A Randomised Intervention Trial to Assess Two Arsenic Mitigation Options in Bangladesh

Abstract

TAA2-O-03 Introduction: Arsenic groundwater contamination in Bangladesh warrants immediate remediation. This randomized controlled intervention trial was conducted to determine the effectiveness of 2 possible interventions: dug wells and 3 pitcher filters. Methods: A total of 640 individuals participated: with 218 randomized to the dug well group, 216 to the 3 pitcher group, and 206 to a control group. Baseline information on socio-demographics, water use patterns, history of arsenic exposure, body mass index, and smoking status was collected. Following the activation of the dug wells and 3 pitcher filters, postinterventional compliance surveys were carried out after 1, 6, and 12 months. Water samples from all the dug wells after 1, 6, and 12 months and from the randomly selected 88 3 pitcher filters after 10 months of intervention were collected to test the total arsenic concentration of these interventions. Urine samples were collected from all the participants at baseline, after 1 and 12 months of intervention for total and speciated arsenic concentration. Results: Self-reported compliance with dug wells remained below 20% during the entire 12 months of the study. The compliance with the 3 pitcher filters decreased after 6 months and became similar to the compliance of the dug well group after 12 months. A substantial decrease in urinary arsenic metabolites occurred only among those who were compliant to dug well and 3 pitcher filter after 1 month of intervention as opposed to control participants. However, a persistent reduction in urinary arsenic concentrations was observed only among the dug well users after 12 months of intervention. Discussion and Conclusions: Our results show that a functional dug well could be offered as a long-term alternative to tube wells, but use of this option is likely to be low, unless appropriate behavioral change measures are taken. Our study also demonstrates that arsenic removal technologies such as 3 pitcher filters are an effective option as a short-term measure. The 3 pitcher filters that are not adequately maintained are not an effective option for a year. These arsenic removal technologies may be even harmful in the long-term if the resultant water quality is not properly monitored.