Academic journal article Journal of Health Population and Nutrition

Quality of Life and Mental Health Status of Arsenic-Affected Patients in a Bangladeshi Population

Academic journal article Journal of Health Population and Nutrition

Quality of Life and Mental Health Status of Arsenic-Affected Patients in a Bangladeshi Population

Article excerpt

INTRODUCTION

Arsenic is a metalloid element widely distributed in water, air, and soil (1,2). It was found in groundwater in many countries and is highly toxic for humans (3). Results of epidemiological studies indicate that chronic exposure to arsenic increases the risk of arsenic-induced diseases (4-6). Arsenic may also cause low birthweight and many physical and neurological deficiencies (7).

Contamination of groundwater by inorganic arsenic is one of the major public-health hazards in Bangladesh (8,9). According to the World Health Organization (WHO), the problem is "the largest mass poisoning of a population in history" (10). In the beginning of the 1970s, about 10 million hand-pump wells were installed for the prevention of waterborne diseases in Bangladesh (11). However, natural contamination of groundwater by arsenic was realized only in the late 1990s in these wells. In Bangladesh, an estimated 35-77 million people have been chronically exposed to arsenic through drinking-water (12). As a result, 18.7% (n=140) of the study participants (n=750) reported at least one arsenic-affected patient in their households (13).

Arsenic-affected patients have been facing many problems in their daily life. From a social perspective, arsenic-affected people are barred from community activities in Bangladesh (14). For example, women with visible symptoms of arsenicosis may not be able to find marriage partners, and husbands sometimes divorce the affected wives (14). Children with symptoms of arsenicosis also face the prejudice of their peers and may attempt to hide their symptoms when attending school (15).

Under such conditions, the quality of life (QOL) and mental health status of arsenic-affected patients might be of concern. Results of a study showed that arsenic-affected patients had lower QOL than those of controls in Bangladesh (16). However, the study was conducted in four villages, with only 104 patients. Besides the QOL, the burden of mental health problems was significantly higher among people living in arsenic-exposed villages (54%) compared to those in arsenic-free villages (34%) in Inner Mongolia, China (17). In the Wisconsin counties in the USA, arsenic-affected people are known to suffer from depression (18).

The assessment of QOL and mental health status of arsenic-affected patients is important as arsenic-induced suffering has strong social and psychological implications. On the other hand, we need more research on the QOL and mental health status of arsenic-affected patients. To the best of our knowledge, no study was conducted on both QOL and mental health status among the same arsenic-affected patients. Therefore, in this study, we aimed (a) to determine the QOL and mental health status of arsenic-affected patients compared to those of non-patients and (b) to identify the factors associated with the QOL of arsenic-affected people in Bangladesh.

MATERIALS AND METHODS

Study site

This cross-sectional study was conducted in Araihazar upazila of Narayanganj district in Bangladesh. Araihazar upazila is located 25 km southeast from the capital city Dhaka. The total area of upazila is 183.35 square km, and its population is about 300,000 (19). Most people drink water from tubewells containing arsenic concentrations ranging from <10 [micro]g/L to 864 [micro]g/L (20); the arsenic concentration of each tubewell is labelled by the Joint Arsenic and Health Research Project of the Columbia University and the University of Chicago to set arsenic levels that are not hazardous. Of 6,000 tubewells in the study area, 60% had arsenic concentrations of >50 [micro]g/L (20). Of 70,000 people in the study area, about 22% were exposed to the levels of 101-300 [micro]g/L arsenic concentration (20). Briefly, arsenic concentrations of tubewell-water were measured using graphite furnace atomic absorption spectrometry, with a detection limit of 5.0 [micro]g/L. …

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