Drinking water is derived from a variety of sources. These resources include Surface water (rivers, lakes, reservoirs, ponds), Groundwater (aquifers), and Rainwater. The presence of arsenic varies in each source. Higher arsenic contamination is found in ground waters as a result of the influence of water-rock interactions and the greatest tendency in aquifers for the physical and geochemical conditions to be favourable for arsenic mobilization and accumulation. Drinking water poses the greatest risk to human health due to the various sources of arsenic in the environment. In natural waters arsenic is mostly found as oxyanions of trivalent arsenite [As (III)] or pentavalent [As (V)]. Arsenic enters the atmosphere through inputs from wind erosion, volcanic emissions, low temperature volatilization from soils, marine aerosols, pollution and is returned to the earth’s surface by wet and dry deposition. Arsenic is present in copper and lead ores and smelting these metals can release airborne arsenic compounds to settle on the ground and solubilize by rain to contaminate the soil and groundwater (DEQ, 2003). A number of large aquifers in various parts of the world have been identified with problems of arsenic contamination with concentrations above 50 ppb, the most noteworthy occurrences are in parts of Argentina, Bangladesh, China, Northern China, Hungry, India (West Bengal), Mexico, Romania, Taiwan and many parts of the USA.

Arsenic contaminated water may lead to serious health hazards when used for drinking, washing and food preparation. Arsenic is difficult to detect while ingesting, as it is tasteless, odorless and colorless. The effects are not immediately visible and people can absorb significant quantities of Arsenic without any immediate health complications. Generally, a healthy person will withstand the arsenic poison for a longer period than an undernourished or weak person who will perish quickly. Similarly, children are more vulnerable sensitive. Arsenic can damage the nervous system and is also carcinogenic as it can cause various types of cancer. It is also Teratogen as it can enter the metabolic system of newborn children. According to EPA in Arsenic Rule Benefit Analysis, August 9, 2001 (Aapo Saak, 2001), following diseases are suspected to be caused or aggravated by arsenic in drinking water.

1. Cancer of the lungs, bladder, skin, prostate, kidney, nose and liver

2. Still births

3. Post neonatal mortality

4. Ischemic heart diseases (heart attack)

5. Diabetes mellitus

6. Nephritis (chronic inflammation of kidneys)

7. Nephritis (degenerative kidney diseases)

8. Hypertension, hypersensitive heart disease

9. Emphysema, Bronchitis

10. Chronic airway obstruction

11. Lymphoma (tumors in the lymph)

12. Black foot disease and developmental deficit.

The Department of Health and Human Services (DHHS), USA has determined that arsenic is a known carcinogen. Breathing inorganic arsenic increases the risk of lungs cancer (Tahir, M.A, 2000). Ingesting inorganic arsenic increases the risk of skin cancer and tumors of the bladder, kidney, liver and lungs. According to a news report on April 19, 2001, a team of EPA scientists at Carolina has discovered a direct link between DNA damage and arsenic compounds presence. The research demonstrates how a human cell own metabolic response to arsenic exposure produce compounds that cause genetic damage. Early clinical symptoms of acute intoxication of arsenic include:

• Abdominal pain, vomiting, diarrhea

• Muscular pain and weakness

• Flushing of the skin

Signs of chronic arsenicalism include dermal lesions (corns or warts on the palm, soles and torso), Peripheral neuropathy, Skin cancer and Lymphoma. Peripheral vascular disease has been observed in population ingesting arsenic contaminated drinking water (Figure-3).

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Symptoms of skin cancer and Lymphoma caused by Higher Arsenic concentration in drinking water

In March, 1999 the National research Council (NRC) of USA has released a new study suggesting that there may be increased risk of long-term health effects from exposure to arsenic at levels as low as 2 ppb (James and Patrick, 1999).

3.3.1 Case Study - I

Abdul Lateef Son of Ali Gohar Khuhro resident of Mohd-Jo-Wahan Village, Union Council Jado Wahan, Taluka Gambat District, Khairpur health technician at Basic Health Unit, Jado Wahan tells that, “myself and four children developed kidney and skin infection during the last two years. I was treated by many doctors but do not cure properly”. When SAFWCO team visited UC Jado Wahan for drinking water quality survey, we learnt that the presence of Arsenic in drinking water cause many diseases and has also effects on skin and kidney. “When water of our house was tested by volunteers, we came to know that water used for drinking contains higher amount (100 ppb) of Arsenic. I did not believe and went to the Secretary UC for testing the same water, he also tested and confirmed the presence of same degree of Arsenic. Again SAFWCO team tested the same water and found almost the same level of contamination. After that we stopped using the contaminated water and used water from another source having no Arsenic. After few weeks, myself and my children felt some improvement in the kidney disease, whereas skin infection had been subsided.”

3.3.2 Case Study - II

Mr. Hamzo Khan Son of Imam Bux Sheikh aged 45 years resident of village Daro Waleed Sheikh Union Council; Mondar Taluka Dadu District Dadu tells that counselor of Union Council informed that they are conducting drinking water survey in each village of Union Council to detect arsenic in drinking water. The presence of arsenic on drinking water causes serious consequences on health specially skin infections with severe pain. When Hamzo Khan saw the posters on arsenic, distributed by the team, he himself contacted the Counselor and insisted him for the analysis of his water. It was found that arsenic was available in his water. He felt that skin spots on his body were due to the drinking of arsenic contaminated water. SAFWCO team referred him to the local medical doctor who gave him medicine and stopped him from drinking contaminated water. Consequently, he got rid of his pain and felt comfortable.

3.3.3. Case Study - III

Ghulam Sarwar Soomro, teacher aged 52 years resident of village Mahtani, Union Council Agra Taluka Gambat, District Khairpur had skin disease for the last 40 years. He was consulting so many specialists for the cure but has got no relief. I drink water from my house hand pump since long. When I was involved in arsenic drinking water quality survey, I come to know through the training of SAFWCO team that presence of arsenic in water causes skin infection specially on the palm of the hand and the soul of feet. After the end of training, I met with the team for further information. When I came back at my home and tested the water of our house hand pump and found presence of arsenic in positive range (0.1 mg/lt). I requested the team for testing the same source, when they tested the water, the results were the same.  Now I feel that this skin disease is due to presence of such amount of arsenic in drinking water.

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