Arsenic poisoning in Bangladesh

Arsenicosis in Bangladesh

Arsenic contamination in ground water was 1st identified in Argentina. Arsenic contamination has become a problem in more than 20 countries of the world. It is a very common problem of Bangladesh.

The arsenic contamination in Bangladesh is believed to be biggest arsenic calamities of the world. In Bangladesh the origin of arsenic in  ground water is geogenic. Arsenic already exist in sediments at varying level of depths in varying amounts in different parts of the country. Most of the arsenic contamination of tube wells occurs in the middle and upper Holocene sediments. Arsenic is carried with sediments from upstream through the rivers and deposited in these area over thousands of years.   

Arsenic contamination of ground water is a major public health problem in Bangladesh. In1993 the contamination was officially first reported following detection of excessive arsenic I 4 tube wells of Chamagram village of Barogharia union of Nawabgang by DPEH. Subsequently in 1994 the existence of arsenic related problems were formally recognized following detection of 8 arsecosis patients through fact finding survey in 1994 by DOEH of NIPSOM. At present it has been estimated that about 50 – 75 million people are at risk distributed in 61 districts out of 64 districts. So far as many as 15000 arsenicosis patients has been detected.

Some question and answers to provide a guide line about arsenic contamination.

Q: What are the sources of arsenic contamination?

Ans:    Sources of contamination:

1)     The contamination of water has resulted due to leaching of arsenic from mining sites.

2)     The contamination is related to relies of arsenic sediments into the pore water of aquifers.  

Q: Define arsenicosis?

Ans: Definition of arsenicosis – A chronic Condition due to prolonged exposure of arsenic above safe level  (0.05 mg/L) of water usually manifested by characteristic skin lesion with or without involvement of internal organs and malignancy.

Q: Whar are the sign symptoms of arsenicosis?

Ans:   

Signs and symptoms of arsenicosis: 

1st. Phase- Pigmentary changes in skin and mucus membrane e.g. hyper pigmentation (melanosis), keratosis, conjunctival congestion, bronchitis, asthma and gastroenteritis.

2nd Phase- luekomelanosis, hyper keratosis, non pitting edema weakness, peripheral neuropathy e.g. tingling, numbness, burning sensation and pain.

3rd.Phase- Gangrene, cancer of skin, urinary bladder, lungs and liver and kidney failure. 

Q: Steps of diagnosis of arsenicosis?

Ans:

Lab. Investigation:

1. Evaluation of arsenic contamination of drinking water
2. Examination of body tissues like hair, nail, skin and urine

Steps for diagnosis of arsenicosis:

1. History : H/O exposure- History of consumption of arsenic contaminated water for a period exceeding 6 months.
2. Clinical Examination- a) Characteristic skin manifestation, 

           b) Nondermatological manifestation and

           c) Presence of complication

Q: How to manage a case of arsenicosis?

Ans:

Management:

1. Stop intake of arsenic contaminated water
2. Vitamin -A 50000 I.u, Vitamin – E 200 mg and Vitamin - C 500 mg daily.
3. Application of Keratolytic – 5 – 10% urea-salicylic acid ointment

Alternate water supply option:

1. Treatment of surface water
2. Rain water harvesting
3. Dug/ ring well
4. Deep tube well
5. Treatment of arsenic contaminated water
6. Piped water supply