title: Murshidabad--one of the nine groundwater arsenic-affected districts of West Bengal, India. Part II: dermatological, neurological, and obstetric findings.
abstract: BACKGROUND
  To understand the severity of related health effects of chronic arsenic exposure in West Bengal, a detailed 3-year study was carried out in Murshidabad, one of the nine arsenic-affected districts in West Bengal.
  
  
  METHODS
  We screened 25,274 people from 139 arsenic-affected villages in Murshidabad to identify patients suffering from chronic arsenic toxicity for evidence of multisystemic features and collected biological samples such as head hair, nail, and spot urine from the patients along with the tubewell water they were consuming.
  
  
  RESULTS
  Out of 25,274 people screened, 4813 (19%) were registered with arsenical skin lesions. A case series involving arsenical skin lesions resulting in cancer and gangrene were noted during this study. Representative histopathological pictures of skin biopsy of different types of lesions were also presented. Out of 2595 children we examined for arsenical skin lesions, 122 (4%) were registered with arsenical skin lesions, melanosis with or without keratosis. Different clinical and electrophysiological neurological features were noticed among the arsenic-affected villagers. Both the arsenic content in the drinking water and duration of exposure may be responsible in increasing the susceptibility of pregnant women to spontaneous abortions, stillbirths, preterm births, low birth weights, and neonatal deaths. Some additional multisystemic features such as weakness and lethargy, chronic respiratory problems, gastrointestinal symptoms, and anemia were also recorded in the affected population.
  
  
  CONCLUSIONS
  The findings from this survey on different health effects of arsenic exposure were compared to those from previous studies carried out on arsenic-affected populations in India and Bangladesh as well as other affected countries.
  
  
  CONCLUSIONS
  Multisystemic disorders, including dermal effects, neurological complications, and adverse obstetric outcomes, were observed to be associated with chronic arsenic exposure in the study population in Murshidabad, West Bengal. The magnitude of severity was related to the concentration of arsenic in water as well as duration of the exposure.
authors.affiliation: Department of Neurology, Medical College and Hospital, Kolkata, India.
authors.forename: Subhash Chandra
authors.initials: SC
authors.lastname: Mukherjee
authors.forename: Kshitish Chandra
authors.initials: KC
authors.lastname: Saha
authors.forename: Shymapada
authors.initials: S
authors.lastname: Pati
authors.forename: Rathindra Nath
authors.initials: RN
authors.lastname: Dutta
authors.forename: Mohammad Mahmudur
authors.initials: MM
authors.lastname: Rahman
authors.forename: Mrinal Kumar
authors.initials: MK
authors.lastname: Sengupta
authors.forename: Sad
authors.initials: S
authors.lastname: Ahamed
authors.forename: Dilip
authors.initials: D
authors.lastname: Lodh
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Das
authors.forename: M Amir
authors.initials: MA
authors.lastname: Hossain
authors.forename: Bishwajit
authors.initials: B
authors.lastname: Nayak
authors.forename: Amitava
authors.initials: A
authors.lastname: Mukherjee
authors.forename: Dipankar
authors.initials: D
authors.lastname: Chakraborti
authors.forename: Subhir Kumar
authors.initials: SK
authors.lastname: Dulta
authors.forename: Shyamal Kanti
authors.initials: SK
authors.lastname: Palit
authors.forename: Imrul
authors.initials: I
authors.lastname: Kaies
authors.forename: Ajoy Kishore
authors.initials: AK
authors.lastname: Barua
authors.forename: Khondaker Abdul
authors.initials: KA
authors.lastname: Asad
mesh_terms: D020261:Arsenic Poisoning / Q000453:epidemiology* / Q000209:etiology; D001152:Arsenicals / Q000032:analysis*; D002648:Child; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012871:Skin Diseases / Q000139:chemically induced / Q000453:epidemiology*; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000633:toxicity; D014881:Water Supply / Q000592:standards
chemical_list: D001152:Arsenicals; D014874:Water Pollutants, Chemical