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

Yu Chen, Alexander van Geen, Joseph H. Graziano, Alexander Pfaff, Malgosia Madajewicz, Faruque Parvez, A. Z M Iftekhar Hussain, Vesna Slavkovich, Tariqul Islam, Habibul Ahsan

Research output: Contribution to journalArticle

Abstract

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 μg) 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 μg/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 μg As/L) dropped from an average of 375 μg As/g creatinine to 200 μg As/g creatinine, a 46% reduction toward the average urinary As content of 136 μg 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.

Original languageEnglish (US)
Pages (from-to)917-923
Number of pages7
JournalEnvironmental Health Perspectives
Volume115
Issue number6
DOIs
StatePublished - Jun 2007

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Bangladesh
Arsenic
Health Education
arsenic
Creatinine
mitigation
well
Drinking Water
Health Status
Education
Health
Confidence Intervals
Labeling
health education
Body Mass Index
Emergencies
Public health
Cohort Studies
Public Health
Smoking

Keywords

  • Arsenic
  • Bangladesh
  • Environmental epidemiology
  • Epidemiology
  • Intervention

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

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, A. Z M Iftekhar; Slavkovich, Vesna; Islam, Tariqul; Ahsan, Habibul.

In: Environmental Health Perspectives, Vol. 115, No. 6, 06.2007, p. 917-923.

Research output: Contribution to journalArticle

Chen, Y, van Geen, A, Graziano, JH, Pfaff, A, Madajewicz, M, Parvez, F, Hussain, AZMI, Slavkovich, V, Islam, T & Ahsan, H 2007, 'Reduction in urinary arsenic levels in response to arsenic mitigation efforts in Araihazar, Bangladesh', Environmental Health Perspectives, vol. 115, no. 6, pp. 917-923. https://doi.org/10.1289/ehp.9833
Chen, Yu ; van Geen, Alexander ; Graziano, Joseph H. ; Pfaff, Alexander ; Madajewicz, Malgosia ; Parvez, Faruque ; Hussain, A. Z M Iftekhar ; Slavkovich, Vesna ; Islam, Tariqul ; Ahsan, Habibul. / Reduction in urinary arsenic levels in response to arsenic mitigation efforts in Araihazar, Bangladesh. In: Environmental Health Perspectives. 2007 ; Vol. 115, No. 6. pp. 917-923.
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abstract = "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 μg) 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 μg/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 μg As/L) dropped from an average of 375 μg As/g creatinine to 200 μg As/g creatinine, a 46{\%} reduction toward the average urinary As content of 136 μg 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.",
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