Drinking water quality and health impacts in rural Bangladesh

In the 1970s and 1980s, large-scale construction of hand-pumped tubewells started in Bangladesh to provide people  with safe drinking water. By now, over 90% of the population consumes tubewell water. This shift has reduced microbial contamination and as a consequence diarrheal disease. However, it has increased exposure to other minerals present in groundwater, including arsenic. 

Arsenic-contaminated drinking water in Bangladesh has been a public health issue for decades and has been called "the largest mass poisoning in history". Arsenic exposure has been linked to several types of cancers, neurologic disorders, cardiovascular disease, and diabetes mellitus, among others. In Bangladesh, over 20 million people use drinking water sources with higher arsenic than the Bangladesh government’s threshold of 50 µg/l, and around 50 million use sources with higher arsenic than the World Health Organization’s safe limit of 10 µg/l, according to the 2009 National Drinking Water Quality Survey.  

In addition to high arsenic levels, other minerals such as iron, manganese, and sodium chloride have been reported at high levels in drinking water with potential beneficial or adverse health effects. Unsafe storage of untreated water can foster microbial growth, leading to illness, particularly in young children. Moreover, weak water provision infrastructure leads to poor hygiene, such as inadequate hand washing. 

We have been examining potential relationships between tubewell drinking water, wastewater and arsenic contamination in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial population in rural Bangladesh in collaboration with colleagues from the Institute of Earth Sciences at Heidelberg University. Building on these studies, in May 2022 we have launched a new project called 'Safe Water – Advances in Purification Options' (SWAPNO). 

The SWAPNO project will work in areas with high arsenic contamination, providing households with a low-cost, user-friendly and sustainable filtration system to remove both arsenic and microbial contamination from drinking water. Furthermore, households will receive training and support on hand washing and other hygiene practices including water storage.