Analyses of 1600 hair and nail samples from children in As-affected areas of Bangladesh and West Bengal demonstrated that about 90% of the samples had As above the normal levels (Chakraborti et al. 2004). The results showed that children in the As-affected areas of Bangladesh and West Bengal have a higher body burden, but less dermatological symptoms. The dermatological status of these children was reported earlier (Mandal et al. 1997; SOES-DCH 2000). Watanabe et al. (2007) reported the effects of chronic As exposure through consumption of contaminated water among 241 children (age range 4–15 years) living in two villages in Bangladesh. The As levels of the tube-well waters ranged from non-detection limit to 535 µg/L (Watanabe et al. 2007). Guha Mazumder et al. (1998) reported pigmentation and keratosis among children (age below 9 years) exposed to As-contaminated water above 50 µg/L from South 24 Parganas district of West Bengal. Twelve (1.9%) of 613 boys and 9 (1.7%) of 536 girls had pigmentation due to high level of As exposure. Keratosis was found in 1 girl and 3 boys (Guha Mazumder et al. 1998). An epidemiological study of arsenic in drinking water and the prevalence of respiratory effects in 7683 participants of all ages in West Bengal, India showed that about 2% of the children in the age groups ≤9 and 10–19 years manifested cough, shortness of breath and abnormal chest sounds (crepitations and/or bronchi) (Guha Mazumder et al. 2000). In Eurani village, Comilla District, Bangladesh four children under 16 years of age with arsenical skin lesions due to arsenic-contaminated ground water were identified as having sensory neuropathy, a more common finding in adults from the same village with arsenical skin lesions (Ahamed et al. 2006a).
14
Arsenic in Foodstuffs In recent years, As in food chain issue has received great attention. Various studies have already been reported the elevated levels of As in foodstuffs such as rice and vegetables grown in contaminated regions of Bangladesh and West Bengal (Chowdhury et al. 2001; Abedin et al. 2002; Roychowdhury et al. 2002, 2003; Roychowdhury 2008; Alam et al. 2003; Duxbury et al. 2003; Meharg and Rahman 2003; Das et al. 2004; Meharg 2004; Al Rmalli et al. 2005; Williams et al. 2005, 2006, 2007; Huq et al. 2006a, 2006b; Corell et al. 2006; Ven Geen et al. 2006; Smith et al. 2006; Mandal et al. 2007; Kile et al. 2007; Mondal and Polya 2008; Rahman et al. 2008; Meherg et al. 2008). Duxbury et al. (2003) investigated the total As content of 150 paddy rice samples collected from different districts of Bangladesh, and the mean values for the Boro and Aman season rices were measured as 183 and 117 µg/kg, respectively. In another study, the mean As level in Bangladeshi rice was reported as 130 µg/kg (Williams et al. 2005). The range of As in vegetables cultivated in a highly affected village (Samta) of Bangladesh was 19– 489 µg/kg (Alam et al. 2003). Das et al. (2004) reported that the range of As in vegetables of Bangladesh was 70– 3990 µg/kg. Smith et al. (2006) reported that the mean total As content in 46 rice samples was 358 µg/kg and 333 µg/kg in 39 vegetable samples in Bangladesh. Roychowdhury et al. (2002) reported total As content in foodstuffs from two severely As-affected blocks in Murshidabad district of West Bengal, where As-contaminated ground water was used for irrigating crops. The study showed that As concentration in rice ranged from 50 µg/L
Number of As-affected PSs/blocks (groundwater As > 10 µg/L)
3843 88
Total biological samples (hair, nail, skin-scale and urine) analyzed
% of biological samples containing As above normal levels (average)
4,813
Persons from affected villages screened for As patients (preliminary survey)
Number of patients, including children, registered with arsenical skin lesions (preliminary survey)
million, #—Not applicable
25,274
Villages where people with arsenical skin lesions identified
∗ In
139 139
Villages surveyed for As patients
14
1.2∗
Population drinking water with As > 10 µg/L (approx.)
Population drinking water with As > 50 µg/L (approx.)
12
1.97
2.5∗
PSs/blocks where people with arsenical skin lesions identified
2.05
994
Number of As-affected villages with As > 50 µg/L (according to our survey)
PSs/blocks surveyed for As patients
89
1833
Number of villages/wards surveyed
6
Total number of villages/wards
157
1605
33
33
5
5
98
80
89
840
24 2414
Number of As-affected PSs/blocks (groundwater As > 50 µg/L)
6
92.8
95.9
1165
6
7
1704 2.3∗
5326 5.3∗
Bangladesh
West Bengal
Population
Domkal,
Murshidabad,
1,162
5,441
34
34
#
#
86
560
109,089
217,866
101
124
150
#
#
35
71
3,366
#
#
311,683
304
West Bengal
PS/block Chandpur,
District
Area in km2
Parameters
Table 2 Comparative study of an As-affected district, a Block/PS and a village of West Bengal with those of Bangladesh
300
970
17
17
#
#
92
503
164390
243860
93
96
133
#
#
80
89
2,077
#
#
274,000
169
Bangladesh
Ramganj,
149
825
#
#
#
#
93
420
#
#
#
#
#
#
#
63
91
336
#
#
3,500
2.25
West Bengal
Rajapur,
Village
395
1,580
#
#
#
#
98
500
#
#
#
#
#
#
#
97.4
100
193
#
#
6,690
2.2
Bangladesh
Eruain,
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation 15
Murshidabad
West Bengal
district
Chandpur
district
Ramganj PS
Bangladesh
Bangladesh
Domkal PS
village
Eruani
village
Rajapur
1165
29612
2077
3366
193
336
tube-well
analyzed
6.4–89
9.4–122
6.4–93.3
9.4–91.4
6.4–52.4
9.1–30.0
(m)
range of the
samples
area
Depth
Total water
Name of the
West Bengal
Bangladesh
West Bengal
Region
(44.9%) (4.3%)
50
(3.1%)
36
(28.4%)
8404
(9.1%)
13310
189
(10.9%)
(35.9%)
226
1207
(29.0%)
(2.6%)
5
(28.0%)
94
10–50
979
–
(8.6%)
29
1000
Table 3 Comparative distribution of hand tube-well water samples against As concentration ranges from Murshidabad district, Domkal PS and Rajapur village of West Bengal with Chandpur district, Ramganj PS and Eruani village of Bangladesh
16 B. Das et al.
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation
17
Fig. 4 Comparative bar diagram distribution of hand tube-well water samples against As concentration ranges from Murshidabad district, Domkal PS and Rajapur village of West Bengal and Chandpur district, Ramganj PS and Eruani village of Bangladesh
mination is severe. The severity is reflected by the comments of several authors (Pearce 1998; Smith et al. 2000). In a published report on Bangladesh, the World Bank’s local head said, “Tens of millions of people are at risk.” The World Bank further mentioned that in Bangladesh 43,000 villages out of 68,000 are presently or could be at risk in the future (Pearce 1998). A report by the WHO predicts that, within a few years, death across much of southern Bangladesh (1 in 10 adults) could be from cancers triggered by arsenic (Pearce 1998). It was also reported that arsenic disaster of Bangladesh is greater than the disasters at Bhopal, India in 1984 and Chernobyl, Ukraine in 1986 (Smith et al. 2000). The U.S. National Research Council (NRC) reported that exposure to 50 µg/L could easily result in a combined cancer risk of 1 in 100 (NRC 1999). It has been reported that 1 in 10 people who drink water containing 500 µg of As per liter may ultimately die from cancers caused by As, including lung, bladder and skin cancers, based on studies conducted from other countries (Smith et al. 2000, 2002). Another study highlighted that many people living in the affected areas of West Bengal and Bangladesh drinking arsenic-contaminated water may not exhibit skin lesions but could be subclinically affected (Chakraborti et al. 2004). Along with arsenical dermatosis, As neuropathy and pregnancy outcome, other non-carcinogenic effects, such as cardiovascular disease, respiratory problem, diabetes mellitus, gastrointestinal effects, were also reported from Asaffected areas of West Bengal and Bangladesh (IARC 2004; NRC 1999, 2001; WHO 2001). From our field experience,
we observed that those suffering from diffuse melanosis and light spotted melanosis can recover after drinking safe water, eating nutritious food and taking vitamins (Chowdhury et al. 2000). Usually diffuse melanosis disappears easily after drinking safe water. However, if keratosis is considerably visible, it may be reduced by drinking safe water and eating nutritious food, but it may not disappear. In arsenicosis patients with keratosis, the appearance of keratosis does not stop even after drinking safe water over a long period of time and even when hair, nail and skin scale contain safe level of As (Chowdhury et al. 2000). Those suffering from severe keratosis may develop skin cancer in the long run (Chowdhury et al. 2000). In the As-affected areas of Bangladesh and West Bengal, children had higher body burden, but not too many had arsenical skin lesions (Rahman et al. 2001). Recently it was reported that exposure to As through drinking water during early childhood or in utero has pronounced pulmonary effects greatly increasing consequent mortality in young adults from both malignant and non-malignant lung diseases (Andrew et al. 2006). In a recent study, it was also reported the robust impact of a mother’s arsenic consumption on fetal gene expression as evidenced by transcript levels in newborn cord blood (Fry et al. 2007). Considerable amount of As was detected in foodstuffs especially in rice and vegetables of West Bengal and Bangladesh, which posed additional danger for the inhabitants. A detailed in-depth survey and epidemiological studies are needed in the affected areas of West Bengal and Bangladesh.
18
At present, prime importance in arsenic-affected areas is to provide arsenic safe water to the villagers. From our 20year long field experience in As-affected areas of the GMB plain, we have realized that the mitigation strategy should be location-specific. A method suitable for a specific area may not be generalized for the other affected regions due to (i) geographical and geomorphological variations, (ii) differing socio-economic and literacy conditions of people. But whatever be the approach, for success at field level we need awareness among the people and their wholehearted participation. To combat the present As crisis in the GMB plain, we immediately need to consider the following actions: a) More than 95% of the people in Bangladesh and West Bengal depend on tube-wells for drinking water (Rahman et al. 2003). As many villagers are illiterate, one method of informing people about the safety of tubewells would be to color the mouths of all safe tubewells green and the unsafe wells red. Villagers can be encouraged to use the green tube-wells for drinking and cooking purposes, and the red tube-wells for bathing, washing, toilet, etc. Also as we have disturbing evidence from West Bengal that some previously safe tube-wells are now getting As-contaminated (BGS-DPHE 1999; Chakraborti et al. 2001; Rosenboom 2004; Sengupta et al. 2006b; Ravenscroft et al. 2006; Ahamed et al. 2006b), the currently safe tube-wells should be checked for As on a regular basis (say after every 6 months). b) It is observed that in the Gangetic plain, As contamination in hand tube-wells has been observed to decrease after a certain depth but in unconfined aquifers there appear to be no depth guarantee, even if the construction of tube-well is done properly. Based on our study in different parts of the GMB plain, on groundwater Ascontamination analyzing more than 2000 deep tube-wells (>150 m), (SOES website) we observed that deep tubewells (>150 m) could be contamination-free (as per the WHO’s recommended value of 10 µg/L) but may not always provide safe source of drinking water. Safety of deep tube-wells depends on several factors such as construction of the deep tube-well, depth of the deep tubewell, presence of confined aquifer, and the aquifer should be under a thick clay barrier. c) Bangladesh comprises of four geomorphological regions such as (a) Table land, (b) Flood plain, (c) Deltaic region including Coastal belt and (d) Hill tract (Fig. 2). The detailed description of these regions has been described in our earlier publication (Chakraborti et al. 1999). Based on the results from 50,515 analyzed hand tube-well water samples for As from four geomorphological regions of Bangladesh, we observed that Hill tract region and Table land region are free from As contamination and can be used as safe sources (Chakraborti et al. 1999).
B. Das et al.
d) Alternative safe water sources such as dug-wells and rain water harvesting need to be implemented with controls for bacterial and other chemical contamination. e) Community participation in ensuring proper operation and maintenance of the As removal plants (ARP) in the affected areas may be another option for providing Assafe drinking water. f) The villagers in the affected areas need to be taught about the signs and symptoms of As toxicity. g) There is no medicine to cure chronic As toxicity. Safe water, nutritious food and some physical exercise are only the proven measures to fight chronic As toxicity (Chakraborti et al. 2004). It has been reported that in As-affected areas of Bangladesh and West Bengal those consuming nutritious food suffer less from As toxicity than undernourished people (Chowdhury et al. 2001; Rahman et al. 2001). h) Other toxins could appear in the underground water in the future. Groundwater quality needs to be evaluated before it is used on a large scale. i) The scientific community and medical personnel all over the world must work to find out a viable solution for addressing the problem that has put millions of people at risk in Bangladesh and India. West Bengal and Bangladesh are called the lands of rivers. The average annual rainfall in these regions is about 2000 mm, the rivers are abundantly fed. Along with rivers, both countries have other available surface water resources such as wetlands, flooded river basins, lagoons, ponds and oxbow lakes. The per capita available surface water in Bangladesh is 11,000 cubic meters and in As-affected areas of West Bengal about 7000 cubic meters. Instead of installing tube-wells and withdrawing underground water, the use of surface water needs to be considered. So far there has been less effort on the part of the government and aid agencies to harvest available surface water and rain water in either country and reduce the dependence on contaminated ground water. Ground water continues to be the main source of water for household and agricultural purposes. The water bodies that dry out during the summer are also refilled by pumping underground water into them so they can be used for the cultivation of fish. There is even the common practice of draining out vast rain water reserves by connecting them to a river through canals, the river serving as a single source of water for cultivation. The problem perhaps is the complete lack of awareness among villagers about the use of surface water as a safe alternative. Proper watershed management and cost-effective utilization of available surface water along with the education of the villagers and their active participation appear to be the only solutions to resolving the present As crisis in the GMB plain.
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation Acknowledgement Financial support from School of Environmental Studies (SOES), Jadavpur University is gratefully acknowledged. We thank the field workers of SOES for their extensive help in the survey. One of the authors (Bhaskar Das) is also thankful to All India Council for Technical Education (AICTE), India for awarding the NDF Fellowship for the research work.
References Abedin MJ, Cresser MS, Meharg AA et al (2002) Arsenic accumulation and metabolism in rice (Oryzasativa L.). Environ Sci Technol 36:962–968 Ahmad SA, Sayed MH, Barua S et al (2001) Arsenic in drinking water and pregnancy outcome. Environ Health Perspectives 109:629– 631 Ahamed S, Sengupta MK, Mukherjee SC et al (2006a) An eight-year study report on arsenic contamination in ground water and health effects in Eruani village, Bangladesh and an approach for its mitigation. J Health Pop Nutr 24:129–141 Ahamed S, Sengupta MK, Mukherjee A et al (2006b) Arsenic groundwater contamination and its health effects in the state of Uttar Pradesh (UP) in upper and middle Ganga plain, India: a severe danger. Sci Total Environ 370:310–322 Ahsan H, Perrin M, Rahman A et al (2000) Associations between drinking water and urinary As levels and skin lesion in Bangladesh. J Occup Environ Med 42:1195–1201 Alam MGM, Snow ET, Tanaka A (2003) Arsenic and heavy metal contamination of vegetables grown in Samta village, Bangladesh. Sci Total Environ 308:83–96 Alauddin M, Alauddin ST, Bhattacharjee M et al (2003) Speciation of arsenic metabolite intermediates in human urine by ion-exchange chromatography and flow injection hydride generation atomic absorption spectrometry. J Environ Sci Health 38:115–128 Al Rmalli SW, Haris PI, Harrington CF (2005) A survey of arsenic in foodstuffs on sale in the United Kingdom and imported from Bangladesh. Sci Total Environ 337:23–30 Andrew AS, Burgess JL, Meza MM et al (2006) Arsenic exposure is associated with decreased DNA repair in vitro and in individuals exposed to drinking water arsenic. Environ Health Perspect 114:1193–1198 Aposhian HV, Gurzau ES, Le XC et al (2000) Occurrence of monomethylarsonous acid in urine of humans exposed to inorganic arsenic. Chem Res Toxicol 13:693–697 Arnold HL, Odam RB, James WD (1990) Disease of the skin. In: Clinical dermatology. Saunders, Philadelphia, pp 121–122 Bae M, Watanabe C, Inaoka T et al (2002) Arsenic in cooked rice in Bangladesh. Lancet 360:1839–1840 Basu D, Dasgupta J, Mukherjee A et al (1996) Chronic neuropathy due to As intoxication from geo-chemical source-A five-year follow up. JANEI 1:45–47 BGS-DPHE (1999) Groundwater studies for arsenic contamination in Bangladesh. Final Report. London, U.K., Mott MacDonald Ltd., UK BGS-DPHE (2001) Arsenic contamination of ground water in Bangladesh; BGS Technical Report WC/00/19; British Geological Survey, Keyworth, UK Brima EI, Jenkins RO, Lythgoe PR et al (2007) Effect of fasting on the pattern of urinary arsenic excretion. J Environ Monitor 9:98–103 Chakraborty AK, Saha KC (1987) Arsenical dermatosis from tube-well water in West Bengal. Ind J Med Res 85:326–334 Chakraborti D, Biswas BK, Basu GK et al (1999) Possible arsenic contamination-free groundwater source in Bangladesh. J Surface Sci Technol 15:180–188
19
Chakraborti D, Basu GK, Biswas GK et al (2001) Characterization of arsenic bearing sediments in Gangetic Delta of West Bengal – India. In: Chappell WR, Abernathy CO, Calderon RL (eds) Arsenic exposure and health effects. Elsevier, New York, pp 27–52 Chakraborti D, Rahman MM, Chowdhury UK et al (2002) Arsenic calamity in the Indian sub-continent. What lesions have been learned? Talanta 58:3–22 Chakraborti D, Mukherjee SC, Pati S et al (2003) Arsenic groundwater contamination in middle Ganga Plain, Bihar, India: A future danger. Environ Health Perspectives 111:1194–1201 Chakraborti D, Sengupta MK, Rahman MM et al (2004) Groundwater arsenic contamination and its health effects in the Ganga-MeghnaBrahmaputra plain. J Environ Monitor 6:74–83 Chakraborti D, Singh EJ, Das B et al (2008a) Groundwater Ascontamination in Manipur, one of the seven North-Eastern Hill states of India: a future danger. Environ Geol 56:381–390 Chakraborti D, Das B, Rahman MM et al (2008b in press) Status of groundwater arsenic contamination in the state of West Bengal, India: a 20 years study report. Mol Nutri Food Res Chatterjee A, Das D, Mandal BK et al (1995) Arsenic in ground water in six districts of West Bengal, India: the biggest arsenic calamity in the world, Part I. Arsenic species in drinking water and urine of the affected people. Analyst 20:643–650 Chowdhury UK, Biswas BK, Chowdhury TR et al (2000) Groundwater arsenic contamination in Bangladesh and West Bengal, India. Environ Health Perspectives 108:393–397 Chowdhury UK, Rahman MM, Mandal BK et al (2001) Groundwater arsenic contamination and human suffering in West Bengal, India and Bangladesh. Environ Sci 8:393–415 Chowdhury UK, Rahman MM, Sengupta MK et al (2003) Pattern of excretion of arsenic compounds [arsenite, arsenate, MMA (V), DMA (V)] in urine of children compared to adults from an arsenic exposed area in Bangladesh. J Environ Sci Health 38:87–113 Corell R, Huq SM, Smith E et al (2006) Dietary intake of arsenic from crops. In: Naidu R, Owens G, Smith E, Nadebaum P (eds) Managing arsenic in the environment: from soil to human health. CSIRO, Melbourne, pp 255–271 Das D, Chatterjee A, Mandal BK et al (1995) Arsenic in ground water in six districts of West Bengal, India: the biggest arsenic calamity in the world, Part II. Arsenic concentration in drinking water, hair, nails, urine, skin-scale and liver tissue (biopsy) of the affected people. Analyst 120:917–924 Das HK, Mitra AK, Sengupta PK et al (2004) Arsenic concentrations in rice, vegetables, and fish in Bangladesh: a preliminary study. Environ Intl 30:383–387 Datta DV (1976) Arsenic and non-cirrhotic portal hypertension. Lancet Feb 21:433 Dhar RK, Biswas BK, Samanta G et al (1997) Groundwater arsenic calamity in Bangladesh. Curr Sci 73:48–59 Duxbury JM, Mayer AB, Lauren JG et al (2003) Food chain aspects of arsenic contamination in Bangladesh: effects on quality and productivity of rice. J Environ Sci Health 38:61–69 Ehrenstein OSV, Guha Mazumder DN, Smith MH et al (2006) Pregnancy outcomes, infant mortality, and arsenic in drinking water in West Bengal. India Am J Epidemiol 163:662–669 Farmer JG, Johnson LR (1990) Assessment of occupational exposure to inorganic arsenic based on urinary concentrations and speciation of arsenic. Br J Ind Med 47:342–348 Fry RC, Navasumrit P, Valiathan C et al (2007) Activation of inflammation/NF-kB signaling in infants born to arsenic-exposed mothers. PLoS Genet 3:2180–2189 Garai R, Chakraborty AK, Dey SB et al (1984) Chronic arsenic poisoning from tube-well water. J Ind Med Assoc 82:34–35 Guha Mazumder DN (2007) Effect of drinking arsenic contaminated water in children. Indian Pediatr 44:925–927 Guha Mazumder DN, Das Gupta J, Santra A et al (1997) As exposure and health effects. In: Abernathy CO, Calderon RL, Chappell WR
20 (eds) Non-cancer effects of chronic arsenicosis with special reference to liver damage. Chapman and Hall, London, pp 112–123 Guha Mazumder DN, Haque R, Ghosh N et al (1998) Arsenic levels in drinking water and the prevalence of skin lesions in West Bengal, India. Int J Epidemiol 27:871–877 Guha Mazumder DN, Haque R, Ghosh N et al (2000) As in drinking water and the prevalence of respiratory effects in West Bengal, India. Intl J Epidemiol 29:1047–1052 Hafeman DM, Ahsan H, Louis ED et al (2005) Association between arsenic exposure and a measure of subclinical sensory neuropathy in Bangladesh. J Occup Environ Med 47:778–784 Hopenhayn-Rich C, Smith AH, Goeden HM (1993) Human studies do not support the methylation threshold hypothesis for the toxicity of inorganic arsenic. Environ Res 60:161–177 Hore SK, Rahman M, Yunus M et al (2007) Detecting arsenic-related skin lesions: experiences from a large community based survey in Bangladesh. Intl J Environ Health Res 17:141–149 Huq SMI, Correll R, Naidu R (2006a) Arsenic accumulation in food sources in Bangladesh. In: Naidu R, Owens G, Smith E, Nadebaum P (eds) Managing arsenic in the environment: from soil to human health. CSIRO, Melbourne, pp 283–293 Huq SMI, Joardar JC, Parvin S et al (2006b) Arsenic contamination in food-chain: transfer of arsenic into food materials through groundwater irrigation. J Health Popul Nutr 24:305–316 International Agency for Research on Cancer (IARC) (2004) IARC Monographs on the evaluation of carcinogenic risks to humans. Some drinking water disinfectants and contaminants including arsenic. World Health Organization, Lyon, France International Conference on Arsenic (1995) International conference on arsenic in groundwater: cause, effect and remedy. School of Environmental Studies, Jadavpur University, Calcutta, India, 6–8 February Ioanid N, Bors G, Popa I (1961) Beitage zur kenntnis des normalen arsengehaltes von nageln and des Gehaltes in den Faillen von Arsenpolyneuritits. Dstch Z Gesamte Gerichtl Med 52:90–94 Johnston RB, Sarker MH (2007) Arsenic mitigation in Bangladesh: national screening data and case studies in three upazilas. J Environ Sci Health 42:1889–1896 Juhasz AL, Smith E, Weber J et al (2006) In vivo assessment of arsenic bioavailability in rice and its significance for human health risk assessment. Environ Health Perspectives 114:1826–1831 Kile ML, Houseman EA, Breton CV (2007) Dietary arsenic exposure in Bangladesh. Environ Health Perspectives 115:889–893 Li L, Ekström EC, Goessler W et al (2008) Nutritional status has marginal influence on the metabolism of inorganic arsenic in pregnant Bangladeshi women. Environ Health Perspectives 116:315–321 Mandal BK, Chowdhury TR, Samanta G et al (1997) Chronic arsenic toxicity in West Bengal. Curr Sci 72:114–117 Mandal BK, Ogra Y, Suzuki KT (2001) Identification of dimethylarsinous and monomethylarsonous acids in human urine of the arsenic-affected areas in West Bengal, India. Chem Res Toxicol 14(4):371–378 Mandal BK, Suzuki KT, Anzai K (2007) Impact of arsenic in foodstuffs on the people living in the arsenic-affected areas of West Bengal, India. J Environ Sci Health 42:1741–1752 Meharg AA (2004) Arsenic in rice – understanding a new disaster for South-East Asia. Trends Plant Sci 9:415–417 Meharg AA, Rahman MM (2003) Arsenic contamination of Bangladesh paddy field soils: implications for rice contribution to arsenic consumption. Environ Sci Technol 37:229–234 Meherg AA, Lombi E, Willams PN et al (2008) Speciation and localization of arsenic in white and brown rice grains. Environ Sci Technol 42:1051–1057 Milton AH, Smith W, Rahman B et al (2005) Chronic arsenic exposure and adverse pregnancy outcome in Bangladesh. Epidemiology 16:82–86
B. Das et al. Misbahuddin M (2003) Consumption of arsenic through cooked rice. Lancet 361:435–436 Mondal D, Polya DA (2008) Rice is a major exposure route for arsenic in Chakdaha block, Nadia district, West Bengal, India: A probabilistic risk assessment. Appl Geochem 23:2986–2997 Mukherjee SC, Rahman MM, Chowdhury UK et al (2003) Neuropathy in arsenic toxicity from groundwater arsenic contamination in West Bengal-India. J Environ Sci Health 38:165–183 Mukherjee SC, Saha KC, Pati S et al (2005) Murshidabad—one of the nine groundwater arsenic-affected districts of West Bengal, India. Part II: Dermatological, neurological, and obstetric findings. J Toxicol : Clin Toxicol 43:835–848 Mukherjee A, Sengupta MK, Hossain MA et al (2006) Groundwater Arsenic Contamination: a global perspective with special emphasis to Asian scenario. J Health Popul Nutr 24:142–163 National Research Council (1993) Pesticides in the diets of infants and children. National Academy Press, Washington National Research Council (1999) Arsenic in drinking water. National Academy Press, Washington National Research Council (2001) As in drinking water – 2001 update. National Academy Press, Washington Nickson R, Sengupta CS, Mitra P et al (2007) Current knowledge on the distribution of arsenic in ground water in five states of India. J Environ Sci Health 42:1707–1718 Pearce F (1998) Arsenic in the water. The Guardian. London, February 19, pp 1–3 Rahman MM, Chowdhury UK, Mukherjee SC et al (2001) Chronic arsenic toxicity in Bangladesh and West Bengal-India – a review and commentary. J Toxicol: Clin Toxicol 39(7):683–700 Rahman MM, Mukherjee D, Sengupta MK et al (2002) Effectiveness and reliability of arsenic field testing kits: are the million dollar screening projects effective or not? Environ Sci Technol 36:5385– 5394 Rahman MM, Mandal BK, Roychowdhury T et al (2003) Arsenic groundwater contamination and sufferings of people in North 24Parganas, one of the nine arsenic-affected districts of West Bengal, India: the seven years study report. J Environ Sci Health 38:25–59 Rahman MA, Hasegawa H, Rahman MA et al (2006) Influence of cooking method on arsenic retention in cooked rice related to dietary exposure. Sci Total Environ 370:51–60 Rahman A, Vahter M, Ekstrom EC et al (2007) Association of As exposure during pregnancy with fetal loss and infant death: a cohort study from Bangladesh. Am J Epidemiol 165:1389–1396 Rahman MA Hasegawa H, Rahman M et al (2008) Arsenic accumulation in rice (Oryza sativa L.): Human exposure through food chain. Ecotoxicol Environ Saf 69:317–324 Ravenscroft P, Howarth RJ, McArthur JM (2006) Comment on “Limited temporal variability of arsenic concentrations in 20 wells Monitored for 3 years in Araihazar, Bangladesh. Environ Sci Technol 40:1716–1717 Rosenboom JW (2004) Arsenic in 15 Upazilas of Bangladesh: water supplies, health and behaviour – an analysis of available data. Report for the Department of Public Health Engineering (Bangladesh), the Department for International Development (U.K.) and UNICEF Roychowdhury T (2008) Impact of sedimentary arsenic through irrigated ground water on soil, plant, crops and human continuum from Bengal delta: Special reference to raw and cooked rice. Food Chem Toxicol 46:2856–2864 Roychowdhury T, Uchino T, Tokunaga H et al (2002) Survey of arsenic in food composites from an arsenic-affected area of West Bengal, India. Food Chem Toxicol 40:1611–1621 Roychowdhury T, Tokunaga H, Ando M (2003) Survey of arsenic and other heavy metals in food composites and drinking water and estimation of dietary intake by the villagers from an arsenic-affected area of West Bengal, India. Sci Total Environ 308:15–35
Groundwater Arsenic Contamination, Its Health Effects and Approach for Mitigation Samanta G, Roychowdhury T, Mandal BK et al (1999) Flow injection hydride generation atomic absorption spectrometry for determination of arsenic in water and biological samples from arsenic-affected districts of West Bengal, India and Bangladesh. Microchem J 62:174–191 Sengupta MK, Hossain MA, Mukherjee A et al (2006a) Arsenic burden of cooked rice: traditional and modern methods. Food Chem Toxicol 44:1823–1829 Sengupta MK, Mukherjee A, Ahamed S et al (2006b) Comment on “Limited temporal variability of arsenic concentrations in 20 wells Monitored for 3 years in Araihazar, Bangladesh. Environ Sci Technol 40:1714–1715 Shrestha RR, Shrestha MP, Upadhyay NP et al (2003) Groundwater arsenic contamination, its health impact and mitigation program in Nepal. J Environ Sci Health 38:185–200 Signes A, Mitra K, Burlo F et al (2008) Contribution of water and cooked rice to an estimation of the dietary intake of inorganic arsenic in a rural village of West Bengal, India. Food Addit Contam 25:41–50 Smedley PL, Kinniburgh DG (2002) A review of the source, behaviour and distribution of arsenic in natural waters. Appl Geochem 17:517–568 Smith AH, Lingas EO, Rahman M (2000) Contamination of drinking water of arsenic in Bangladesh. A public health emergency. Bull World Health Org 78:1093–1103 Smith AH, Lopipero PA, Bates MN (2002) Arsenic epidemiology and drinking water standards. Science 296:2145–2146 Smith NM, Lee R, Heitkemper DT et al (2006) Inorganic As in cooked rice and vegetables from Bangladeshi households. Sci Total Environ 370:294–301 SOES (2008) Website: www.soesju.org (on December 10) SOES-DCH (2000) Groundwater arsenic contamination in Bangladesh. A. A summary of 239 days field survey from August 1995 to February 2000. B. Twenty seven days detailed field survey information from April 1999 to February 2000, p 70. Available in website: www.soesju.org (on December 10, 2008)
21
Tondel M, Rahman M, Magnuson A et al (1999) The relationship of As levels in drinking water and the prevalence rate of skin lesions in Bangladesh. Environ Health Perspectives 107:727–729 Torres-Escribano S, Leal M, Velez D et al (2008) Total and inorganic arsenic concentrations in rice sold in Spain, effect of cooking, and risk assessments. Environ Sci Technol 42:3867–3872 UNICEF (2008) Web: www.unicef.org/bangladesh/Arsenic.pdf USEPA (1999) USEPA office of water. Analytical methods support documents for arsenic in drinking water. December, p 36 Van Geen A, Cheng Z, Jia Q (2007) Monitoring 51 community wells in Araihazar, Bangladesh, for up to 5 years: implications for arsenic mitigation. J Environ Sci Health 42:1729–1740 Ven Geen A, Zheng Y, Cheng Z (2006) Impact of irrigating rice paddies with ground water containing arsenic in Bangladesh. Sci Total Environ 367:769–777 Wasserman GA, Liu X, Parvez F et al (2004) Water As exposure and children’s intellectual function in Araihazar, Bangladesh. Environ Health Perspectives 112:1329–1333 Watanabe C, Matsui T, Inaoka T et al (2007) Dermatological and nutritional/growth effects among children living in arsenic contaminated communities in rural Bangladesh. J Environ Sci Health 42:1835–1841 WHO (World Health Organization) (2001) IPCS environmental health criteria 224 As and As compounds. International programme on chemical safety, World Health Organization, Geneva Williams PN, Price AH, Raab A et al (2005) Variation in arsenic speciation and concentration in paddy rice related to dietary exposure. Environ Sci Technol 39:5531–5540 Williams PN, Islam MR, Adomako EE et al (2006) Increase in rice grain arsenic for regions of Bangladesh irrigating paddies with elevated arsenic in ground waters. Environ Sci Technol 40:4903– 4908 Williams PN, Raab A, Feldman J et al (2007) Market basket survey shows elevated levels of As in South Central U.S. Processed rice compared to California: Consequences for human dietary exposure. Environ Sci Technol 41:2178–2183
