PAET, Hannah Lou A.Clinical ToxicologyBS Pharm 4-A8:30-9:30 MWFACTIVITY 1History of Toxicology

1. Short Narration of the Arsenic Poisoning in Bangladesh

In 1971, international aid agencies including the United Nations Children's Fund (UNICEF), the World Bank, and the United Nations Development Program (UNDP) began installing tubewells throughout Bangladesh and West Bengal, India. Millions of tube-wells were dug in an effort to provide enough water for agricultural purposes and to combat poor quality surface drinking water that was causing fatal diarrhea. But, at the time, arsenic contamination of the water supply was not recognized as a problem and the surrounding area was not tested for arsenic. The problems began appearing in the 1980s and included arsenicosis, most notably lesions on the hands and feet.By the early 1990s, when it was found that up to half of 10 million tube wells were contaminated with arsenic, Bangladesh was confronting a huge problem.More than 30 million people in Bangladesh and more than 6 million people across the border in West Bengal, India were at risk in the area according to 2000 statistics and the lifetime risk of dying by cancer in the area is as high as 13 per 1000 people.

2. Correlate this with Toxicology in the Philippines

Same toxicological event also happened in Boac, Marinduqueon November 29, 2006 --- arsenic poisoning in mine waste-contaminated rivers. Signs of arsenic poisoning, were believed to be caused by a mine waste spill 10 years ago, were starting to manifest in three farmers who came in close contact with sources of the deadly chemical element.The National Poison Management and Control Center of the University of the Philippines-Manila confirmed thethree farmers tested positive for high levels of arsenic.The three farmers were among the 108 residents from the municipalities of Boac and Mogpog that were screened and thoroughly tested for skin lesions and neurologic complaints. The farmers complained of itchiness, numbness, roughening of skin texture, nasal congestion, frequent coughs and colds, hyper-pigmentation of skin, weakness and headaches.The symptoms appeared after they were exposed to the mine waste-contaminated rivers of Boac and Mogpog.Arsenic poisoning of the residents resulted from drinking water with high levels of arsenic over a long period of time. This might have occurred due to arsenic contamination of ground water, Marinduque provincial health officer said.

3. Contribution of this capsule in the development of Clinical Toxicology

Arsenic poisoning in Bangladesh paved way in the development of toxicological research on both Environmental and Clinical Toxicology. It has raised awareness to the public and health-concerned agencies about the serious and long-term effects of arsenic poisoning and prompted studies to identify possible ways to prevent toxicity in the population.

4. Point out ONE important detail of the history with the supplement of pictures or any supporting diagrams/documents

One of the worst incidents of arsenic poisoning via well water occurred in Bangladesh, which the World Health Organization called it "the largest mass poisoning of a population in history... The scale of the environmental disaster is greater than any seen before; it is beyond the accidents in Bhopal, India, in 1984, and Chernobyl, Ukraine, in 1986".

Arsenic contaminated water is still being consumed, and will continue to be consumed, by millions of people throughout Bangladesh and West Bengal, India because there has been no alternate to the wells. According to 2000 statistics, more than 30 million people in Bangladesh were at risk in the area. According to the data provided by UNICEF in 2008, there are approximately 8.6 million tube-wells in Bangladesh. Of these, 4.75 million tube wells (55%) have been tested for arsenic among which 3.3 million (39%) were marked green indicating that the ground water is safe; while 1.4 million (16%) were marked red indicating that they are unsafe to use as sources of drinking water due to the high arsenic level, (Fig. 1). Recent findings show that about 20 million people in Bangladesh are using tube-wells contaminated with arsenic over the permissible level (>50 ppb).

Figure 2. Groundwater arsenic contamination in different districts of Bangladesh based on compilation of field and laboratory test dataFigure 1. Safety profiles of the tube-wells supplying groundwater to the community