Abstract
Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric data was collected at 3, 6 and 9 months of the infant’s age for nutritional assessment whereas arsenic exposure level was assessed via tube well drinking water arsenic concentration at the initiation of the study. Weight and height measurements were converted to Z-scores of weight for age (WAZ-underweight), height for age (HAZ-stunting), weight for height (WHZ-wasting) for children by comparing with WHO growth standard. Arsenic exposure levels were categorized as <50 μg/L and ≥50 μg/L. Stunting rates (<−2 SD) were 10% at 3 months and 44% at both 6 and 9 months. Wasting rates (<−2 SD) were 23.3% at 3 months and underweight rates (<−2 SD) were 25% and 10% at 3 and 6 months of age, respectively. There was a significant association of stunting with household drinking water arsenic exposure ≥50 μg/L at age of 9 months (p = 0.009). Except for stunting at 9 months of age, we did not find any significant changes in other nutritional indices over time or with levels of household arsenic exposure in this study. Our study suggests no association between household arsenic exposure and under-nutrition during infancy; with limiting factors being small sample size and short follow-up. Difference in stunting at 9 months by arsenic exposure at ≥50 μg/L might be a statistical incongruity. Further longitudinal studies are warranted to establish any association.
Highlights
In Bangladesh, the prevalence of any form of under-nutrition among under-5 children is one of the highest in the world, with 43% stunted, 41% underweight and 17% moderate to severely wasted [1].Among young children in Bangladesh, high malnutrition can be as a consequence of intrauterine growth retardation and postnatal growth faltering [2,3]
Considering the paucity of arsenic related infantile malnutrition data and distinct ways of arsenic exposure in infants, this study evaluates the nutritional status of a cohort of infants living in arsenic contaminated areas in Bangladesh
The red markings signified tube wells contaminated with high concentration of arsenic (≥50 μg/L) which is beyond the WHO (World Health Organization) safety limit for drinking water in Bangladesh
Summary
In Bangladesh, the prevalence of any form of under-nutrition among under-5 children is one of the highest in the world, with 43% stunted, 41% underweight and 17% moderate to severely wasted [1]. Among young children in Bangladesh, high malnutrition can be as a consequence of intrauterine growth retardation and postnatal growth faltering [2,3]. Childhood under-nutrition could be even higher in the areas where drinking water is contaminated with arsenic compared to other areas and warrants an evaluation. Intrauterine growth retardation is related to many known and unknown maternal and environmental causes including maternal exposure to arsenic. Lead and arsenic in placenta are associated with low birth weight [4] while maternal exposure to arsenic alone is related with reduced birth weight [5,6].
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