GTZ Project : Arsenic Removal Plants and Health Impact

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(Indo-German Environment Programme), New Delhi Funded Project (PPP)

Activity

To Study the efficacy of Arsenic Removal Plants (ARP) fitted with Tube wells for amelioration of Health effects due to chronic arsenic toxicity
(Period of study: 1st August 2005 to 31st December 2006)

Background

Public meetings and health camps were organized at Panchayet Samity/Block Office premises, Block Primary Health Centres or at local schools with the consent of Panchayet Shabhapati and Block Development Officers. Arsenicosis case demonstration was given to physicians and para-medical personnel for case diagnosis and management. Booklets containing information and photographs of arsenicosis patients were also distributed among the participants After the meeting health Camp was conducted, where an arsenic expert examined suspected arsenicosis patients. Patients were provided with free medicines for minor illness. Severely ill patients were referred to Block Hospital/District Hospital or tertiary referral centres at Kolkata for further treatment and follow up

Survey data and study areas in Murshidabad district

Report

Results of Study

During baseline survey a total number of 707 people were examined out of 174 user families who were taking water from 8 ARPs studied.

Arsenic estimation in water samples collected

The water samples collected during the 3 studies from all the ARPs were analyzed by Atomic Absorption spectrophotometer with hydride generation system. The effluent water from all ARPs were found to have arsenic level fulfilling WHO standard. Water samples were collected from 147 tube wells from where 174 families studied were previously taking water for drinking and cooking purposes. Out of these, 65 tube wells (44.2%) were contaminated with arsenic (arsenic level 0.055-0.888 g/l). It was ensured that all participants switched over to safe drinking water source from ARPs during the the whole period of study.


Health survey at Murshidabad	Arsenic removal plant in Murshidabad

Clinical study

Clinically confirmed cases of arsenicosis were diagnosed on the basis of WHO criteria (WHO 2005) in 123 cases out of 707 participants (17.4%) examined during base line study. Amongst the 123 patients seen, only pigmentation of skin was found in 62 (50.4%) and both pigmentation and keratosis were seen in 61(49.6%) cases. People having low nutritional status (BMI <20) were found to have more arsenical skin lesion compared to people with better nutritional status (BMI >20). In regard to systemic manifestation, pallor (38.2%), weakness (24.4%), conjunctival congestion (21.14%), cough (19.5%), claudication (13.8%) and paraesthesia (10.5%) were present in a good number of cases having skin lesions of cases of arsenicosis in the baseline study.

No new case of arsenicosis was found amongst the people examined at the end of 12 months of drinking arsenic free water. There was significant improvement of arsenical skin lesion among the cases studied. Clearance of pigmentation was noticed in 22 (19.64%) while 6 cases of severe pigmentation became moderate. Clearance of keratosis was observed in 8 (14.28%) out of 56 cases of base line study. Though severe keratosis was observed in 4 cases during baseline study no case of severe keratosis was seen at the end of 12 months. There was also improvement of systemic manifestation in good number of arsenicosis cases. This improvement was significant in regard to symptoms like weakness, cough, conjunctival congestion and chronic diarrhea. There was some improvement of other symptoms like pallor, dyspnoea, splenomegaly and claudication also, but these were not statistically significant.

Showing improvement of Keratosis after drinking arsenic free water

Test Results

TEST RESULTS OF Arsenic Removal Plants (ARPs) at Murshidabad

WATER TEST RESULTS OF ARPs
ARP-1	SL. NO.	CODE NO	WATER SAMPLE FROM	Results (Ist visit) mg / L of water	Results ( 2nd visit) mg / L of water	Results (3rd visit) mg/L of water
ARP-1(In)	1	AA-001	H1 T1	0.037	0.057	0.014
ARP-1(Out)	2	AA-001	H1 T1	0.001	0.001	0.000
ARP-2(In)	3	DZ-104	H1 T1	0.290	0.268	0.334
ARP-2(Out)	4	DZ-104	H1 T1	0.002	0.003	0.003
ARP-3(In)	5	HV-204	H1 T1	0.051	0.019	0.091
ARP-3(Out)	6	HV-204	H1 T1	0.003	0.000	0.000
ARP-4(In)	7	MK-323	H1 T1	0.003	0.001	0.000
ARP-4(Out)	8	MK-323	H1 T1	0.001	0.000	0.000
ARP-5(In)	9	RD-446	H1 T1	0.028	0.068	0.057
ARP-5(Out)	10	RD-446	H1 T1	0.000	0.005	0.000
ARP-6(In)	11	VN-560	H1 T1	0.007		0.016
ARP-6(Out)	12	VN-560	H1 T1	0.000	0.000	0.003
ARP-7(In)	13	XV-620	H1 T1	0.126	0.058	shutdown
ARP-7(Out)	14	XV-620	H1 T1	0.000	0.000	shutdown
ARP-8(In)	15	ZQ-667	H1 T1	0.003	0.002	0.000
ARP-8(Out)	16	ZQ-667	H1 T1	0.003	0.000	0.000

Conclusion

It appears that supply of safe water through ARP is one of the important methods of intervention in the management of patients of arsenicosis. During the survey it was observed that many ARPs were not functioning properly because of poor maintenance. Before installation of ARP in arsenic affected area it is essential to ensure proper motivation of the people who will use it and carry out regular maintenance of the plants.

Report of funded projects (Mitigation & Research)