The
webmaster's 2004 visit
The 2003 National Arsenic Policy (directory)
(File)
Chronic Arsenic Poisoning:
History, Study and Remediation
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COUNTRIES
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| 1. Argentina | description | reference |
| 2. Australia | description | reference |
| 3. Austria | description | reference |
| 4. Bangladesh (30,000,000) | description | reference |
| 5. Canada | description | reference |
| 6. Chile | description | reference |
| 7. China | description | reference |
| 8. Germany | description | reference |
| 9. India | description | reference |
| 10. Inner Mongolia (300,000) | description | reference |
| 11. Jamaica | description | reference |
| 12. Japan | description | reference |
| 13. Mexico | description | reference |
| 14. NewZealand | description | reference |
| 15. Sweden | description | reference |
| 16. Taiwan | description | reference |
| 17. Thailand (2,000) | description | reference |
| 18. USA (~300) | description | reference |
| 19. Vietnam |
description |
reference
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| 20. Yugoslavia | description | reference |
The
webmaster's 2004 visit
The 2003 National Arsenic Policy (directory)
(File)
Maps
of the distribution of arsenic
Arsenic Poisoning in
Drinking Water: Challenges and Solutions Report of a North America Bangladesh
Conference
The Dhaka
Declarations
At five conferences from 1998 to 2003participants have become increasingly concerned about the slow pace of progress in solving the arsenic problem. This is shown by the declarations of the particpants at each of the five conferences.
The worst arsenic problem in the
world is clearly in BANGLADESH. Mott
Macdonald Ltd., working on behalf of DPHE and the UK
Geological
Survey (BGS) in summer 1998 collected all
available data
and
surveyed another "representative sample" (although not formally
a
random sample) of 1,800 wells. By being representative they
avoided
the criticism of biassing the numbers high by only measuring in
areas
with known contamination. Nonetheless they estimate that
18%
of all wells have levels of arsenic above 50
ppb.
The fraction of wells
with levels above 50 ppb
for the various regions are shown in a
map and water quality data can be
downloaded from
that report. In May 2000 the BGS website was updated
with a phase 2 report. Thus between 20
million
and 60 million people have been exposed to arsenic above the EPA
regulatory limit.
In 1998,
Dhaka Community Hospital, in conjunction with the Bangladesh Arsenic
Victims Rehabilitation Trust (UPOSHON) completed a 500 village (out of a total of
60,000) Rapid Assessement
Report (published in 2000). This
was initiated by the Ministry of Health and Family welfare of
the
government of Bangladesh with funding assistance from
UNDP.
In April 2000, the
Dhaka
Community
Hospital (DCH) and Jadvapur
University (Calcutta, India) produced a report
on 239 days field work over 5 years. A
draft report of a 2003 survey of tubewell arsenic screening data
(archived in NAMIC) from 36 Upzillas is Phase II of a BAMWSP
project. In a report
to a seminar on
global emergencies, of which this surely is one, Professor Barkat
of the University of Dhaka describes the socioeconomic impact.
It seems to be the
official Bangladesh National
Water Policy to return to the use of
surface waters whenever possible, in spite of the fact that many
communities have excellent water supplies from ground water (deep
wells). In the directory there is included the Report
of the Committee on Surface Water Development and Management for
Drinking Water Supply in the Arsenic affected areas of Bangladesh, July
2003
Tragedy in
some form or
another
has always plagued the land of Bangladesh. It is located at the
delta
of two major rivers - the Ganges and Brahmaputra - and frequently
floods during and after the monsoons. The Ganges in
particularisa
polluted river and is a breeding ground for cholera. The
population
has grown from 35 million to 120 million in 25 years and the air
pollution
in the capital city, Dhaka, is massive. But the arsenic in the
water
introduces a psychological element which is different. The very actions
proposed
by the world community to avoid cholera brought disfigurement to many
of
the Bangladeshi peopleand a slow death from the cancers that arsenic
causes.
Nowhere else in the world is the contamination from arsenic as
severe
or as widespread. Nowhere is there a group of people more
vulnerable
and less prepared to deal with such a massive environmental
health
catastrophe.
Bangladesh is a small country with a land mass of about 52,000 square miles. It is therefore approximately the size of Wisconsin. The climateand the soil are such that in many places it is possible to grow 3 to 4 crops a year. There is natural gas available. But, it has a population of approximately 120 million inhabitants (compared to theUnited States population of approximately 260 million). Thus, Bangladesh has the official designation of being the most densely populated country in the world, with 2,308 people per square mile. It is also one of the poorest countries in the world, with a per capita Gross National Product (GNP) of only 230 United States Dollars ($230). The country is also a deltaic plain criss-crossed by mighty rivers such as the Ganges, Brahmaptra, Megna and the Teesta. There are 230 rivers with a total length of 24,140 km.
Yet Bangladesh has always had a problem with getting clean water to its people. It has three types of water resources: surface water, rain water and ground water. At first glance, the surface water is the most obvious resource (due to the great number of rivers), but on closer inspection, there are problems with it. The river Ganges is polluted for 1,000 miles upstream and cannot be used without purification because of the extreme contamination. During the Monsoon season, waters from the melting snows from the Himalayas, and rain _water from other regions of the Indian sub-continent accumulate in the low-lying areas of Bangladesh before eventually passing into the Bay of Bengal. Flooding therefore becomes a yearly occurrence. Details of the September 2000 and October 2000 floods, which were the worst in 100 years, are available here . Cyclones also take their death toll. 500,000 people died in 1970 and 200,000 in 1991.
The arsenic
problem cannot, in the long term, be separated from these overall water
problems of the country. Nor can it be separated from the
relationship with the neighboring country India, which in West Bengal
has many of the same problems. In order to bring better water and
a better standard of living to its increasing population, India has
built dams, barrages and hydroelectic systems on the Ganges and plans
to build more both on the Ganges, the Bramaputra and its tributories.
Some people have blamed the arsenic catastrophe on the
consequent reduction in river flow in Bangladesh. But this makes
little sense, because the relavant aquifer is recharged by rainfall -
not by the rivers. Nonetheless, the failure of
Bangladesh to come to agreement with India on a common water policy
that can satisfy the needs of both countries, has led to India, with
the help of World Bank loans, going its own way.
A careful examination of the political problems in implementing any
scientific policy can be seen in the senior thesis entitled "Crisis
of
Capacity" by
Pripya Patel, Harvard University. Another Harvard student,
Christopher
Shim, also wrote a report.
See also Dr. Chakraborti's 2001 report on Bangladesh , which we have
also captured in a
local file . A recent draft summary of the Bangladesh situation has
been circulated for comment by
WATERAID.
The
best review of the situation in Bangladesh is in the
paper by
Feroze
Ahmed, presented to the
International
Workshop on Arsenic on January 14-16 2002 in Dhaka. A
more recent (2002) report by the NGO forum copied here in
pdf
form
and in
html. Sylvia Mortoza
of the
DISASTER FORUM produces
regular
"Fact sheets" about the arsenic problems in Bangladesh.
The latest sheet was in December
2003,
and the rest of the Fact
Sheets are listed here, and an article.
.Professor
Zuberi
is also sending regular letters about his visits to the
Bangladesh villages.
The tragedy is well described in a
recent detailed (2004) report on the village of Eruaine.
The arsenic
in Bangladesh is
the greatest case of mass poisoning the world has ever
experienced. In the sheer magnitude and numbers ofvictims
it exceeds the Chernobyl disaster nearly 100 fold. In
Bangladesh 97% of the population, or 116 million people ingest
wellwaters. An early map in 1998 by Dainichi Consultant Inc.
in early 1998 shows high levels of arsenic primarily in the western
part of the country. The figures are the maximum average
concentrations
ofmeasurements in the particular region of the countrytaken from
measurements
from a variety of sources varying from a "field kit"
(manufactured
by Merck) to Atomic Absorption Spectroscopy (AAS) (see page on
measurements). The "Rapid Action Program" of 1999 (report of April
2000 noted above) measured both concentrations in the wells and
diagnosed
chronic arsenic poisoning. As shown on the map
below,
most regions in the countryhad villages which hadwells above the
country
standardof 50 ppb. By a rough extrapolation they estimatethat
half of
all
wells in the country exceed this limit. These measurements were
made
with a Merck field kit, which cannot measure arsenic levels below
50
ppb so that it is not known how many people are drinking water with
levels
of
arsenic above the WHO recommendation of 10 ppb. A
UNDP survey indicated that 40% of all wells are
contaminated . Mott
Macdonald Ltd., working on behalf of DPHE and the UKGeological
Survey (BGS) . in summer 1998 collected all available data
and
surveyed another "representative sample" (although not formally
a
random sample) of 1,800 wells. By being representative they
avoided
the criticism of biassing the numbers high by only measuring in
areas
with known contamination. Nonetheless they estimate that
18%
of all wells have levels of arsenic above 50
ppb. In May 2000 the BGS website was updated
with a phase 2 report. Water quality data can be
downloaded here. The fraction of wells with levels above 50
ppb
for the various regions are shown in a
map from that report. Thus between 20
million
and 60 million people have been exposed to arsenic above the EPA
regulatory limit.
A much more
complete survey of the wells in the country BACAMP
and a copy can be accessed
here.
A
systematic framework
for
estimating the
health effects
from
the
measured concentrations, using
GIS and other tools has been made by Professor Charles Harveyof
MIT
and his student Dr. Winston Yu of Harvard.
The
paper answers a fundamental question: What is the distribution of
health effects due to the arsenic
problem currently and in the future? The abstract of another PhD
thesis (presented at Sydney Australia) has been provided by Dr M. Shamsudduha who
studied the spatial variation using multivariate analysis (See also the
paper by
Feroze Ahmed
.)
Progress in
resolving these
questions is very slow. The 4th Dhaka declaration (from the
January 2002 conference organized by the Dhaka Community Hospital)
emphasizes this. I have said
at the 1998 Dhaka conference
that there are 3 types of action
that
should be taken simultaneously.
(1) Enabling the people
to have arsenic and bacteria free water
(2) Treating and
finaciallyaiding the sufferers
(3) Undertstanding the
hydrogeology and the health effects to enhance future knowledge so that
this and similar catastrophes will never again happen anywhere in the
world.
As we look at these it becomes clear that the rest of the world has an enormous interest in helping Bangladesh that is not completely recognized. The whole world made mistakes in thinking that arsenic is not a big medical problem.
(1) The World Bank and
UNICEF are morally (even if not legally)
responsible because they installed tube wells without checking for
arsenic, and the
British Geological Survey (BGS) was similarly delinquent.
However, a lawsuit
instituted in UK against
BGS
during 2003 was dismissed by the court of appeals in 2004 and this
was upheld in 2006 by the House of Lords.
(3) It is the whole
world,
not just Bangladesh, that will learn from the experience of
coping
withthe health effects and the hydrogeological understanding that will
be
achieved. The whole world should pay for it. Alas, this is not
really
understood.
Some investigators have gone to a village, made studies on the many volunteers, and done nothing directly to help. If the investigators return for a follow up they should expect to be thrown out by the villagers. Each and every epidemiological or hydrogeological study in a village must be accompanied, at least, with help for the villagers by providing them with access to pure water. This webmaster is paying attention to (2) for all of these reasons and although there are several options available in specific circumstances is, in particular, urging that people help by building new, sanitary, arsenic free wells - preferably with water piped to the individual houses. (see the remediation page)
In 2000 the Bangladesh government made some recommendations. These have not been widely addressed. You are invited to comment upon the recommendations that the participants made to the Bangladesh government . Comments will be forwarded to the government and to WHO.
The measurement problem has not been fully addressed. Ideally we could all have confidence in any measurement in the same way that we have confidence in our weights and measures. Even laboratory measurements have problems as an inter-laboratory comparison shows. Filed kits may well be worse. Although an accurate portable device (the arsenator - link is dead and there is no new website) has been developed by Professor Walter Kosmos, this has a high capital cost and has proved more difficult to use in the field than hoped.
A look at the maps of arsenic concentrations will show that the southern part of the country, and the town of Dhaka, are free of serious contamination. _This is because they obtain their water from deep wells - greater than 150, sometimes over 200 meters in depth. Although this suggests that villagers should turn_to deep wells, this should only be done where the hydrogeology suggests that there is indeed an impermeableclay layer above the deep aquifer. Moreover a deep well, if improperly grouted, can mix the water in the acquifier with water in the shallower aquifers.This is discussed further on the remediation page. A more general solution is a return to the shallow, open, dug well which seems to be free of arsenic for reasons which are not entirely clear. These wells must of course beinstalled ina sanitary manner - far from latrines for example - and the level of coliform bacteria must be monitored.
A vital
issue is whether or
not
appreciable arsenic enters through the
food chain . Most of the water from the wells is used for
agriculture
and irrigation. If these wells do not have to be tested or
changed
the whole remediation problem will be simpler and can be solved more
rapidly.
But if arsenic-laden water is continually brought to the surface the
concentrations of arsenic and the uptake
by plants is likely to increase in the forthcoming years. The
simple
calculation made by the webmaster 10 years ago may be overly
optimistic. From
about
1950 - 1970 the USA put 40,000 tons of arsenic a year on the best
cropland
and forgot about it. The amount of arsenic pulled out of the
subsoil
in Bangladesh is similar, so the effect should be similar - equivalent
to
1 - 5 ppb of arsenic in the water. This could be
tested by either examining concentrations of arsenic in toenails or in
the urine, and examining toenails is now simpler.
Studies of toenail concentrations in the Pabna upazilla by the
Harvard/DCH group, which are reported in the PhD thesis of Dr Molly
Kile, suggest that arsenic in foodstuffs is roughly equivalent to
about 25 ppb in the water - 10 times what this webmaster had
imagined. A set of
four
measurements could also scope the problem. Arsenic in
the urine measures the amount of arsenic absorbed in the previous
24 hours or
so.
One could measure the arsenic in the urine ofeveryone in a village, and
then
ask the villagers to eat for the next week only food from an arsenic
free
village
and measure the urine again a week later. Similarly one
could
ask the villagers to drink and cook with bottled waterfor a week and
see
what reduction there is in the arsenic levels in
urine. Then
one might do the inverse; ask villagers from an arsenic free
village
to eat (or drink) food (or water) from an arsenic-laden
village. The first of these tests seems to have been performed
and it seemed that
foodstuffs were not yet a major problem. A study in progress by
CSIRO of
Australia
on arsenic in foods should help in resolving these questions.
Julian Spallholz of the USA is also engaged in this work.
This is
vitally important because the present policy of the Government of
Bangladesh is to ignore arsenic in foodstuffs. Now that
Bangladesh has become a major exporter of rice to SE Asia, it seems
vital to address it before the world, and in particular the trading
parners, embargo the rice.
As noted above, world governments and concerned
individuals MUST help
Bangladesh.
The US Government
has taken some steps. The CommunityHealth
Development Society has outlined the goals and activitiesof
their arsenic project and requested assistance
. The Dhaka Community Hospital depends upon
donations to treat patients (most of whom cannot pay the $900 per
total treatment), to rehabilitate patients after measures such as
limb ampuation, and to proceed with their program of installing
and measuring,
dugwells, pond sand filters and river sand filters. For these reasons the webmaster has started
the
.
The governing laws are The Safe Drinking Water Act for water we drink, the Clean Water Act for water in rivers and other locations, the superfund law for arsenic in various waste sites. The United States Environmental Protection Agency (EPA) is the major agency trying to cope with the theselaws and their problems. But although as noted in the main pages of this site, the fact that long term medium level arsenic exposure leads to chronic health problems was known in 1986, it was basically ignored by EPA till 2000. On a pessimistic calculation using a linear dose response curve the Office of Health and HazardAssessment (OEHHA) of the California EPA calculated that a level for a one-in-a-million risk is 1.5 parts per trillion - 3000 times less than the proposed level. But it would be impossible to set a regulatory limit this low since no water supply could meet it. Moreover arsenic in take into people would be dominated by arsenic in foodstuffs . After much travail, the US Environmental Protection Agency in January 2001 finally issued a regulation with a a new standard for drinking water of 10 ppb to take effect in 2006. This was confirmed on October 31st 2001 by the new EPA administrator, Christine Whitman.
Once the wheels of the US Government turn, they are hard to stop and they grind very small. One of the crucial actions is under the superfund law. A very effective way of treating wood against rot and infestation has been pressure treating it with Copper chromium arsenate (CCA). Some of this wood has been used in cheldrens' playgrounds, and there is little doubt that some arsenic will get into the soil. While eating playground wood is a taste acquired by very few (if any) children, eating soil is more popular and dominates the hazard. CCA treated wood is not now being used in new construction,and after December 2003, it will not be permissible (under the Superfund law) to burn it or dispose of it in an ordinary dumpster. Unlike nuclear waste that decays or chlorinated hydrocarbons that break down, arsenic lasts for ever, so that the disposal is an important issue. Since risks of waste disposal are risks of exposure of a lot of people to small amounts, it becomes very important to discover whether or not the effects on health are linear with exposure at low doses or are non-linear. So far these webmastes see no reason why arsenic should not be treated as carefully as nuclear waste. The regualtions should not be similar. Inversely if arsenic is let "off the hook" the regulations for nuclear waste should be correspondingly relaxed.
Some of the travails of the US Environmental
Protection Agency
can
be seen
lower down this page. California often
goes its own way and has stricter regulations than the federal
government. The California Office of Environmental
and Health Hazard Assessment (OEHHA) propose a 4 ppt (0.004 ppb) Public
Health Goal for arsenic in drinking water. While this level
is unlikely to ever be achieved, it will be a constant reminder that
arsenic at ordianary levels is a toxic substance.
While for many years it was believed that the only sources of arsenic contamination in the USA were arsenic in mine tailings, and the run off from agricultural land which had used arsenical pesticides, it has now been realized that there is arsenic in many ground water aquifers some of which are now being tapped for drinking water supplies. Indeed hydrogeologists argue that there is as much arsenic in soil surrounding the aquifers in Massachussets as in Bangladesh; it is merely not easily available in the water, and moreover few people drink water from wells. But there is still a lot of arsenic around as the attached map shows. This therefore needs needs careful reexamination. It has been pointed out by the UK National Pure Water Association,Wakefield WF4 3ET in a PRESS RELEASE of July 5, 2000 that arsenic impurities come in as fluoride is added to the water. This needs to be examined. In February 2001 the US Geological Survey held a workshop in Denver which was primarily addressed to discussions of the concentrations in each state and how to ensure that the only wells that are drilled in the future are free of arsenic. The abstracts of this workshopare available on the USGS website . Below is a listing, state by state, of web references, in so far as the webmasters have been able to find them, to problems in the USA.
Before 1986, it was widely believed that arsenic was only a carcinogen under special circumstances. By inhalation of high doses from smelters or spraying of arsenic insecticides. By ingestion, it was believed to cause skin cancer but it was widely believed that this showed a clear threshold at about 150 ppb in water. But this should have changed at once when the fact that long term medium level arsenic exposure, at about 500 ppb in water, leads to chronic health problems became known. Although the papers by CJ Chen and collaborators from Taiwan were published in 1986, it was basically ignored by EPA till 2000. Their committees did not include Chen's work in the list of references. In 1991 Smith at Berkeley published his assessment of the Taiwan data and Lamm et al. presented their analyses at an epidemiology meeting in Baltimore at which EPA represenatives were present. Using the pessimistic calculations using a linear dose response curve, presented by these authors, and somewhat later by the Office of Health and Hazard Assessment (OEHHA) of the California EPA calculated that a level for a one-in-a-million risk that the EPA use for a lot of other water pollutants, is 4 parts per trillion - 3000 times less than the level to be enforced in 2006. This was ignored by the EPA in spite of calls for an emergency standard of 20 ppb to convey a sense of urgency. Why was this ignored for another 10 years?
It would be impossible to set a regulatory limit as low as 1.5 parts per trillion since no water supply could meet it. Moreover arsenic intake into people would be dominated by arsenic in foodstuffs. It would be necessary to be incosistent or to change the regulations for these other carcinogens. Moreover, since arsenic is a carciogen that lasts for ever in the environment it would be necessary to treat it as a hazardous waste. It seems that the EPA shied away from the problem hoping against hope that it would go away or not come to public attention until the next administration. But it did not go away.
A report of the US
National Academy of Sciences/National
Research Council in 1999 recommended a reduction in the
allowable
level in drinking water. At last, after14years,
the US Environmental Protection Agency finally acted on June
22nd 2000,
Federal
Register (HTML
version;
PDF version) and
proposed to enforce a regulatory standard of
between 3 ppb and 20 ppb for arsenic in drinking water.
The
Science Advisory Board of the US Environmental Protection Agency
discussed
this proposal at their meeting in June 2000. The EPA also
held
many
stakeholders
meetings including one on August 9th 2000. Comments
on the proposed standard were made, interalia, by
Richard Wilson ,
Daniel Byrd
and
Steve Lamm and
Allan Smith. In January 2001, in the last week of
the Clinton
administration President Clinton approved a new standard of 10ppb to
take effect in 2006. As is not uncommon, the incoming
administration of George W. Bush rolled
back this decision for reconsideration. To resolve the
dilemma,
EPA
Administrator
Christine Whitman asked the
National
Academy of Sciences/National Research Council for an
immediate
review of the science and set up an EPA Panel
on
cost-benefit
analysis.
The following
comments were made:
(1) EPA press releases and commentary by
Wall
Street Journal
(2) Two papers in
Regulation in Fall 2001 issue
(a) "EPA's Arsenic Rule: The Benefits of the Standard Do Not
Justify the Costs" by Hahn and Burnett
(b)
The
Proposed
Arsenic Regulation - by Richard Wilson
(3) American
Society
of Civil Engineers
(4) Steven
Milloy
(5) Richard
Wilson
(6) EPA
Panel Discussion draft of the report Arsenic Rule Benefits Analysis: An
SAB
Review
(7) Arsenic
and Science Integrity 0521 - Testimony to the NRC - by
KevinL.
Bromberg, U.S. Small Business Administration
(8) Regarding
Arsenic Panel Selection - 051601 - by Susan Walthall, Board of
Environmental
Studies and Technology
(9) A Science Advisory Board
Review
of Certain Elements of the Proposal
This was followed by the 2001 NAS/NRC report
.
Finally the Adminstrator late on October
31st announced that her agency would continue to support a 10 ppb
standard.
EPA
fact
sheet and
press release . Curiously, although there was a public
comment
period till October 31st for the NAS/NRC report she did not wait for
the
end of the public comment period although it was obvious that
there
would be comments at the last moment.
In 2005 the Science Advisory Board of
the EPA considered again the hitorically important Taiwan
study. But they seem to have the opinion that all truth can
be summarized in one analysis of this study. This is absurd
as emphasized by Richard Wilson . But in 2007 the Science Advisory Board of
the EPA made a more
systematic study as noted here and confirmed that a linear dose
response is a wise default.
In December 2007, it
was announced that the EPA was developing a
Biologically Based Dose Response (BBDR) model, with the hope of being
able to modify the present regulation by 2015. This
webmaster notes that in the announcement, Dr Connoly of EPA makes no
mention of the necessity of reconcling whatevwer new model is used with
the low dose linearity demanded by Taylor's theorem, as explained by
Crump et al and Guess et al in 1975 and 1976, and stated at that time
by EPA as the reason for the linear default.
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