Smith A H, Lingas E O, Rahman M
School of Public Health, University of California, Berkeley 94720-7360, USA.
Bull World Health Organ. 2000;78(9):1093-103.
The contamination of groundwater by arsenic in Bangladesh is the largest poisoning of a population in history, with millions of people exposed. This paper describes the history of the discovery of arsenic in drinking-water in Bangladesh and recommends intervention strategies. Tube-wells were installed to provide "pure water" to prevent morbidity and mortality from gastrointestinal disease. The water from the millions of tube-wells that were installed was not tested for arsenic contamination. Studies in other countries where the population has had long-term exposure to arsenic in groundwater indicate that 1 in 10 people who drink water containing 500 micrograms of arsenic per litre may ultimately die from cancers caused by arsenic, including lung, bladder and skin cancers. The rapid allocation of funding and prompt expansion of current interventions to address this contamination should be facilitated. The fundamental intervention is the identification and provision of arsenic-free drinking water. Arsenic is rapidly excreted in urine, and for early or mild cases, no specific treatment is required. Community education and participation are essential to ensure that interventions are successful; these should be coupled with follow-up monitoring to confirm that exposure has ended. Taken together with the discovery of arsenic in groundwater in other countries, the experience in Bangladesh shows that groundwater sources throughout the world that are used for drinking-water should be tested for arsenic.
孟加拉国地下水受砷污染是历史上最大规模的群体中毒事件，数百万人受到影响。本文描述了孟加拉国饮用水中砷的发现历程，并推荐了干预策略。为预防胃肠道疾病导致的发病和死亡，当地安装了管井来提供“纯净水”。数百万口已安装的管井所抽取的水并未经过砷污染检测。其他一些国家的研究表明，长期饮用每升含500微克砷的水的人群中，每10人就有1人最终可能死于砷引发的癌症，包括肺癌、膀胱癌和皮肤癌。应推动迅速拨款并及时扩大当前应对这种污染的干预措施。根本的干预措施是识别并提供不含砷的饮用水。砷可通过尿液迅速排出，对于早期或轻症病例，无需特殊治疗。社区教育和参与对于确保干预措施取得成功至关重要；还应辅以后续监测，以确认已停止接触砷。结合其他国家地下水砷污染的发现情况来看，孟加拉国的经验表明，全球用于饮用水的地下水源都应进行砷含量检测。
