Arsenic-contaminated groundwater and its potential health risk: A case study in Long An and Tien Giang provinces of the Mekong Delta, Vietnam

Assessment of water, sanitation, and hygiene services in district health care facilities in rural area of Mekong Delta, Vietnam

Access to sufficient water, sanitation, and hygiene (WASH) services is a crucial requirement for patients during therapy and general well-being in the hospital. However, in low- and middle-income countries, these services are often inadequate, resulting in increased morbidity and mortality of patients. This study aimed at assessing the current situation of WASH services in six District Health Care Facilities (DHCFs) in rural areas of the Mekong Delta provinces, Vietnam. The results showed that these services were available with inappropriate quality, which did not compromise the stakeholders' needs. The revealed WASH infrastructures have raised concerns about the prolonged hospital stays for patients and push nosocomial infections to a high level. The safety of the water supply was doubted as the high E. coli (> 60%) and total coliform incidence (86%) was observed with very low residual chlorine concentration (< 0.1 mg/L) in water quality assessment. Moreover, water supply contained a high concentration of iron (up to 15.55 mg/L) in groundwater in one DHCF. Technical assessment tool analysis proved that the improper management and lack of knowledge by human resources were the primary roots of the observed status WASH services. Improvement of the perceptions of WASH should be done for the hospital staff with collaboration and support from the government to prevent incidents in the future.

Anthropogenic Organic Pollutants in Groundwater Increase Releases of Fe and Mn from Aquifer Sediments: Impacts of Pollution Degree, Mineral Content, and pH

In many aquifers around the world, there exists the issue of abnormal concentrations of Fe and Mn in groundwater. Although it has been recognized that the main source of this issue is the release of Fe and Mn from aquifer sediments into groundwater under natural environmental conditions, there lacks enough reliable scientific evidence to illustrate whether the pollutants imported from anthropogenic activities, such as organics, can increase this natural release. On the basis of time series analysis and comparative analysis, the existence of an increasing effect was verified through laboratorial leaching test, and the impacts of aquatic chemical environment conditions, such as pH, on the effect were also identified. The results showed that the increase of organics in groundwater made the release of Fe and Mn more thorough, which was favorable for the increase of groundwater concentrations of Fe and Mn. The higher the contents of Fe- and Mn-bearing minerals in aquifer sediments, the higher the concentrations of Fe and Mn in groundwater after the release reaches kinetic equilibrium. Lower pH can make the leaching more thorough, but the neutral environment also increases the amount of Mn. It can be deduced that the pollutants such as organics imported by anthropogenic activities can indeed increase the releases of Fe and Mn from aquifer sediments into groundwater, thus worsening the issue of groundwater Fe and Mn pollution. The findings provide a deeper insight into the geochemical effects of Fe and Mn in the natural environment, especially in the groundwater system.

Arsenic level in bladder tumor of patients from an exposed population: association with progression and prognosis

Aims: To elucidate the impact of arsenic on progression and prognosis of bladder cancer. Patients & methods: Total arsenic in 145 tumors (80 non-muscle-invasive [NMIBC] and 65 muscle-invasive bladder cancer [MIBC]) was measured and associated with Ki67 expression, tumor-clinicopathological parameters and patient outcome. Results: Tumor arsenic concentration was higher in exposed than unexposed patients (256 μg/kg vs 77 μg/kg; p < 0.0001) and positively correlated (r = 0.65; p < 0.0001) with arsenic content of patient's drinking water. Arsenic concentration showed significant association with Ki67-overexpression (p = 0.001) and advanced tumor stages (NMIBC vs MIBC; p = 0.0009). In NMIBC, high tumor arsenic (>100 μg/kg) and Ki67 overexpression was established as predictors for recurrence (hazard ratio [HR]: 4.68; p = 0.005 and HR: 3.91; p = 0.018) and progression (HR: 6.04; p = 0.023 and HR: 6.87; p = 0.013). In MIBC, association of high arsenic remained significant with increased risk of recurrence (HR: 4.58; p = 0.04). Conclusion: In NMIBC, high arsenic and Ki67 overexpression and in MIBC, only high arsenic showed prognostic importance in predicting poor patient outcome.