title: Effect of Safe Water on Arsenicosis: A Follow-up Study.
abstract: BACKGROUND
  Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water.
  
  
  OBJECTIVE
  The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (<50 μg/L) on disease manifestation of arsenicosis.
  
  
  RESULTS
  Manifestations of various skin lesions and systemic diseases associated with chronic arsenic exposure were ascertained initially by carrying on baseline study on 208 participants in Nadia (Cohort-I, with skin lesion and Cohort-II, without skin lesion) using a scoring system, as developed by us, and compared objectively at the end of each year for 3 year follow-up period. All the participants who had arsenic contaminated drinking water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P < 0.001 at the end of 3 year's intervention study indicating beneficial effect of safe water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen's disease in spite of taking arsenic-safe water. Further, death could not be prevented to occur because of lung cancer and severe lung disease.
  
  
  CONCLUSIONS
  It is, therefore, an urgent need to make arrangement for availability of safe water source among the arsenic-affected people in the district. Many of the people in the affected villages are not aware of contamination of their home tube wells with arsenic. Awareness generation and motivation of the people for testing their drinking water sources for arsenic and environmental interventions like rain water harvesting, ground water recharge, and restricting excessive use of ground water for domestic and agricultural purposes are also important to prevent further exposure of arsenic to these people.
authors.affiliation: Department of Community Medicine, KPC Medical College and Hospital, Jadavpur, Kolkata, India.
authors.forename: Kunal K
authors.initials: KK
authors.lastname: Majumdar
authors.affiliation: Department of Community Medicine, DNGM Research Foundation, Kolkata, India.
authors.forename: Aloke
authors.initials: A
authors.lastname: Ghose
authors.affiliation: Department of Community Medicine, DNGM Research Foundation, Kolkata, India.
authors.forename: Nilima
authors.initials: N
authors.lastname: Ghose
authors.affiliation: Department of Community Medicine, DNGM Research Foundation, Kolkata, India.
authors.forename: Anirban
authors.initials: A
authors.lastname: Biswas
authors.affiliation: Department of Community Medicine, DNGM Research Foundation, Kolkata, India.
authors.forename: D N Guha
authors.initials: DN
authors.lastname: Mazumder
keywords: Arsenic and safe water; arsenic and skin score; arsenic and systemic disease score; treatment of arsenicosis