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Arsenic in tube well water in Bangladesh: health and economic impacts and implications for arsenic mitigation

机译:孟加拉国管井水中的砷:对健康和经济的影响及其对减轻砷的影响

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摘要

A national drinking water quality survey conducted in 2009 furnished data that were used to make an updated estimate of chronic arsenic exposure in Bangladesh. About 20 million and 45 million people were found to be exposed to concentrations above the national standard of 50 μg/L and the World Health Organization’s guideline value of 10 μg/L, respectively. From the updated exposure data and all-cause mortality hazard ratios based on local epidemiological studies, it was estimated that arsenic exposures to concentrations > 50 μg/L and 10–50 μg/L account for an annual 24 000 and perhaps as many as 19 000 adult deaths in the country, respectively. Exposure varies widely in the 64 districts; among adults, arsenic-related deaths account for 0–15% of all deaths. An arsenic-related mortality rate of 1 in every 18 adult deaths could represent an economic burden of 13 billion United States dollars (US$) in lost productivity alone over the next 20 years. Arsenic mitigation should follow a two-tiered approach: (i) prioritizing provision of safe water to an estimated 5 million people exposed to > 200 μg/L arsenic, and (ii) building local arsenic testing capacity. The effectiveness of such an approach was demonstrated during the United Nations Children’s Fund 2006–2011 country programme, which provided safe water to arsenic-contaminated areas at a cost of US$ 11 per capita. National scale-up of such an approach would cost a few hundred million US dollars but would improve the health and productivity of the population, especially in future generations.
机译:2009年进行的一项全国饮用水水质调查提供了一些数据,这些数据用于对孟加拉国的慢性砷暴露进行最新估算。发现分别有约2000万人和4500万人暴露于高于国家标准50μg/ L和世界卫生组织指导值10μg/ L的浓度。根据当地流行病学研究的更新暴露数据和全因死亡率危险比,估计砷暴露于浓度> 50μg/ L和10–50μg/ L的人每年造成24000,也许多达19该国分别有000名成人死亡。在64个地区中,暴露程度差异很大。在成年人中,与砷有关的死亡占所有死亡的0-15%。与砷有关的死亡率是每18名成人死亡中就有1名死亡,这意味着在未来20年中,仅生产力的损失就将造成130亿美元的经济负担。缓解砷的措施应采取两级方法:(i)优先向估计有500万暴露于> 200μg/ L砷的人提供安全水,以及(ii)建立本地砷测试能力。联合国儿童基金会2006-2011年国家方案证明了这种方法的有效性,该方案以人均11美元的价格向砷污染地区提供了安全用水。在全国范围内推广这种方法将花费数亿美元,但将改善人民的健康和生产力,尤其是在子孙后代。

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