Contamination of drinking-water by arsenic in Bangladesh: a public health emergency.

TLDR

Arsenic contamination of Bangladesh’s groundwater is the largest mass poisoning in history, exposing millions, and studies elsewhere show that drinking water with 500 µg/L can cause cancers in 1 in 10 people, underscoring the need to test all drinking‑water sources worldwide. The paper reviews the discovery of arsenic in Bangladesh’s drinking water and calls for rapid funding, expanded interventions, and the provision of arsenic‑free water. Interventions involve installing tube‑wells for clean water, identifying and supplying arsenic‑free sources, and engaging communities with education and monitoring. Despite widespread tube‑well installation, the water was not tested for arsenic, and while arsenic is rapidly excreted and early cases need no treatment, the risk remains.

Abstract

The contamination of groundwater by arsenic in Bangladesh is the largest poisoning of a population in history, with millions of people exposed. This paper describes the history of the discovery of arsenic in drinking-water in Bangladesh and recommends intervention strategies. Tube-wells were installed to provide "pure water" to prevent morbidity and mortality from gastrointestinal disease. The water from the millions of tube-wells that were installed was not tested for arsenic contamination. Studies in other countries where the population has had long-term exposure to arsenic in groundwater indicate that 1 in 10 people who drink water containing 500 micrograms of arsenic per litre may ultimately die from cancers caused by arsenic, including lung, bladder and skin cancers. The rapid allocation of funding and prompt expansion of current interventions to address this contamination should be facilitated. The fundamental intervention is the identification and provision of arsenic-free drinking water. Arsenic is rapidly excreted in urine, and for early or mild cases, no specific treatment is required. Community education and participation are essential to ensure that interventions are successful; these should be coupled with follow-up monitoring to confirm that exposure has ended. Taken together with the discovery of arsenic in groundwater in other countries, the experience in Bangladesh shows that groundwater sources throughout the world that are used for drinking-water should be tested for arsenic.