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Martin Tondel,¹ Mahfuzar Rahman,¹ Anders Magnuson,¹ Ireen Akhter Chowdhury,² Mohammad Hossain Faruquee,³ and Sk. Akhtar Ahmad³

¹Division of Occupational and Environmental Medicine, Department of Health and Environment, Faculty of Health Sciences, Linköping University, Linköping, Sweden
²Radda-MCH FP Center, Mirpur, Dhaka, Bangladesh
³Department of Occupational and Environmental Health, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, Bangladesh

Abstract

To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1,481 subjects 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation) . Individual exposure assessment could only be estimated by present levels and in terms of a dose index, i.e., arsenic levels divided by individual body weight. Arsenic water concentrations ranged from 10 to 2,040 µg/L, and the crude overall prevalence rate for skin lesions was 29/100. After age adjustment to the world population the prevalence rate was 30.1/100 and 26.5/100 for males and females, respectively. There was a significant trend for the prevalence rate both in relation to exposure levels and to dose index (p < 0.05) , regardless of sex. This study shows a higher prevalence rate of arsenic skin lesions in males than females, with clear dose-response relationship. The overall high prevalence rate in the studied villages is an alarming sign of arsenic exposure and requires an urgent remedy. Key words: cross-sectional study, ecology, environment, epidemiology, exposure, keratosis, public health. Environ Health Perspect 107:727-729 (1999) . [Online 29 July 1999]

http://ehpnet1.niehs.nih.gov/docs/1999/107p727-729tondel/ abstract.html

Address correspondence to M. Rahman, Division of Occupational and Environmental Medicine, Department of Health and Environment, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden. Telephone: 46 13 22 14 41. Fax: 46 13 14 58 31. E-mail: mahfuzar.rahman@ihm.liu.se

We thank O. Axelson (Division of Occupational and Environmental Medicine, Faculty of Health Sciences, Linköping University, Sweden) for his comments on this manuscript. The study was approved by the ethical committee of Bangladesh Medical Research Council, and study participation was voluntary.

Received 23 September 1998 ; accepted 20 May 1999.