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Abstract
The people were drinking arsenic-contaminated underground water in Bangladesh. We had analyzed 33,092 hand tube-well water samples, collected from all four geomorphological areas (i.e., from all 64 districts) in Bangladesh and found arsenic in 60 districts that were above the WHO recommended value in drinking water (10 μg/L) and in 50 districts that were above maximum permissible limit, 50 μg/L.
In this paper, I have reported the magnitude of arsenic contamination in the tubewell water samples that were collected from two districts of Bangladesh, one from Flood Plain, named Chandpur, and another one from Deltaic region, named Madaripur. It describes the analytical report of arsenic concentrations in underground drinking water and biological samples, and people suffering from arsenic toxicity in these two districts.
In the Madaripur district, 19.62% of the total tubewell water samples (n=2,309) contained arsenic concentrations that were below WHO recommended value (10 μg/L) and safe to drink, and 80.38% and 59.59% of the tubewells contained levels arsenic that were above 10 μg/L and 50 μg/L, respectively. In Chandpur district (n=1,165 tubewell water samples), these values are 4.12, 95.88, and 92.79%, respectively. Of the samples in Madaripur, the percentage of water samples with arsenic are 26.94, 12.68, 3.29. 0.91, and 0.22% in the ranges 100-299, 300-499, 500-699, 700-1,000, and above 1,000 μg As/L, respectively. In Chandpur district, these values are 57.86, 25.15, 4.81, 1.80, and 0.43%, respectively.
During our preliminary survey, arsenical patients were identified in all 42 villages, and we surveyed 8 police stations under these two districts. In this survey, 1,038 and 1,605 people (including children) were examined and 81 (7.8%) and 157 (9.78%) people had been identified with arsenical skin lesions from Madaripur and Chandpur districts, respectively. It appears that the overall arsenical skin lesions of adult females are somewhat higher than adult males. We identified arsenical skin lesions of one teenager (girl) and four children (girls) in Madaripur and Chandpur districts, respectively. We could not identify any cancer patient out of a total of 238 patients in these two districts.
The analytical results show that 100% of all hair, nail, and urine samples from Madaripur district, and 96% of hair & 100% of nail samples from Chandpur district, have levels of arsenic that were above toxic/normal level, respectively. The mean concentrations of arsenic in hair, nail, and urine samples from Madaripur district are 4,591 μg/kg, 9,004 μg/kg, and 550 μg/L; and hair & nail from Chandpur district are 3,990 μg/kg and 7,355 μg/kg, respectively. The arsenic level in hair, nail, and urine from Madaripur; and hair & nail from Chandpur districts were much higher than that of the people residing in an area where drinking water is not arsenic contaminated (<3 μg/L) i.e., control population. During our dermatological
survey in the affected villages, it was observed that all members in a family were drinking arsenic contaminated water and have high arsenic body burden (hair, nail) but not all have arsenic skin lesions. The linear regressions analyses between the arsenic concentrations in drinking water samples and arsenic concentrations in hair / nail / urine samples (combining samples from these two districts) show a positive co-relation (for hair samples r = 0.677, n = 69, p = 0.0000001; for nail samples r = 0.724, n = 67, p = 0.00000004; and for urine samples r = 0.545, n = 44, p = 0.0001). The linear regression between arsenic in hair and nail samples also shows a positive correlation (r = 0.81, n = 67, p= 0.00000006).
In conclusions, (a) it appears to be that there is a higher concentration of arsenic groundwater contamination in Chandpur district (Flood Plain) as compared to Madaripur district (Deltaic region); (b) shallow hand tube-wells (<100 meters depth) are more dominating with arsenic in both Madaripur and Chandpur districts; (c) arsenic concentration decreasing with the increase of depth in both Madaripur and Chandpur districts (above 40 meters); (d) arsenical skin lesions of adult females are higher than adult males, and the reasons could be: (i) women drink water from the same tubewell whereas men from different tubewells and (ii) in villages of Bangladesh, women suffer more from malnutrition than men; (e) common problems in arsenic patients such as intolerance to sunlight, burning sensations on whole body, and respiratory problems; (f) many villagers are sub-clinically affected due to arsenic toxicity; and (g) this study took place before 2001, and we need a follow-up study/survey to know the present status.
Introduction:
The origin of arsenic (As) in groundwater is not clear. The opinion of many scientists that heavy groundwater withdrawal may be one of the reasons for As in groundwater. The United States Geological Survey (USGS)1 comments “Mobilization of As in sedimentary aquifers may be, in part of result of changes in the geochemical environment due to agricultural irrigation.” Though it is confirmed that the arsenic in groundwater of Bangladesh and West Bengal, India is of geological origin2-6, but the exact source and mechanism of leaching are still not well understood3-5.
In a period from 1995 to 2000, we had collected and analyzed 33,092 hand tubewell water samples from four different/principal geomorphological regions (Hill tract, Table Land, Flood Plain, and Deltaic reason) i.e., from all 64 districts of Bangladesh (Fig. 1) and found arsenic in 60 districts that were above WHO recommended value in drinking water (10 µg/L) and 50 districts that were above the maximum permissible limit7,8, 50 µg/L. In some areas of Bangladesh, the arsenic concentration in groundwater is minimum, some parts are almost arsenic contamination free, and others are highly contaminated (Fig. 2).
Figure 1: Four principal geomorphological reasons in Bangladesh
Figure 2: Groundwater arsenic status in all 64 districts of Bangladesh
Groundwater arsenic status in Bangladesh
In our study period from 1995 to December 2000 in Bangladesh, we had collected and analyzed 33,092 tubewell water samples from all four geomorphological areas (from all 64 districts)8 and found arsenic in 60 districts that were above WHOrecommended value in drinking water (10 µg/L) and in 50 districts that were above maximum permissible limit7, 50 µg/L. This does not mean that the total areas of these 50 districts are arsenic contaminated, and people are drinking arsenic contaminated water, but no doubt they are under risk. Table 1 shows the status of arsenic in groundwater in all 64 districts of Bangladesh
| Table 1: Overall arsenic situation in underground tubewell waters in Bangladesh | |
| Parameters | |
| Total no. of districts in Bangladesh | 64 |
| No. of districts we had surveyed | 64 |
| No. of districts where arsenic in groundwater > 10 µg/L | 60 |
| No. of districts where arsenic in groundwater > 50 µg/L | 50 |
| Total no. of police stations | 490 |
| No. of police stations we had surveyed | 299 |
| No. of police stations we had found arsenic > 10 µg/L | 205 |
| No. of police stations we had found arsenic > 50 µg/L | 178 |
| Total no. of villages in Bangladesh | 68,000 |
| No. of villages we had surveyed | 2,900 |
| No. of villages we had found arsenic > 10 µg/L | 2,500 |
| No. of villages we had found arsenic > 50 µg/L | 1,955 |
| Total no. of groundwater samples we had collected and analyzed | 33,092 |
| Percent (%) of groundwater samples having arsenic > 10 µg/L | 56.35 |
| Percent (%) of groundwater samples having arsenic > 50 µg/L | 37.38 |
| Percent (%) of groundwater samples having arsenic > 1000 µg/L | 0.82 |
| Highest arsenic concentration found in groundwater (µg/L) | 4,730 |
| 1,217 | |
| Percent (%) of deep tubewells water samples having arsenic > 10 µg/L | 26.87 |
| Percent (%) of deep tubewells water samples having arsenic > 50 µg/L | 8.71 |
| Depth of the tubewells for safe water (arsenic concentration <3 µg/L) | |
Arsenic patients and biological samples status in 33 districts of Bangladesh
In our study for 6 years (from 1995 to December 2000) in Bangladesh, the survey was conducted by our group with a medical team (at least one dermatologist and one general physician/pediatric) in 261 villages of 80 police stations in 33 out of 50 districts where contamination of groundwater with arsenic is above 50 µg/L. During our survey, we had also collected hair,
nails, skin scales (skin scales from those having keratosis), and urine samples from the people of these villages. Biological samples were collected from 40-50% of those having skin lesions, and the rest of the samples were from those without skin lesions. Parametric presentation of arsenic situation (from six years study) in Bangladesh is shown in Table 2.
| Table 2: Parametric presentation of arsenic situation in Bangladesh | ||
| Parameters | ||
| 01 | Total no. of districts in Bangladesh | 64 |
| 02 | No. of district we have surveyed | 64 |
| 03 | No. of districts where arsenic in groundwater > 10 µg/L | 60 |
| 04 | No. of districts where arsenic in groundwater > 50 µg/L | 50 |
| 05 | No. of districts where we have surveyed for arsenic patients | 33 |
| 06 | No. of districts where we have identified for arsenic patients | 31 |
| 07 | No. of police stations surveyed for arsenic patient | 77 |
| 08 | No. of police stations where we have identified arsenic patient | 69 |
| 09 | No. of villages surveyed for arsenic patient | 253 |
| 10 | No. of villages where we have identified arsenic patient | 222 |
| 11 | Total no. of people examined for arsenic patient | 18,841 |
| 12 | No. of patients identified | 3,725 |
| 13 | Total no. of adult examined | 13,976 |
| 14 | No. of adult patient identified | 3,420 (24.47%) |
| 15 | Total No. of children examined | 4,864 |
| 16 | No. of children patient identified | 298 (6.12%) |
| 17 | Total No. of hair samples analyzed | 4,386 |
| 18 | Percent (%) of hair samples content arsenic above toxic level | 83 |
| 19 | Total No. of nail samples analyzed | 4,321 |
| 20 | Percent (%) of nail samples content arsenic above normal level | 94 |
| 21 | Total No. of urine samples analyzed | 1,084 |
| 22 | Percent (%) of urine samples content arsenic above normal level | 95 |
| 23 | Total No. of skin scales samples analyzed | 705 |
| 24 | Arsenic concentration range in skin scales samples with mean value | 600 to 53,390 µg/ kg (mean value 5,730 µg/kg) |
Out of total 64 districts in Bangladesh, there are 22 districts in Deltaic region and 28 districts in Flood Plain. Surveying all police stations and villages under each district in Flood Pain and Deltaic areas is a mammoth job for a single group. Thus, I selected, two districts, one from Flood Plain named Chandpur and another one from Deltaic region named Madaripur (Fig. 3) and made a detailed study of groundwater arsenic contamination to get an idea of the magnitude of the contamination in Flood Pain (FP) andDeltaic regions (DR) of Bangladesh. The total area and
thepopulation of Madaripur and Chandpur districts are 1,140 sq. km. & 1185000, and 1700 sq. km. & 2180000, respectively. In this paper, I have reported the magnitude of arsenic contamination in the tubewell water samples collected from these districts and described the analytical report of arsenic in tubewell water samples. Also, I have reportedthe analytical report of arsenic inbiological samples from villagers and people suffering from arsenical skin lesions due to arsenic toxicity in these two districts of Bangladesh.
Madaripur (DR); Chandpur (FP)North-24Parganas,India (Deltaic region, DR)
Figure 3: Locations of Madaripur and Chandpur districts in Bangladesh map and North 24 Parganas district, WB in India
Groundwater arsenic contamination in Madaripur district from Deltaic region and Chandpur district from Flood Plain
Madaripur district is situated on the western part of Padma and Ahrial Kha river and Chandpur district on the eastern side of
the Meghna River. Figure 3 shows the position of Madaripur and Chandpur districts in Bangladesh map. Table 3shows the physical parameters of Madaripur and Chandpur districts, and this study was conducted between 1995 and December 2000.
| Table 3:Physical parameters of Madaripur and Chandpur districts in Bangladesh | ||
| Parameters | Madaripur | Chandpur |
| Area (sq. km) | 1,140 | 1,700 |
| Population (million) | 1.185 | 2.18 |
| Total no. of police stations | 4 | 7 |
| No. of police stations surveyed | 4 | 6 |
| Total no. of villages | 480 (approx.) | 840 (approx.) |
| No. of villages from where tubewell water samples were collected | 199 | 89 |
| No. of arsenic affected villages | 187 (93.97%) | 89 (100%) |
| Total no. of tubewell water samples analyzed | 2,309 | 1,165 |
| No. of samples having arsenic > 10 µg/L | 1,856 (80.38%) | 1,117 (95.88%) |
| No. of samples having arsenic > 50 µg/L | 1,376 (59.59%) | 1,081 (92.79%) |
| Expected population drinking arsenic contaminated water > 10 µg/L (million) | 0.91 (77.26%) | 2.05 (94.07%) |
| Expected population drinking arsenic contaminated water > 50 µg/L (million) | 0.61 (51.44%) | 1.97 (90.66%) |
| No. of villages served for arsenic patients | 9 | 33 |
| No. of villages where patients identified | 9 (100%) | 33 (100%) |
| No. of people examined for arsenical manifestation | 1,038 | 1,605 |
| No. of people found with arsenical manifestation | 81 (7.80%) | 157 (9.78%) |
Analyses of 2,309 and 1,165 tubewell water samples covering all police stations in Madaripur district and 6 out of 7 police stations in Chandpur district, respectively, had been done and found arsenic levels that were above the WHO7 maximum permissible limit (50 µg/L) in all surveyed police stations. The preliminary survey indicates that the level of arsenic in groundwater was above 50 µg/L in 187 out of 199 surveyed villages in Madaripur, and all 89 surveyed villages in Chandpur district of Bangladesh. The total villages in Madaripur and Chandpur districts are 480 (approx.) and 840 (approx.), respectively. This does not mean that all people in these two districts were drinking arsenic contaminated water but no doubt they are at risk. Tables 4 and 5 show the distribution of arsenic in 2,309 and 1,165 hand tubewells of Madaripur and Chandpur districts, respectively. Figures 4 and 5 show the distribution of the percentage of tubewells in different arsenic concentrations ranging at different police stations of Madaripur and Chandpur districts, respectively. Figure 6 shows a comparative study of the
percentage of water samples in different concentrations ranges (µg/L) in Madaripur (n=2,309) and Chandpur (n=1,165) districts of Bangladesh. In the Madaripur district 19.62% of the total tubewells contained arsenic concentrations that were below WHO recommended value (10 µg/L) and safe to drink, and 80.38% and 59.59% of the tubewells contained arsenic levels that were above 10 µg/L and 50 µg/L, respectively. In Chandpur, these values are 4.12%, 95.88%, and 92.79%, respectively. Of the samples in Madaripur, the percentage of water samples with arsenic are 26.94%, 12.68%, 3.29%. 0.91%, and 0.22% in the ranges 100-299, 300-499, 500-699, 700-1,000, and above 1,000 µg/L, respectively. In Chandpur district, these values are 57.86%, 25.15%, 4.81%, 1.80%, and 0.43%, respectively. These values appear to be of higher concentration of arsenic groundwater contamination in Chandpur district (Food Plain) as compared to Madaripur district (Deltaic region) (Tables 4 & 5 and Figures 4-6).
| Table 4: Distribution of the number of tubewells against the arsenic range (µg/L) in different police stations (PS) of Madaripur district in Bangladesh. | |||||||||||||
| No. of PS | No. of PS surveyed | Name of PS | No. of samples analyzed | No. of samples having arsenic | Distribution of the number of tubewells with different arsenic concentration (µg/L) range | ||||||||
| >10(µg/L) | >50(µg/L) | <10 | 10-50 | 51-99 | 100-299 | 300-499 | 500-699 | 700-1000 | above1000 | ||||
| 4 | 4 | Kalkini | 774 | 483 | 346 | 291 | 137 | 81 | 150 | 93 | 16 | 6 | - |
| MadaripurSadar | 770 | 680 | 516 | 90 | 164 | 94 | 251 | 113 | 39 | 14 | 5 | ||
| Rajoir | 675 | 610 | 473 | 65 | 137 | 133 | 208 | 110 | 21 | 1 | - | ||
| Shibchar | 90 | 83 | 41 | 7 | 42 | 28 | 13 | - | - | - | - | ||
| Total tubewells | 2,309 | 1,856 | 1,376 | 453 | 480 | 336 | 622 | 316 | 76 | 21 | 5 | ||
| % of tubewells | 80.8 | 59.9 | 19.6 | 20.8 | 14.5 | 26.9 | 13.7 | 3.3 | 0.91 | 0.22 | |||
| Table 5:Distribution of the number of tubewells against the arsenic range (µg/L) in different police stations (PS) of Chandpur district in Bangladesh | |||||||||||||
| No. of PS | No. of PS surveyed | Name of PS | No. of samples analyzed | No. of samples having arsenic | Distribution of the number of tubewells with different arsenic concentration (µg/L) range | ||||||||
| >10(µg/L) | >50(µg/L) | <10 | 10-50 | 51-99 | 100-299 | 300-499 | 500-699 | 700-1000 | above1000 | ||||
| 7 | 6 | ChandpurSadar | 77 | 72 | 70 | 5 | 2 | 3 | 24 | 35 | 8 | - | - |
| Faridganj | 91 | 80 | 76 | 11 | 4 | 2 | 21 | 23 | 14 | 12 | 4 | ||
| Haziganj | 106 | 100 | 100 | 6 | - | - | 20 | 48 | 24 | 7 | 1 | ||
| Kachua | 31 | 30 | 27 | 1 | 3 | 4 | 18 | 5 | - | - | - | ||
| Matlab | 119 | 119 | 116 | - | 3 | 9 | 68 | 37 | 2 | - | - | ||
| Shahrasti | 741 | 716 | 692 | 25 | 24 | 14 | 523 | 145 | 8 | 2 | - | ||
| Total tubewells | 1,165 | 1,117 | 1,081 | 48 | 36 | 32 | 674 | 293 | 56 | 21 | 5 | ||
| % of tubewells | 95.88 | 92.79 | 4.1 | 3.1 | 2.8 | 57.9 | 25.2 | 4.8 | 1.8 | 0.43 | |||
Figure 4:Distribution of the percentage of tubewellsagainstthe arsenic concentration range (µg/L) in different police stations of Madaripur district
Figure 5:Distribution of the percentage of tubewellsagainst the arsenic concentration range (µg/L) in different police stations of Chandpur district
Figure 6:A comparative study of the percentage of tubewell water samples againstthe arsenic concentrations’ ranges (µg/L) in Madaripur(Deltaic region) (n= 2,309) and Chandpur (Flood Plain) districts (n=1,165) of Bangladesh
Figure 7: A comparative study of the percentage of tubewell water samples in different arsenic concentrations ranges (µg/L) in Madaripur district (Deltaic region) (n= 1,899) and Chandpur district (Flood Plain) (n=1,124) of Bangladesh where depth of the tubewells are less than 100 meters.
Figure 7 shows that the percentage of tubewell water samples in different concentration ranges (µg/L) in Madaripur (n= 1,899) and Chandpur (n=1,124) districts of Bangladesh where depth of the tubewells are less than 100 meters. This figure also supports that the underground water arsenic concentrations in Flood plain (Chandpur district) are higher compared to the Deltaic region (Madaripur district).
Arsenic concentration in underground water at differentdepth of tubewells in Madaripur (Deltaic region) and Chandpur (Flood plain) districts of Bangladesh
The objective of this study is to find out the distribution of arsenic at different depthsin hand tubewells in Madaripur and Chandpur districts of Bangladesh from our questionnaire filled-up by villagers. The questionnaire pertains to depth and identity
(including owner name, village, and police stations) of each tube well which were obtained for 2,309 and 1,083 tubewells (out of 2,309 and 1,165), covering Madaripur and Chandpur districts, respectively. The concentration of arsenic was measured by FI-HG-AAS with 3 µg/L as the detection limit with 95% confidence level. The percentage of tubewells with different depth ranges are shown in Table 6for both Madaripur and Chandpur districts in Bangladesh.
| Table 6: Distribution of the percentage of tubewells against different depth ranges (meters) in Madaripur (n = 2,309) and Chandpur (n = 1,083) districts of Bangladesh | ||||
| Depth (m) | Madaripur district (n=2,309) | Chandpur district (n=1,083) | ||
| No. of tubewells analyzed | % of the tubewells | No. of tubewells analyzed | % of the tubewells | |
| 6.4-9.7 | 6 | 0.26 | - | - |
| > 9.7-15.6 | 257 | 11.13 | 55 | 5.08 |
| > 15.8-21.9 | 494 | 21.40 | 459 | 43.38 |
| > 21.9-28.0 | 475 | 20.57 | 452 | 40.75 |
| > 28.0-34.1 | 126 | 5.45 | 67 | 6.18 |
| > 34.1-40.2 | 67 | 2.91 | 15 | 1.38 |
| > 40.2-52.4 | 177 | 7.66 | 13 | 1.20 |
| > 52.4-89.0 | 280 | 12.12 | 16 | 1.48 |
| > 89.0-150.0 | 14 | 0.62 | 6 | 0.55 |
| >150.0-250.0 | 206 | 8.92 | - | - |
| > 250.0 | 207 | 8.96 | - | - |
From Table 6, it appears that shallow hand tubewell (<100 meters) water is more dominant with arsenic in both Madaripur and Chandpur districts of Bangladesh. The lowest depth of hand tubewells available in Bangladesh is 6.4 meters. The villagers use 4.6- or 6-meters pipes, with 1 or 2 filters (each filter 1.8 m). Therefore, all tube wells are multiple of 4.6- or 6-meters pipes with 1 or 2 filters.
The data on arsenic concentration in groundwater and depths of tubewells were proposed for statistical interpretation. Statistical parameters (mean, median, standard (std) deviation, minimum, maximum, 1st quartile and 3rd quartile) are given in Tables 7 and 8 for Madaripur district and Chandpur district, respectively. From Tables 7 and 8,mean values at different depths indicate the overall decline trend of arsenic concentration with theincrease of depth. Figures 8 and 9also show the decrease of arsenic concentration with the increase of depth (above 40 meters) in both Madaripur district (Deltaic region) and Chandpur district (Flood Plain).
| Table 7:Parametric presentation of arsenic concentration (µg/L) in tubewell water samples with depth ranges (meters) of 2,309 tubewells from Madaripur district (Deltaic region) in Bangladesh | |||||||||||
| Parameters | Depth range (m) | ||||||||||
| 6.4-9.7 | >9.7-15.6 | >15.8-21.9 | >21.9-28.0 | >28.0-34.1 | >34.1-40.2 | >40.2-52.4 | >52.4-89.0 | >89.0-150.0 | >150.0-250.0 | >250 | |
| No. of tubewells | |||||||||||
| No. of samples | 6 | 257 | 494 | 475 | 126 | 67 | 177 | 280 | 14 | 206 | 207 |
| As concentration in µg/L | |||||||||||
| Mean | 250 | 100 | 214 | 234 | 255 | 210 | 102 | 93 | 89 | 10 | 10 |
| Median | 270 | 60 | 167 | 211 | 234 | 176 | 40 | 49 | 53 | 3 | 3 |
| Std deviation | 171 | 130 | 198 | 162 | 176 | 245 | 135 | 123 | 104 | 35 | 36 |
| Minimum | 15 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 |
| Maximum | 517 | 587 | 1200 | 875 | 794 | 1200 | 524 | 833 | 281 | 352 | 129 |
| 1st quartile | 90 | 20 | 70 | 100 | 106 | 40 | 22 | 14 | 3 | 3 | 3 |
| 3rd quartile | 358 | 148 | 292 | 342 | 391 | 300 | 190 | 113 | 88 | 12 | 10 |
| Table 8:Parametric presentation of arsenic concentration (µg/L) in tubewell water samples with depth ranges (meters) of 1,083 tubewells from Chandpur district (Flood Plain) in Bangladesh | ||||||||
| Parameters | Depth range (m) | |||||||
| 9.7-15.8 | >15.8-21.9 | >21.9-28.0 | >28.0-34.1 | >34.1-40.2 | >40.2-52.4 | >52.4-89.0 | >89.0-150.0 | |
| No. of tubewells | ||||||||
| No. of samples | 55 | 459 | 452 | 67 | 15 | 13 | 16 | 6 |
| As concentration in µg/L | ||||||||
| Mean | 344 | 289 | 250 | 260 | 291 | 233 | 70 | 40 |
| Median | 230 | 250 | 240 | 245 | 254 | 220 | 40 | 30 |
| Std deviation | 267 | 165 | 120 | 135 | 171 | 40 | 80 | 40 |
| Minimum | 37 | 30 | 30 | 28 | 33 | 200 | 3 | 3 |
| Maximum | 1318 | 1186 | 706 | 800 | 625 | 281 | 227 | 168 |
| 1st quartile | 159 | 190 | 171 | 190 | 200 | 133 | 10 | 7 |
| 3rd quartile | 469 | 333 | 309 | 300 | 400 | 281 | 110 | 90 |
Figure 8: Variation of arsenic concentration in groundwater (n=2,309) with depth of the tubewells in Madaripur district (Deltaic region) of Bangladesh
Arsenical skin manifestation to the people from villages of Madaripur district (Deltaic region) and Chandpur district (Flood Plain) in Bangladesh
Patients with arsenical skin lesions are expected in all 4 police stations of Madaripur districts and 6 surveyed police stations (out of 7) of Chandpur district as groundwater contains elevated levels of arsenic (Tables 4 & 5). In our preliminary study with our medical team, we surveyed 9 villages of 3 police stations out of 4 in Madaripur district and 33 villages of 5 police stations out of 7 in Chandpur district to identify patients with arsenical skin lesions (Tables 9 and 10). During our survey, arsenic patients were identified in all 42 villages that we surveyed in 8 police stations under these two districts. In this study, 1,038 and 1,605 people (including children) were examined, and 81 (7.8%) and 157 (9.78%) people had been identified with arsenical skin lesions from Madaripur and Chandpur districts, respectively. Tables 9 and 10 show overall findings of arsenic patients among adults and children in different police stations of Madaripur and Chandpur districts, respectively. This is a very preliminary survey, and we expect more patients from arsenic affected villages of Madaripur and Chandpur districts of Bangladesh if we survey in detail. Figure 10 and Table 11 show the distribution of the percentage of prevalence of common arsenical dermatological symptoms among 81 and 157 people (including children) in Madaripur and Chandpur districts of Bangladesh.
Figure 9: Variation of arsenic concentrations in groundwater (n=1,083) with depth of the tubewells in Chandpur district (Flood Plain) of Bangladesh
| Table 9: Overall study report of 3 police stations (PS) of Madaripur district (Deltaic region) where people with arsenical skin lesions were identified | ||||||||||||
| Total No. of PS | No. of PS surve-yed | No. ofPSwhere patient identi-fied | Name of the PS | Areas (km2) | Popula-tion | No. of villssurve-yed | No. of villswherepatientsidenti-fied | No. of people exa-mined | No. of patients identi-fied | No. ofadultmalepatients | No. ofadultfemalepatients | No. ofchildpatients |
| 4 | 3 | 3 | Kalkini | 280 | 279,000 | 2 | 2 | 50 | 4 | 3 | 1 | |
| Madari-Pur Sadar | 314 | 341,000 | 2 | 2 | 640 | 59 | 11 | 47 | 1 (F) | |||
| Rajoir | 229 | 226,000 | 5 | 5 | 348 | 18 | 9 | 9 | ||||
| Total | 823 | 846,000 | 9 | 9 | 1,038 | 81 | 23 | 57 | 1 (F) | |||
| Table 10: Overall study report of 5 police stations (PS) of Chandpur district (Flood Plain) where people with arsenical skin lesions were identified | ||||||||||||
| Total No. of PS | No. of PS surve-yed | No. of PS where patient identi-fied | Name of the PS | Areas (km2) | Popula-tion | No. of villssurv-eyed | No. of villswherepatientsidenti-fied | No. of people exa-mined | No. of patients identi-fied | No. ofadultmalepatients | No. ofadultfemalepatients | No. ofchildpatients |
| 7 | 5 | 5 | Chand-purSadar | 309 | 451,000 | 6 | 6 | 110 | 10 | 10 | - | - |
| Farid-ganj | 232 | 395,000 | 9 | 9 | 470 | 50 | 30 | 20 | - | |||
| Hazi-ganj | 190 | 289,000 | 6 | 6 | 420 | 43 | 24 | 16 | 3 (F) | |||
| Matlab | 409 | 507,000 | 1 | 1 | 200 | 14 | 8 | 6 | - | |||
| Shahra-sti | 154 | 205,000 | 11 | 11 | 405 | 40 | 26 | 13 | 1 (F) | |||
| Total | 1294 | 1,847,000 | 33 | 33 | 1,605 | 157 | 98 | 55 | 4 (F) | |||
Figure 10:Distribution of arsenical skin lesions [Dorsum, WB-M (Whole Body Melanosis), Leuco, DK-S (Diffuse Keratosis-Sole), SK-S (Spotted Keratosis-Sole), DK-P (Diffuse Keratosis-Palm), SK-P (Spotted Keratosis-Palm), DM-T (Diffuse Melanosis-Trunk), SM-T (Spotted Melanosis-Trunk), DM-P (Diffuse Melanosis-Palm), SM-P (Spotted Melanosis-Palm)] among the people of Madaripur (n=81) and Chandpur (n=157) districts of Bangladesh
| Table 11:Distribution of arsenical skin lesions among the people in Madaripur (n = 81) and Chandpur (n = 157) districts of Bangladesh | ||
| Symptoms | % of prevalence | |
| Madaripur | Chandpur | |
| SM-P | 19.75% | 20.43% |
| DM-P | 62.96% | 75.18% |
| SM-T | 92.59% | 83.94% |
| DM-T | 83.95% | 67.88% |
| SK-P | 45.68% | 45.98% |
| DK-P | 37.03% | 40.14% |
| SK-S | 56.79% | 51.09% |
| DK-S | 41.97% | 40.87% |
| WB-M | 39.51% | 27.00% |
| Leuco | 32.09% | 27.00% |
| Dorsum | 6.17% | 2.92% |
Figure 10 and Table 11show the overall skin lesions of the patients from Madaripur and Chandpur districts. Figures 11 & 12 and Table 12show a comparative study of dermatological symptoms among the adult male and adult female patients in Madaripur and Chandpur districts, respectively. In this study, it appears (Figures 11 and 12)that the overall arsenical skin lesions
of adult females are somewhat higher than males. We have no explanation for this, but the reasons may be (a) in villages of Bangladesh women drink water from the sametubewell whereas men from different tubewells (as they stay about 12 hours outside in their workplace); and (b) women suffer more from malnutrition than men.
Figure 11:Distribution of arsencal skin lesions among the adult males (n=23) and females (n=57) in Madaripur district (Deltaic region)
Figure 12:Distribution of arsencal skin lesions among the adult males (n=98) and females (n=55) in Chandpur district (Flood Plain)
| Table 12: Distribution of the percentage of common arsenical skin lesions among the adult males and females in Madaripur and Chandpur districts of Bangladesh | ||||
| Symptoms | % of prevalence | |||
| Madaripur | Chandpur | |||
| Males (23) | Females (57) | Males (98) | Females (55) | |
| SM-P | 34.78% | 14.03% | 22.22% | 18.60% |
| DM-P | 39.13% | 73.68% | 73.33% | 79.07% |
| SM-T | 95.65% | 91.22% | 90.00% | 74.42% |
| DM-T | 78.26% | 85.96% | 73.33% | 58.14% |
| SK-P | 34.78% | 49.12% | 43.33% | 55.81% |
| DK-P | 26.08% | 42.10% | 38.88% | 46.51% |
| SK-S | 52.17% | 57.89% | 53.33% | 51.60% |
| DK-S | 34.78% | 45.61% | 36.66% | 53.48% |
| WB-M | 21.74% | 35.08% | 26.66% | 30.23% |
| Leuco | 21.74% | 47.36% | 24.44% | 34.88% |
| Dorsum | 4.34% | 7.01% | 2.22% | 4.65% |
Table 13 shows the dermatological features of 8 patients from 8 police stations of these two districts (one patient from each police station), and Photographs 1-5 show the patients with all possible arsenical skin manifestations from different villages of Madaripur and Chandpur districts. In addition to dermatological symptoms, we also observed some common problems in arsenic patients such as intolerance to sunlight, burning sensations on the whole body, and respiratory problems.
Table 13: Dermatological features of patients from 3 police stations in Madaripur and 5 police stations in Chandpur districts of Bangladesh (one patient from each police station)
Photograph Captions:
| Photograph 1 | Vill: Barna, PS: Shahrasti, Dist: Chandpur |
| Photograph 2 | PS: HaziganjDist: Chandpur |
| Photograph 3 | Vill: Datterhat, PS: Madaripur Sadar, Dist: Madaripur |
| Photograph 4 | Vill: Datterhat, PS: Madaripur Sadar, Dist: Madaripur |
| Photograph 5 | Vill: Datterhat, PS: Madaripur Sadar, Dist: Madaripur |
Status of total arsenic in urine, hair, nail, and skin-scale from the villagers of Madaripur district (Deltaic region) and total arsenic in hair, nail, and skin scale from the villagers of Chandpur district (Flood Plain) where we had identified arsenic patients
Urine, hair, and nails are used as the universal biomarker of arsenic body burden9. During our investigation, urine, hair, nail, and skin-scales samples were collected from different groups of people in arsenic-affected villages of different police stations in Madaripur and Chandpur districts. About 40-50% of these samples are from people having arsenic skin lesions, and the rest of the samples are from non-patients that live in the arsenic
