A health impact survey in arsenic affected areas in three VDC's of Kailali district : final report

Though several thousand tubewell water samples from arsenic contaminated Terai (Nepal) have been analyzed to determine arsenic contamination levels, scarce data are available on the health effects of chronic arsenic poisoning. This study was, thus, undertaken from July- December 2007 aiming to identify arsenicosis cases, know the extent of manifestations and status of arsenic exposure among risk population in three arsenic affected VDCs; namely Chaumala, Lalbojhi and Kota Tulsipur in Kailali district selected by DACC based on blanket arsenic testing analysis report for RVWRMP, Dhangadhi, Kailali. In present survey, households with tubewell water arsenic concentration above the national standard of 50 ppb were only included. Shallow tube wells were the major water sources used by the people for drinking and other domestic purposes. Measurement of arsenic concentrations in 50 tubewell water, 150 spot urine (male-76 and female-74), 26 hair (male-13 and female-13) and 26 nail (male-13 and female-13) samples were done at laboratory by HG-AAS. Identification of arsenicosis cases was done according to "A Field Guide for Detection, Management and Surveillance of Arsenicosis Cases”, WHO Technical Publication No. 30, SEARO, New Delhi, 2005. Data were collected by administering pre-developed three different types of tools. Besides, daily water intake through drinking was measured. Prior to data collection, project staff orientation and two-days training was organized for field staff. All the arsenicosis cases (suspected case or probable case) identified by health workers were re-examined and verified by a Health Expert having experience on diagnosing arsenic-related health effects. In present survey, the geographical distribution, demographic characteristics and living styles of the people in three VDCs are almost similar. Hence, data are analyzed en bloc.

(authors abstract)