Contamination of groundwater and risk assessment for arsenic exposure in Ha Nam province, Vietnam

The characteristics of arsenic-contaminated groundwater and the potential risks from the groundwater were investigated. Arsenic contamination in groundwater was found in four villages (Vinh Tru, Bo De, Hoa Hau, Nhan Dao) in Ha Nam province in northern Vietnam. Since the groundwater had been used as one of the main drinking water sources in these regions, groundwater and hair samples were collected in the villages. The concentrations of arsenic in the three villages (Vinh Tru, Bo De, Hoa Hau) significantly exceeded the Vietnamese drinking water standard for arsenic (10 microg/L) with average concentrations of 348, 211, and 325 microg/L, respectively. According to the results of the arsenic speciation testing, the predominant arsenic species in the groundwater existed as arsenite [As(III)]. Elevated concentrations of iron, manganese, and ammonium were also found in the groundwater. Although more than 90% of the arsenic was removed by sand filtration systems used in this region, arsenic concentrations of most treated groundwater were still higher than the drinking water standard. A significant positive correlation was found between the arsenic concentrations in the treated groundwater and in female human hair. The risk assessment for arsenic through drinking water pathways shows both potential chronic and carcinogenic risks to the local community. More than 40% of the people consuming treated groundwater are at chronic risk for arsenic exposure.     

Contamination of drinking water resources in the Mekong delta floodplains: arsenic and other trace metals pose serious health risks to population

This study presents a transnational groundwater survey of the 62,000 km(2) Mekong delta floodplain (Southern Vietnam and bordering Cambodia) and assesses human health risks associated with elevated concentrations of dissolved toxic elements. The lower Mekong delta generally features saline groundwater. However, where groundwater salinity is <1 g L(-)(1) Total Dissolved Solids (TDS), the rural population started exploiting shallow groundwater as drinking water in replacement of microbially contaminated surface water. In groundwater used as drinking water, arsenic concentrations ranged from 0.1-1340 microg L(-)(1), with 37% of the studied wells exceeding the WHO guidelines of 10 microg L(-)(1) arsenic. In addition, 50% exceeded the manganese WHO guideline of 0.4 mg L(-)(1), with concentrations being particularly high in Vietnam (range 1.0-34 mg L(-)(1)). Other elements of (minor) concern are Ba, Cd, Ni, Se, Pb and U. Our measurements imply that groundwater contamination is of geogenic origin and caused by natural anoxic conditions in the aquifers. Chronic arsenic poisoning is the most serious health risk for the ~2 million people drinking this groundwater without treatment, followed by malfunction in children's development through excessive manganese uptake. Government agencies, water specialists and scientists must get aware of the serious situation. Mitigation measures are urgently needed to protect the unaware people from such health problems.     

Arsenic and other trace elements contamination in groundwater and a risk assessment study for the residents in the Kandal Province of Cambodia

Concentrations of arsenic and other trace elements in groundwater were examined at three villages (PT, POT and CHL) in the Kandal Province of Cambodia. Concentrations of arsenic in the groundwater ranged from 6.64 (in POT village) to 1543 microg/L (in PT village), with average and median concentrations of 552 and 353 microg/L, respectively. About 86% out of fifteen samples contained arsenic concentrations exceeding the WHO drinking water guidelines of 10 microg/L. Concentrations of arsenic (III) varied from 4 (in POT village) to 1334 microg/L (in PT village), with an average concentration of 470 microg/L. In addition, about 67%, 80% and 86% of the groundwater samples had higher concentrations for, respectively, barium, manganese and lead than the WHO drinking water guidelines. These results reveal that groundwater in Kandal Province is not only considerably contaminated with arsenic but also with barium, manganese and lead. A risk assessment study found that one sample (PT25) had a cumulative arsenic concentration (6758 mg) slightly higher than the threshold level (6750 mg) that could cause internal cancer in smelter workers with chronic exposure to arsenic from groundwater. High cumulative arsenic ingestion poses a health threat to the residents of Kandal Province.     

Arsenic poisoning in groundwater: health risk and geochemical sources in Bangladesh

Of the 2508 water samples analyzed in 10 districts of Bangladesh, 51%, on an average, contained arsenic levels of 0.05 to 2.50 mg/l. 95% of nail, 96% of hair, and 94% of urine samples contained arsenic above the normal level. Approximately 3.58 million people out of a total of 17.92 million who are drinking water containing arsenic levels >0.20 mg/l are potentially exposed to high risk of health hazard. Eight thousand and five hundred arsenic patients are identified; they are suffering from various skin lesions, gangrene in leg, skin, lung, bladder, liver, and renal cancer. A big portion of the total population is highly vulnerable to various internal cancers. Lowest arsenic concentration in drinking water producing dermatological disease is found to be 0.103 mg/l. However, the exposure time to develop arsenicosis varies from case to case reflecting its dependence on arsenic level in drinking water and food, nutritional status, genetic variant of human being, and compounding factors. This study has determined the high intensity of fluorescent humic substances in drinking water containing elevated concentrations of arsenic and very low concentrations of heavy metals. The synergistic/antagonistic effect of fluorescent compounds present in drinking water may aggravate the toxicity of arsenic. Geochemical study suggests that arsenic may be released from both reductive dissolution of Fe and Mn (oxy)hydroxide and microbial oxidation of organic matter.     

Recent advances in the bioremediation of arsenic-contaminated groundwater

The biological treatment of groundwater is used primarily to remove electron donors from water sources, providing (biologically) stable drinking water, which preclude bacterial regrowth during subsequent water distribution. To the electron donors belong also the dissolved metal cations of ferrous iron and manganese, which are common contaminants found in most (anaerobic) groundwater. The removal of iron and manganese is usually accomplished by the application of chemical oxidation and filtration. However, biological oxidation has recently gained increased importance and application due to the existence of certain advantages, over the conventional physicochemical treatment. The oxidation of iron and manganese is accelerated by the presence of certain indigenous bacteria, the so-called "iron and manganese oxidizing bacteria." In the present paper, selected long-term experimental results will be presented, regarding the bioremediation of natural groundwater, containing elevated concentrations of iron and arsenic. Arsenic is considered as a primary pollutant in drinking water due to its high toxicity. Therefore, its efficient removal from natural waters intended for drinking water is considered of great importance. The application of biological processes for the oxidation and removal of dissolved iron was found to be an efficient treatment technique for the simultaneous removal of arsenic, from initial concentrations between 60 and 80 microg/l to residual (effluent) arsenic concentrations lower than the limit of 10 microg/l. The paper was focused on the removal of As(III) as the most common species in anaerobic groundwater and generally is removed less efficiently than the oxidized form of As(V). To obtain information for the mechanism of As(III) removal, X-ray photoelectron spectroscopy (XPS) analyses were applied and it was found that As(III) was partially oxidized to As(V), which enabled the high arsenic removal efficiency over a treatment period of 10 months.     

A study on the arsenic concentration in groundwater of a coastal aquifer in south-east India: an integrated approach

The occurrence of arsenic in drinking water and its detrimental effects have drawn much attention in recent years. Several studies have been conducted in the deltaic plains of River Ganga, NE part of the India, and in other countries, but no systematic study was conducted in South India on occurrence of arsenic in groundwater. The main aim of this study is to determine the level of arsenic in groundwater and to understand the relation with other geochemical parameters of groundwater in the south-eastern coastal aquifer at Kalpakkam region, India. This region is represented by three different lithologies, viz. charnockites, flood plain alluvium and marine alluvium. Twenty-nine representative samples of groundwater were collected and analysed for major ions, metals and isotopes such as ²H and ¹⁸O. In addition, geophysical method was also attempted to understand the subsurface condition. The spatial variation in arsenic (As) indicates that higher concentration was observed around the landfill sites and irrigated regions, which was supported by geochemical, statistical and isotopic inferences. The variation in the As with depth, lithology and sources has been clearly brought out. Though the values of As does not exceed the drinking water permissible limit (10 mg/l), it has reached a near permissible level of 8.7 ppb. Hence, it is essential to understand the geochemical behaviour of As for a proper future management of the water resource in the study area.     

Impacts of arsenic contamination in groundwater: case study of some villages in Bangladesh

The contamination of groundwater in Bangladesh by arsenic is a widespread and serious environmental problem, affecting mainly the rural population who rely extensively on groundwater for drinking and cooking. The study conducted survey work in a few affected villages of the Northwest region in Bangladesh. The household survey gathered information on the respondents (affected by arsenic) water usage and sources, knowledge of the arsenic problem, changes in the source of water for drinking and cooking, arsenic mitigation technologies and socio-economic information on the households. The survey work shows that percentage of male patient is higher than female patient among the same level of household income in each study villages. Prevalence of arsenicosis is more among poorer sections and it is directly related to the poverty situation of the community. People know more about the health problems caused by arsenicosis but lack knowledge about mitigation aspects. In one of the study areas, every year an extra 4% tubewell is getting contaminated by arsenic. Arsenic contamination in groundwater also affects the environment and the ecology negatively. The NGOs have been found contributing to a knowledge creation process in the village community as the villagers are showing marked behavioral changes in water-use practice.

Toxicological responses in Laeonereis acuta (annelida, polychaeta) after arsenic exposure

Several environmental pollutants, including metals, can induce oxidative stress. So, the objective of this study was to evaluate the effects of arsenic (As(III), as As(2)O(3)) on the antioxidant responses in the polychaete Laeonereis acuta. Worms were exposed to two environmentally relevant concentrations of As, including the highest previously allowed by Brazilian legislation (50 microg As/l). A control group was kept in saline water (10 per thousand) without added metal. It was observed that: (1) a peak concentration of lipid peroxide was registered after 2 days of exposure to 50 microg As/l (61+/-3.2 nmol CHP/g wet weight) compared to the control group (43+/-4.5 nmol CHP/g wet weight), together with a lowering of the activity of the antioxidant enzyme catalase (-47 and -48%, at 50 or 500 microg As/l respectively) and a higher superoxide dismutase activity (+305% at 50 microg As/l with respect to the control group); (2) a lower conjugation capacity through glutathione-S-transferase activity was observed after 7 days of exposure to 50 microg As/l (-48% compared to the control group); (3) a significant increase in As concentration was verified after 1 week of exposure to both As concentrations (50 and 500 microg/l); (4) worms exposed to As showed a limited accumulation of related methylated As species and the levels of non-toxic As species like arsenobetaine (AsB) and arsenocholine (AsC) remained unchanged during the exposure period when compared with the controls. Overall, it can be concluded that As interfered in the antioxidant defense system of L. acuta, even at low concentrations (50 microg/l) that Brazilian legislation previously considered safe. The fact that worms exposed to As showed high levels of methylated As species indicates the methylation capability of L. acuta, although the high levels of inorganic As suggest that not all the administered As(III) (as As(2)O(3)) is completely removed or biotransformed after 7 days of exposure.     

Arsenic contamination of the environment: a new perspective from central-east India

This paper reports a regional contamination of the environment in central-east India that does not share geology or boundary with the Bengal Delta Plain. About 30,000 people residing in 30 villages and towns are directly exposed to arsenic and more than 200,000 people are "at risk." Complete geographical extent of this contamination is being established, and this newly reported contaminated area could be quite large. This paper further reports that the mechanisms involved in arsenic mobilisation are complex and the two theories of arsenic mobilisation, i.e., pyrite oxidation and oxyhydroxides reduction, do not fully explain the high levels of arsenic contamination. This paper also proposes the "oxidation-reduction theory" for arsenic mobilisation where the arsenic originates from the arsenopyrite oxidation and the arsenic thus mobilised forms the minerals and gets reduced underground in favourable Eh conditions. The stoppage of water withdrawal from the contaminated sources did not result in lowering of arsenic levels as expected according to the heavy groundwater extraction theory (pyrite oxidation theory). Cases of arsenicosis in the region are on the rise and the switchover to less contaminated water has not reversed the arsenicosis progression in the affected persons even after 2 years. Surface water of the rivers is also being contaminated because of the probable dislocation of contaminated groundwater due to the heavy rains in monsoon season, which indicates that the river water could be a major carrier of arsenic in dissolved or adsorbed forms that may be a cause of contamination of the delta plains.     

Assessment of arsenic level in the hair of the nonoccupational Egyptian population: pilot study.

Arsenic level of hair samples of apparently healthy Egyptian was measured by means of hydride atomic absorption spectrophotometery. It ranged between 0.04 and 1.04 mg As/kg hair, about 55% of the analysed hair samples were within the range of allowable values (0.08-0.25 mg As/kg hair), but 45% were not. There were no considerable sex-related differences (0.303 and 0.292 mg As/kg hair for males and females, respectively). Different educational levels did not influence it either, when the effect of the age had been excluded. Children and adolescents proved to be more susceptible to arsenic as their mean levels (0.353 microg/g), and were significantly higher than those in the adults (0.233 microg/g). Smoking and some dietary habits had an important role in the elevation of arsenic levels among the nonoccupational Egyptian population: 60% of smokers and 66.7% of indoor passive smokers had arsenic levels >0.25 mg As/kg hair. Arsenic levels were also dependent on the kind of smoking, as hair arsenic of the subject smoking molasses tobacco was found to be significantly higher than that of cigarette smokers (0.459 and 0.209 mg As/kg hair, respectively). The frequency of meat and fish consumption per week was also found to be positively, significantly correlated with arsenic levels. On the other hand, the frequency of consumption of fruits, fresh and cooked vegetables, milk and milk products per week beneficially influenced the arsenic level of the hair samples examined. Arsenic content of the consumed water in Egypt was 0.001 mg/l, which is below the maximum drinking water level allowed by World Health Organisation (WHO). Therefore, the arsenic content of domestic tap water hardly contributed to the arsenic exposure of the Egyptian population in the regions of the study. It is likely that exposure routes by smoking, fish and animal protein consumption are the principal cause of arsenic accumulation in the general Egyptian population.     

Groundwater in the Limpopo Basin: occurrence,use and impact

The Limpopo River Basin is underlain by an alluvial aquifer along the main river stem and fractured water-bearing units in tributary catchments. Notwithstanding that development priorities in parts of the basin in South Africa have historically preferred surface water sources for irrigation and domestic supply, water resources auditing suggests that groundwater presents the only viable alternative source of cost-effective supply to meet future requirements. However, while aquifer yields are favourable in places, averaging 16.7 l/s for main-stem alluvium, groundwater is already extensively used. Between 1995 and 2002, total groundwater use in the area rose by almost 40%, increasing from 98 to 136 million m³ per year. In all catchments, groundwater use grew by varying proportions, reaching a rather high 200% in the Mogalakwena catchment. In the particular case of commercial irrigation, over-exploitation of groundwater has been recorded in a number of places, especially in the northwest where drawdowns of more than 50 m have resulted from decades of intense agricultural water use. Although groundwater use for mining is still low at 4% of total usage in the study area, the region is currently witnessing a surge in mining operations, and a significant growth in water requirements is envisaged for mining development. Further, domestic water supply to the predominantly rural dwellers in the area is relatively low, even in terms of meeting the basic need of 25 l/day per person, underscoring the fact that groundwater will remain a critical source of community drinking water in the foreseeable future. Readers should send their comments on this paper to: BhaskarNath@aol.com within 3 months of publication of this issue.     

四湖地区地下水“三氮”含量及时空分布特征分析

在4次地下水水质监测的基础上，对潜水和浅层承压水的“三氮”含量进行了季节变化和空间差异分析，同时探讨了时空变化的影响因素。分析结果表明：（1）地下水氨氮浓度超标率较高，承压水中浓度明显高于潜水，4次采样结果承压水氨氮浓度超标率均在50% 以上；（2）硝酸盐氮和亚硝酸盐氮含量在承压水中能达到良好的标准，在潜水中超标率高；（3）氨氮浓度季节变化明显，9月份浓度显著高于4、6和11月。硝酸盐氮和亚硝酸盐氮在潜水中6月份浓度最高，在承压水中季节变化不明显；（4）地下水氨氮含量空间变异性强，浓度较高的多集中在流经洪湖的内荆河两侧区域。研究区地下水水质受气象因素、农业活动、农村生活污染以及氧化还原环境的综合影响     

苏州地区地下水资源城市应急利用适宜性研究

随着太湖水体富营养化程度的不断加剧,建立安全、稳定、可靠的应急备用水源日益重要。利用2005~2009年苏州地区地下水水质连续监测和补充监测资料,对第Ⅱ承压含水层进行了应急利用(生活饮用和工业利用)的水质适宜性和安全性评价分析。研究结果表明:第Ⅱ承含水层主要水化学类型为Na-HCO3、Ca-HCO3和Na-CaHCO3型,水质总体稳定,年际差异很小;地下水水质指数(WQI)均值较低(位于49.98~68.75之间),地下水没有受到有机物污染,可作为应急利用水源;WQI的水质指标贡献率表明,As、Fe、pH和Mn指标的贡献率最大,局部区域As、Fe、Mn及氨氮和亚硝酸盐含量较高,应急利用时应进行处理。朗格里尔饱和指数(LSI)和拉森比(LnR)评价结果表明,该水源易结垢,具有轻微腐蚀倾向,作为工业备用水源时应进行适当的处理。为苏州地区地下水应急水源建设和安全利用提供了科学依据和参考。     

Elevated childhood exposure to arsenic despite reduced drinking water concentrations — A longitudinal cohort study in rural Bangladesh

ObjectivesThe aim of this study was to evaluate the massive efforts to lower water arsenic concentrations in Bangladesh.MethodsIn our large mother–child cohort in rural Matlab, we measured the arsenic concentrations (and other elements) in drinking water and evaluated the actual exposure (urinary arsenic), from early gestation to 10 years of age (n = 1017).ResultsMedian drinking water arsenic decreased from 23 (2002–2003) to < 2 μg/L (2013), and the fraction of wells exceeding the national standard (50 μg/L) decreased from 58 to 27%. Still, some children had higher water arsenic at 10 years than earlier. Installation of deeper wells (> 50 m) explained much of the lower water arsenic concentrations, but increased the manganese concentrations. The highest manganese concentrations (~ 900 μg/L) appeared in 50–100 m wells. Low arsenic and manganese concentrations (17% of the children) occurred mainly in > 100 m wells. The decrease in urinary arsenic concentrations over time was less apparent, from 82 to 58 μg/L, indicating remaining sources of exposure, probably through food (mean 133 μg/kg in rice).ConclusionDespite decreased water arsenic concentrations in rural Bangladesh, the children still have elevated exposure, largely from food. Considering the known risks of severe health effects in children, additional mitigation strategies are needed.     

Perchlorate in sewage sludge, rice, bottled water and milk collected from different areas in China

As a new emerging environmental contaminant, perchlorate has prompted people to pay more attention. The presence of perchlorate in the human body can result in improper regulation of metabolism for adults. Furthermore, it also causes developmental and behavioral problems for infants and children because it can interfere with iodide uptake into the thyroid tissue. In this paper, perchlorate in sewage sludge, rice, bottled drinking water and milk was detected for investigating the perchlorate pollution status in China. The places, where the samples were collected, cover most regions of China. Therefore, the final data on perchlorate levels will give an indication of the perchlorate pollution status in China. The final determination of perchlorate was performed by ion chromatography-electrospray tandem mass spectrometry with negative mode. The concentration of perchlorate in sewage sludge, rice, bottled drinking water and milk was in the range of 0.56-379.9 microg/kg, 0.16-4.88 mug/kg, 0.037-2.013 microg/L and 0.30-9.1 microg/L, respectively. The results show that perchlorate has been widespread in China.     

Arsenic concentrations in rice, vegetables, and fish in Bangladesh: a preliminary study

Arsenic contaminating groundwater in Bangladesh is one of the largest environmental health hazards in the world. Because of the potential risk to human health through consumption of agricultural produce grown in fields irrigated with arsenic contaminated water, we have determined the level of contamination in 100 samples of crop, vegetables and fresh water fish collected from three different regions in Bangladesh. Arsenic concentrations were determined by hydride generation atomic absorption spectrophotometry. All 11 samples of water and 18 samples of soil exceeded the expected limits of arsenic. No samples of rice grain (Oryza sativa L.) had arsenic concentrations more than the recommended limit of 1.0 mg/kg. However, rice plants, especially the roots had a significantly higher concentration of arsenic (2.4 mg/kg) compared to stem (0.73 mg/kg) and rice grains (0.14 mg/kg). Arsenic contents of vegetables varied; those exceeding the food safety limits included Kachu sak (Colocasia antiquorum) (0.09-3.99 mg/kg, n=9), potatoes (Solanum tuberisum) (0.07-1.36 mg/kg, n=5), and Kalmi sak (Ipomoea reptoms) (0.1-1.53 mg/kg, n=6). Lata fish (Ophicephalus punctatus) did not contain unacceptable levels of arsenic. These results indicate that arsenic contaminates some food items in Bangladesh. Further studies with larger samples are needed to demonstrate the extent of arsenic contamination of food in Bangladesh.     

What is the best biomarker to assess arsenic exposure via drinking water?

Arsenic (As) is a ubiquitous element. The current WHO guideline for As in drinking water is 10 μg/L. Furthermore, about 130 million people have only access to drinking water containing more than 10 gAs/L. Although numerous studies have shown the related adverse effects of As, sensitive appropriate biomarkers are still required for studies of environmental epidemiology. A review of the literature has shown that various biomarkers are used for such research. Their limits and advantages are highlighted in this paper: (i) the detection of As or its derivatives in the blood is an indication of the dose ingested but it is not evidence of chronic intoxication. (ii) The detection of As in urine is an indispensible procedure because it is a good marker for internal dose. It has been demonstrated to correlate well for a number of chronic effects related to As levels in drinking water. However confounding factors must be taken into account to avoid misinterpretation and this may require As speciation. (iii) As in the hair and nails reflects the level of long term exposure but it is difficult to relate the level with the dose ingested. (iv) Some studies showed a correlation between urinary As and urinary and blood porphyrins. However, it is difficult to use only porphyrins as a biomarker in a population survey carried out without doing further studies. (v) Genotoxic effects are based on the characterization of these potential effects. Most studies have detected increases in DNA damage, sister chromatid exchange, micronuclei or chromosomal aberrations in populations exposed to As in drinking water. Micronuclei assay is the technique of choice to follow these populations, because it is sensitive and easy to use.To conclude, whatever epidemiological studies are, the urinary and toenail biomarkers are useful to provide indications of internal dose. Moreover, micronuclei assay can be complementary use as biomarker of early effects.     

Association of arsenic and kidney dysfunction in people with diabetes and validation of its effects in rats

We studied villagers with and without diabetes from arsenic-endemic areas and a nearby control site in Xinjiang Autonomous Region, PR China. Water and urinary arsenic were assayed for exposure measurement. Urinary NAG (N-acetyl-beta-glucosaminidase), a kidney function test, blood glucose, triglyceride, cholesterol, high density lipid and low density lipid were measured. Villagers from endemic areas were found to have higher urinary arsenic concentrations. The NAG results also suggest that chronic arsenic exposure presents a significant adverse impact on the kidney function of villagers in the endemic areas. However, blood glucose levels of diabetes individuals were lower than those from the control site. These observations were validated in rats which were chronically exposed to arsenic in drinking water. The distinct relationship between chronic arsenic exposure and diabetes mellitus requires further investigation. A rodent model is a useful tool for study of this type.     

Groundwater quality and its health impact: An assessment of dental fluorosis in rural inhabitants of the Main Ethiopian Rift

This study aims to assess the link between fluoride content in groundwater and its impact on dental health in rural communities of the Ethiopian Rift. A total of 148 water samples were collected from two drainage basins within the Main Ethiopian Rift (MER). In the Ziway–Shala basin in particular, wells had high fluoride levels (mean: 9.4 ± 10.5 mg/L; range: 1.1 to 68 mg/L), with 48 of 50 exceeding the WHO drinking water guideline limit of 1.5 mg/L. Total average daily intake of fluoride from drinking groundwater (calculated per weight unit) was also found to be six times higher than the No-Observed-Adverse-Effects-Level (NOAEL) value of 0.06 mg/kg/day. The highest fluoride levels were found in highly-alkaline (pH of 7 to 8.9) groundwater characterized by high salinity; high concentrations of sodium (Na⁺), bicarbonate (HCO₃⁻), and silica (SiO₂); and low concentrations of calcium (Ca^2 +). A progressive Ca^2 + decrease along the groundwater flow path is associated with an increase of fluoride in the groundwater. The groundwater quality problem is also coupled with the presence of other toxic elements, such as arsenic (As) and uranium (U). The health impact of fluoride was evaluated based on clinical examination of dental fluorosis (DF) among local residents using the Thylstrup and Fejerskov index (TFI). In total, 200 rural inhabitants between the ages of 7 and 40 years old using water from 12 wells of fluoride range of 7.8–18 mg/L were examined. Signs of DF (TF score of ≥ 1) were observed in all individuals. Most of the teeth (52%) recorded TF scores of 5 and 6, followed by TF scores of 3 and 4 (30%), and 8.4% had TF scores of 7 or higher. Sixty percent of the teeth exhibited loss of the outermost enamel. Within the range of fluoride contents, we did not find any correlation between fluoride content and DF. Finally, preliminary data suggest that milk intake has contributed to reducing the severity of DF. The study highlights the apparent positive role of milk on DF, and emphasizes the importance of nutrition in management efforts to mitigate DF in the MER and other parts of the world.     

Arsenic and fluoride removal from groundwater by reverse osmosis

The reverse osmosis process was evaluated for removal of naturally occurring arsenic and fluoride from groundwater. Arsenic removal was affected by the prevalent arsenic species present in the water. Arsenic concentrations were reduced by approximately 60%–90% from nearly 80 μg/L. Fluoride concentrations were reduced by approximately 60% from nearly 1.7 mg/L.