A consolidated reply of experiences and examples shared by various members of the Solution Exchange Water Community
From Ashok Kumar Ghosh, Department of Environment and Water Management, A.N.College, Bihar
Posted 5 January 2010
I am Dr. Ashok Ghosh, working as Professor In charge of Department of Environment and Water Management, A.N. College , Patna . I am working on a UGC-sponsored research project titled “Health Impact of Arsenic in Ground Water of Bihar.” We have confirmed a very high arsenic content of up to 1,861 ppb (parts per billion) against WHO permissible limit of 10 ppb in ground water at several locations of Bihar . Recent studies have indicated that arsenic readily crosses the human placental barrier, giving rise to arsenic concentrations that are about as high in cord blood as in maternal blood. This affects foetal development.
During the course of our research, we have observed many cases of distinct association between Arsenic exposure via drinking water and obstetric outcomes in women in Bhojpur District of Bihar. The obstetric outcomes such as spontaneous abortion, stillbirth, pre-term birth, low birth weight, and neonatal death were very common in almost all the villages surveyed. Many pregnant women tend to have erratic blood pressure and anaemia. Depression and hypertension due to social ostracism is also very common among the pregnant women.
Further, rural women suffering from severe arsenic poisoning symptoms are confined to their homes. They view their suffering as a matter of shame to be hidden from male family members. Seeking medical help is unheard of as it leads to social isolation and stigma. We feel a complete picture of arsenic-related health issues can emerge only after the affected women are examined thoroughly.
I request members of Maternal and Child Health Community and Water Community for the following:
- Are there any field-based experiences/research outcomes that bring out the relationship between arsenic exposure and obstetric outcomes and neonatal deaths in different parts of the world?
- Are there studies that confirm the dose-response effect of arsenic on obstetric outcomes?
- Is it possible to reduce this risk through proper nutrition and medication and if so how?
In addition, please share a possible arsenic mitigation strategy to minimize the risks considering complex interplay of genetic, environmental, and social factors. It requires a sophisticated and thoughtful intervention on the part of health care providers to resolve the issue.
The information provided will help in understanding the arsenicosis related health issues, particularly on woman and children, and also the preventive measures. Practitioners working on health and water issues in rural India can also use this information. Moreover, the inputs provided can be used for increasing awareness among the arsenic exposed populations to minimize the risk related to ingestion of arsenic laced water.
Responses were received, with thanks, from
- Han Heijnen, (Retired WHO Bangladesh, Nepal and SEARO), Mbale , Uganda
- Nidhi Nagabhatla, Natural Resource Management, The WorldFish Center, Penang, Malaysia (response1, response2)
- Surendra Kumar Yadav, School of Studies in Environment Management Vikram University , Ujjain
- Muhammad Mukhtar Alam, Center for Ecological Audit, Social Inclusion and Governance, Delhi
- J. Kanagavalli, DHAN Vayalagam Tank Foundation, Madurai
- Uday Pathak, Mahavir Vatsalya Aspatal, Bihar
- P. Ranjan Mishra, Middle East Centre for Sustainable Development (MECSD), Dubai
- Richard Johnston, Eawag - Swiss Federal Institute of Aquatic Science and Technology and Sandec - Department of Water and Sanitation in Developing Countries, Dübendorf
- N. Muthu Krishnan, GERIND Technology India Pvt. Ltd., Chennai
- Sunanda Gupta, WHO India, Delhi
- Henk van Norden, UNICEF Regional Office for South Asia, Kathmandu
- Shankar Prinja, School of Public Health , Post Graduate Institute of Medical Education and Research, Chandigarh
- Sunil, Icarus Design Pvt Ltd, Bangalore
- Nupur Bose, A. N. College, Patna, Bihar (response1, response2)
- Arunabha Majumder, Presidency College, Kolkatta
- Prosun Bhattacharya, Royal Institute of Technology (KTH) -International Groundwater Arsenic Research Group, Sweden
Further contributions are welcome!
Arsenic is a potent carcinogen if consumed over a long time, as often happens by people living in areas where groundwater is laced with high concentrations (greater than 10 micrograms per litre (µg/L) that is the provisional guideline specified by the World Health Organization). Its effects vary from person to person, making it difficult to come up with a single definition of disease caused by the element. Chronic arsenic poisoning causes cancers of the skin, lungs, urinary bladder and kidneys.
More recently, several studies have linked exposure to arsenic in the womb to severe effects on health in later life, as well as a higher incidence of still-births. A study in India shows women drinking arsenic-contaminated water during pregnancy are six – thirteen fold increase in risk of still birth than those drinking water without arsenic. The study also says the effects become more severe with longer exposure to arsenic and depend on the concentration of arsenic in the water.
Other studies in Bangladesh indicate women chronically exposed to high concentrations of arsenic in drinking water face excess risks for spontaneous abortion and stillbirth. This takes into account factors such as their height, hypertension, diabetes and age at first pregnancy (for neonatal deaths only). Those who drink water with an arsenic concentration of greater than 50 µg/L are 2.5 times more likely to have a spontaneous abortion or still birth than those who drank water with less than 50 µg/L concentration; for neonatal deaths, the figure was 1.8
Additionally, while in late gestation, arsenic is easily transferred from mother to foetus, the transmission rates in early pregnancy are lower. It seems very little arsenic is excreted in breast milk even if the mother drinks water that has a high concentration of the element. Thus, exclusive breast feeding protects infants from exposure to arsenic.
There is also a strong negative correlation between the nutrition levels and symptoms caused by arsenic poisoning. There is a greater prevalence of symptoms among impoverished women in particular who have limited knowledge about daily intake of nutrients. In agriculturally rich rural areas, the quantity of food eaten is often mistaken for quality of nutritional intake, resulting in dietary deficiencies.
Women drinking water with even moderate levels of arsenic are nearly thrice as likely to be anaemic during pregnancy as those who drink water without arsenic. This is the result of a small study in Chile that also states further research is needed to determine the types of anaemia.
The effects of arsenic continue into later life as well, these studies say. A few suggest exposure to arsenic in drinking water during early childhood or in-utero effects the pulmonary function, greatly increasing the mortality rates of young adults from both malignant and nonmalignant lung disease. A series of experimental animal studies provides strong support for the late effects of arsenic, including various forms of cancer, following intrauterine exposure. Another study shows current arsenic concentrations in urine, which reflect all sources of recent exposure, including water and food, is associated with small decrements in intellectual testing in school-aged children in West Bengal.
All these studies link the health effects – still birth, abortions, mortality rates among young adults – to both the duration of drinking arsenic-contaminated water and the concentration of arsenic in the water. As mentioned, there are other mitigating or aggravating factors such as the nutrition levels, as well as climate, hygiene and the existence of other diseases that also determine how arsenic in drinking water affects people.
However, opinion on the effects of arsenic on the foetus and the adverse effects of chronic arsenic poisoning was divided among respondents. They said research showed some impact, but further studies were needed to conclusively establish the results of arsenic poisoning.
There are a range of methods to reduce this risk. Most focus on providing arsenic-free water from other sources, such as rainwater harvesting, tapping arsenic-free aquifers or removing arsenic from water. The arsenic-affected areas in India get good rainfall, making rainwater harvesting a viable option. The problem is designing a system that is not inundated by flood-water, something that has plagued this approach in the past.
Among methods to remove arsenic from water, the Multiple Effect Humidification (MEH) desalination system provides water at the point of use. It can meet the drinking water needs of as small community in any remote location, is nearly free to operate and needs no special skills for maintenance. This is effectively a water distillation process. The Water Cone is a simple solar distiller made of food grade plastic material and can produce 1.5 to 2.0 litres of safe drinking water in a day from sunlight. A third one developed in Bangalore for home use along with the National Institute of Design provides 2 liters of distilled water per hour (on a sunny day in Bangalore ) and costs Rs 3,000 per unit.
Another method uses bio-sand filters, a household water treatment technology in Tamil Nadu. In Nepal this bio-sand filter design has been adopted. This uses non-galvanized iron nails to remove certain level of arsenic from the drinking water using iron hydroxide adsorption principles. Reverse osmosis systems also remove all arsenic from water, along with every other dissolved substance.
Given the spread of arsenic beyond water, mitigation strategies can include integrated in situ bioremediation. A N College, Patna, have experimented successfully with these processes in their laboratory and are awaiting field trials. In Bangladesh , an organization has advised farmers to channel rain water to grow fish and remaining water for irrigating subsequent crops. This involves first adapting to longer inundation periods and addressing the problem of groundwater depletion. This flushing with rainwater has reduced the amount of arsenic entering the food chain substantially.
Thus, while many studies suggest drinking arsenic-contaminated water causes neo-natal defects and impairs health in later life, more research is needed to conclusively establish the causal linkages. There are many ways to remove arsenic from water, but fewer to eliminate it from the food chain. There is a gap in research on where arsenic comes from and how it spreads through the water.
Bihar
Significance of Community Ownership and Government Accountability, Semariya Ojhapatti Village, Bhojpur District (from Sunetra Lala, Research Associate)
Mitigation strategies in arsenic affected river belt districts, adopted by the government include construction of overhead tanks, rainwater harvesting units, revival of open wells, and provision of piped water. However, no initiative has worked and villagers continue to drink arsenic affected water, due to the lack of community participation, no accountability by state government officials, and subsequent lack of linkage between authorities and villagers
From Han Heijnen, (Retired WHO Bangladesh, Nepal and SEARO), Mbale, Uganda
Article; by Centre for Occupational and Environmental Health, University of California ; July 2006; Available at http://coeh.berkeley.edu/research/bridges/06july/06july_arsenic.htm
Reports different studies from Chile , India and USA showing strong link between exposure to a toxic substance in the earliest stages of life can have severe health consequences
From Nidhi Nagabhatla, Natural Resource Management, The WorldFish Center, Penang, Malaysia; response 1
Arsenic: When will the Clean Water start Flowing?
Artilce; by T. V. Padma; Science and Development Network; United Kingdom; November 2009; Available at http://www.scidev.net/en/features/arsenic-when-will-the-clean-water-start-flowing--1.html
Discusses how many new technologies have promised to remove arsenic from drinking water but little has changed on the ground
Monsoon flooding flushes Arsenic from Rice Paddies
Article; by Papri Sri Raman; Science and Development Network; United Kingdom; December 2009;
Available at http://www.scidev.net/en/news/monsoon-flooding-flushes-arsenic-from-rice-paddies.html
Describes how scientists have found that monsoon flooding removes arsenic from rice-paddy soils in Bangladesh
Arsenic Groundwater Contamination and its health effects in the state of Uttar Pradesh (UP) in upper and middle Ganga plain, India: A severe danger (from P. Ranjan Mishra, Middle East Centre for Sustainable Development (MECSD), Dubai)
Article; by Sad Ahamed, Mrinal Kumar Sengupta, Amitava Mukherjee, M. Amir Hossain, Bhaskar Das, Bishwajit Nayak, Arup Pal, Subhas Chandra Mukherjee, Shyamapada Pati, Rathindra Nath Dutta, Garga Chatterjee, Adreesh Mukherjee, Rishiji Srivastava and Dipankar Chakraborti; Science of the Total Environment; November 2006;
Available here
Presents results of a 2-year survey on groundwater arsenic contamination in three districts of Uttar Pradesh n the upper and middle Ganga plain
From Richard Johnston, Eawag - Swiss Federal Institute of Aquatic Science and Technology and Sandec - Department of Water and Sanitation in Developing Countries, Dübendorf
United Nations Synthesis Report on Arsenic in Drinking Water
Report; by World Heatlh Organisation; Switzerland
Available at http://www.who.int/water_sanitation_health/dwq/arsenic3/en/
An expert synthesis report on arsenic in drinking-water which been prepared as a UN system-wide initiative and has been released in draft form for comment
An eight-year study report on arsenic contamination in groundwater and health effects in Eruani Village, Bangladesh and an approach for its mitigation
Article; by S. Ahamed, M. K. Sengupta, et al; Journal of Health, Population and Nutrition ;
Available at http://www.solutionexchange-un.net.in/health/cr/res05011001.doc (DOC; Size: 73KB)
Provides references for several articles related to arsenic contamination in groundwater and its resultant health effects
From N. Muthu Krishnan, GERIND Technology India Pvt. Ltd., Chennai
Water Desalinisation Systems using Solar Energy or Waste Heat
Article; by GERIND Technology India Pvt. Ltd.; Chennai
Available at http://www.solutionexchange-un.net.in/health/cr/res05011002.pdf (PDF; Size: 551KB)
Describes how decentralised desalinisation techniques can enable water availability everywhere and help to deal with arsenic contamination of groundwater
Watercone
Article; by GERIND Technology India Pvt. Ltd.; Chennai;
Available at http://www.solutionexchange-un.net.in/health/cr/res05011003.pdf (PDF; Size: 92.1KB)
Describes Watercone as an inexpensive and portable solar still to produce safe drinking water, which can help to mitigate the problem of arsenic in drinking water
Sea Water Desalinisation System - Using Solar Energy System only, to convert Salt Water into Drinking Water Article; by MAGE Water Management GmbH; Germany;
Available at http://www.solutionexchange-un.net.in/health/cr/res05011004.pdf (PDF; Size: 1.82MB)
Describes Watercone, which is a solar distiller made of food grade plastic material and can produce 1.5 to 2.0 litres of drinking water in a day from sunlight, piloted in Yemen
From Sunanda Gupta, WHO India, Delhi
Arsenicals in maternal and fetal mouse tissues after gestational exposure to arsenite
Article; by V. Devesa, B. M. Adair, J. Liu, M. P. Waalkes, B. A. Diwan, M.Styblo and D.J. Thomas; Toxicology; July 2006; Permission Required: Yes, paid publication
Available at http://www.ncbi.nlm.nih.gov/pubmed/16753250
Describes how exposure of pregnant mice to arsenic as sodium arsenite in drinking water between days 8 and 18 of gestation increases tumor incidence in their offspring
In utero arsenic exposure induces early onset of atherosclerosis in ApoE−/− mice
Article; by S. Srivastava, S.E. D'Souza, U. Sen, J.C. States; Reproductive Toxicology; April-May 2007; Permission Required: Yes, paid publication.
Available at
Describes how evidences suggest consumption of arsenic contaminated water has been linked to higher rates of coronary disease, stroke and peripheral arterial disease
Arsenic groundwater contamination in Middle Ganga Plain, Bihar, India: a future danger?
Article; by Dipankar Chakraborti, Subhash C Mukherjee, Shyamapada Pati, Mrinal K Sengupta, Mohammad M Rahman, Uttam K Chowdhury, Dilip Lodh, Chitta R Chanda, Anil K Chakraborti, and Gautam K Basu; Environment Health Perspectives; July 2003; Permission Required: Yes, paid publication.
Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241574/?tool=pmcentrez
Describes that a study reveals an apparent increase in fetal loss and premature delivery in the women with the highest concentrations of arsenic in their drinking water
Chronic arsenic exposure and risk of infant mortality in two areas of Chile
Article; by Hopenhayn-Rich, S. R. Browning, I. Hertz-Picciotto, C. Ferreccio, C. Peralta and H.Gibb; Organization; Environment Health Perspectives; July 2000; Permission Required: Yes, paid publication
Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1638185/
Describes the trends in infant mortality in Chile: Antofagasta, which has a history of arsenic exposure from naturally contaminated water and Valparaíso, a low-exposure city
From Henk van Norden, UNICEF Regional Office for South Asia, Kathmandu
Pregnancy Outcomes, Infant Mortality, and Arsenic in Drinking Water in West Bengal, India
Article; by O. S. von Ehrenstein, D. N. Guha Mazumder, M. Hira-Smith, N. Ghosh, Y. Yuan, G. Windham, A. Ghosh, R. Haque, S. Lahiri, D. Kalman, S. Das, and A. H. Smith; American Journal of Epidemiology; USA; 2006
Available at www.solutionexchange-un.net.in/health/cr/res05011005.pdf (PDF; Size: 83.3KB)
Describes a study of the relation of arsenic exposure during pregnancy to pregnancy outcome and infant mortality among 202 married women in West Bengal
Children’s Intellectual Function in Relation to Arsenic Exposure
Article; by O. S. von Ehrenstein, Shalini Poddar, Y. Yuan, D. Guha Mazumder, Brenda Eskenazi, Arin Basu, Meera Hira-Smith, Nalima Ghosh, Sabari Lahiri, Reina Haque, Alakendu Ghosh, Dave Kalman, Subankar Das and Allan H. Smith; Epidemiology; January 2007;
Available at www.solutionexchange-un.net.in/health/cr/res05011006.pdf (PDF; Size: 263KB)
Describes how little evidence exists concerning the possible impairment of children’s intellectual function in relation to arsenic exposure in utero and during childhood
Health Effects of Arsenic and Chromium in Drinking Water: Recent Human Findings
Article; by Allan H. Smith and Craig M. Steinmaus; School of Public Health, University of California; Public Health; USA; November 2008;
Available at http://www.solutionexchange-un.net.in/health/cr/res05011007.pdf (PDF; Size: 205KB)
Discusses how new studies address the dose-response relationship between drinking-water arsenic concentrations and skin lesions and cardiovascular disease
Adverse reproductive and child health outcomes among people living near highly toxic waste water drains in Punjab, India (from Shankar Prinja, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh)
Article; by Jarnail Singh Thakur, Shankar Prinja, Dalbir Singh, Arvind Rajwanshi, Rajendra Prasad, Harjinder Kaur Parwana, Rajesh Kumar; Journal of Epidemiol Community Health ; United Kingdom; October 2009; Permission Required: Yes, paid publication
Available at http://jech.bmj.com/content/64/2/148.abstract
Explains although no direct association can be established, heavy metal and pesticide exposure may be risk factors for adverse reproductive and child health outcomes
From Sunil, Icarus Design Pvt Ltd, Bangalore
Drinking Distilled Water - The Truth about the Health Benefits of Distilled Water
Article; by Josh Neumann; Ezine Articles; Location; July 2007;
Available at http://ezinearticles.com/?Drinking-Distilled-Water---The-Truth-About-The-Health-Benefits-Of-Distilled-Water&id=640741
Explains how drinking distilled water has both pros and cons for health, yet in the short term, it can be a life saver
Early Death Comes from Drinking Distilled Water
Article; by Zoltan P. Rona; Health and Beyond; United Kingdom;
Available at http://www.chetday.com/distilledwater.htm
Explains how there is a correlation between the consumption of soft water (distilled water is extremely soft) and the incidence of cardiovascular disease
Low Cost Solar Water Purifier
Video; by Icarus Design Pvt Ltd; Karnataka;
Available at http://www.youtube.com/watch?v=bF6akEqaFmk
Explains a low cost water purifier which uses solar energy which is available abundantly and is free. The cost of making this purifier is about $ 60-75 with easily available material
Quality of community drinking water and the occurrence of spontaneous abortion (from Arunabha Majumder, Presidency College, Kolkatta)
Article; by Aschengrau A, Zierler S, Cohen A; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; U.S. National Library of Medicine, National Institutes of Health ; USA; September-October 1989; Permission Required: Yes, paid publication
Available at http://www.ncbi.nlm.nih.gov/pubmed/2554824
To investigate the relationship between water quality and abortion, the study compares trace element levels in the drinking water of 286 women having a spontaneous abortion
From Meenakshi Aggarwal, Research Associate
Mortality from Lung Cancer and Bronchiectasis in Young Adults Following Exposure to Arsenic in Utero and Early Childhood
Article; by H. Smith Allan, Guillermo Marshall, Yan Yuan, Catterina Ferreccio, Jane Liaw, Ondine S. von Ehrenstein, Craig Murray Steinmaus, Michael N. Bates, and Steve Selvin; Environmental Health Perspectives; USA; July 2006;
Available at http://www.medscape.com/viewarticle/542482_4
Suggests biologic plausibility for arsenic having effects in utero, there is evidence that arsenic is a developmental toxicant affecting birth weight and reproductive outcomes
The Evaluation of Two New Arsenic Field Test Kits Capable of Detecting Arsenic Water Concentrations Close to 10 μg/l
Article; by C. M. Steinmaus, C.M.George, D.A.Kalman, A.H.Smith; Environmental Science and Technology; USA; 2006; Permission Required: Yes, paid publication
Available at http://cat.inist.fr/?aModele=afficheN&cpsidt=17996895
Explains how arsenic field test kits may offer a cost-effective approach for measuring exposures, although the accuracy of some kits used in the past has been poor
Arsenic Primer: Guidance for UNICEF Country Offices on the Investigation and Mitigation of Arsenic Contamination (from Nitya Jacob, Resource Person)
Report; by Rick Johnston, Ross Nickson and Greg Keast; UNICEF; USA; 2008;
Available at http://www.unicef.org/spanish/wash/files/Arsenic_primer_28_07_2008_final.pdf (PDF; Size: 1.52MB)
It is a synthesis of the knowledge UNICEF and its partners have gained over the last ten years in arsenic mitigation programmes in Asia
From Sunetra Lala, Research Associate
Arsenic Drinking Water Regulations in Developing Countries with Extensive Exposure
Paper; by Allan H. Smith, et al; Toxicology; Elsevier Ireland Ltd; 2004
Available at http://socrates.berkeley.edu/~asrg/04SmithAsDWRegulations.pdf (PDF Size: 204 KB)
Discusses the complexity in choosing an appropriate regulatory response in developing countries with large populations and higher concentrations of arsenic in drinking water
Contamination of Drinking-Water by Arsenic in Bangladesh : A Public Health Emergency
Paper; by Allan H. Smith et al; Bulletin of the World Health Organization; 2000;
Available at http://socrates.berkeley.edu/~asrg/00SmithContamDWBngldsh.pdf (PDF Size: 862KB)
Describes the history of the discovery of arsenic in drinking-water in Bangladesh and recommends intervention strategies
Arsenic – India ’s Health Crisis Attracting Global Attention
News Article; by Samuel Taylor Coleridge; Current Science; March 2005
Available at http://www.iisc.ernet.in/currsci/mar102005/683.pdf (PDF Size: 24KB)
Details the evolution and spread of arsenic contamination in ground water and suggests solutions for alleviating the arsenic problem
Recommended Organizations and Programmes
Dhan Foundation, Tamil Nadu(from J. Kanagavalli)
18, Pillaiyar Koil Street, S.S. Colony, Madurai 625016, Tamil Nadu; Tel: 91-452-2610794; Fax: 91-452-2602247; dhan@md3.vsnl.net.in; http://www.dhan.org/themes/index.php
Working on implementing bio-sand filters, a water treatment technology which with non-galvanized iron nails can remove certain levels of arsenic from drinking water
A.N College , Patna (From Ashok Kumar Ghosh)
Boring Road, Patna-800013, Bihar ; Tel: 91-612-2222482; principal@ancollege.org http://www.ancollege.org/faculty.html
The Department of Environment and Water Management in College is working on Health Impact of Arsenic in Ground Water of Bihar
From Henk van Norden, UNICEF Regional Office for South Asia, Kathmandu
Arsenic Health Effects Research Programme, Berkeley, California
University of California, School of Public Health, 50 University Hall MC7360, Berkeley, CA 94720-7360; Tel: 91-452-2610794; Fax: 9510/843-1736; asrg@berkeley.edu
Programme was initiated in 1990 to study the health risks from exposure to inorganic arsenic. Currently it involves international research projects in Chile and Bangladesh
From Sunetra Lala, Research Associate
National Environmental Engineering Research Institute (NEERI), Maharashtra
Nehru Marg, Nagpur 440020, Maharashtra ; Tel: 91-712-2249885-88, 2249970-72; Fax: 91-712-2249900;http://www.neeri.res.in/
Developed low cost methods to remove Arsenic from water which requires inputs of Alum and small doses of Chorine to completely remove all traces of Arsenic and make it safe
Titanor Components Limited, Goa
Plot Nos.184, 185 & 189, Kundaim Industrial Estate, Kundaim 403115, Goa ; Tel: 91-832-3981100; Fax: 91-832-3981101;titanor@denora.com; http://www.titanor.com/
Recommended for details of arsenic treatment equipment such as modern electrochlorinators etc
Centre for Affordable Water & Sanitation Technology (CAWST), Canada
Bay 12, 2916 5th Avenue NE , Calgary , Alberta , Canada -T2A 6K4; Tel: 1-403-2433285; Fax: 1-403-2436199;cawst@cawst.org; http://www.cawst.org/
Promotes biosand filter in many parts of the world including India and adds on an arsenic removal component to the conventional biosand filter to serve for arsenic removal
Innervoice Foundation, Uttar Pradesh (From Meenakshi Aggarwal, Research Associate)
GB-1, Chandrashekhar Nagar, Ballia, Uttar Pradesh; innervoicefoundation@gmail.com;www.innervoicefoundation.blogspot.com;
Working with Arsenic affected people in the state of Uttar Pradesh, Ballia District
Recommended Portals and Information Bases
World Health Organization (WHO), Geneva, Switzerland (from Han Heijnen, (Retired WHO Bangladesh, Nepal and SEARO), Mbale, Uganda)
http://www.who.int/water_sanitation_health/dwq/arsenic/en/index.html; Contact Tel: 41-22-7912111; info@who.int
Provides a state-of-the-art review on arsenic in drinking water conducted by WHO with other UN organisations
METEAU, ACTION 637: Metals and Related Substances in Drinking Water, United Kingdom (from Prosun Bhattacharya, Royal Institute of Technology (KTH) -International Groundwater Arsenic Research Group, Sweden)
http://www.meteau.org/; Contact Colin Hayes; Chair; Tel: 44-1792-602257; c.r.hayes@swansea.ac.uk
Explains the need to prompt better technical knowledge and further research in Europe on the range of issues relating to metals and related substances in drinking water
Related Consolidated Replies
Mitigation of Arsenic Contamination in Groundwater from Arunabha Majumder , All India Institute of Public Health and Hygiene (AIIHPH), Kolkata. Maternal and Child Health Community, Solution Exchange India,
Issued 31 March 2008. Available at http://www.solutionexchange-un.net.in/environment/cr-se-wes-20020801-public.pdf(PDF,Size: 216KB)
Discussed need for a Centre of Excellence in Arsenic mitigation, measures to eliminate arsenic in drinking water and the permissible standards of arsenic in drinking water
Arsenic Levels and Drinking Water Quality; from Nupur Bose, A.N. College, Patna. Health Community, Solution Exchange India,
Issued 8 September 2005. Available at http://www.solutionexchange-un.net.in/environment/cr-se-wes-08090501-public.pdf(PDF,Size: 56KB)
Discusses arsenic contamination and the levels of arsenic contamination that are considered permissible
Han Heijnen, (Retired WHO Bangladesh, Nepal and SEARO), Mbale , Uganda
I am very inspired today to see a query linking Maternal and Child Health and Water and Sanitation. It is an excellent start of the year. Let us continue to think of each other and link up more often.
In the last 10 years or so, a lot of research work has gone into water quality and health implications, and especially with respect to arsenic in groundwater. Arsenic has been found in groundwater used for human consumption in Bangladesh , Northern India and Nepal , and beyond. In 1999, WHO put together a web-based document on arsenic that should be available on the website. Visit link to know more: http://www.who.int/water_sanitation_health/dwq/arsenic/en/index.html. My WHO colleagues can help to locate it.
A good bit of research on obstetric and child health outcomes has been undertaken in recent years with support of WHO (ICDDRB, Bangladesh), University of California, Berkeley (http://coeh.berkeley.edu/research/bridges/06july/06july_arsenic.htm), by Dr. Allan Smith and Dr. Guha Mazumder (West Bengal), National Centre for Epidemiology and Population Health and Dr. Bruce Caldwell, Dr. A.H. Milton (Australia National University, Canberra).
Nidhi Nagabhatla, Natural Resource Management, The WorldFish Center , Penang , Malaysia (response 1)
Wishes for 2010 and good start with the talk about one of the biggest mass poisoning reported in the history of mankind: Arsenic Poisoning. It is not just playing an epidemiological havoc, our work in water resource management from downstream Ganges Basin reflects multiple ways of exposure. Drinking water is surely the most direct. It is taking a lot of debate and innovative action to look for potential low cost mitigation options. I am sharing two recent stories:
Story in SciDev in November 2009 - Arsenic: when will the clean water start flowing?.
Available at http://www.scidev.net/en/features/arsenic-when-will-the-clean-water-start-flowing--1.html
Story in SciDev in December 2009 - Monsoon flooding flushes arsenic from rice paddies.
Available at http://www.scidev.net/en/news/monsoon-flooding-flushes-arsenic-from-rice-paddies.html
Quite evidently, scientists (Harvey et al, 2002) relate the aquifer arsenic mobilization with recent inflow of carbon, clarifying that high concentrations of radiocarbon-young methane (increase in carbon emission from natural and anthropogenic sources; apparently climate change) has driven recent bio geochemical processes, and suggesting that the oxidants/sediments in river/flood water may lower the concentrations.
While the authors in the article suggest that "arsenic contamination could be avoided by digging deeper drinking water wells below the ponds", a point to worry is speedy decline (0.5-0.7 m per year ) in ground water table reported from the Indo-Gangentic basin. Considering the severity of the issue, a simple solution can be a good start, rain water harvesting both at household and field level can help lower exposure at least at seasonal scale.
Surendra Kumar Yadav, School of Studies in Environment Management Vikram University , Ujjain
Arsenic poisoning on one organ system may affect the functioning of another organ system in human body. There are many documented evidences for this in literature. It is also possible that arsenic problem may be coupled with other health problem (like hormone associated problem in females) and this cumulatively creates physiological problems and affects foetal development. The best option seems to be utilization of treated water.
Muhammad Mukhtar Alam, Center for Ecological Audit, Social Inclusion and Governance, Delhi
I would like to suggest that we work for the arsenic mitigation by addressing the root cause of the problem. It is important to focus on how this has happened? My experience from my home village at Mathurapur in Bhagalpur district ( Bihar ) is that over the last thirty years water use pattern has changed with the installation of electric motors. Ground level for clean drinking water has gone down substantially in locations where use of water has increased. Earlier, not many electric motors were used and wells and hand pumps were used for water used for domestic purposes. Now, I find many people have installed motors for pumping water and store them in tanks. Though it makes it easier to have water for domestic use, but it appears, this also causes overuse of water.
I am not sure of the reasons of increasing arsenic in drinking water in Bhojpur. I would be grateful, if there is possibility of having chronological data sets on arsenic content in the region for understanding the locations where the increase in the arsenic content in water has been due to overuse of water. I would like Dr. Ashok Ghosh to throw some light in this regard.
J. Kanagavalli, DHAN Vayalagam Tank Foundation, Madurai
I am working with DHAN foundation, Madurai . I am working on implementation of Bio-sand Filters, a household water treatment technology in Tamil Nadu. In Nepal this bio-sand filter design has been adopted. Please refer Kanchan™Arsenic Filter (KAF) - a biosand filter with non-galvanized iron nails to remove certain level of arsenic from the drinking water using iron hydroxide adsorption principles.
Uday Pathak, Mahavir Vatsalya Aspatal, Bihar
A lot of work on this issue been done in Murshidabad, West Bengal . The best work seems to be from Bangladesh . It could be improved upon. I would suggest doing follow-up with the work done in Bangladesh and take the work done in Bihar against the same frame work or improve on it.
P. Ranjan Mishra, Middle East Centre for Sustainable Development (MECSD), Dubai
I would like to share an article published in Science of The Total Environment; Volume 370, Issues 2-3, November 2006. The article is on Arsenic Groundwater Contamination and its health effects in the state of Uttar Pradesh (UP) in upper and middle Ganga plain, India: A severe danger by Sad Ahamed, Mrinal Kumar Sengupta, Amitava Mukherjee, M. Amir Hossain, Bhaskar Das, Bishwajit Nayak, Arup Pal, Subhas Chandra Mukherjee, Shyamapada Pati, Rathindra Nath Dutta, Garga Chatterjee, Adreesh Mukherjee, Rishiji Srivastava and Dipankar Chakraborti. An abstract of the study is as follows:
The study presented results of a 2-year survey on groundwater arsenic contamination in three districts Ballia, Varanasi and Gazipur of Uttar Pradesh (UP) in the upper and middle Ganga plain, India . Analyses of 4780 tubewell water samples revealed that arsenic concentrations in 46.5% exceeded 10 μg/L, in 26.7%, 50 μg/L and in 10% 300 μg/L limits. Arsenic concentrations up to 3192 μg//L were observed. The age of tubewells (n = 1881) ranged from less than a year to 32 years, with an average of 6.5 years. The study shows that older tubewells had a greater chance of contamination. Depth of tubewells (n = 3810) varied from 6 to 60.5 m with a mean of 25.75 m.
A detailed study in three administrative units within Ballia district, i.e. block, Gram Panchayat, and village was carried out to assess the magnitude of the contamination. Before the survey the affected villagers were not aware that they were suffering from arsenical toxicity through contaminated drinking water. A preliminary clinical examination in 11 affected villages (10 from Ballia and 1 from Gazipur district) revealed typical arsenical skin lesions ranging from melanosis, keratosis to Bowens (suspected). Out of 989 villagers (691 adults, and 298 children) screened, 137 (19.8%) of the adults and 17 (5.7%) of the children were diagnosed to have typical arsenical skin lesions. Arsenical neuropathy and adverse obstetric outcome were also observed, indicating severity of exposure. The range of arsenic concentrations in hair, nail and urine was 137–10,900, 764–19,700 μg/kg, and 23–4030 μg/L, respectively. The urine, hair and nail concentrations of arsenic correlated significantly (r = 0.76, 0.61, and 0.55, respectively) with drinking water arsenic concentrations. The similarity to previous studies on arsenic contamination in West Bengal, Bihar and Bangladesh indicates that people from a significant part of the surveyed areas in UP are suffering and this will spread unless drives to raise awareness of arsenic toxicity are undertaken and an arsenic safe water supply is immediately introduced.
Richard Johnston, Eawag - Swiss Federal Institute of Aquatic Science and Technology and Sandec - Department of Water and Sanitation in Developing Countries, Dübendorf
The WHO led synthesis report on Arsenic in Drinking Water is still online, though not easy to find. Available at http://www.who.int/water_sanitation_health/dwq/arsenic3/en/
Moreover, most of the work on maternal and child impacts is more recent. Please find a few more recent references in the document (Link provided). I am sure the list is not comprehensive but it's a good start. Available at www.solutionexchange-un.net.in/health/cr/res05011001.doc (Doc, Size: 72 KB)
N. Muthu Krishnan, GERIND Technology India Pvt. Ltd., Chennai
I would like to share 2 different solutions, which could be tried out for Arsenic mitigation.
Though the process of Distillation is known as a very effective way of purifying water of heavy metals such as Arsenic, distillation could not be commercially used till now due to the high energy demand of the process. Our principals in Germany have designed a unique solar based distillation process based on Multiple Effect Humidification, which is very low on energy demand and modular. The Multiple Effect Humidification (MEH) desalination system is a system specifically designed to decentralize the water production to the point of usage. MEH system has been designed to meet the drinking water needs of as small community in any remote location. The operational cost is almost NIL and no skilled labour is required for maintenance of the system. Available at www.solutionexchange-un.net.in/health/cr/res05011002.pdf (PDF, Size: 552 KB)
Another product, Water Cone is a simple solar distiller made of food grade plastic material and can produce 1.5 to 2.0 liters of safe drinking water in a day from sunlight. Available at www.solutionexchange-un.net.in/health/cr/res05011003.pdf (PDF, Size: 93 KB). The information on using Water Cone in the Yemen Pilot project is available at www.solutionexchange-un.net.in/health/cr/res05011004.pdf (PDF, Size: 1.8 MB)
These two products are the result of dedicated research spread over 12 years for development and optimization and now ready for trials in India .
Please review the information and feel free to contact me.
Sunanda Gupta, WHO India, Delhi
I found no studies that provide sound evidence of feto-maternal transmission and adverse effects of chronic or acute arsenic poisoning. Research does show some effects, but more targeted research is needed to document adverse effects.
Please find below few references:
- Arsenicals in maternal and fetal mouse tissues after gestational exposure to arsenite by Devesa V, Adair BM, Liu J, Waalkes MP, Diwan BA, Styblo M, Thomas DJ. Toxicology, 224, Jul 2006. http://www.ncbi.nlm.nih.gov/pubmed/16753250
- In utero arsenic exposure induces early onset of atherosclerosis in ApoE−/− mice by Srivastava S, D'Souza SE, Sen U, States JC. Reproductive Toxicology, 23(3), Apr-May 2007. http://www.ncbi.nlm.nih.gov/pubmed/17317095?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=6
- Arsenic groundwater contamination and its health effects in the state of Uttar Pradesh (UP) in upper and middle Ganga plain, India: a severe danger by Ahamed S, Kumar Sengupta M, Mukherjee A, Amir Hossain M, Das B, Nayak B, Pal A, Chandra Mukherjee S, Pati S, Nath Dutta R, Chatterjee G, Mukherjee A, Srivastava R, Chakraborti D. Science of the Total Environment, 370, Nov 2006. http://www.ncbi.nlm.nih.gov/pubmed/16899281?ordinalpos=1&itool=PPMCLayout.PPMCAppController.PPMCArticlePage.PPMCPubmedRA&linkpos=1
- Arsenic groundwater contamination in Middle Ganga Plain, Bihar , India : a future danger? by Dipankar Chakraborti, Subhash C Mukherjee, Shyamapada Pati, Mrinal K Sengupta, Mohammad M Rahman, Uttam K Chowdhury, Dilip Lodh, Chitta R Chanda, Anil K Chakraborti, and Gautam K Basu. Environment Health Perspectives, 111(9), July 2003. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241574/?tool=pmcentrez
- Chronic arsenic exposure and risk of infant mortality in two areas of Chile by C Hopenhayn-Rich, S R Browning, I Hertz-Picciotto, C Ferreccio, C Peralta, and H Gibb. Environment Health Perspectives, 108(7), July 2000. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1638185/
Henk van Norden , UNICEF Regional Office for South Asia, Kathmandu
The following studies should be of interest -
- Pregnancy Outcomes, Infant Mortality, and Arsenic in Drinking Water in West Bengal, India by O. S. von Ehrenstein, D. N. Guha Mazumder, M. Hira-Smith, N. Ghosh, Y. Yuan, G. Windham, A. Ghosh, R. Haque, S. Lahiri, D. Kalman, S. Das, and A. H. Smith. The study was published in American Journal of Epidemiology in 2006. Available at www.solutionexchange-un.net.in/health/cr/res05011005.pdf (PDF, Size: 84 KB)
- Children’s Intellectual Function in Relation to Arsenic Exposure by O. S. von Ehrenstein, Shalini Poddar, Y. Yuan, D. Guha Mazumder, Brenda Eskenazi, Arin Basu, Meera Hira-Smith, Nalima Ghosh, Sabari Lahiri, Reina Haque, Alakendu Ghosh, Dave Kalman, Subankar Das and Allan H. Smith published in Epidemiology, Volume 18, Number 1, January 2007. Available at www.solutionexchange-un.net.in/health/cr/res05011006.pdf (PDF, Size: 264 KB)
One of the other recent publications in the Annual Reviews of Public Health includes pregnancy outcomes. It also makes reference to some of the findings of marked increase in young adult mortality from various causes following early life exposure to arsenic. The details of the study are as follows - Health Effects of Arsenic and Chromium in Drinking Water: Recent Human Findings by Allan H. Smith and Craig M. Steinmaus published 5 November 2008. Available at www.solutionexchange-un.net.in/health/cr/res05011007.pdf (PDF, Size: 206 KB)
The web site of Arsenic Health Effects Research Programme gives more publications at http://asrg.berkeley.edu/publications.html
Shankar Prinja, School of Public Health , Post Graduate Institute of Medical Education and Research, Chandigarh
I agree with Dr Sunanda Gupta that robust evidence is still lacking to attribute reproductive health effects of arsenic toxicity. This is also due to the complex requirements of environmental epidemiological studies to attribute causation and relatively less developed laboratory methods to quantify effects in resource poor developing countries.
I would like to add to the list of studies, a recent research which got published in the Journal of Epidemiology and Community Health recently.
Adverse Reproductive and Child Health Outcomes among people living near highly toxic waste water drains in Punjab, India. Thakur JS, Prinja S, Singh D, Rajwanshi A, Prasad R, Parwana HK, Kumar R. Journal of Epidemiology and Community Health 2010; 64:148-154. Abstract available at http://jech.bmj.com/content/64/2/148.abstract
The article shows association of adverse reproductive and child health effects with heavy metal and pesticide contamination of ground water and may be a potential risk factor.
Hope this adds to the ongoing research and debate. I look forward to your comments.
Sunil, Icarus Design Pvt Ltd, Bangalore
As mentioned by N. Muthu Krishnan, distillation is probably the best water purification method to eliminate all pollution and disease causing organisms. There is a school of thought that drinking distilled water is not good for the body as it is devoid of minerals. There is another school which says that we are feeding our bodies with enough minerals from food so there is no need for additional minerals from water. I am with the latter school.
Here is a link that advocates drinking distilled water -
Here is another link that is against drinking distilled water - http://www.chetday.com/distilledwater.htm
We have developed a low-cost solar water distiller for home use along with the National Institute of Design and Aurore. It provides 2 liters of distilled water per hour (on a sunny day in Bangalore ) and costs Rs 3000 per unit. Please watch the Youtube video to see how easy it is to assemble this product: http://www.youtube.com/watch?v=bF6akEqaFmk.
We would like to collaborate with interested individuals to scale up production that can also bring down the unit cost.
Nupur Bose, A. N. College , Patna , Bihar (response1)
Apropos to Nidhi’s response, it is not only the ground waters that are contaminated with arsenic. In Bhagalpur (perhaps the worst affected district in terms of arsenic contaminated aquifers; socio-economic status; and socio-political responses to the crisis), what is worrisome is that surface water bodies, abandoned channels, even river inlets have arsenic concentrations above the permissible limits. A re-assessment of geo-chemical aspects is called for in Bihar so that suitable mitigation can be adopted for the rural masses, particularly women and child populations.
Although proper nutrition does help in resisting symptoms of arsenic poisoning to an extent, what one faces in Bihar is more the complex problem of arsenic contaminated soils and agricultural produce. With arsenic now “in the environment”, mitigation strategies could be ideally based upon integrated in situ bioremediation for its rapid containment. Already bioremediation work has been successfully conducted in labs conditioned by our study group, and awaits implementation on-field.
Arunabha Majumder, Presidency College , Kolkatta
In a case-control study in Masschusetts of 286 women with spontaneous abortions and 1391 women with live birth, elevated odds ratios for miscarriages were associated with exposure to arsenic in drinking water. Reference - Aschengrau A, Zierler S, Cohen A. Quality of community drinking water and the occurrence of spontaneous abortion; Archives of Environmental Health, Sep – Oct 1989, 44; 283-290. Available at http://www.ncbi.nlm.nih.gov/pubmed/2554824
The odds ratio for spontaneous abortion, adjusted for maternal age, educational level, and history of prior spontaneous abortion, for women exposed to undetectable concentrations, 0.8-1.3 microgram/litre, and 1.4-1.9 microgram/litre of arsenic in their drinking water were 1.0, 1.1, and 1.5 respectively. Reference- WHO : Guidelines for Drinking Water Quality, 2nd edition 1996.
Study needs to be carried out in India in three rural zones for comparative analysis on lines of –
Study I - Safe water is provided in arsenic affected area.
Study II - Safe water is yet to be provided in affected area.
Study III - Area is not affected by arsenic.
Prosun Bhattacharya, Royal Institute of Technology (KTH) -International Groundwater Arsenic Research Group, Sweden
I am not in agreement to the points raised by Mr. Sunil with regard to no need for additional minerals especially in the context of nutritional status of common Indian population in rural and peri-urban India .
To learn more on this please visit the website for COST Action-637: Metals and Related Substances in Drinking Waterat http://www.meteau.org/
Nupur Bose, A. N. College , Patna , Bihar (response 2)
Our investigations show that there is a correlation between nutrition levels and symptoms of arsenic toxicity among rural women. There is a greater prevalence of symptoms among impoverished women in particular who have limited knowledge about daily intake of nutrients. It needs to be pointed out that in agriculturally rich rural areas; quantity of food eaten is often mistaken for quality of nutritional intake, resulting in dietary deficiencies. To make an arsenic mitigation strategy robust and responsive, involvement of women health specialists and health workers, counselors, nutritional experts serving vulnerable female population in the child-bearing group becomes imperative in rural areas.
Nidhi Nagabhatla, Natural Resource Management, The WorldFish Center , Penang , Malaysia (response 2)
I agree to what Nupur added. The problem spreads beyond just groundwater. Scientific studies by and far are linking it primarily to groundwater interaction with surface hydrology. Indeed in-depth understanding of bio-geochemical analysis would help identify such interactions. Bio-Remediation is surely promising.
In Bangladesh , more at a subsistence level and poverty prone areas, we have advised farmers to channel rain water (inundated for more than six months) to grow fish for economic activity, while use the regulated water after harvest for irrigating subsequent crops. That's a two way process, first to adapt to increased duration in inundation, primarily in the lowlands and second to address the current challenges of ground water depletion. By product of the process, is slow substitution of nearly 40% irrigation cycles from abstraction of ground water to surface water from seasonal flooding. On the other side, there is reduced susceptibility to potential crop contamination by Arsenic.
Many thanks to all who contributed to this query!
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