Well, Well, Well…: A Secondary Data Analysis of Risk Factors for the Presence and Consumption of Arsenic-Contaminated Water in Hand-Pumped Tubewells in Narail District, Bangladesh Open Access
Mahmood, Mahnoor (Spring 2019)
Abstract
In one of the largest contemporary environmental crises in the world, an estimated 20-35 million Bangladeshis are chronically exposed to arsenic concentrations exceeding 0.05 mg/L through their groundwater-based drinking hand pumps. In low-resource settings like Narail, Bangladesh, it is important to identify tubewell attributes that increase the risk of their arsenic contamination as well as household attributes that increase the risk of consumption of arsenic-contaminated water, so that key characteristics may be targeted through exposure mitigation efforts. Purpose: The aims of this thesis are to: 1) To examine the association between tubewell attributes and the presence of arsenic contamination in household tubewells. 2) To examine the association between household attributes and the presence of arsenic contamination in household tubewells. 3) To examine the association between household attributes and the consumption of drinking water from an arsenic-unsafe alternative source, among those who have arsenic-contaminated household tubewells. Results: It was found that between two tubewells that differ in depth by 500 feet but have the same number of years since installation and ownership status, the shallow tubewell has 233 times the odds of containing unsafe levels of arsenic (p < 0.0001). Government-owned tubewells are less likely to be unsafe than privately-owned tubewells (p = 0.0455). Households whose primary source of income is the service industry are more likely to have unsafe tubewells (p = 0.0053). Furthermore, approximately 35% of respondents who switched from their unsafe tubewell did so to another unsafe tubewell. Among those who switched, older respondents were more likely to switch to unsafe tubewells than their younger counterparts (p = 0.0133). Recommendations: Public health professionals working in exposure mitigation efforts in this region should promote the equitable installation of sufficiently deep tubewells, and closely consider the role government can play in their installation, operation, and maintenance. Furthermore, arsenic risk communication strategies should be amended to reflect the dose-response nature of arsenic exposure to promote effective and feasible switching behaviors. Lastly, a targeted effort must be made to ensure access to safe water for high-risk subpopulations, such as those working in the service industry.
Table of Contents
Table of Contents
1. Introduction 1
2. Literature Review 5
2.1. Adverse Effects of Arsenic Exposure 5
2.1.1. Adverse Effects on Physical Well-Being 5
2.1.2. Adverse Effects on Social Well-Being7
2.1.3. Adverse Effects on Economic Well-Being 8
2.2. Tubewell Attributes and Arsenic Concentration 8
2.2.1. Tubewell Depth and Arsenic Concentration 9
2.2.2. Tubewell Installation Year and Arsenic Concentration 10
2.2.3. Tubewell Ownership and Arsenic Concentration 10
2.3. Household Attributes and Arsenic Concentration 11
2.3.1. Demographic Characteristics11
2.3.2. Socioeconomic Characteristics 12
2.3.3. WASH-Related Characteristics 14
2.4. Arsenic Mitigation 15
2.4.1. Arsenic Mitigation Activities and Technologies 15
2.4.2. Factors Influencing the Decision to Switch to a Safe Water Option 15
2.4.3. Considerations for Water Safety in Arsenic Mitigation Activities 17
3. Methods 21
3.1. Dataset Properties 21
3.2. Data Cleaning 23
3.3. Exploratory Analysis 23
3.4. Exploring Associations through Regression Models 24
3.4.1. Association of Tubewell Attributes and Contamination of Household Tubewell 24
3.4.2. Association of Household Attributes and Contamination of Household Tubewell 25
3.4.3. Association of Household Attributes and Contamination of Drinking Water Source 26
4. Results27
4.1. Exploratory Analysis 27
4.2. Association of Tubewell Attributes and Contamination of Household Tubewell 34
4.2.1. Bangladeshi Threshold 34
4.2.2. WHO Threshold 35
4.2.3. Continuous Arsenic Value 36
4.3. Association of Household Attributes and Contamination of Household Tubewell 37
4.3.1. Bangladeshi Threshold 37
4.3.2. WHO Threshold 38
4.3.3. Continuous Arsenic Value 40
4.4. Association of Household Attributes and Contamination of Alternative Source of Drinking Water40
4.4.1. Bangladeshi Threshold 40
4.4.2. WHO Threshold 41
5. Discussion 44
5.1. Key Findings 44
5.2. Discussion on Exploratory Analysis 44
5.3. Discussion on the Association of Tubewell Attributes and Contamination of Household Tubewell45
5.4. Discussion on the Association of Household Attributes and Contamination of Household Tubewell 46
5.5. Discussion on the Association of Household Attributes and Contamination of Alternative Source of Drinking Water 47
5.6. Limitations 47
6. Recommendations 49
7. References 51
8. Appendices 57
8.1. Appendix A 57
8.2. Appendix B 61
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