title: Persistent exposure to arsenic via drinking water in rural Bangladesh despite major mitigation efforts.
abstract: OBJECTIVE
  Elevated arsenic levels in tube-well water in Bangladesh have prompted extensive mitigation projects. We evaluated the effectiveness of long-term mitigation efforts by longitudinally measuring arsenic exposure in pregnant women and their children, the most susceptible population groups.
  
  
  METHODS
  The study was nested in a population-based nutrition intervention in Matlab, Bangladesh. Mother-child pairs (n = 1951) were followed from 2001 to 2003, beginning in early gestation and continuing to 5 years postpartum. We measured arsenic concentrations in urine (U-As) of the 5-year-old children by using high-performance liquid chromatography online with hydride generation and inductively coupled plasma mass spectrometry and compared them with earlier childhood U-As and maternal U-As during pregnancy.
  
  
  RESULTS
  Children had elevated U-As at 5 years old (median = 51 μg/L, 5th-95th percentiles = 16-355 μg/L), and U-As distribution was similar to that observed in the mothers during gestation. Children's U-As at 5 years old significantly correlated with their U-As at 1.5 years old and to maternal U-As during early and late gestation.
  
  
  CONCLUSIONS
  Despite major mitigation efforts, arsenic exposure remains highly elevated in rural Bangladesh. Further mitigation strategies are required and must be rigorously evaluated for long-term efficacy.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Renee
authors.initials: R
authors.lastname: Gardner
authors.forename: Jena
authors.initials: J
authors.lastname: Hamadani
authors.forename: Margaretha
authors.initials: M
authors.lastname: Grandér
authors.forename: Fahmida
authors.initials: F
authors.lastname: Tofail
authors.forename: Barbro
authors.initials: B
authors.lastname: Nermell
authors.forename: Brita
authors.initials: B
authors.lastname: Palm
authors.forename: Maria
authors.initials: M
authors.lastname: Kippler
authors.forename: Marie
authors.initials: M
authors.lastname: Vahter
mesh_terms: D001151:Arsenic / Q000633:toxicity / Q000652:urine*; D001459:Bangladesh; D015415:Biomarkers / Q000652:urine; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D060766:Drinking Water / Q000737:chemistry*; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis* / Q000517:prevention & control; D052918:Environmental Restoration and Remediation; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D013058:Mass Spectrometry; D012275:Oryza / Q000737:chemistry; D011159:Population Surveillance; D011247:Pregnancy; D012424:Rural Population; D060986:Water Wells / Q000737:chemistry
chemical_list: D015415:Biomarkers; D060766:Drinking Water; D001151:Arsenic