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Spatial modelling of individual arsenic exposure via well water: Evaluation of arsenic in urine, main water source and influence of neighbourhood water sources in rural Bangladesh
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
School of Geography and Earth Science, McMaster University, Hamilton, ON, Canada.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
International Centre for Diarrhoeal Disease Research (ICDDR,B), Dhaka, Bangladesh.
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2010 (English)In: Journal of Environmental Monitoring, ISSN 1464-0325, E-ISSN 1464-0333, Vol. 12, no 6, 1341-1348 p.Article in journal (Refereed) Published
Abstract [en]

Arsenic concentrations in well water often vary even within limited geographic areas. This makes it difficult to obtain valid estimates of the actual exposure, as people may take their drinking water from different wells. We evaluated a spatial model for estimation of the influence of multiple neighbourhood water sources on the actual exposure, as assessed by concentrations in urine in a population in rural Bangladesh. In total 1,307 individuals  were randomly selected. Arsenic concentrations of urine and water were analysed. Simple average and inverse distance weighted average of arsenic concentrations in the five nearest water sources were calculated for each individual. Spatial autocorrelation was evaluated using Moran’s I statistics, and spatial regression models were employed to account for spatial autocorrelation. The average distance from a household to the nearest tube-well was 32 meters (Inter Quartile Range 1-49 meters). Water arsenic concentrations of the reported main water sources were significantly correlated with concentrations in urine (R2=0.41, ρ< 0.0001, R2 for women=0.45 and for men=0.36). General model fit improved only slightly after spatial adjustment for neighbouring water sources (pseudo R2=0.53, spatial lag model), compared to covariate adjusted regression coefficient (R2=0.46). Arsenic concentration in urine was higher than arsenic in main water source with an intercept of 57µg/L, indicating exposure from food. A suitable way of estimating an individual’s past exposure to arsenic in this rural setting, where influence of neighbouring water sources was minimal, was to consider the reported main source of drinking water.

Place, publisher, year, edition, pages
2010. Vol. 12, no 6, 1341-1348 p.
Keyword [en]
arsenic exposure, urine, drinking-water, spatial model, Bangladesh
National Category
Medical and Health Sciences
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-121795DOI: 10.1039/C001708FISI: 000278588400015PubMedID: 20390220OAI: oai:DiVA.org:uu-121795DiVA: diva2:306602
Available from: 2010-03-30 Created: 2010-03-30 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Epidemiological and Spatial Association between Arsenic Exposure via Drinking Water and Morbidity and Mortality: Population based studies in rural Bangladesh
Open this publication in new window or tab >>Epidemiological and Spatial Association between Arsenic Exposure via Drinking Water and Morbidity and Mortality: Population based studies in rural Bangladesh
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to evaluate the risk for increased morbidity and mortality due to long-term arsenic exposure via drinking water by use of epidemiological and spatial approaches in studies performed in Matlab, Bangladesh. A total of 166,934 individuals aged 4 years and above were screened for skin lesions in 2002-2003. Another sample of 115,903 adults aged 15 years or more and a third sample of 26,972 pregnancies in 1991-2000 were considered in a historical cohort and an ecological study, respectively, where risk of adult mortality and spatial clusters of foetal loss and infant death were analysed in relation to arsenic exposure.

More than 70% of the tube-wells in the study area exceeded the threshold for arsenic contamination according to the WHO guideline (10 µg/L). The prevalence of arsenic-induced skin lesions was 3/1000 and men had significantly higher prevalence of skin lesions (SMR 158, 95% CI: 133-188) compared to women. There was an increased risk for death in adulthood due to all non-accidental causes (hazards ratio = 1.16, [95% CI 1.06-1.26]) even at a low level of arsenic contamination (10-49 µg/L). Slightly lower risks were observed for death in cancers (1.44 [1.06-1.95]) and infectious diseases (1.30 [1.13-1.49]) at 50-149 µg/L, but for cardiovascular diseases, it was evident (1.23 [1.01-1.51]) from the level 150-299 µg/L. A dose-response relationship was observed for each of these causes.

We identified high and low risk clusters of foetal loss and infant death that coincided with identified high and low clusters of arsenic exposure.

Water arsenic concentration of the reported main water source was significantly correlated with arsenic concentration in urine, which reflects current arsenic intake from all sources (R2=0.41, ρ< 0.0001), and the influence of neighbouring water sources was minimal.

The study findings underlines that the ongoing arsenic exposure has resulted in a series of severe public health consequences in Bangladesh that call for reinforcement in the mitigation efforts. Knowledge about the spatial distribution of exposure and health effects may be of value in that process.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. x, 51 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 549
Keyword
Arsenic, tube-well, skin lesion, adult mortality, foetal loss, infant death, cohort, spatial model, Bangladesh
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-121788 (URN)978-91-554-7774-5 (ISBN)
Public defence
2010-05-17, Rosénsalen, Akademiska sjukhuset, 751 85 Uppsala, Ingång 95/96 nbv, 09:15 (English)
Opponent
Supervisors
Available from: 2010-04-22 Created: 2010-03-30 Last updated: 2010-04-22Bibliographically approved

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Sohel, NazmulPersson, Lars Åke

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