Public Health Strategies for Western Bangladesh That Address Arsenic, Manganese, Uranium, and Other Toxic Elements in Drinking Water

BACKGROUND: More than 60,000,000 Bangladeshis are drinking water with unsafe concentrations of one or more elements. OBJECTIVES: Our aims in this study were to evaluate and improve the drinking water testing and treatment plans for western Bangladesh. METHODS: We sampled groundwater from four neighborhoods in western Bangladesh to determine the distributions of arsenic, boron, barium, chromium, iron, manganese, molybdenum, nickel, lead, antimony, selenium, uranium, and zinc, and to determine pH. RESULTS: The percentages of tube wells that had concentrations exceeding World Health Organization (WHO) health-based drinking water guidelines were 78% for Mn, 48% for U, 33% for As, 1% for Pb, 1% for Ni, and 1% for Cr. Individual tube wells often had unsafe concentrations of both Mn and As or both Mn and U. They seldom had unsafe concentrations of both As and U. CONCLUSIONS: These results suggest that the ongoing program of identifying safe drinking water supplies by testing every tube well for As only will not ensure safe concentrations of Mn, U, Pb, Ni, Cr, and possibly other elements. To maximize efficiency, drinking water testing in Bangladesh should be completed in three steps: 1) all tube wells must be sampled and tested for As; 2) if a sample meets the WHO guideline for As, then it should be retested for Mn and U; 3) if a sample meets the WHO guidelines for As, Mn, and U, then it should be retested for B, Ba, Cr, Mo, Ni, and Ph. All safe tube wells should be considered for use as public drinking water supplies.