Arsenic mitigation programs in Bangaladesh (AusAID)

Professor Wayne Smith (Project Director, University of Newcastle), Bruce Caldwell, Geetha Ranmathugala, Kamalini Lokuge, Dr Keith Dear (The National Centre for Epidemiology and Population Health, Australian National University), Hasnat Milton (NGO Forum for Drinking Water Supply and Sanitation, Bangladesh), Malcolm Sim (Dept of Epidemiology and Preventive Medicine, Monash University Medical School) and Jack Ng (The National Research Centre for Environmental Toxicology, University of Queensland)

This collaborative project funded by AusAID has been designed to address the lack of scientifically rigorous epidemiological assessments of the health effects arising from arsenic contamination of ground water in Bangladesh, and from arsenic mitigation interventions. In particular, this project will address the following issues / questions:

Validation of the prevalence of dermatological manifestations of chronic arsenicosis determined by the Bangladesh National Arsenic and Water Usage Survey (component 1)

• To assess the associations between dermatological evidence of chronic arsenicosis and arsenic concentration in drinking water (component 1)
• To assess the costs and effectiveness of interventions currently in place in Bangladesh (component 2)
• To assess toxicity and bioavailability of arsenic rich sludge generated by arsenic removal process using iron compounds (component 3)
• To strengthen epidemiological / health research capacity in Bangladesh

The goal of this project is to better inform funders and policy makers about the need for, and relative merits of arsenic mitigation strategies in order to:

• Potentially save tens of millions of dollars in useless interventions, and
• Prevent tens of thousands of cases of potentially fatal cases of diarrhoea as a possible consequence of the interventions.

Component description

Component one expands on the success of the National Survey of Arsenic and Water Usage in providing estimates of the prevalence of arsenicosis in Bangladesh, and of basic information on water usage and knowledge of arsenicosis. This component will allow an accurate assessment of the validity of self-reporting of arsenicosis and hence allow more refined estimates of arsenicosis based on the previous data collection. The simultaneous collection and testing of water samples will also enable an accurate estimate of the correspondence between arsenicosis and arsenic in drinking water. These estimates are essential for an understanding of the national impact of ground-water arsenic on arsenicosis and potential arsenic related mortality

Component two is a randomised trial comparing two areas receiving arsenic mitigation interventions, the three pitcher system and dug wells, and a control area receiving no intervention. This component will assess the efficacy of the interventions in reducing arsenic consumption and to assess a range of potential adverse effects of the interventions including diarrhoeal incidence and socio-economic factors.

Component three is a toxicological study assessing the acute toxicity and bioavailability of arsenic-rich sludge generated from arsenic the removal process. This study will assess these factors on rats.