Arsenicosis is a medical condition that results from increased levels of arsenic elements in the bod and it is a global health concern that many states are vehemently fighting to eradicate. A study in 2007 noted that over 137 million people globally are victims of arsenic poisoning and many more face risks of exposure. For instance, the situation in Bangladesh has been alarming, where arsenic poisoning dates many decades back. Apparently, it has a population of over 156.6 million citizens and at least 90 percent face a chronic risk of exposure of the arsenic poisoning (Khan et al., 2003).
Bangladesh geographical location has made tapping of ground water a suitable solution to water the shortage in the country. As a result, it ranks as a state with the highest number of hand-pumped tube wells and it has been established that half of them have huge traces of arsenic contamination. Health organizations recommend only 50 parts per billion (PPB) of arsenic in water. However, the higher fraction of Bangladesh water wells measure between 150 to 200ppb (Rahman, 2015). West Bengal where most of the tube wells are located, measures the highest level of tube well waters averaging 180 ppb.
According to a study by UNICEF, Bangladesh had approximately 8.6 million of such wells as in the year 2008 and only 39 percent fell within the recommended fraction of arsenic concentration. Over16 percent of these tested unsafe for human consumption due to high quantities of arsenic compounds. UNICEF has established that at least 20 million of its populace is ignorantly using arsenic poisoned water for drinking purposes. The National Drinking Water Quality Survey in the year 2009 reported that at least 22 million people in Bangladesh were using arsenic-contaminated water its rural population faces even higher risk (Rahman, 2015). The study demonstrates that 97 percent of its rural population depends heavily on tube wells as their only source of water.
Exposure to arsenic poisoning presents serious concerns to the current and future generations. Although much of the health concern is attributed to high levels of arsenic elements, continuous exposure to small quantities poses a similar threat at the end, the most notable health-related conditions include skin lesions (McDonald et al., 2007). Besides, it triggers cancers of several body organs not limited to, lungs, liver, bladder, and skin. It has other non-cancerous conditions such as impaired cognitive development, cardiovascular effects, and neurological disorders (Chowdhury, Krause & Zimmermann, 2015). Maternal exposure causes a loss or poor development of the fetus, infant mortality and underweight at birth (Kile et al., 2012). The implications have been serious in Bangladesh raising serious questions of sustainability of tube-wells as a source of drinking water.
The challenge of arsenic poisoning has had a long history dating back its discovery in the 1970’s (Masuda et al., 2012). To date, neither the Bangladesh nor the global community has bothered to provide a lasting solution. With a growing population, the reliance on the tube well water is increasing at a higher rate and the trend threatens to exacerbate the problem by lifting it to a level of a health crisis. Although health concerns are the most alarming, the problem has a social and economic dimension worth exploring.
Scope of the Problem
The number of people using arsenic-contaminated water is on the rise and many people remain ignorant of the operation of arsenic poisoning. The efforts of World Health Organization, UNICEF, and UNDP among other bodies have not done enough to create sufficient awareness on the same. The apparent social stigma associated with its impact is clear evidence of this ignorance. The population in Bangladesh remains at a lifetime risk of death due to this exposure. Statistics establishes that 13 in every 1000 deaths have an ascertainable connection to arsenic poisoning (Edmunds, Ahmed & Whitehead, 2015). Poverty has been a major impediment in the battle against arsenic poisoning, and the government response mechanism has been scrawny and ineffective. As a state with a low per-capita, a majority of its population is poor and without the finances to secure medical plans or even addresses the issue. At least 60 percent of its population does not have access to modern health facilities (Edmunds, Ahmed & Whitehead, 2015). As a result, the government has only engaged little effort to create awareness in a population that lacks the necessary financial muscle to respond.
Bangladesh uses an outdated formula to calculate the level of acceptable arsenic contamination, 50ug/ L and this scale differ with that of WHO and EPA, 10ug/ L, and the deviation obscures the real threat of the situation (Khan et al., 2003). As a result, the state adopts a lighter approach when dealing with the rather serious and demanding threat. The study has established a further development of the problem of indirect poisoning through crop contamination.
Inception of the Problem
The problem of arsenic poisoning in Bangladesh did not exist until the 1970’s, when most of the families started facing chronic shortage of water. The ensuing joint intervention between the US and WHO devised tube wells as a quick solution (Akter, 2015). However, it did not conduct enough testing to its health implication, even when immediate health concerns began to emerge through arsenic lesions and the two delayed in engaging remedial measures. According to the US, one out of ten people that use arsenic wells are condemned to die from the arsenic-related conditions (Tareq, Maruo & Ohta, 2013). The US has come to label it as the highest tragedy of mass poisoning globally, although the international community has done little to control the problem.
Social Impact
Ignorance among the public on the operation of arsenicosis has been a major cause of social challenges attached to the problem. The majority of the populace considers arsenic symptoms contagious. As a result, the victims undergo much social stigma and consequently psychological trauma (Islam, 2016). Within the community structure, those with visible signs are barred from social functions. For instance, infected women lose a chance of getting a spouse, while the married are divorced without justification. Children are not spared either as parents opt to keep those infected at homes to avoid what the community considers as an embarrassment.
Cancer
According to the US, 10 percent of people exposed to arsenicosis eventually die from either cancer of liver, lungs or kidney. Arscenicosis cancer is one of the lifetime risks that has doubled the mortality rate over time in Bangladesh. Apparently, cancer is the principle cause of death of arsenic-induced mortality. However, only little is known about the future of this line of cancers. According to a study that aimed at estimating the level of risk of arsenic-induced cancers in Bangladesh, 103 people out of 100000 were found to be at risk of internal cancers (Chen & Ahsan, 2004). Females were found to be more prone to such cancers and regions such as West Bengal exhibited higher levels of cancer risks. On average, exposure to arsenic poisoning doubles the probability of a person contracting cancer.
Arsenic Lesions
According to International Agency for Research on Cancer, arsenic is both a skin pathogen and a carcinogen (McDonald et al., 2007). Development of arsenic lessons is perhaps the immediate effect of the exposure. The population in Bangladesh lives with many misconceptions about the condition. Some people believe them to be highly contagious occasioning much stigma against the victims. There have been several studies in Bangladesh to find out the scope of this risk. A unanimous finding is that regions with an established concentration above 50μg/L exhibit a high risk of the problem than those with a lesser level of exposure. In some instances, arsenic lesions have demonstrated an ability to degenerate to cancerous level. However, much depends on the level of exposure and preceding curative measures. The attaching social stigma of the condition is unprecedented and increases the victims’ troubles.
Cardiovascular Diseases
High level of exposure to arsenic results in several cardiovascular conditions. First, it leads to capillary leakage and cardiomyopathy, both responsible for shock, hypertension, vasodilation and transudation of plasma (Chen et al., 2013). However much depends on the age, individual’s susceptibility and the level of exposure. Long-term exposure could occasion peripheral vascular and myocardial damage, which triggers other health complications not limited to depressions and flattening of T waves. In some other cases, the study has reported the development of ‘black foot disease,’ an extreme case of gangrene occasioned by drinking contaminated water. A study to assess the risk of arsenic-related cardiovascular diseases led to two important conclusions. First, arsenic has a role in 43 percent of all heart-related diseases. Secondly, it settled the mortality rate of arsenic-related cardiovascular cases to 214 in every 100000 citizens (Smedley & Kinniburgh, 2013).
Limitations and strengths of the Study
Many scientists consider the arsenic contamination of water as purely geological and natural. This is the dominant position well explored, but it denies a chance to explore other available dimensions. As a result, research on other causes such as organic contaminations with an indirect poisoning link lacks thorough research for reference. Due to this, researchers only focus on inorganic pollution and possible solutions. Owing to this, available propositions solve the problem halfway. More so, only scanty literature on organic contamination exists, insufficient to get a clear picture of the problem. Lack of empirical data on the same meant that the paper had to engage deductive reasoning to fill research gaps where necessary (Smedley & Kinniburgh, 2013).
The research is a compilation of findings from several credible sources. The inclusion process depended on the availability of corroborating findings on the same. A major limitation, however, is that the specific researches focused on a small region, but taken to represent the bigger image of the problem. Besides, the available research do not explain the input of independent variables predisposing individuals to the extremes of arsenic conditions, or even give an acknowledgment of the same. Notwithstanding that, they availed sufficient information to prepare a cogent and reliable argument on the topic.
Recommendations
Cell Phone Tracking Systems
Provision of Government Monitored Water
Well, screening and treatment are known mitigating procedures to reduce the arsenic poisoning, but few engage them (Seow et al., 2012). Poverty has been a major obstacle in the provision of arsenic free water. Considering the symptoms of exposure take a long time to emerge, the public finds it easy to ignore the threat. A government-led intervention could be of much importance. This procedure requires the government to conduct thorough screenings on all wells to identify the ones that need attention. Thereafter, it should engage treatment procedures such as coagulation and any other suitable method. Of course, for this to work the government must be prepared to be the sole provider of drinking water. This could be through privatization or state managed corporations. The rates of water should be reasonably low for affordability (Edmunds, Ahmed & Whitehead, 2015). For efficiency, the government should maintain stringent regulations on drilling and treatment standards to regulate private drillers.
Future Study
As already noted, arsenic exposure is not the only cause of cardiovascular diseases, skin lessons and cancers. Independent variable such as cigarette smoking, the nature of preventive measures one adopts, and personal susceptibility predispose a person to the conditions. The available research does not demonstrate the input of these factors or even take notice of their presence. The future study needs to focus on establishing the nexus among these factors to facilitate the development of a lasting solution. Furthermore, future studies need to explore the success of the current mitigating measures such as screening and water treatment. These are missing information yet necessary in exploring the missing link between cause and preventive measures.
The Big Picture Implications
Arsenic health implications have far-reaching implications. Firstly, they raise the mortality rate both at community and state level (Rahman, 2014). The ensuing cancerous condition is especially a lifetime risk with the inevitable end of death and at the state level, the rising concern is the reduced life expectancy (Laskar et al., 2015). Besides, arsenicosis conditions have an ability to trickle to the economy of a state, as it has to direct huge sums to prevention and curative measures on the same. Obviously, the state would have to lag in some crucial sectors due to a shortage of money. More so, arsenic conditions affect the capacity of a state’s workforce raising serious on their viability.
References
Akter, A., Mia, M. Y., & Zakir, H. M. (2015). Arsenic contamination in surface and
groundwater in major parts of Manikganj district, Bangladesh. J. Bangladesh Agril. Univ, 13(1), 47-54.
Chen, Y., Wu, F., Liu, M., Parvez, F., Slavkovich, V., Eunus, M., & Hasan, R. (2013).
A prospective study of arsenic exposure, arsenic methylation capacity, and risk of cardiovascular disease in Bangladesh. Environmental Health Perspectives (Online),
121(7), 832.
Chowdhury, S., Krause, A., & Zimmermann, K. F. (2015). Arsenic contamination of
drinking water and mental health.
Edmunds, W. M., Ahmed, K. M., & Whitehead, P. G. (2015). A review of arsenic and
its impacts in groundwater of the Ganges–Brahmaputra–Meghna delta,
Bangladesh. Environmental Science: Processes & Impacts, 17(6), 1032-1046.
Islam, M. S. (2016). Culture, Health and Development in South Asia: Arsenic Poisoning
in Bangladesh. Routledge.
Khan, M. M. H., Sakauchi, F., Sonoda, T., Washio, M., & Mori, M. (2003). Magnitude
of arsenic toxicity in tube-well drinking water in Bangladesh and its adverse effects on
human health including cancer: evidence from a review of the literature. Asian Pacific
Kile, M. L., Baccarelli, A., Hoffman, E., Tarantini, L., Quamruzzaman, Q., Rahman, M.,
& Christiani, D. C. (2012). Prenatal arsenic exposure and DNA methylation in maternal
and umbilical cord blood leukocytes. Environmental health perspectives, 120(7), 1061.
Laskar, M. S., Gazi, E. A., Basu, B. K., Chowdhury, S., Ahmad, S. A., & Khan, M. H.
(2015). Disability adjusted life years among arsenicosis patients in an arsenic-affected area of southern Bangladesh. Mediscope, 2(1), 4-12.
Masuda, H., Shinoda, K., Okudaira, T., Takahashi, Y., & Noguchi, N. (2012). Chlorite—
source of arsenic groundwater pollution in the Holocene aquifer of Bangladesh.
Geochemical Journal, 46(5), 381-391.
McDonald, C., Hoque, R., Huda, N., & Cherry, N. (2007). Risk of arsenic-related skin lesions
in Bangladeshi villages at relatively low exposure: a report from Gonoshasthaya
Kendra. Bulletin of the World Health Organization, 85(9), 668-673.
Rahman, M. M., Bakker, M., Patty, C. H. L., Hassan, Z., Röling, W. F. M., Ahmed, K. M.,
& van Breukelen, B. M. (2015). Reactive transport modeling of subsurface arsenic
removal systems in rural Bangladesh. Science of the Total Environment, 537, 277-293.
Rahman, M. M., Mondal, D., Das, B., Sengupta, M. K., Ahamed, S., Hossain, M. A.,
& Chakraborti, D. (2014). Status of groundwater arsenic contamination in all 17
blocks of Nadia district in the state of West Bengal, India: A 23-year study report. Journal of Hydrology, 518, 363-372.
Seow, W. J., Pan, W. C., Kile, M. L., Baccarelli, A. A., Quamruzzaman, Q., Rahman, M.
& Christiani, D. C. (2012). Arsenic reduction in drinking water and improvement in
skin lesions: a follow-up study in Bangladesh. Environmental health perspectives, 120(12), 1733.
Smedley, P. L., & Kinniburgh, D. G. (2013). Arsenic in groundwater and the environment.
In Essentials of medical geology (pp. 279-310). Springer Netherlands.
Tareq, S. M., Maruo, M., & Ohta, K. (2013). Characteristics and role of groundwater
dissolved organic matter on arsenic mobilization and poisoning in Bangladesh. Physics and Chemistry of the Earth, Parts A/B/C, 58, 77-84.
