| ObjectivesTo investigate the effects of water improvement on the occurrence and development of endemic arsenic poisoning disease and the relationship between the pathema and the levels of arsenic exposure by analyzing the people who live in the village which has improved water for 20 years as compared to those who live in the area where has high level of arsenic in water. Observe the results of B ultrasound, electrocardiogram, blood pressure of the residents who live in these two areas, and discuss the diseases types of these abnormal inspection and the characteristics of long-term hazards. In addition, the results can provide evidence for alleviating the symptoms and evaluating the treatment of the chronic arsenic poisoning patients.Methods43 people lived in the village which had improved water for 20 years in Datong Shanxi were chosen as water improvement group; 167 people lived in the area has high level of arsenic in water were chosen as exposure group. The diagnosis of endemic arsenic poisoning was based on Standard of endemic arsenic poisoning diagnose WS/T 211-2001 State of illness was obtained by using investigation tables, interrogation and physical examination. Arsenic in water and urine were tested using atomic fluorescence spectrometry and the concentration of arsenic modified with urine creatinine, all the experiments were completed by the same lab assistants. Professional medical staff operate the examination of B ultrasound, electrocardiographic and blood pressure by using a portable B ultrasound machine, a portable ECG machine, and electronic sphygmomanometer. Likewise, the inspecting results were diagnosed by same people. The collected dates of questionnaire were input into the EpiDate database, and were analyzed by SPSS 17.0 software.Results1. The effects of water improvement on the occurrence and development of endemic arsenic poisoning disease:Concentration of arsenic in water was 9.53μg/L in water improvement group and meets the present national standard of drinking water. It ranged from 8.65 to 193.45μg/L in exposure group, and the median was 25.72μg/L. Concentration of urine arsenic in water improvement group was from 11.92 to 298.23μg/g creatinine and the median was 76.09μg/g creatinine, urine arsenic in exposure group ranged from 14.95 to 2748.38μg/g creatinine and the median was 170.77μg/g creatinine. The result of diagnosis of endemic arsenic poisoning was that 12 in 43 people were diagnosed in water improvement group, the ratio was 27.91%, and 86 in 167 people were diagnosed in exposure group, the ratio was 51.50%; concentration of water arsenic, urine arsenic and degree of chronic arsenic poisoning were positive related with each other(P<0.001).2. Results of clinical examinations:B ultrasound examination of water improvement group had 23 abnormal results. There were 18 cases about liver,3 cases about renal,2 cases about gallbladder, and 4 people about hepatobiliary; The exposed group contained 53 abnormal results, in which the liver abnormality was 23, renal abnormality was 10,25 people were about gallbladder lesion, spleen abnormality was 1,6 people were about hepatobiliary abnormality, and 1 people had disease both of renal and liver. Electrocardiographic examination of water improvement group had 8 abnormal results,5 people were T wave abnormality,1 had aerial fibrillation,1 had atrioventricular block, and 1 person was diagnosed as low voltage. The exposed group had 55 anomalies, of which 14 cases had ST segment changes,9 had T wave abnormality, Q wave appeared in 3 people,5 cases were diagnosis as low voltage,2 had P wave abnormality,15 people were abnormal heart rate,5 had atrioventricular block, and 2 people had FPVC. It showed that there were 26 people about abnormal systolic pressure in examination of blood pressure of control group, and 16 cases were diastolic pressure anomaly.79 people had systolic pressure anomaly in the exposed group, and 34 had abnormal diastolic pressure. The abnormal results of blood pressure of water improvement group were higher than those in the exposed group. But the difference has no statistical significant (P> 0.05).Conclusions1. The state of endemic arsenism illness was still progressing after water mitigation; concentration of urine arsenic just reflect the real-time arsenic exposure of water; In addition to arsenic exposure of water, ther possible routes of exposure should be considered when determine health standard of arsenic exposure of endemic arsenic poisoning.2. There is no significant change on the abnormal rate of ECG, type-B ultrasonic,and blood pressure check after water mitigation, it shows that there may be other pathogenic factors except arsenic exposure; The abnormal rate of ECG in the residents without skin damage is lower than it in the residents with skin damage, but there is no difference in the abnormal rate of type-B ultrasonic and ECG between the two groups of people.3. Water mitigation play an important role in preventing and treating endemic arsenism scientifically, but the relevant organs and systems of arsenic poisoning ward residents can’t be ameliorated completely. Beyond that, symptomatic treatment is also essential for the individual ward resident with chronic conditions. |
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