A field guide: detection, management and surveillance of arsenicosis in South-East Asia Region

Overview

Drinking water contaminated with an unsafe level of arsenic is known to result in adverse health outcomes. In many parts of the world, the source of drinking water is groundwater. While groundwater is relatively safe as regards bacterial contamination and other impurities, it is prone to chemical contamination such as arsenic. Arsenic contamination of groundwater may occur in two ways: drawing of water from aquifers that naturally contain arsenic or contamination from anthropogenic activities such as mining. Groundwater contamination in excess of the World Health Organization guideline value of 0.01 mg/L has been observed in parts of USA, Canada, Argentina, Chile, Mexico, Hungary and many countries of the South-East Asia Region. The most affected countries in the SouthEast Asia Region are in the river basins of the GangaBrahmaputra or the Mekong Delta. Affected countries include India, Bangladesh, Nepal, Myanmar, Vietnam, Cambodia, Laos and China.

Until now there have been no internationally accepted criteria for the diagnosis and management of arsenicosis or diseases associated with arsenic exposure. The purpose of this document is to serve as a guideline for the diagnosis, surveillance and management of arsenicosis. It is recognized that arsenicosis may manifest with or without skin manifestation. However, generally skin manifestation is the primary condition leading a patient to seek medical care. Therefore, the emphasis in this document is the diagnosis of arsenicosis based on dermal manifestations.