Exposure to manganese via inhalation has long been known to elicit neurotoxicity in adults, but little is known about possible consequences of exposure via drinking water. In this study, we report results of a cross-sectional investigation of intellectual ...

A national drinking water quality survey conducted in 2009 furnished data that were used to make an updated estimate of chronic arsenic exposure in Bangladesh. About 20 million and 45 million people were found to be exposed to concentrations above the national standard of 50 µg/L and the World Health Organization's guideline value of 10 µg/L, respectively. From the updated exposure data and all-cause mortality hazard ratios based on local epidemiological studies, it was estimated that arsenic exposures to concentrations > 50 µg/L and 10-50 µg/L account for an annual 24,000 and perhaps as many as 19,000 adult deaths in the country, respectively. Exposure varies widely in the 64 districts; among adults, arsenic-related deaths account for 0-15% of all deaths. An arsenic-related mortality rate of 1 in every 16 adult deaths could represent an economic burden of 13 billion United States dollars (US$) in lost productivity alone over the next 20 years. Arsenic mitigation should follow a two-tiered approach: (i) prioritizing provision of safe water to an estimated 5 million people exposed to > 200 µg/L arsenic, and (ii) building local arsenic testing capacity. The effectiveness of such an approach was demonstrated during the United Nations Children's Fund 2006-2011 country programme, which provided safe water to arsenic-contaminated areas at a cost of US$ 11 per capita. National scale-up of such an approach would cost a few hundred million US dollars but would improve the health and productivity of the population, especially in future generations.

Arsenic concentrations measured by graphite furnace atomic absorption range from < 5 to 900 μg/L in groundwater pumped from 6000 wells within a 25 km² area of Bangladesh. The proportion of wells that exceed the Bangladesh standard for drinking water of 50 μg/L arsenic increases with depth from 25% between 8 and 10 m to 75% between 15 and 30 m, then declines gradually to less than 10% at 90 m. Some villages within the study area do not have a single well that meets the standard, while others have wells that are nearly all acceptable. In contrast to the distribution of arsenic in the 8–30 m depth range which does not follow any obvious geological feature, the arsenic content of groundwater associated with relatively oxic Pleistocene sand deposits appears to be consistently low. The depth of drilling necessary to reach these low‐As aquifers ranges from 30 to 120 m depth within the study area.