RANGE OF HEALTH HAZARDS DUE TO DRINKING WATER, NATURALLY CONTAMINATED WITH FLUORIDE AND ARSENIC IN INDIA : RISK ASSESSMENT METHODOLOGIES WITH INTERVENTIONS TO PRACTISE FOR COMPLETE RECOVERY
Susheela A. K.
Director, Fluorosis Research & Rural Development Foundation
C-103 Saransh, 34. I. P. Extension
Delhi – 110 092
Email: susheela@bol.net.in
Fax: 91-11-2272-5156
Tel: 91-11-2273-1886
Topic: Arsenic, Fluoride and Human Health
Keywords: Fluorosis, Arsenicosis, Risk Assessment, Diagnosis, Recovery
ABSTRACT
Excess fluoride and arsenic in drinking water have caused serious public health problems in India . This communication highlights · the gravity of the health problems in India · other routes of exposure · range of health hazards with devastating effects in children.
In Fluorosis, in contrast to Arsenicosis, risk assessment methodologies and interventions to practise for recovery are developed taking the cue from results of basic researches. The observations from musculo-skeletal tissues, ‚ gastro-intestinal mucosa ƒ RBCs, „ spermatozoa … ligaments, † collagen protein, ‡ non- collagenous matrix molecules and ˆ hormones involved in thyroid gland function have unravelled a host of factors both in adults and children. The earliest manifestations pertain to Non-ulcer dyspepsia, Polyuria, Polydipsia, Anemia, fatigue and joint pain in adults besides male infertility. The manifestations with overlapping clinical profile with diseases of different etiology are addressed through testing of fluoride in body fluids and drinking water besides a radiograph of the fore-arm for assessing ectopic calcification. The battery of tests lead to definitive diagnosis of Fluorosis.
Children suffer from low IQ, mental retardation, cretinism, deaf-mutism, borne deformities with often mistaken for Iodine deficiency disorders (IDD) and introduced to Iodine supplementation, when the requirement is removal of fluoride first followed by Iodine supplementation,
Early detection of Fluorosis lead to complete recovery within a fortnight through practise of 2 interventions to stop fluoride entry to arrest the progression of the disease ‚ to supplement the diet with essential nutrients, vitamins and antioxidants through dietary sources for repair and maintenance of damaged cells and tissues. Pharmaceutical products are however, not recommended. In children the recovery would depend upon the onset of exposure to fluoride.. If exposure is during intrauterine life or in early infancy, the chances of recovery are poor.
In the arsenic front, in contrast to the fluoride scenario, the investments and efforts are diverted to developing technologies for arsenic removal form water and fixing guidelines / norms for arsenic in drinking water. Though such efforts are necessary, it has not helped the community to recover from Arsenicosis . Lessons learned suggest that investments to be diverted for a better understanding of the toxicity of arsenite and arsenate on the biological system. In the absence of such essential information, mere technological innovations to remove arsenic form drinking water alone may not be helpful.
In conclusion, the reasons for achieving success in the fluoride front and the grey areas for focus in the arsenic arena are highlighted.