Quantification of Deaths and DALYs Due to Chronic Exposure to Arsenic in Groundwaters Utilized for Drinking, Cooking and Irrigation of Food-Crops
Groundwaters with arsenic concentrations higher than the WHO provisional guide value of 10 μg/L are found in many parts of the world. Widespread utilization of these groundwaters for drinking, irrigation of food crops and cooking over the past few decades has resulted in chronic exposure to tens of millions of people, annual excess deaths of the order of thousands and annual DALYs of the order of hundreds of thousands in Bangladesh, the worst impacted country. Chronic exposure to arsenic may result in a wide range of cancerous and non-cancerous deleterious health impacts; particularly for cancers, these health impacts may not manifest themselves until decades after the exposure. Many health end-points are non-fatal but nevertheless result in considerable loss of quality of life. Calculation of arsenic-attributable DALYs is therefore important to inform policy-makers.
Assessing the overall risk of utilization of arsenic-bearing groundwaters may be achieved, in principle, by quantifying (1) dose–response relationships; (2) exposure routes; and (3) groundwater arsenic hazard.
There is a clear association between chronic arsenic exposure and various cancers, particularly skin and lung cancers, at drinking water concentrations above 100 μg/L but there is considerable argument over the nature of dose–response relationships at concentrations much below this. Nutritional status, including intake of selenium and folate, genetic disposition, smoking habits, age and gender are all contributory factors to the risk of acquiring arsenic-related diseases as a result of a given chronic exposure.
The major exposure routes for arsenic from groundwaters are: (1) drinking groundwater; (2) eating rice and other food-crops irrigated with groundwater; and (3) indirectly through cooking rice with high arsenic groundwater.
Assessing the impact of various arsenic remediation options needs to explicitly consider potential risk-substitution and, in particular, the balance between DALYs arising from arsenic-related health impacts and those related to water-borne pathogens.
KeywordsArsenic Concentration Arsenic Exposure Probabilistic Risk Assessment Chronic Arsenic Exposure Remediation Option
List of Abbreviations:
- As, arsenic, DALY
disability adjusted life year
global burden of disease study
parts per billion
parts per million
pond sand filter
World Health Organization
This work is a joint output of the PRAMA and AquaTRAIN projects. PRAMA is a UKIERI (UK India Education and Research Initiative) project funded by the British Council, the UK Department for Innovation, Universities and Skills (DIUS), Office of Science and Innovation, the FCO, Department of Science and Technology, Government of India, The Scottish government, Northern Ireland, Wales, GSK, BP, Shell and BAE for the benefit of the India Higher Education Sector and the UK Higher Education Sector. AquaTRAIN is funded by the European Commission Sixth Framework Programme (2002–2006), Marie Curie Actions – Human Resources and Mobility Activity Area, Research Training Networks. DM acknowledges the receipt of an NERC Dorothy Hodgkins Postgraduate Award. We thank George Adamson, Dipankar Chakraborti, Tony Fletcher, Guy Howard, D.N. Guha Mazumder, Ross Nickson, Luis Rodriguiz-Lado and Allan Smith for discussions. The views expressed here are not necessarily those of any of the funding bodies or any of the individuals acknowledged here.
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