Clinicians' roles in management of arsenicosis in Bangladesh: interview study

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Abstract
Introduction The British Geological Survey in 2001 estimated that 46% of all shallow tube wells in Bangladesh contained arsenic at concentrations exceeding the World Health Organization's guideline concentration of 0.01 mg/litre. An estimated 28-35 million people were thought to be exposed to arsenic in their drinking water at concentrations exceeding even Bangladesh's arsenic standard of 0.05 mg/litre.1 Many thousands of cases of chronic arsenic poisoning have now been identified, but the real magnitude of the health impact is still undefined. In the 10 years since the problem of arsenic contamination of tube wells, on which a large proportion of the population depend for their drinking water, was identified the development of a coherent national strategy to manage this problem has been disappointingly slow.2 Doctors have a vital role both in the diagnosis and management of arsenicosis and in the mitigation of this major public health threat3 through educating their patients about options open to them to avoid the health effects of chronic poisoning. We explored the current and the desirable participation by doctors in the national arsenic mitigation effort.