Arsenic in Drinking Water and the Human Health Effects MPH 632 By: Vaisali Patel 1.

Arsenic in Drinking Water and the Human Health EffectsMPH 632

By: Vaisali Patel1

Learning Objectives • 1) Students will be able to define what arsenic is and where it

is located.

• 2) Students will become familiar with the health consequences related to arsenic in drinking water.

• 3) Students will be able to evaluate current policies regarding arsenic in drinking water.

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What is Arsenic?• Arsenic [As] is a chemical element discovered by Albertus

Magnus in 1250.

• Arsenic is a metalloid and has an atomic number of 33 (Emsley, 2001).

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Where is Arsenic Found?• According to the Natural Resources Defense Council (2000), arsenic is a natural

part of the earth’s crust and it can enter drinking water from natural deposits in the earth or from industrial and agricultural pollution.

• The Natural Resources Defense Council (2000) mentions that arsenic is commonly used in industries and agriculture, and it is also a byproduct of melted copper, mining, and coal burning.

• Handful of arsenic contamination of water stems from leakage of old waste dumps, mines or tailings, or from pesticides that encompass arsenic.

• Arsenic in drinking water can also occur from incessant industrial pollution.

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What is the Problem?• In the environment, arsenic is discovered in organic and

inorganic forms with different valence states. • Trivalent and pentavalent states of arsenic are of greater

interest when studying arsenic in the environment because these are the arsenicals that humans are unprotect from.

• The World Health Organization (WHO) calculates that over 200 million people worldwide are chronically exposed to high levels of arsenic in their drinking water (Naujokas et al., 2013).

• Arsenic found in drinking water exists entirely in its stable trivalent and pentavalent inorganic form (Hughes, Beck, Chen, Lewis, & Thomas, 2011).

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A Global Picture• Globally, Arsenic is present in many countries including:

Argentina, Bangladesh, Canada, Chile, China, Finland, Ghana, Hungary, India, Japan, Mexico, Taiwan, Thailand, United Kingdom, United States of America, and West Bengal (Bhattacharya, Jacks, Frisbie, Smith, Naidu, & Sarkar, 2002).

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Safety Level of Arsenic• The WHO safety standard of consumption of arsenic

contaminated water is 10 µg/L (World Health Organization [WHO], 2008).

• However, in many parts of the world, arsenic concentrations in drinking water are as high as 3,100 µg/L, including private wells in the United States of America (Naujokas et al, 2013).

• Detection of arsenic even at high levels in drinking water poses a major concern because of its colorless, odorless, and tasteless properties (Naujokas et al., 2013).

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In Bangladesh• In many developing nations, such as Bangladesh, the safety standard of

arsenic in drinking water is 50 µg/L due to the difficulties in finding water with arsenic concentration below that level (Smith, Lingas, & Rahman, 2000).

• After the detection of arsenic contamination in Bangladesh in 1998, researchers estimated that about 94% of tube wells and 35% of wells in Bangladesh contained arsenic concentrations greater than 50 µg/L (Smith, Lingas, & Rahman, 2000).

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How About the United States?• In the United States, the U.S. Geological Survey stated that in the state of Maine,

18.4% of wells that were examined had more than 10 µg/L arsenic concentration and the survey approximated about 24,000-44,000 homes may be affected (Nielsen, Lombard, Schalk, 2010).

• Sanders et al. (2012) tested 63,000 wells in North Carolina, and they found 1,436 wells had arsenic concentrations higher than 10 µg/L with a highest level of 806 µg/L.

• Some private wells in the United States have concentrations in drinking water are as high as 3,100 µg/L (Naujokas et al, 2013).

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Arsenic and Health• Research has shown that chronic exposure to arsenic in

drinking water has caused many health concerns.

• As the understanding of arsenic exposure proliferates, the knowledge of the health effects related to the exposure should also increase.

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Health Consequences due to Arsenic Exposure• Long term exposure to arsenic in drinking water poses as a huge threat to

public’s health.

• Cutaneous lacerations are the greatest indicators of persistent arsenic exposure.

• Petrusevski et al. (2007) discuss how drinking low arsenic concentrations in water can cause:• Melanosis: Which is an atypical black-brown coloring of the skin• Keratosis: Which is the hardening of the soles of the feet and the palms

of the hands.

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Health Consequences and Arsenic Exposure• Arsenic in drinking water also causes leukomelanosis.• A de-pigmentation of the skin which develops white spots that

look like raindrops on the trunk of an individual’s body (Petrusevski et al., 2007).

• In a study conducted in West Bengal, 94% of the individuals who were exposed to high levels of arsenic in drinking water, had raindrop pigmentation on their body (Petrusevski et al., 2007).

• The researchers further discuss hyperkeratosis, which is the cracking of the palms and soles of the feet.• Hyperkeratosis can also lead to skin cancer as well as other

cancers due to long term exposure by arsenic in drinking water (Petrusevski et al., 2007). 12

Arsenic Exposure and Cancer• In a study conducted by Chen and Ahsan (2004), the researchers evaluated the

possible burden of internal cancers due to exposure of arsenic in drinking water in Bangladesh.

• The researchers projected lifetime threats of death from liver, bladder, and lung cancers using exposure distribution, death probabilities, and cancer death rates from Bangladesh and dose-specific relative risk approximations from Taiwan.

• The study consisted of a sample of 65,876 people who were the population of an ongoing prospective cohort study which looked at the effects of exposure to arsenic in drinking water. • The researchers collected water samples from 5,966 hand-pumped tube wells in

Bangladesh and were tested for arsenic in 2000. • The authors also interviewed the well owners to collect information and data

on the 65,876 regular users of the water supply. • The authors concluded that a doubling of lifetime death risk (229.6 people in

Bangladesh versus 103.5 in Taiwan per 100,000 people in the population) from lung, liver, and bladder cancers in Bangladesh is due to the chronic exposure of arsenic in their drinking water.

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Early-life Arsenic Exposure and Lung Cancer• Dauphine et al. (2011) researched the effects of arsenic

exposure in early-life and the long-term functioning of the lungs.

• The authors of this study examined a sample of nursing school employees in Antofagasta and Africa. The researchers looked at the lung function and respiratory symptoms in 32 adults who had been exposed to >800 μg/L of arsenic concentration in their drinking water before they were 10 years old.

• The researchers compared their sample to 65 adults who did not have an early-life exposure to arsenic in their drinking water.

• The authors concluded early-life exposure to arsenic in water can lead to permanent respiratory effects that are similar to the effects of smoking through adulthood.

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Arsenic Exposure and Infant Mortality• Harmful pregnancy and developmental outcomes are linked to early life exposures to

arsenic. • Studies have shown that arsenic exposure in early childhood or in utero is associated

with increased mortality in young adults from malignant or non-malignant lung diseases (Vahter, 2008).

• Arsenic exposure has been related to increase in infant mortality and other studies have also found increase in spontaneous abortions and stillbirths.

• Rahman et al. (2010) examined 2,924 pregnant women between 2002 and 2004 in a population-based cohort study in Matlab, Bangladesh.

• The researchers did not find strong evidence of an increase in the number and frequency of stillbirths. However, the rate of infant mortality does show an increase with the increase of arsenic exposure.

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Current Policies • On January 22, 2001 EPA adopted a new standard for arsenic in drinking

water at 10 parts per billion (ppb), replacing the old standard of 50 ppb. The rule became effective on February 22, 2002.

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United States Environmental Protection Agency. (2014, April 13). Arsenic and clarifications to compliance and new source monitoring rule: A quic reference guide. Retrieved from http://water.epa.gov/drink/info/arsenic/upload/2005_11_10_arsenic_quickguide.pdf

Current Policies

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• The current rule requires water to be sampled frequently to make sure the arsenic concentration does not increase.

United States Environmental Protection Agency. (2014, April 13). Arsenic and clarifications to compliance and new source monitoring rule: A quic reference guide. Retrieved from http://water.epa.gov/drink/info/arsenic/upload/2005_11_10_arsenic_quickguide.pdf

Public Health Implications• Ongoing exposures to toxic chemicals from arsenic continues

to pose a significant threat to public health. • Despite all of the studies and research regarding this problem,

more than 200 million people around the world are at risk of arsenic exposure and that is enormous public health concern.

• The WHO, Canada, and the U.S. Environmental Protection Agency have all categorized arsenic as a known carcinogen (Bhattracharya et al., 2002).

• By proper allocation of funding for further research and cost-effective creation of filtration, the presence of arsenic in drinking water can be diminished and adverse health and poor environmental outcomes can be eliminated.

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References • Bhattacharya, P., Frisbie, S. H., Smith, E., Naidu, R. Jacks, G., & Sarkar, B. (2002). Arsenic in the environment: A global perspective. B. Sarkar (Ed.). New York, NY: Marcel Dekker Inc.• Chen, Y., & Ahsan, H. (2004). Cancer burden from arsenic in drinking water in Bangladesh. American Journal of Public Health, 94(5), 741-744 doi:10.2105/AJPH.94.5.741• Dauphine, D. C., Ferreccio, C., Guntur, S., Yuan, Y., Hammond, S. K., Balmes, J., Smith, A. H., & Seinmaus, C. (2011). Lung function in adults following in utero and childhood exposure to arsenic in drinking water: Preliminary findings. International Archives of Occupational and Environmental Health. 84(6), 591–600. doi: 10.1007/s00420-010-0591-6• Emsley, J. (2001). Nature's building blocks: An a-z guide to the elements (pp. 43, 513,

529). Oxford: Oxford University Press. • Hughes, M. F., Beck, B. D., Chen, Y., Lewis, A. S., & Thomas D. J. (2011). Toxicological Sciences,

123(2), 305-332. doi: 10.1093/toxsci/kfr184• Natural Resources Defense Council. (2000). Arsenic in drinking water. New York: Natural Resources

Defense Council. Retrieved from http://www.nrdc.org/water/drinking/qarsenic.asp• Naujokas, M., Anderson, B., Ahsan, H., Aposhian, H. V., Joseph, H. G., Thompson, C.,& Suk, W. A. (2013). The broad scope of health effects from chronic arsenic exposure: Update on a worldwide public health problem. Environmental Health Perspectives, 121(3), 295-302. doi: 10.1289/ehp.1205875• Nielsen, M. G., Lombard, P. J., Schalk, L. K. (2010). Assessment of arsenic concentrations in domestic well water, by town, in Maine, 2005-09. U.S. Geological Survey Scientific Investigations Report 2010-5199. Retrieved from http://pubs.usgs.gov/sir/2010/5199/ 19

References • Petrusevski, B., Sharma, S., Schippers, J., & Shordt, K. (2007). Arsenic in drinking

water. Oxford: IRC International Water and Sanitation Center. Retrieved from http://www.depurazioneacquearrigoni.it/pdf/technologies-for-the-purification-of- polluted-water-by-arsenic.pdf

• Rahman, A., Persson, L. A., Nermell, B., El Arifeen, S., Ekstrom, E. C., Smith, A. H., Vahter, M. (2010). Arsenic exposure and risk of spontaneous abortion, stillbirth, and infant mortality. Epidemiology, 21(6), 797–804. doi: 10.1097/EDE.0b013e3181f56a0d• Sanders, A. P., Messier, K. P., Shehee, M., Rudo, K., Serre, M. L., & Fry, R. C. (2012). Arsenic in North Carolina: Public health implications. Environ International, 38(1), 10- 16. Retrieved from http://www.sciencedirect.com/science/article/pii/S0160412011002200• Smith, A. H., Lingas, E. O., & Rahman M. (2000). Contamination of drinking water by arsenic in Bangladesh: A public health emergency. Bull World Health Organization, 78(9), 1093–1103. Retrieved from http://europepmc.org/articles/PMC2560840/• United States Environmental Protection Agency. (2014, April 13). Arsenic and clarifications to compliance and new source monitoring rule: A quick reference guide. Retrieved from http://water.epa.gov/drink/info/arsenic/upload/2005_11_10_arsenic_quickguide.pdf• Vahter, M. (2008). Health effects of early life exposure to arsenic. Basic & Clinical Pharmacology & Toxicology, 102(2), 204–211. Retrieved from http://europepmc.org/abstract/MED/18226075• World Health Organization. (2008). Guidelines for drinking-water quality – volume 1: Recommendations third edition, incorporating first and second addenda. Retrieved on March 26, 2014 from http://www.who.int/water_sanitation_health/dwq/gdwq3rev/en/

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