Discovering the Largest Mass Poisoning in History Arsenic, Manganese, Uranium, and Other Toxic...

Discovering the Largest Mass Discovering the Largest Mass Poisoning in HistoryPoisoning in History

Arsenic, Manganese, Uranium, and Other Toxic Metals in the Arsenic, Manganese, Uranium, and Other Toxic Metals in the Drinking Water of Argentina, Bangladesh, India, Myanmar, Drinking Water of Argentina, Bangladesh, India, Myanmar,

and Ultimately the Worldand Ultimately the World

Copyright Copyright ©© 2014 Seth H. Frisbie, Ph.D. All rights reserved. 2014 Seth H. Frisbie, Ph.D. All rights reserved.

Erika Mitchell, Ph.D.Erika Mitchell, Ph.D.

Donald Maynard, P.E.Donald Maynard, P.E.

Thomas Bacquart, Ph.D.Thomas Bacquart, Ph.D.

George Springston, M.S.George Springston, M.S.

Laurie Grigg, Ph.D.Laurie Grigg, Ph.D.

Seth Frisbie, Ph.D.Seth Frisbie, Ph.D.

Bibudhendra Sarkar, Ph.D.Bibudhendra Sarkar, Ph.D.

Hannah Dustin, B.S.Hannah Dustin, B.S.

Kelly Bradshaw, B.S.Kelly Bradshaw, B.S.

Jeffrey Defelice, B.S.Jeffrey Defelice, B.S.

A History of Drinking WaterA History of Drinking Water• Since the beginning of human Since the beginning of human

history until very recently, we history until very recently, we have used only surface or dug have used only surface or dug well water for drinking.well water for drinking.

• In 1862 the tubewell was In 1862 the tubewell was invented by Col. Nelson W. invented by Col. Nelson W. Green and deep well water Green and deep well water became easily accessible for became easily accessible for drinking.drinking.

• Today billions of people use Today billions of people use deep well water for drinking.deep well water for drinking.

(Photograph by Peer (Photograph by Peer Water Exchange, 2006)Water Exchange, 2006)

(Col. Nelson W. Green)(Col. Nelson W. Green)

• Surface and dug well water Surface and dug well water often has microorganisms often has microorganisms that can make a person sick that can make a person sick hours or days after drinking.hours or days after drinking.

• High dissolved oxygen (OHigh dissolved oxygen (O22) )

and the removal of ions by and the removal of ions by leaching gives surface and leaching gives surface and dug well water low dug well water low concentrations of arsenic concentrations of arsenic (As), manganese (Mn), and (As), manganese (Mn), and other metals.other metals.

(Photograph of (Photograph of Vibrio choleraVibrio cholera by Jozef Rosinský)by Jozef Rosinský)

A History of Drinking WaterA History of Drinking Water

• In contrast, deep well water rarely has pathogenic In contrast, deep well water rarely has pathogenic microorganisms.microorganisms.

• Low dissolved OLow dissolved O22 and the accumulation of ions and the accumulation of ions

from leaching gives deep well water high from leaching gives deep well water high concentrations of As, Mn, and other metals that concentrations of As, Mn, and other metals that can make a person sick after years or decades of can make a person sick after years or decades of regular drinking.regular drinking.

(Images by Element Collection, Inc.)(Images by Element Collection, Inc.)

• The diagnosis of The diagnosis of chronic metal poisoning chronic metal poisoning is made difficult by the is made difficult by the 5 to 20 or more years of 5 to 20 or more years of exposure needed to exposure needed to produce symptoms.produce symptoms.


Graph of As concentration (mg/L) Graph of As concentration (mg/L) versus oxidation-reduction potential versus oxidation-reduction potential

(mV).(mV).

0.000

0.100

0.200

0.300

0.400

0.500

-200 -100 0 100 200 300

Oxidation-Reduction Potential (mV)A

rse

nic

Co

nc

en

tra

tio

n (

mg

/L)

• This graph suggests This graph suggests that As is released that As is released from solids to deep from solids to deep well water by low well water by low dissolved Odissolved O22..


A History of Drinking Water in ArgentinaA History of Drinking Water in Argentina• In the 1880s tubewells were first used in Northern In the 1880s tubewells were first used in Northern

Argentina.Argentina.• In 1916 Dr. Abel Ayerza found that both people and In 1916 Dr. Abel Ayerza found that both people and

chickens had symptoms similar to pharmaceutical chickens had symptoms similar to pharmaceutical As poisoning.As poisoning.

• Later, Ayerza checked things in common and Later, Ayerza checked things in common and found As and vanadium (V) in the drinking water.found As and vanadium (V) in the drinking water.

(Photographs by Ayerza, 1918)(Photographs by Ayerza, 1918)

• Many premature deaths were caused by drinking Many premature deaths were caused by drinking surface water.surface water.

• The life expectancy during the mid-1960s was only The life expectancy during the mid-1960s was only 46 years.46 years.

A History of Drinking Water in BangladeshA History of Drinking Water in Bangladesh• Rivers, ponds, and dug Rivers, ponds, and dug

wells were the only wells were the only practical source of practical source of drinking water from at drinking water from at least 900 BC until the least 900 BC until the 1970s.1970s.

• A massive cholera A massive cholera outbreak began in outbreak began in 1963.1963. (Photograph by Dhaka Hospital)(Photograph by Dhaka Hospital)

• Approximately 10,000,000 Approximately 10,000,000 tubewells have been tubewells have been installed since 1971 to installed since 1971 to supply safe drinking water.supply safe drinking water.

• Within 1 generation the Within 1 generation the population changed from population changed from drinking surface water to drinking surface water to drinking groundwater.drinking groundwater.

• By 2000, approximately By 2000, approximately 97% of Bangladeshis drank 97% of Bangladeshis drank tubewell water.tubewell water.

(Photograph by Steven Brace, 1995)(Photograph by Steven Brace, 1995)

A History of Drinking Water in BangladeshA History of Drinking Water in Bangladesh

• The symptoms of The symptoms of chronic As poisoning chronic As poisoning from drinking water from drinking water usually take 5 to 20 usually take 5 to 20 years to manifest.years to manifest.

• Chronic As poisoning Chronic As poisoning from drinking tubewell from drinking tubewell water was first water was first diagnosed in 1993.diagnosed in 1993.

Melanosis of the chestMelanosis of the chest

Keratosis of the palmsKeratosis of the palms(Photograph by Dhaka Community (Photograph by Dhaka Community Hospital and Richard Wilson, 2002)Hospital and Richard Wilson, 2002)

Keratosis of the feetKeratosis of the feet

Blackfoot diseaseBlackfoot disease


• The first national-scale The first national-scale map of As concentration map of As concentration in Bangladesh’s tubewell in Bangladesh’s tubewell water was made in 1997.water was made in 1997.

• Approximately Approximately 75,000,000 Bangladeshis 75,000,000 Bangladeshis are at risk of death from are at risk of death from skin, bladder, liver, and skin, bladder, liver, and lung cancers caused by lung cancers caused by chronic As poisoning.chronic As poisoning.

• The source of As is The source of As is geological.geological.

Map of As Map of As concentration (mg/L).concentration (mg/L).


The Discovery of Other Toxic Elements in The Discovery of Other Toxic Elements in Bangladesh’s Drinking WaterBangladesh’s Drinking Water

AnalyteAnalyte IndependentIndependentStandard RecoveryStandard Recovery(Analyte Added to (Analyte Added to

Distilled Water)Distilled Water)

Sample Matrix Sample Matrix Spike RecoverySpike Recovery

(Analyte Added to (Analyte Added to Drinking Water)Drinking Water)

Arsenic (As)Arsenic (As) 83%83% 89 89 11% 11%

Ferrous iron (FeFerrous iron (Fe2+2+)) 93 93 10% 10% 34 34 23% 23%

Total iron (Fe)Total iron (Fe) 95%95% Not measured, at least 27% of Not measured, at least 27% of samples developed the wrong color.samples developed the wrong color.

• At least 27% of the drinking water wells in Bangladesh At least 27% of the drinking water wells in Bangladesh apparently contain an analytical interference to the 1,10-apparently contain an analytical interference to the 1,10-phenanthroline methods for measuring ferrous iron and phenanthroline methods for measuring ferrous iron and total iron.total iron.

Map of Fe Map of Fe concentration concentration

(mg/L).(mg/L).


• Locations of tubewells that Locations of tubewells that contained interfering metals are contained interfering metals are labeled with the letter “E”.labeled with the letter “E”.

• This suggests that other toxic This suggests that other toxic metals besides As are widely metals besides As are widely distributed in Bangladesh’s distributed in Bangladesh’s drinking water.drinking water.


• In addition, the early onset of In addition, the early onset of chronic As poisoning chronic As poisoning suggested that multimetal suggested that multimetal health effects are possible.health effects are possible.

• The problems measuring The problems measuring iron and the early onset of iron and the early onset of chronic As poisoning were chronic As poisoning were the first evidence that other the first evidence that other toxic elements are widely toxic elements are widely distributed in Bangladesh’s distributed in Bangladesh’s drinking water.drinking water.

(Photograph by NGO Forum, 2002)(Photograph by NGO Forum, 2002)

• 60% of Bangladesh’s area contains groundwater with Mn 60% of Bangladesh’s area contains groundwater with Mn concentrations greater than the WHO drinking water guideline.concentrations greater than the WHO drinking water guideline.

• Manganese in drinking water is a potent neurotoxin, associated with Manganese in drinking water is a potent neurotoxin, associated with violent behaviors and depression. It causes learning disabilities in violent behaviors and depression. It causes learning disabilities in children and Parkinson's-like symptoms in adults.children and Parkinson's-like symptoms in adults.

• It causes liver and kidney damage, and is associated with hearing loss.It causes liver and kidney damage, and is associated with hearing loss.

Map of Mn concentration (mg/L).Map of Mn concentration (mg/L).

• 3% of Bangladesh’s area contains groundwater with Pb concentrations 3% of Bangladesh’s area contains groundwater with Pb concentrations greater than the WHO drinking water guideline.greater than the WHO drinking water guideline.

• Lead is a potent neurotoxin, associated with IQ deficits and learning Lead is a potent neurotoxin, associated with IQ deficits and learning disabilities in children and dementia in adults.disabilities in children and dementia in adults.

• It is also associated with kidney, liver, and heart disease, tooth loss, It is also associated with kidney, liver, and heart disease, tooth loss, cataracts, hypertension, diabetes, and bladder cancer.cataracts, hypertension, diabetes, and bladder cancer.

Map of lead (Pb) concentration (mg/L).Map of lead (Pb) concentration (mg/L).

• < 1% of Bangladesh’s area contains groundwater with Ni < 1% of Bangladesh’s area contains groundwater with Ni concentrations greater than the WHO drinking water guideline.concentrations greater than the WHO drinking water guideline.

• Nickel is a potent carcinogen.Nickel is a potent carcinogen.• It is also associated with lung, heart, and kidney disease and can It is also associated with lung, heart, and kidney disease and can

induce spontaneous abortions.induce spontaneous abortions.

Map of nickel (Ni) concentration (mg/L).Map of nickel (Ni) concentration (mg/L).

• < 1% of Bangladesh’s area contains groundwater with Cr < 1% of Bangladesh’s area contains groundwater with Cr concentrations greater than the WHO drinking water guideline.concentrations greater than the WHO drinking water guideline.

• Cr(III) is the form most often found in drinking water. Chronic Cr(III) is the form most often found in drinking water. Chronic exposure inhibits DNA synthesis and the fidelity of DNA replication. exposure inhibits DNA synthesis and the fidelity of DNA replication.

• Cr(III) accumulates in the liver; persons with existing liver disease may Cr(III) accumulates in the liver; persons with existing liver disease may be exceptionally susceptible to its toxic effects.be exceptionally susceptible to its toxic effects.

Map of total chromium (Cr) concentration (mg/L).Map of total chromium (Cr) concentration (mg/L).

aa Assuming Bangladesh has 158,570,535 people (July 2011 est.) and 97% of its Assuming Bangladesh has 158,570,535 people (July 2011 est.) and 97% of its population drinks well water.population drinks well water.

Estimated number of Bangladeshis drinking water Estimated number of Bangladeshis drinking water with metal concentrations above WHO guidelines.with metal concentrations above WHO guidelines.

MetalMetal Carcinogenic Carcinogenic PotentialPotential

WHO WHO Guideline Guideline

(µg/L)(µg/L)

Percent of Percent of Bangladesh’s Area Bangladesh’s Area

Exceeding WHO Exceeding WHO GuidelineGuideline

Number of Number of Bangladeshis Bangladeshis

Drinking Unsafe Drinking Unsafe Water Water aa

AsAsMnMnPbPbNiNiCrCr

Known carcinogenKnown carcinogenNoncarcinogenNoncarcinogenPossible carcinogenPossible carcinogenProbable carcinogenProbable carcinogenNoncarcinogenNoncarcinogen

1010400400101020205050

4949606033

< 1< 1< 1< 1

75,000,00075,000,00092,000,00092,000,000

4,600,0004,600,000< 1,500,000< 1,500,000< 1,500,000< 1,500,000

• Tens of millions of Bangladeshis are drinking water that Tens of millions of Bangladeshis are drinking water that exceeds WHO health-based guidelines for As, Mn, Pb, Ni, exceeds WHO health-based guidelines for As, Mn, Pb, Ni, and Cr.and Cr.

• Boron (B), barium (Ba), molybdenum (Mo), and uranium (U) Boron (B), barium (Ba), molybdenum (Mo), and uranium (U) have also been found above WHO health-based guidelines have also been found above WHO health-based guidelines in Bangladesh.in Bangladesh.

The Discovery of Multiple Toxic Elements in The Discovery of Multiple Toxic Elements in West Bengal’s Drinking WaterWest Bengal’s Drinking Water

• The deep well The deep well water from water from neighboring neighboring West Bengal, West Bengal, India has unsafe India has unsafe concentrations concentrations of As, B, fluoride of As, B, fluoride (F(F--), Mn, and ), Mn, and possibly thorium possibly thorium (Th).(Th).

The Discovery of Multiple Toxic Elements in The Discovery of Multiple Toxic Elements in Myanmar’s Drinking WaterMyanmar’s Drinking Water

• The deep well water from The deep well water from neighboring Myanmar has neighboring Myanmar has unsafe concentrations of As, unsafe concentrations of As, FF--, Mn, and U., Mn, and U.

• This rapid switch to deep well This rapid switch to deep well water is exposing hundreds water is exposing hundreds of millions of people in south of millions of people in south Asia to unsafe concentrations Asia to unsafe concentrations of metals.of metals.

• This has been called the This has been called the largest mass poisoning in largest mass poisoning in history.history.

WHO Guideline for Manganese in Drinking WaterWHO Guideline for Manganese in Drinking Water

• In 2011 the 400 µg/L drinking-water guideline for In 2011 the 400 µg/L drinking-water guideline for manganese (Mn) was discontinued with the manganese (Mn) was discontinued with the assertion that since “assertion that since “this health-based value is this health-based value is well above concentrations of manganese normally well above concentrations of manganese normally found in drinking-water, it is not considered found in drinking-water, it is not considered necessary to derive a formal guideline valuenecessary to derive a formal guideline value”.”.

• However, over 50 countries have drinking-water or However, over 50 countries have drinking-water or potential drinking-water supplies with Mn potential drinking-water supplies with Mn concentrations above 400 µg/L.concentrations above 400 µg/L.

• In Bangladesh alone, over 60,000,000 people are In Bangladesh alone, over 60,000,000 people are likely drinking water with Mn above 400 µg/L.likely drinking water with Mn above 400 µg/L.

• The WHO 2011 decision to discontinue the The WHO 2011 decision to discontinue the drinking-water guideline for Mn was based on a drinking-water guideline for Mn was based on a literature review that did not include any literature review that did not include any references on human toxicity published after 2001; references on human toxicity published after 2001; some recent studies suggest the former 400 µg/L some recent studies suggest the former 400 µg/L guideline may have been too high to protect public guideline may have been too high to protect public health.health.

• Since 2001, chronic exposure to Mn in drinking Since 2001, chronic exposure to Mn in drinking water has been correlated with neurological water has been correlated with neurological disorders ranging from learning disabilities in disorders ranging from learning disabilities in children to Mn-induced parkinsonism in adults, as children to Mn-induced parkinsonism in adults, as well as with all-cause cancer rates.well as with all-cause cancer rates.

• And high maternal Mn has been associated with And high maternal Mn has been associated with low birthweight and increased infant mortality.low birthweight and increased infant mortality.



• These findings were published in the peer-These findings were published in the peer-reviewed journal reviewed journal Environmental Health Environmental Health PerspectivesPerspectives by the National Institutes of Health by the National Institutes of Health and sent to Dr. Margaret Chan, the Director-and sent to Dr. Margaret Chan, the Director-General of the WHO.General of the WHO.


• Robert Bos, Coordinator for Robert Bos, Coordinator for Water, Sanitation, Hygiene Water, Sanitation, Hygiene and Health at the WHO and Health at the WHO replied, “replied, “Manganese is of Manganese is of aesthetic concern (taste, aesthetic concern (taste, odour, staining of laundry odour, staining of laundry and fixtures) at and fixtures) at concentrations around 0.1 concentrations around 0.1 mg/l [100 µg/L]. This may mg/l [100 µg/L]. This may lead to rejection of drinking-lead to rejection of drinking-water at concentrations well water at concentrations well below the WHO ‘health-below the WHO ‘health-based value’ of 0.4 mg/l [400 based value’ of 0.4 mg/l [400 µg/L].µg/L].””


• In other words, since In other words, since manganese might affect the manganese might affect the taste of drinking-water and taste of drinking-water and stain laundry and plumbing stain laundry and plumbing fixtures at less than 400 fixtures at less than 400 µg/L, it is assumed that a µg/L, it is assumed that a person will not drink such person will not drink such water, so a 400 µg/L water, so a 400 µg/L guideline is not needed.guideline is not needed.


• However, over 60,000,000 However, over 60,000,000 people in Bangladesh were people in Bangladesh were found to have been drinking found to have been drinking water with an average 940 water with an average 940 µg/L of manganese for 6 µg/L of manganese for 6 years in 1998 (Frisbie et al. years in 1998 (Frisbie et al. 2002).2002).

• In another study, people in western Bangladesh In another study, people in western Bangladesh were found to have been drinking water with 400 were found to have been drinking water with 400 µg/L to 2,400 µg/L of manganese for an average of µg/L to 2,400 µg/L of manganese for an average of 9 years in 2002 (Frisbie et al. 2009).9 years in 2002 (Frisbie et al. 2009).

• In 2011 the WHO In 2011 the WHO increased the drinking-increased the drinking-water guideline for water guideline for uranium from 15 µg/L to uranium from 15 µg/L to 30 µg/L.30 µg/L.

• The 30 µg/L health-based The 30 µg/L health-based guideline was calculated guideline was calculated using a “using a “no-effect groupno-effect group” ” with “with “no evidence of renalno evidence of renal

WHO Guideline for Uranium in Drinking WaterWHO Guideline for Uranium in Drinking Water

damagedamage” based on a study of human adults who ” based on a study of human adults who drank water with a median uranium concentration drank water with a median uranium concentration of 25 µg/L for an average of 16 years.of 25 µg/L for an average of 16 years.

• The following was published in the peer-reviewed The following was published in the peer-reviewed journal journal Environmental Science: Processes & Environmental Science: Processes & ImpactsImpacts by the Royal Society of Chemistry. by the Royal Society of Chemistry.


• However, this nominal “However, this nominal “no-effect groupno-effect group” had ” had statistically significant increases in diastolic blood statistically significant increases in diastolic blood pressure, systolic blood pressure, and glucose pressure, systolic blood pressure, and glucose excretion in urine.excretion in urine.

• Moreover, this “Moreover, this “no-effect groupno-effect group” was a ” was a subpopulation from a larger study that had subpopulation from a larger study that had statistically significant increases in calcium statistically significant increases in calcium fractional excretion, phosphate fractional fractional excretion, phosphate fractional excretion, diastolic blood pressure, systolic blood excretion, diastolic blood pressure, systolic blood pressure, and diuresis.pressure, and diuresis.

• These results suggest this group is not a true no-These results suggest this group is not a true no-effect group.effect group.


• Furthermore, the method used to calculate the no Furthermore, the method used to calculate the no observed adverse effect level (NOAEL) for the observed adverse effect level (NOAEL) for the current 30 µg/L health-based drinking-water current 30 µg/L health-based drinking-water guideline for uranium is illogical.guideline for uranium is illogical.

• The NOAEL was calculated by estimating the 95th The NOAEL was calculated by estimating the 95th percentile of exposure from the supposed no-percentile of exposure from the supposed no-effect group (1,094 μg/day), then an unspecified effect group (1,094 μg/day), then an unspecified bootstrap method was used to construct a 95% bootstrap method was used to construct a 95% confidence interval around this 95th percentile confidence interval around this 95th percentile (637-1,646 μg/day).(637-1,646 μg/day).

• The lower 95% confidence limit (637 μg/day) of the The lower 95% confidence limit (637 μg/day) of the 95th percentile of exposure was selected as the 95th percentile of exposure was selected as the NOAEL.NOAEL.


• This produces a NOAEL that is biased high and This produces a NOAEL that is biased high and not representative of the exposures experienced not representative of the exposures experienced by the study group.by the study group.

• The exposures experienced by this group would The exposures experienced by this group would have been better represented by a mean or have been better represented by a mean or median, which was a method previously used by median, which was a method previously used by the WHO and readily accepted by the scientific the WHO and readily accepted by the scientific community.community.

• Notably, the 637 μg/day NOAEL that was derived Notably, the 637 μg/day NOAEL that was derived by the WHO is over 12.5 times greater than the 50 by the WHO is over 12.5 times greater than the 50 μg/day median exposure of the nominal no-effect μg/day median exposure of the nominal no-effect group and yields a 30 µg/L drinking-water group and yields a 30 µg/L drinking-water guideline that is most likely too high to protect guideline that is most likely too high to protect public health.public health.


No.No. Ele.Ele. ppmppm No.No. Ele.Ele. ppmppm No.No. Ele.Ele. ppmppm No.No. Ele.Ele. ppmppm

112233445566778899

1010111112121313141415151616171718181919

OOSiSiAlAlFeFeCaCaMgMgNaNaKKTiTiHHPP

MnMnFF

BaBaSrSrSSCCZrZrVV

455,000455,000272,000272,00083,00083,00062,00062,00046,60046,60027,64027,64022,70022,70018,40018,4006,3206,3201,5201,5201,1201,1201,0601,060544544390390384384340340180180162162136136

2020212122222323242425252626272728282929303031313232

33a33a33b33b3535363637373838

ClClCrCrNiNiRbRbZnZnCuCuCeCeNdNdLaLaYY

CoCoScScNbNbNN

GaGaLiLiPbPbPrPrBB

1261261221229999787876766868666640403535313129292525202019191919181813139.19.199

393940404141424243434444454546464747

48a48a48b48b50505151525253535454

55a55a55b55b55c55c

ThThSmSmGdGdErErYbYbHfHfCsCsBrBrUU

SnSnEuEuBeBeAsAsTaTaGeGeHoHoMoMoWWTbTb

8.18.17.07.06.16.13.53.53.13.12.82.82.62.62.52.52.32.32.12.12.12.122

1.81.81.71.71.51.51.31.31.21.21.21.21.21.2

585859596060616162626363

64a64a64b64b666667676868696970707171

72a72a72b72b7474

75a75a75b75b

TlTlTmTm

IIInInSbSbCdCdAgAgHgHgSeSePdPdPtPtBiBiOsOsAuAuIrIrTeTeReReRuRuRhRh

0.70.70.50.5

0.460.460.240.240.20.2

0.160.160.080.080.080.080.050.05

0.0150.0150.010.01

0.0080.0080.0050.0050.0040.0040.0010.0010.0010.001

0.00070.00070.00010.00010.00010.0001

A Challenge for Drinking Water ScientistsA Challenge for Drinking Water ScientistsAbundance of elements in the earth’s crust.Abundance of elements in the earth’s crust.

Elements with WHO drinking water guidelines are red.Elements with WHO drinking water guidelines are red.

• Only 14 of 76 (18%) elements in the earth’s crust have a WHO drinking Only 14 of 76 (18%) elements in the earth’s crust have a WHO drinking water guideline. Many of the remaining elements are toxic and water guideline. Many of the remaining elements are toxic and commonly found in groundwater. More guidelines are needed.commonly found in groundwater. More guidelines are needed.

SourcesSourcesPrimary:Primary:

• Frisbie, S.H., D.M. Maynard, and B.A. Hoque. 1999. The nature and extent of Frisbie, S.H., D.M. Maynard, and B.A. Hoque. 1999. The nature and extent of arsenic-affected drinking water in Bangladesh. arsenic-affected drinking water in Bangladesh. InIn Metals and Genetics. Ed. by Metals and Genetics. Ed. by B. Sarkar. Plenum Publishing Company. New York, NY. Pp. 67-85.B. Sarkar. Plenum Publishing Company. New York, NY. Pp. 67-85.

• Frisbie, S.H., R. Ortega, D.M. Maynard, and B. Sarkar. 2002. The concentrations Frisbie, S.H., R. Ortega, D.M. Maynard, and B. Sarkar. 2002. The concentrations of arsenic and other toxic elements in Bangladesh’s drinking water. of arsenic and other toxic elements in Bangladesh’s drinking water. Environmental Health Perspectives. 110(11):1147-1153.Environmental Health Perspectives. 110(11):1147-1153.

• Frisbie, S.H., E.J. Mitchell, D.M. Maynard, R. Ortega, and B. Sarkar. 2004. Frisbie, S.H., E.J. Mitchell, D.M. Maynard, R. Ortega, and B. Sarkar. 2004. Arsenic and multimetal environmental contamination in Bangladesh. Clinical Arsenic and multimetal environmental contamination in Bangladesh. Clinical Biochemistry. 37:1126.Biochemistry. 37:1126.

• Frisbie, S.H., E.J. Mitchell, A.Z. Yusuf, M.Y. Siddiq, R.E. Sanchez, R. Ortega, Frisbie, S.H., E.J. Mitchell, A.Z. Yusuf, M.Y. Siddiq, R.E. Sanchez, R. Ortega, D.M. Maynard, and B. Sarkar. 2005. The development and use of an innovative D.M. Maynard, and B. Sarkar. 2005. The development and use of an innovative laboratory method for measuring arsenic in drinking water from western laboratory method for measuring arsenic in drinking water from western Bangladesh. Environmental Health Perspectives. 113(9):1196-1204.Bangladesh. Environmental Health Perspectives. 113(9):1196-1204.

• Frisbie, S.H., E.J. Mitchell, L.J. Mastera, D.M. Maynard, A.Z. Yusuf, M.Y. Siddiq, Frisbie, S.H., E.J. Mitchell, L.J. Mastera, D.M. Maynard, A.Z. Yusuf, M.Y. Siddiq, R. Ortega, R.K. Dunn, D.S. Westerman, T. Bacquart, and B. Sarkar. 2009. Public R. Ortega, R.K. Dunn, D.S. Westerman, T. Bacquart, and B. Sarkar. 2009. Public health strategies for western Bangladesh that address the arsenic, manganese, health strategies for western Bangladesh that address the arsenic, manganese, uranium and other toxic elements in their drinking water. Environmental Health uranium and other toxic elements in their drinking water. Environmental Health Perspectives. 117(3): 410–416.Perspectives. 117(3): 410–416.

SourcesSourcesPrimary:Primary:

• Mitchell, E.J., S.H. Frisbie, and B. Sarkar. 2011. Exposure to multiple metals Mitchell, E.J., S.H. Frisbie, and B. Sarkar. 2011. Exposure to multiple metals from groundwater—a global crisis: Geology, climate change, health effects, from groundwater—a global crisis: Geology, climate change, health effects, testing, and mitigation. Metallomics. 3(9): 874-908.testing, and mitigation. Metallomics. 3(9): 874-908.

• Bacquart, T., K. Bradshaw, S.H. Frisbie, E.J. Mitchell, G. Springston, J. Bacquart, T., K. Bradshaw, S.H. Frisbie, E.J. Mitchell, G. Springston, J. Defelice, H. Dustin, and B. Sarkar. 2012. A survey of arsenic, manganese, Defelice, H. Dustin, and B. Sarkar. 2012. A survey of arsenic, manganese, boron, thorium, and other toxic metals in the groundwater of a West Bengal, boron, thorium, and other toxic metals in the groundwater of a West Bengal, India neighbourhood. Metallomics. 7(4): 653–659.India neighbourhood. Metallomics. 7(4): 653–659.

• Frisbie, S.H., E.J. Mitchell, H. Dustin, D.M. Maynard, and B. Sarkar. 2012. World Frisbie, S.H., E.J. Mitchell, H. Dustin, D.M. Maynard, and B. Sarkar. 2012. World Health Organization discontinues its drinking-water guideline for manganese. Health Organization discontinues its drinking-water guideline for manganese. Environmental Health Perspectives. 120(6): 775-778.Environmental Health Perspectives. 120(6): 775-778.

• Frisbie, S.H., E.J. Mitchell, and B. Sarkar. 2013. World Health Organization Frisbie, S.H., E.J. Mitchell, and B. Sarkar. 2013. World Health Organization increases its drinking-water guideline for uranium. Environmental Science: increases its drinking-water guideline for uranium. Environmental Science: Processes & Impacts. 15:1817–1823.Processes & Impacts. 15:1817–1823.

• Frisbie, S.H., E.J. Mitchell, and B. Sarkar. Urgent need to reevaluate latest Frisbie, S.H., E.J. Mitchell, and B. Sarkar. Urgent need to reevaluate latest World Health Organization guidelines for toxic metals in drinking water. (World Health Organization guidelines for toxic metals in drinking water. ( InIn review.)review.)

• Bacquart, T., S.H. Frisbie, E.J. Mitchell, L. Grigg, C. Cole, and B. Sarkar. Bacquart, T., S.H. Frisbie, E.J. Mitchell, L. Grigg, C. Cole, and B. Sarkar. Multiple toxins contaminating the groundwater of Mingyan Township, Multiple toxins contaminating the groundwater of Mingyan Township, Myanmar: Arsenic, manganese, fluoride and uranium. (Myanmar: Arsenic, manganese, fluoride and uranium. (InIn preparation). preparation).

Secondary:Secondary:

• 76th New York State Volunteers. Available: 76th New York State Volunteers. Available: http://www.bpmlegal.com/76NY/76greenn.html [cited 28 April 2011].http://www.bpmlegal.com/76NY/76greenn.html [cited 28 April 2011].

• Ayerza, A. 1918. Arsenicismo regional endémico. Bol Acad Nac Medicina. (1): Ayerza, A. 1918. Arsenicismo regional endémico. Bol Acad Nac Medicina. (1): 11-24.11-24.

• Brace, S. 1995. Bangladesh. Thomson Learning. New York, NY. P. 9.Brace, S. 1995. Bangladesh. Thomson Learning. New York, NY. P. 9.

• Central Intelligence Agency. Available: Central Intelligence Agency. Available: https://www.cia.gov/library/publications/the-world-factbook/geos/bg.html [cited https://www.cia.gov/library/publications/the-world-factbook/geos/bg.html [cited 8 June 2011].8 June 2011].

• Dhaka Community Hospital, and R. Wilson. Pictures of Sufferers (Chronic Dhaka Community Hospital, and R. Wilson. Pictures of Sufferers (Chronic Arsenic Poisoning). Available: Arsenic Poisoning). Available: http://phys4.harvard.edu/~wilson/arsenic_project_pictures2.html [cited 7 http://phys4.harvard.edu/~wilson/arsenic_project_pictures2.html [cited 7 September 2002].September 2002].

• Greenwood, N.N., and A. Earnshaw. 1989. Chemistry of the Elements. Greenwood, N.N., and A. Earnshaw. 1989. Chemistry of the Elements. Pergamon Press. New York, NY. Pp. 428-429, 1450-1455, 1496.Pergamon Press. New York, NY. Pp. 428-429, 1450-1455, 1496.

• Hrozba cholery je stále reálna. Available: http://www.bedekerzdravia.sk/?Hrozba cholery je stále reálna. Available: http://www.bedekerzdravia.sk/?main=article&id=72 [cited 28 April 2011].main=article&id=72 [cited 28 April 2011].

• International Centre for Diarrhoeal Disease Research, Bangladesh. Available: International Centre for Diarrhoeal Disease Research, Bangladesh. Available: http://www.icddrb.org/media-centre/multimedia/image-gallery [cited 21 June http://www.icddrb.org/media-centre/multimedia/image-gallery [cited 21 June 2011].2011].

SourcesSources

Secondary (Continued):Secondary (Continued):

• IRPMAIL.COM. Available: http://irpmail.com/2009/12/16/copenhagen-on-the-IRPMAIL.COM. Available: http://irpmail.com/2009/12/16/copenhagen-on-the-climate-change-front-line-in-bangladesh/ [cited 28 April 2011].climate-change-front-line-in-bangladesh/ [cited 28 April 2011].

• Knight, E.H. 1876. Knights American Mechanical Dictionary. Houghton, Mifflin Knight, E.H. 1876. Knights American Mechanical Dictionary. Houghton, Mifflin and Company. Boston, MA. Pp. 2645.and Company. Boston, MA. Pp. 2645.

• Peer Water Exchange. Available: http://peerwater.org/apps/15-Drinking-Water-Peer Water Exchange. Available: http://peerwater.org/apps/15-Drinking-Water-Project-Pimpri-hamlet-Block-Akole/attachments/41 [cited 28 April 2011].Project-Pimpri-hamlet-Block-Akole/attachments/41 [cited 28 April 2011].

• The Photographic Periodic Table of the Elements. Available: The Photographic Periodic Table of the Elements. Available: http://periodictable.com/ [cited 28 April 2011].http://periodictable.com/ [cited 28 April 2011].

SourcesSources

Discovering the Largest Mass Poisoning in History Arsenic, Manganese, Uranium, and Other Toxic...

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