Epidemiological Transitions and the Changing Face of Medical Geology

Abstract

ion of groundwater, ultimately a result of population pressure, led to the inappropriate sinking of new wells into geologically unsuitable strata. Shallow aquifers in alluvial and deltaic sediments now deliver drinking water to tens of millions of people through millions of domestic bores, over half of which exceed the World Health Organization (WHO) arsenic guideline of 10 ,ug L-1 (22). With the causal relationship between skin changes (hyperkeratosis, squamous cell carcinoma, basal cell carcinoma) and arsenic exposure now well established (23), it is clear that the nonsustainable use of geological resources is already contributing significantly to the global disease burdena disease burden that is becoming increasingly consistent with the changes expected from a third epidemiological transition. The creation of a global geochemical database has been proposed as one means of providing a frame of reference on which to base interpretations of change and recommendations for the sustainable use of the Earth's land surface (24). Medical geology could, in this context, inform land use planning on the broadest scale, including mining, agriculture, and waste disposal. On this broadest planning scale, there is also a relationship between fossil fuel use, global warming, and increases in climate-related morbidity and mortality arguably the greatest challenge that will face environmental health practitioners for several generations to come (25, 26).