Association of Clinical Complications with Nutritional Status and the Prevalence of Leukopenia among Arsenic Patients in Bangladesh

Abstract

This study conducted in Bangladesh reports the relationship of clinical complications with nutritional status and the prevalence of leukopenia among arsenic exposed patients living in the rural villages. A total of 115 exposed individuals diagnosed as arsenicosis patients were randomly selected from four known arsenic endemic villages, and age-matched 120 unexposed subjects were enrolled in the study program. The duration of arsenic exposure in about 37% of the patients was at least 10 yrs, while the population mean and range were 7.6 ± 5.2 yrs, and 1 -25 yrs, respectively. The mean arsenic concentrations in the drinking water for the exposed and unexposed (control) population were 218.1 µg/L and 11.3 µg/L, respectively. The spot urine sample of the arsenicosis patients contained an average of 234.6 µg/L arsenic. Although very few patients showed elevated WBC count, 16% had leukopenia (below normal count), and the whole population had significantly low WBC count than the control subjects. Prevalences of neutropenia and lymphocytosis were observed in patients with chronic exposure to high levels of arsenic in water. The body mass index was found to be lower than 18.5, the cut-off point for malnutrition (underweight), in about 28% of the arsenicosis cases compared to 15% of the controls. The monthly income and total calorie consumption per day showed the patients were underprivileged than the controls. Arsenical symptoms and complications were more severe in the nutritionally vulnerable (underweight) patients than the overweight ones. Also, the incidences of leukopenia and anaemia were more common in the female patients who were underweight. The findings of this research demonstrate that the poor nutritional status of patients increases the complications of chronic arsenic toxicity; suggest the possibility of other sources of arsenic contamination different from drinking water in the study area; and establish a higher prevalence of leukopenia and lymphocytosis in arsenicosis patients.

Assessment of Arsenic Exposure to Human, Concentrations in Tube Well Water and Urine, and Body Mass Index

“…Average UAs concentration of the present study was higher than the other studies, such as 16 to 2746 μg/g [37] and smaller than 11 to 4144 μg/g [38]. The other study reported that the mean arsenic concentrations in the drinking water for the exposed and unexposed (control) population were 218.1 μg/L and 11.3 μg/L, respectively [39]. …”

Evaluation of Biochemical Changes in Chronic Arsenic Poisoning among Bangladeshi Patients

“…Also increased mortality from ischemic heart disease has been reported among copper smelter workers exposed to arsenic [11]. Our recent publication reports an association of clinical complications of arsenic toxicity with the nutritional status of the intoxicated subjects [12]. Study carried out in Taiwan concluded that patients affected with black foot disease, a unique peripheral vascular disease caused by long-term arsenic exposure via drinking water, have a significantly higher mortality due to ischemic heart disease [13].…”

Gingival Health Status among the Arsenicosis Patients

“…Melanosis is found on trunk and gradually covers the whole body. [1][2][3] Some signs are also seen in other tissues of the body like tongue, gingival and buccal mucosa. 2 Arsenic was once used topically as pulp devitalizer for endodontic treatment.…”

“…[1][2][3] Some signs are also seen in other tissues of the body like tongue, gingival and buccal mucosa. 2 Arsenic was once used topically as pulp devitalizer for endodontic treatment. Arsenic is toxic to vital pulp due to prolonged leakage of arsenic trioxide that can cause severe damage to periodontal tissues and also can widespread necrosis of gingiva and bone, which can lead to osteomyelitis of the jaws.…”

“…The arsenic hazard in Bangladesh villagers now appeared as a 'real disaster', affecting thousands physically, physiologically, mentally and economically; it is intensifying malnutrition, poverty and destitution among the already poor villagers. 2,4,7,8 The future of the Bangladesh villages are jeopardized. Arsenic contaminated underground water is one of such severe problems that the government has been failed to manage properly.…”