Running head: ARSENIC CONTAMINATION

Arsenic Contamination and Its Health Effects in Bangladesh

Valentina Chawdhury

HSCI 616: Environmental Health

California State University of San Bernardino

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Arsenic Contamination and Its Health Effects in Bangladesh

Arsenic is defined as an “element that occurs naturally in rocks and soil and is used for a

variety of purposes within industry and agriculture.” (CDC, 2015). “It is also a byproduct of

copper smelting, mining, and coal burning.” (CDC. 2015). The effects of ingested arsenic

contaminated water and foods can lead to a multitude of deadly illnesses. These illnesses

include, “increasing mortality from lung cancer, bronchiectasis, and tuberculosis, as well as

decreasing lung function, and increasing susceptibility to lower respiratory infections.” (Jochem,

Razzaque, & Dowling, p.2). Arsenic is an element that can contaminate “soil, water and plants

including other compartments of the ecosystem and ultimately affect human health and well-

being.” (Islam et al., 2014, p.1982). The process of arsenic contamination is visualized in three

food chain pathways. The first food chain pathway for arsenic is the soil-plant-human cycle, the

second being the plant-animal-human cycle, and lastly, the third is the soil-water-animal cycle.

Although arsenic poisoning is not commonly heard of in the United States of America, it is of

great concern for other countries in the world. “Natural arsenic contamination in drinking

water is a major concern for public health in Bangladesh and other countries in South and

Southeast Asia, where people drink arsenic contaminated ground water.” (Hassan et al., 2016,

p.781). Arsenic poisoning and contamination is not limited to adults that are able to retrieve

water from tube-wells, it also affects child mortality rates. This is seen especially among

Bangladeshi pregnant women with low socioeconomic status that primarily rely on tube-wells

for their source of drinking water. This paper will delve into the country of Bangladesh and

discuss the causes and concerns for the high rates of arsenic poisoning among its large

population.
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I. Background

Bangladesh is a small country, although dubbed as the world’s eighth most populous

country, that is located in South Asia. The total population as of 2014 is one hundred and fifty-

three million people and the total area in kilometers squared is one hundred and forty-seven

thousand five hundred and seventy kilometers squared (Natarajan & Prathapar, 2014). Due to

the rural environment dominating most of the country and the use of tube-wells, arsenic

poisoning is prevalent among the population. “Tube-wells are long tubes drilled down about

20-100 m to extract groundwater and were primarily designed for irrigation purposes.” (Sohel

et al., 2010, p.2).

In a study done by Natarajan and Prathapar (2014), it was found that in Bangladesh there

are a total of five million tube-wells, three million of which are affected by arsenic poisoning. It

was also found that although the World Health Organizations’ (WHO) standard for arsenic in

drinking water is 0.01 mg/L, Bangladesh’s standard for arsenic in drinking water is 0.05 mg/L

(Natarajan & Prathapar, 2014). In the same study, it was found that Bangladesh has sixty-four

total districts, which sixty-one of those districts were found to be affected by having arsenic in

their drinking water above the country’s standard of 0.05 mg/L (Natarajan & Prathapar, 2014).

Therefore, it was concluded that more than eighty million individuals of Bangladesh’s

population are affected by arsenic contamination, while more than thirty million of that

population is potentially exposed. As of 2014, there are more than thirty-eight thousand

patients suffering from arsenicosis, or arsenic poisoning (Natarajan & Prathapar, 2014). The

high number of cases make the issue of arsenic contamination and poisoning a national

epidemic.
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II. The Problem

Arsenic is described to be “ubiquitous in nature due to the ecological systems and

population of Bangladesh” leading to the country’s vulnerability to arsenic poisoning (Islam et

al., 2014, p.1990). Although arsenic contamination in Bangladesh is a common prevalence and

affects millions in the country, it was an “unintended consequence of successful programs from

the 1970s that installed wells across the region in order to provide clean drinking water and

prevent diarrheal diseases.” (Jochem, Razzaque, & Dowling, 2016, p.2). In rural areas of the

country, particularly villages, it is common for villagers to walk miles to receive water from the

nearest body of water which simultaneously, that body of water was also used to clean oneself.

Through the creation of tube-wells, accessibility of water greatly increased. During this time of

well or tube-well installation, arsenic contamination “was not routinely tested for” and

therefore, was not detected “until health problems were identified in the mid-1990s” (Jochem,

Razzaque, & Dowling, 2016, p.2).

Even though arsenic poisoning is most commonly formed from tube-wells, other sources

of ingesting arsenic are possible. “Routes of arsenic intake include respiratory exposure from

dust and fumes and oral exposure from water, beverages, soil and food.” (Islam et al., 2014,

p.1982). The most common types of foods that were found to be contaminated by arsenic

poisoning were cereal, vegetables, fruits, fish, eggs, milk and meat (Islam et al., 2014, p.1986).

Specifically, cereal consumption “contributed the greatest proportion of total arsenic intake in

adults (about 62%) and children (50%), in the urban city of Bogra City.” (Islam et al., 2014,

p.1987). This was discovered because according to Islam et al. (2014), cereal was found to have

the higher concentrations of arsenic than other food items, and was also consumed at a higher
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rate than the other food items mentioned previously. Three food chain pathways of arsenic

contamination were described by Islam et al. (2014), the first being “soil-plant-human”, the

second pathway being “plant-animal-human”, and the third being “soil-water-animal” (p.1989).

Through the description of the three food chain pathways of arsenic ingestion, it can be

seen that arsenic can be spread in multiple ways. The soil-plant-human food chain pathway

involves soil that has been contaminated by arsenic which provides the plant the necessary

means to grow, although contaminated. The now contaminated plant or crop is harvested then

ingested by the individual thus, leading to potential arsenic poisoning. For example, “previous

studies showed that an elevated accumulation of arsenic might be due to the high arsenic

content in soil of crop fields and excessive use of contaminated irrigation water” (Islam et al.,

2014, p.1987). The plant-animal-human food chain pathway involves either the plant receiving

contaminated water directly or the plant’s soil being previously contaminated from arsenic,

either from seepage or prior exposure. This food chain continues with animals consuming the

now contaminated plants or crops, which humans that are meat eaters will now consume.

Thus, furthering the cycle of arsenic contamination by this food chain pathway. The third food

chain pathway, soil-water-animal, involves contaminated soil seeping arsenic into water bodies

which are then ingested by animals. Through these three food chain pathways, the ubiquitous

nature of arsenic is presented systematically.

III. Health Effects from Arsenic

Arsenic contamination of foods and water sources can lead to a variety of health issues

among the population of Bangladesh as it is considered to be a toxic element, as well as one of

the “most widely distributed toxic metals in foods” (Islam et al., 2014, p. 1982). Specifically,
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arsenic and lead have been considered to be the most toxic elements in the environment and

included in the United States Environmental Protection Agency’s (USEPA) list of priority

pollutants (Islam et al., 2014, p.1982). In fact, the total dietary study performed by the USFDA

indicated that food contributes to ninety three percent of the total intake of arsenic (Islam et

al., 2014, p.1982). Chronic arsenic poisoning can cause serious health effects including “cancers,

melanosis (hyperpigmentation or dark spots and hypopigmentation or white spots),

hyperkeratosis, restrictive lung disease, peripheral vascular disease (blackfoot disease),

gangrene, diabetes mellitus, hypertension and ischemic heart disease.” (Islam et al., 2014, p.

1982). Being diagnosed with one of the mentioned effects of arsenic poisoning is especially

difficult on the low socioeconomic population of Bangladesh as they lack the resources and

accessibility to receive proper treatment.

a. Arsenic Effects Among Pregnant Women in Bangladesh

An example of a particularly affected population of Bangladesh is that of pregnant

women and infants. Arsenic exposure in pregnant women is associated with multiple adverse

pregnancy outcomes and increase in infant mortality. “Despite improvements in child survival,

annually, more than nine million children die before the age of five, mostly in low and middle

income countries.” (Sohel et al., 2010, p. 1). Specifically, sixty-five out of every thousand live-

born infants in Bangladesh die before the age of one due to polluted drinking water being a

common source of infant mortality (Sohel et al., 2010). Studies performed in Bangladesh

indicate that arsenic exposure may “increase the risk of low birth weight, fetal loss and, infant

death” (Sohel et al., 2010, p.2). Therefore, arsenic contaminated water consumption among
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pregnant mothers is shown to increase infant mortality rates and other health issues among

mother and child.

Although arsenic contaminated water consumption among pregnant mothers can lead

to multiple health issues to mother and child, there are other factors that need to be assessed

in order to mitigate the issue. One study found a correlation between arsenic exposure among

pregnant women and the year of pregnancy outcome, age, parity, education and

socioeconomic status (Sohel et al., 2010). This study was performed in the rural area of Matlab,

with a population of about two hundred and twenty thousand. In this area, the majority of the

population lives in poor socioeconomic conditions and is mostly engaged in agricultural

production (Sohel et al., 2010, p.2). Matlab in particular is one of the more severely affected

areas of Bangladesh that is effected by arsenic poisoning. This is because ninety-five percent of

the area’s population relies on tube-wells for their drinking water. This gave cause and reason

for the researchers to explore this area of Bangladesh to discover the effects of pregnancy and

consumption of arsenic contaminated water leading to infant mortality.

In their study, Sohel et al. (2010), observed a “fourteen percent increased risk for fetal

loss and seventeen percent increased risk for infant death in pregnant women drinking tube-

well water” (p.2). This study found that women with lower socioeconomic status or “low

educational attainment had higher fetal loss infant death and higher exposure to arsenic”

(Sohel et al., 2010, p.4). This is due to the lack of knowledge among these low socioeconomic

individuals that are not aware of the arsenic contamination issue in their area and the lack of

resources as a result of their low socioeconomic status. Overall, one of the factors that affected

arsenic exposure among mothers and their children found in this study besides socioeconomic
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status was their age and education. As “the average age at pregnancy was twenty-seven years

and half the mothers had not formal education” (Sohel et al., 2010, p.4). Another factor

attributing to the issue was the number of pregnancies a woman has gone through. For

example, “fetal loss and infant death were higher for women in their first pregnancy” (Sohel et

al., 2010, p.4). it was also seen that “the rates of fetal loss and infant mortality increased with

increasing arsenic exposure, decreased over time, and were higher for women below twenty

years of age or above thirty-five years of age” (Sohel et al., 2010, p.4). As a result, it can be seen

there is a strong correlation among pregnant women who drink from tube-wells containing

arsenic contaminated water and infant mortality rates.

IV. Possible Solutions

Although there have been numerous studies done on the issue of arsenic contamination in

tube-wells in Bangladesh, there has been no concentration on “long-term monitoring of arsenic

accumulation in arsenic affected areas.” (Natarajan & Prathapar, 2014). Having a long-term

monitoring of arsenic affected areas will “help to understand temporal variation in arsenic

concentrations with respect to recharge and evaporation, and will help to avoid the

uncertainties associated with arsenic estimations in the field as well as in the laboratory.”

(Natarajan & Prathapar, 2014). Bangladesh has multiple areas affected by arsenic in their water

sources, therefore, efforts should be made to create long-term solutions to provide healthy

water to inhabitants of those areas. Moreover, even though several studies and “researchers

have contributed in providing as arsenic estimation, there is still a debate to identify the exact

source and transport process linked to arsenic contamination.” (Natarajan & Prathapar, 2014).

Due to the lack of awareness on where exactly arsenic comes from, which stems from
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Bangladesh’s multiple streams of water coming together and providing water to the population,

studies should be done to find the root of the problem. Therefore, “a comprehensive method

should be developed to conduct a complete and thorough evaluation of arsenic contamination

in soil, water, foods (grains, vegetable, fruits, etc.) and its impact on human health.” (Natarajan

& Prathapar, 2014). Also, since water contaminated with arsenic cannot be cleansed by boiling

water “because some of the water evaporates during the boiling process, the arsenic

concentrations can actually increase slightly as the water is boiled” (CDC, 2015). This knowledge

of boiling arsenic contaminated water is not known among the lesser educated population that

is affected. Therefore, efforts should be made to educate the population, find the source of

arsenic contamination, and provide clean water to the people affected in Bangladesh.

V. Conclusion

Arsenic is an environmental health hazard affecting millions in the country of Bangladesh

through the contamination of tube-wells utilized by inhabitants for drinking purposes and foods

and animals in contact with arsenic contaminated water. Although tube-wells were created to

increase water access and decrease illnesses arising from using water sources from lakes and

streams, studies show that three out of the five million tube-wells in Bangladesh are

contaminated with arsenic. This is an issue because prolonged exposure to arsenic

contaminated water can lead to multiple health issues such as increasing mortality from lung

cancer, bronchiectasis, and tuberculosis, as well as decreasing lung function, and increasing

susceptibility to lower respiratory infections. Consuming arsenic contaminated water is also an

issue among pregnant women as studies have shown arsenic exposure leads to an increase in

infant mortality and fetal death. Therefore, educating the affected population and providing
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alternative methods of obtaining clean water is of importance to prevent such negative health

outcomes from occurring.

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References

Centers for Disease Control and Prevention. (2015). Diseases and Contaminants. Retrieved from

http://www.cdc.gov/healthywater/drinking/private/wells/disease/arsenic.html

Hassan, Z., Sultana, M., Westerhoff, H. V., Khan, S. I., & Roling, W. M. (2016). Iron cycling

potentials of arsenic contaminated groundwater in Bangladesh as revealed by

enrichment cultivation. Geomicrobiology Journal, 33(9), 779-792.

doi:10.1080/1490451.2015.1111471

Islam, M. S., Ahmed, M. K., Habibullah-Al-Mamum, M., Islam, K. N., Ibrahim, M., & Masunaga, S.

(2014). Arsenic and lead in foods: a potential threat to human health in Bangladesh.

Food Additives & Contaminants. Part A: Chemistry, Analysis, Control, Exposure & Risk

Assessment, 31(12), 1982-1992. doi:10.1080/19440049.2014.974686

Jochem, W. C., Razzaque, A., & Dowling Root, E. (2016). Effects of health intervention programs

and arsenic exposure on child mortality from acute lower respiratory infections in rural

Bangladesh. International Journal of Health Geographics. 151-13. doi:10.1186/s12942-

016-0061-9

Rahman, M., Sohel, N., Yunus, M., Chowdhury, M. E., Hora, S. K., Zaman, K., & Streatfield, P. K.

(2013). Increased childhood mortality and arsenic in drinking water in Matlab,

Bangladesh: a population-based cohort study. Plos ONE, 8(1), 1-8.

doi:10.1371/journal.pone.0055014
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Sohel, N., Vahter, M., Ali, M., Rahman, M., Rahman, A., Streatfield, P. K., & Persson, L. A.,

(2010). Spatial patterns of fetal loss and infant death in an arsenic-affected area in

Bangladesh. International Journal of Health Geograohics. 953-63. doi:10.1186/1476-

072X-9-53