Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Sci Total Environ. 2023 Mar 1;862:160217. doi: 10.1016/j.scitotenv.2022.160217. Epub 2022 Nov 19.
Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 μg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.
许多使用地下水作为饮用水和烹饪用水的农村人口，包括美国印第安人社区，都面临着砷含量升高的不成比例的风险。然而，旨在减少美国印第安人社区砷含量的项目有限。《坚强的心水研究》（SHWS）是一项旨在减少美国印第安人北大平原社区私人水井用户砷暴露的随机对照试验。该社区主导的 SHWS 项目在家庭的厨房水槽中安装了即需型（POU）砷过滤器，并由健康促进者提供了砷健康传播方案。在这项研究中，我们评估了这些 POU 砷过滤器在两年安装期间去除砷的功效。参与者被随机分为两组。在第一组中，家庭收到了 POU 砷过滤器，并进行了 3 次电话宣传过滤器使用（SHWS 移动健康（mHealth）&过滤器组）。第二组收到了相同的过滤器和电话，以及 3 次家访和 3 次 Facebook 消息（SHWS 强化组）用于项目交付。我们还评估了主厨房水龙头水中砷浓度的时间变化。从 50 户使用地下水的私人水井家庭中采集了总共 283 个水样（139 个过滤器和 144 个厨房水龙头样本）。在我们为期两年的研究期间，基线后有 93%的家庭的过滤龙头水砷浓度低于砷最大污染物水平 10μg/L，两组之间没有差异（强化组为 98%，mHealth&过滤器组为 94%）。在研究期间，厨房砷浓度没有观察到明显的时间变化（组内相关系数=0.99）。这项研究表明，即使只提供 POU 砷过滤器和 mHealth 计划，为社区参与的 SHWS 计划安装的 POU 砷过滤器在两个组中都能有效降低研究家庭的水中砷浓度。此外，我们观察到在我们的研究环境中，从私人水井收集的厨房水龙头样本的水中砷浓度随时间变化的时间变化有限。
