Groundwater quality and human health risk assessment in selected coastal and floodplain areas of Bangladesh

Groundwater aquifers are a common source of drinking water in Bangladesh. However, groundwater contamination is a major public health concern across the country. This research aims to examine the groundwater quality and health concerns using a random sampling process. Multivariate statistical and health risk analyses of elements were performed to determine the source of contaminants and their effects on human health. A total of 24 parameters were analyzed, where Na⁺, NH₄⁺, K⁺, Mg²⁺, F^-, NO₃^-, Mn, Fe, Se, U, and As concentrations were found to be high in different sampling points compared to the Department of Environment of Bangladesh (DoE), and the World Health Organization (WHO) groundwater quality standards. Principal Component Analysis (PCA) and Cluster Analysis (CA) identified the dominant and potential sources of contaminants in the groundwater aquifer, including geogenic, salinity intrusion, industrial, and agricultural. The results of the degree of contamination level (C_d) and the heavy metal pollution index (HPI) showed that 28% and 12% of the sampling points had high levels of heavy metal contamination, indicating a high risk for human health issues. Cr concentrations were found to have a higher carcinogenic (cancer) risk than As and Cd concentrations. Hazard quotient (HQ) and hazard index (HI) scores expressed the hazardous status and possible chronic effects in the context of individual sampling points. For both child and adults, 44% and 36% of the sampling points had a high HI score, indicating the possibility of long-term health risks for local populations.

Experience of Chikungunya in a Chikungunya Clinic at Tertiary Medical College Hospital in Bangladesh

A large outbreak of Chikungunya occurred in Bangladesh in 2017. It caused a serious impact on sufferers of the disease. Study aimed to assess the real scenario unfolding as case reporting to Directorate General of Health is less in Bangladesh by physicians. For this observational study a Chikungunya Clinic was set at Dhaka Medical College, Dhaka, Bangladesh and physicians were attached to the clinic who got training on Chikungunya by directorate General of Health from 9th July 2017 to 10th September 2017. A pre-tested questionnaire was supplied to all the physicians working at the clinic. Appropriate training was provided before data collection. Total 301 patients were enrolled. Most striking features were fever (99.3%), arthralgia (99.3%), rash 70.4%, Itching 64.8%, oral ulcer 23.9%, loose motion 18.6% and bleeding 8%.%. Most affected joints were MCP 76.9%, knee 74.9%, wrist 69.2%, Inter phalangeal joints of hand were 67.2%. Chikungunya was not very familiar with the physicians of Bangladesh. This was first time large scale experience by physicians of Bangladesh. Severity and chronicity of arthritis, rash, bleeding caused serious morbidity.

An illicit economy: scavenging and recycling of medical waste

This paper discusses a significant illicit economy, including black and grey aspects, associated with medical waste scavenging and recycling in a megacity, considering hazards to the specific group involved in scavenging as well as hazards to the general population of city dwellers. Data were collected in Dhaka, Bangladesh, using a variety of techniques based on formal representative sampling for fixed populations (such as recycling operatives) and adaptive sampling for roaming populations (such as scavengers). Extremely hazardous items (including date expired medicines, used syringes, knives, blades and saline bags) were scavenged, repackaged and resold to the community. Some HCE employees were also observed to sell hazardous items directly to scavengers, and both employees and scavengers were observed to supply contaminated items to an informal plastics recycling industry. This trade was made possible by the absence of segregation, secure storage and proper disposal of medical waste. Corruption, a lack of accountability and individual responsibility were also found to be contributors. In most cases the individuals involved with these activities did not understand the risks. Although motivation was often for personal gain or in support of substance abuse, participants sometimes felt that they were providing a useful service to the community.

Quantitative assessment of medical waste generation in the capital city of Bangladesh

There is a concern that mismanagement of medical waste in developing countries may be a significant risk factor for disease transmission. Quantitative estimation of medical waste generation is needed to estimate the potential risk and as a basis for any waste management plan. Dhaka City, the capital of Bangladesh, is an example of a major city in a developing country where there has been no rigorous estimation of medical waste generation based upon a thorough scientific study. These estimates were obtained by stringent weighing of waste in a carefully chosen, representative, sample of HCEs, including non-residential diagnostic centres. This study used a statistically designed sampling of waste generation in a broad range of Health Care Establishments (HCEs) to indicate that the amount of waste produced in Dhaka can be estimated to be 37+/-5 ton per day. The proportion of this waste that would be classified as hazardous waste by World Health Organisation (WHO) guidelines was found to be approximately 21%. The amount of waste, and the proportion of hazardous waste, was found to vary significantly with the size and type of HCE.