We studied a group of women of reproductive age (15-49 years) who were chronically exposed to arsenic through drinking water to identify the pregnancy outcomes in terms of live birth, stillbirth, spontaneous abortion, and preterm birth. We compared pregnancy outcomes of exposed respondents with pregnancy outcomes of women of reproductive age (15-49 years) who were not exposed to arsenic-contaminated water. In a cross-sectional study, we matched the women in both exposed and nonexposed groups for age, socioeconomic status, education, and age at marriage. The total sample size was 192, with 96 women in each group (i.e., exposed and nonexposed). Of the respondents in the exposed group, 98% had been drinking water containing [Greater and equal to] 0.10 mg/L arsenic and 43.8% had been drinking arsenic-contaminated water for 5-10 years. Skin manifestation due to chronic arsenic exposure was present in 22.9% of the respondents. Adverse pregnancy outcomes in terms of spontaneous abortion, stillbirth, and preterm birth rates were significantly higher in the exposed group than those in the nonexposed group (p = 0.008, p = 0.046, and p = 0.018, respectively).
The study was carried out in a village in Jessore district, Bangladesh, to identify the epidemiological characteristics of arsenicosis. Eighty-seven per cent of the tubewells had arsenic concentration more than the WHO maximum permissible limit of 0.05 mg l ±1 . The mean arsenic concentration was 0.240 mg l ±1 and the maximum concentration was 1.371 mg l ±1 . Of the total 3606 villagers, 10% (363) were found to be suffering from arsenicosis. Most of the arsenicosis patients were between 10 to 39 years of age. There were more male patients (52.6%). There were no patients among villagers who consumed tubewell water having arsenic levels less than 0.082 mg l ±1 . The majority (93.4%) of the patients were in the first and second stage of arsenicosis. With increasing exposure to arsenic, a simultaneous increase in the severity of clinical manifestations of arsenicosis was observed (F = 43.699; p = 0.000). The time-weighted arsenic exposure varied from 0.248 to 5.482 mg day ±1 and the mean was 1.918 mg day ±1 . Melanosis was present in almost all the patient (99.5%) and keratosis was present in 68.9%. Cancer (basal cell epithelioma) was present in three (0.8%) patients. The duration of clinical manifestations of arsenicosis varied from 1 to 12 years and the majority were suffering for 4 ±6 years.
This was a cross-sectional study under taken to explore the socioeconomic perspective of the arsenicosis problem, carried out in arsenic contaminated Upazillas where at least 100 arsenicosis patients had been identified. Two of the Upazillas with significant arsenic mitigation intervention and three of the Upazillas with limited interventions were selected for the study. Seven hundred fifty respondents were included in the study from 25 villages of the 5 Upazillas. Arsenicosis became a serious problem for the affected communities. Majority (71.31%) of respondents obtained their drinking water from tubewells, almost one third (29%) of the respondents still knowingly using arsenic contaminated water. Primary reason identified for this practice was distance of safe water source. Majority (58.6%) of the respondents said to face economic and 17.9% said to face social problem of varied range. Patients of lower income group were particularly more likely to face economic problems (P< .001) as well as social problem (P< .01). About half (50.7%) of the arsenicosis patients faced difficulty whilst receiving treatment, particularly female patients were more likely to face problem than male (P< .05). Several concerns also were surfaced regarding the heath care service provider particularly to the women patients, some of which are: long waiting time for receiving treatment (15%), discrimination in service delivery (10.7%) and inadequate separate facility for female patients (14.3%). Moreover the issues of financial burden raised by the respondents seem to have emerged as significant in terms of health care access. Access to Health service was particularly difficult for poor patients, as they often had to face problems associated with accessing service like, non availability of medicines in the hospitals (50.7%), traveling long distance (26.7%), purchasing medicine in most cases (32.4%) etc. Their dissatisfaction was compounded by negligent behavior of health care staff and nature of treatment provided. Furthermore length of time needed for reversal of symptoms led to loosing faith on efficacy of treatment, which cascades to negligence of patient's part in seeking health care. Women are less likely to get treatment for arsenicosis than men (P< .01). As there appear to be specific difficulties for women particularly for poor women in accessing health care, social and cultural values make it difficult for them to attend to their own health needs and to travel to service providers. Study findings suggest that a significant proportion (79.9%) of arsenicosis patient was found to access alternative health care. This includes; Homeopath, village doctors, Kabiraj and local pharmacists. Respondents in high intervention Upazillas were significantly more likely to get treatment (P< .05), to face fewer problems and to be satisfied with the facility (P< .001). Provision of safe water options, periodic screening of water source for arsenic, availability of trained doctor, regular availability of medicine, doorstep treatment, follow up on sev...
The objective of this cross-sectional comparative study was to assess quality of life (QOL) of arsenicosis patients. A total of 104 arsenicosis patients, 104 arsenic-exposed individuals without arsenicosis (nonpatients), and 104 individuals not exposed to arsenic (controls) were interviewed based on a questionnaire constructed based on the WHOQOL-BREF instrument. The facets of life considered for assessing QOL were physical health domain, psychological domain, social relationships domain, and environment domain. All the domain-wise QOL scores of the arsenicosis patients were significantly smaller than those of the controls as well as of the nonpatients. The findings of the study assessing QOL of arsenicosis patients might be helpful to understand the condition and justify for the policy makers to adopt adequate measures to alleviate the sufferings through prevention, treatment, and rehabilitation.
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