Dermatological and nutritional/growth effects among children living in arsenic-contaminated communities in rural Bangladesh

Abstract

While many reports have outlined the health risk of chronic arsenic exposure on adult populations, relatively little is known about the effects on children. We have examined the effects of chronic arsenic exposure through consumption of contaminated groundwater among 241 children (age 4–15 yr) living in two rural villages in northern Bangladesh. The arsenic concentrations of the tubewell waters ranged from less than detection limit to 535 ng/mL, and in 72 of 241 (30%) tubewells, the water arsenic concentration exceeded 50 ng/mL, the provisional guideline of Bangladesh. Approximately half of the examined children exhibited dermatological symptoms with relatively obscured dose-response relationship; an observation suggesting that the children were no more susceptible to the dermatological effects of arsenic than the adults living in the same communities. Proportion of the children with lower BMI significantly increased with increasing arsenic exposure level; the dose-response relationship was consistently observed among the subgroups. These results suggested that while mild dermatological manifestations, potentially associated with arsenic exposure, could be found as much as half of the children, nutritional status of the children, evaluated by BMI, might be a sensitive endpoint than the dermatological manifestations among children in this area.

Keywords:

• Groundwater
• arsenic
• arsenicosis
• children
• dermatological manifestations
• nutritional status
• growth
• body mass index

Acknowledgment

The authors would like to thank Drs. S.K. Aktar Ahmad, Enamul Karim for their continuous support for the survey. Our most cordial thanks should go to all the villagers who collaborated with and supported our study. The study was financially supported by Grant-in-Aid of Ministry of Education, Culture, Science, and Technology and by Alliance for Global Sustainability (AGS).

Notes

¹For a child with sole = 2, palm = 2, and trunk = 0, corresponding ranks are 2, 5, 0, respectively. Thus this child is classified to DS = 2 based on the highest rank (= 5).

²Actual distribution of the subjects classified for each DS.

³DSC: Dermatological Stage for Children.

⁴In deriving the rank of each manifestation, it was assumed that the manifestations are cumulative; i.e., a child with sole 3 is also positive (and counted as) for sole2 and sole1, likewise a child with palm2 is also counted as positive in palm1 (see text for details).

^a number of children

^b geometric mean and SD

^c arithmetic mean and SD

^d ANOVA has been performed using geometric results, wherever available.

¹. Number (and percentage) of the children (percentage in the parenthesis) are shown.

². Number of the children that had the skin manifestation only in right (R) or left (L) side.

³. Number of the children and percentage of the children against the total number of the children sharing the same Grade.