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Molly L. Kile,¹ E. Andres Houseman,¹ Carrie V. Breton,¹ Thomas Smith,¹ Quazi Quamruzzaman,² Mahmuder Rahman,² Golam Mahiuddin,² and David C. Christiani¹

¹Harvard School of Public Health, Boston, Massachusetts, USA; ²Dhaka Community Hospital, Dhaka, Bangladesh

Abstract
Background: Millions of people in Bangladesh are at risk of chronic arsenic toxicity from drinking contaminated groundwater, but little is known about diet as an additional source of As exposure.

Methods: We employed a duplicate diet survey to quantify daily As intake in 47 women residing in Pabna, Bangladesh. All samples were analyzed for total As, and a subset of 35 samples were measured for inorganic arsenic (iAs) using inductively coupled plasma mass spectrometry equipped with a dynamic reaction cell.

Results: Median daily total As intake was 48 µg As/day [interquartile range (IQR) , 33–67) from food and 4 µg As/day (IQR, 2–152) from drinking water. On average, iAs comprised 82% of the total As detected in dietary samples. After adjusting for the estimated inorganic fraction, 34% [95% confidence interval (CI) , 21–49%] of all participants exceeded the World Health Organization's provisional tolerable daily intake (PTDI) of 2.1 µg As/kg-day. Two of the 33 women who used a well with < 50 µg As/L exceeded this recommendation.

Conclusions: When drinking water concentrations exceeded the Bangladesh drinking water standard of 50 µg As/L, ingested water was the dominant source of exposure. However, as drinking water As concentrations decrease, the relative contribution of dietary As sources becomes more important to ingested dose. The combined intake from both diet and drinking water can cause some individuals to exceed the PTDI in spite of using a tube well that contains < 50 µg As/L.

Key words: arsenic, Bangladesh, dose, duplicate diet, food, intake, water. Environ Health Perspect 115:889–893 (2007) . doi:10.1289/ehp.9462 available via http://dx.doi.org/ [Online 20 February 2007]

Address correspondence to M. Kile, Harvard School of Public Health, Building 1, Room 1408, 677 Huntington Ave., Boston, MA 02115 USA. Telephone: (617) 432-1890. Fax: (617) 432-3441. E-mail: mkile@hsph.harvard.edu

We thank our colleagues, technicians, and laboratory and administrative staff at Dhaka Community Hospital and the Pabna Community Clinic in Bangladesh. We also acknowledge the technical expertise of C. Amarasiriwardena, E. Rodrigues, M. Jones, and E. Madonick, and guidance from R. Wilson and J. Harrington.

This work was supported by grants ES 011622, ES 05947, and ES 00002 from the U.S. National Institutes of Health.

The authors declare they have no competing financial interests.

Received 27 June 2006 ; accepted 20 February 2007.