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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1388-1389
Public health measures to minimize exposure to arsenic and associated morbidities


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Tamil Nadu, India

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Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Public health measures to minimize exposure to arsenic and associated morbidities. Ann Trop Med Public Health 2017;10:1388-9

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Public health measures to minimize exposure to arsenic and associated morbidities. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Dec 10];10:1388-9. Available from: http://www.atmph.org/text.asp?2017/10/5/1388/196740


Dear Editor,

Arsenic is an ubiquitous element and has been identified as one of the ten chemicals of significant public health concern owing to its wide distribution in the environment and extreme toxicity.[1] However, owing to the varied clinical manifestations between individuals, population groups or geographical regions, it is quite difficult to estimate the precise burden of disease attributed to the exposure.[1],[2]

Nevertheless, the recent estimates suggest that more than 300 million people are affected due to the contamination of drinking water, air, food, and beverages with the chemical, and almost one-quarter of the affected people are from Bangladesh alone.[2],[3]

Arsenic has been identified as an extremely toxic chemical in its inorganic form, and people are exposed to elevated levels via drinking or utilizing contaminated water under various settings.[1] Moreover, despite exposure to the element in drinking water, within the safe limits (less than 10 μg/L), the inorganic form can still result in the development of cancer or raised systolic blood pressure among post-natal women, especially in regions with high levels in drinking water.[1],[3],[4] The inorganic form is associated with a wide range of health morbidities depending upon the exposed concentration.[1]

Apart from the acute poisoning, the first symptom of chronic exposure (minimum 5 years) is observed in skin with pigmentation, lesions and hyperkeratosis.[3],[4] Exposure to the inorganic form in concentrations of more than 50 μg/L, has been linked with heightened risk of cancer (viz. bladder, kidney, liver, lung, etc.), cardiovascular diseases (including ischemic heart disease, blockade of peripheral vessels), raised blood pressure, anaemia in pregnancy, adverse pregnancy outcome or infant mortality, diabetes, neurodevelopment problems, and deaths from respiratory diseases.[3],[4]

To acknowledge the magnitude of the problem, it is very important to safeguard the health standards of affected communities through prevention of further exposure. It can be achieved by ensuring provision of a safe water supply for drinking, food preparation and for irrigation of food crops.[1],[5] A wide range of interventions have been recommended to minimize the levels of arsenic in drinking water, which are:

utilizing rain water or treated surface water as it has low level of elements,

creating awareness among local population about the adverse effects associated with exposure to high levels of the element,

using color coding to differentiate between high and low arsenic sources and educating people about the same, and

installing cost-effective systems for the removal of element either as a centralized or domestic level.[1],[2],[5]

In addition, measures are required to minimize the exposure to the employees in industries, and periodically monitor high-risk population groups for the early detection of clinical features of poisoning.[2],[4] Further, standardized guidelines have been released to assist nations in setting their local recommended level and provide risk management recommendations.[1] It has even attracted due attention in the goals adopted by the global stakeholders pertaining to the drinking water, and to be achieved by the end of 2030.[1]

To conclude, arsenic is an important cause of global public health concern due to its potential to affect different dimensions of health. Thus, the policy makers and other stakeholders should aim to reduce the exposure to inorganic form in the near future and hence minimize the risk of development of cancer and other morbidities.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health OrganizationArsenic - Fact sheet 2016;Available from: http://who.int/mediacentre/factsheets/fs372/en/. [Last accessed on 2016 Jul 2].  Back to cited text no. 1
    
2.
Sarkar A, Paul B, The global menace of arsenic and its conventional remediation - A critical review. Chemosphere 2016;158:37-49.  Back to cited text no. 2
    
3.
Navasumrit P, Chaisatra K, Ruchirawat M, Arsenic projects in SE Asia. Rev Environ Health 2016;31:11-2.  Back to cited text no. 3
    
4.
Chakraborti D, Rahman MM, Ahamed S, Dutta RN, Pati S, Mukherjee SC, Arsenic groundwater contamination and its health effects in Patna district (capital of Bihar) in the middle Ganga plain, India. Chemosphere 2016;152:520-9.  Back to cited text no. 4
    
5.
Quansah R, Armah FA, Essumang DK, Luginaah I, Clarke E, Marfoh K, et al. Association of arsenic with adverse pregnancy outcomes/infant mortality: A systematic review and meta-analysis. Environ Health Perspect 2015;123:412-21.  Back to cited text no. 5
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Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196740

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