Drinking Water Salinity and Maternal Health in Coastal Bangladesh: Implications of Climate Change

Abstract

Background: Drinking water from natural sources in coastal Bangladesh has become contaminated by varying degrees of salinity due to saltwater intrusion from rising sea levels, cyclone and storm surges, and upstream withdrawal of freshwater.Objective: Our objective was to estimate salt intake from drinking water sources and examine environmental factors that may explain a seasonal excess of hypertension in pregnancy.Methods: Water salinity data (1998–2000) for Dacope, in rural coastal Bangladesh, were obtained from the Centre for Environment and Geographic Information System in Bangladesh. Information on drinking water sources, 24-hr urine samples, and blood pressure was obtained from 343 pregnant Dacope women during the dry season (October 2009 through March 2010). The hospital-based prevalence of hypertension in pregnancy was determined for 969 pregnant women (July 2008 through March 2010).Results: Average estimated sodium intakes from drinking water ranged from 5 to 16 g/day in the dry season, compared with 0.6–1.2 g/day in the rainy season. Average daily sodium excretion in urine was 3.4 g/day (range, 0.4–7.7 g/day). Women who drank shallow tube-well water were more likely to have urine sodium > 100 mmol/day than women who drank rainwater [odds ratio (OR) = 2.05; 95% confidence interval (CI), 1.11–3.80]. The annual hospital prevalence of hypertension in pregnancy was higher in the dry season (OR = 12.2%; 95% CI, 9.5–14.8) than in the rainy season (OR = 5.1%; 95% CI, 2.91–7.26).Conclusions: The estimated salt intake from drinking water in this population exceeded recommended limits. The problem of saline intrusion into drinking water has multiple causes and is likely to be exacerbated by climate change–induced sea-level rise.

Drinking Water Salinity and Infant Mortality in Coastal Bangladesh

“…Recent micro-level research on drinking water salinity in the coastal region of Bangladesh and its impact on hypertension in pregnant women (Khan, et al 2008, Khan, et al 2011) draws on numerous international observational studies and clinical trials that establish a strong link between higher salt intake and elevated blood pressure (Alderman 2000;Calabrese and Tuthill 1981;Hallenbeck, et al 1981;He and MacGregor 2007;Midgley, et al 1996;Welty, et al 1986). The current state of the art has been established by Khan, et al (2011), who focus on the links between drinking water salinity and 5 Sarwar (2005) and SRDI (1998aSRDI ( ,b, 2000SRDI ( , 2010 have documented changes in salinity that have accompanied coastal subsidence and thermal expansion of the ocean.…”

“…The current state of the art has been established by Khan, et al (2011), who focus on the links between drinking water salinity and 5 Sarwar (2005) and SRDI (1998aSRDI ( ,b, 2000SRDI ( , 2010 have documented changes in salinity that have accompanied coastal subsidence and thermal expansion of the ocean. Detailed assessments of salinization have employed two principal methods.…”

Climate Change, Groundwater Salinization and Road Maintenance Costs in Coastal Bangladesh

“…One approach focuses on simulation of salinity changes in rivers and estuaries, using hydraulic engineering models whose results are compared with actual measures (Bhuiyan and Dutta 2011;Aerts et al 2000;Nobi and Das Gupta 1997). Another approach focuses on salinity changes in local soil and groundwater, using surveys and descriptive statistics (Mahmood et al 2010;Khan et al 2008Khan et al , 2011Haque 2006;Sarwar 2005;Rahman and Ahsan 2001;Hassan and Shah 2006;Karim et al 1982Karim et al , 1990). In the most comprehensive study to date, Dasgupta et al (2014a) use new monitoring data to develop detailed projections of river salinity through 2050 in Bangladesh's coastal region.…”

“…In Bangladesh, about 30% of the cultivable land is in coastal areas where salinity is affected by tidal flooding during the wet season, direct inundation by storm surges, and movement of saline groundwater during the dry season (Haque, 2006). In consequence, the potential impact of salinity has become a major concern for the Government of Bangladesh and affiliated research Khan et al 2011), the Bangladesh Agricultural Research Council (Karim et al 1982(Karim et al , 1990, and the Bangladesh Soil Resources Development Institute (SRDI 1998a,b;Peterson and Shireen 2001).…”

Saline Drinking Water and Salt in Diet: An Approximate Picture of the Situation in a Coastal Area of Southeastern Bangladesh

“…In the past decade, studies on the impact of saline drinking water on health in Bangladesh were bolstered (Khan et al 2008(Khan et al , 2014Vineis et al 2011;Rasheed et al 2014Rasheed et al , 2016Talukder et al 2017). Khan et al (2011) studied the influence of saline water on pregnant women living in the coastal zones of Bangladesh. They were alarmed to report that drinking water containing sodium intakes ranging from 5 to 16 g/day may cause hypertension and preeclampsia.…”