Ramly et al. 2023 — Arsenic in drinking water, hair biomonitoring, and arsenicosis in Perak, Malaysia
This comparative cross-sectional study investigated arsenic contamination in drinking water and chronic arsenic exposure in residents of two villages in Perak, Malaysia, where a water treatment plant (WTP) serving the exposed village had reported violations of the 0.01 mg/L arsenic standard. Of 395 household drinking water samples, 41 percent from the exposed village (Village AG) exceeded the 0.01 mg/L threshold, while no samples from the non-exposed village (Village P) exceeded this level. Among 639 hair samples, 85 individuals (13.5%) had arsenic levels above the 1 µg/g reference, concentrated in Village AG. Physical examination confirmed 18 residents with arsenicosis signs, all from Village AG. Female sex, increasing age, residence in Village AG, and smoking were significantly associated with elevated hair arsenic.
Key numbers
- Drinking water arsenic: 41% of Village AG samples > 0.01 mg/L (WHO/national standard); 0% in Village P
- Hair arsenic: 85/639 (13.5%) participants > 1 µg/g; predominance in Village AG
- Arsenicosis cases: 18 confirmed (Village AG only)
- n water = 395 (198 Village AG, 197 Village P); n hair = 639 (324 Village AG, 315 Village P)
- Arsenic analyzed by ICP-MS; speciation not performed (total arsenic reported)
- WHO drinking water standard: 0.01 mg/L (10 µg/L; 10 ppb)
- National Malaysia standard: 0.01 mg/L
Methods (brief)
Comparative cross-sectional study. Water samples from household taps; hair from scalp. Analysis: ICP-MS for total arsenic (no speciation). Physical examination by medical doctors for arsenicosis signs (hyperkeratosis, hypomelanosis, hyperpigmentation). Logistic regression for factors associated with hair arsenic. Data collection 2018–2019.
Implications
Certification: Demonstrates that municipal water treatment failures at the source level (mining/timber/agriculture along river catchment) translate to arsenicosis in end-user communities; relevant to supply-chain water source risk and ingredient water sourcing. Courses: Real-world arsenicosis case study with matched biomonitoring and clinical data. App: Southeast Asia drinking water arsenic exposure data point.