Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Am J Public Health. 2011 Dec;101 Suppl 1(Suppl 1):S333-8. doi: 10.2105/AJPH.2010.300025. Epub 2011 Jul 21.
Elevated arsenic levels in tube-well water in Bangladesh have prompted extensive mitigation projects. We evaluated the effectiveness of long-term mitigation efforts by longitudinally measuring arsenic exposure in pregnant women and their children, the most susceptible population groups.
The study was nested in a population-based nutrition intervention in Matlab, Bangladesh. Mother-child pairs (n = 1951) were followed from 2001 to 2003, beginning in early gestation and continuing to 5 years postpartum. We measured arsenic concentrations in urine (U-As) of the 5-year-old children by using high-performance liquid chromatography online with hydride generation and inductively coupled plasma mass spectrometry and compared them with earlier childhood U-As and maternal U-As during pregnancy.
Children had elevated U-As at 5 years old (median = 51 μg/L, 5th-95th percentiles = 16-355 μg/L), and U-As distribution was similar to that observed in the mothers during gestation. Children's U-As at 5 years old significantly correlated with their U-As at 1.5 years old and to maternal U-As during early and late gestation.
Despite major mitigation efforts, arsenic exposure remains highly elevated in rural Bangladesh. Further mitigation strategies are required and must be rigorously evaluated for long-term efficacy.
孟加拉国管井水中砷含量升高促使开展了广泛的缓解项目。我们通过纵向测量孕妇及其子女（最易受影响的人群）的砷暴露情况，评估了长期缓解措施的效果。
本研究嵌套在孟加拉国马塔巴里的一项基于人群的营养干预研究中。从妊娠早期开始，对 1951 对母婴对（n=1951）进行了为期 5 年的随访，一直持续到产后 5 年。我们使用高效液相色谱法与在线氢化物发生和电感耦合等离子体质谱法测量了 5 岁儿童的尿中砷浓度（U-As），并将其与儿童早期的 U-As 和妊娠期间的母体 U-As 进行了比较。
儿童在 5 岁时的 U-As 升高（中位数=51μg/L，5 分位数-95 分位数=16-355μg/L），且 U-As 分布与妊娠期间母亲的 U-As 相似。儿童在 5 岁时的 U-As 与 1.5 岁时的 U-As 以及妊娠早期和晚期的母体 U-As 显著相关。
尽管采取了主要的缓解措施，但孟加拉国农村地区的砷暴露仍高度升高。需要进一步采取缓解策略，并对其长期效果进行严格评估。
