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There is a growing discussion about the possibility of arsenic mitigation measures in Bengal and similar areas leading to undesirable substitution of water-borne-pathogen attributable risks pathogens for risks attributable to arsenic, in part because of uncertainties in relative pathogen concentrations in supplied and end-use water. We try to resolve this discussion, by assessing the relative contributions of water supply and end-user practices to water-borne-pathogen-attributable risks for arsenic mitigation options in a groundwater arsenic impacted area of West Bengal. Paired supplied arsenic-mitigated water and end-use drinking water samples from 102 households were collected and analyzed for arsenic and thermally tolerant coliforms [TTC], used as a proxy for microbiological water quality, We then estimated the DALYs related to key sequelae, diarrheal diseases and cancers, arising from water-borne pathogens and arsenic respectively. We found [TTC] in end-use drinking water to depend only weakly on [TTC] in source-water. End-user practices far outweighed the microbiological quality of supplied water in determining diarrheal disease burden. [TTC] in source water was calculated to contribute <1% of total diarrheal disease burden. No substantial demonstrable pathogen-for-arsenic risk substitution attributable to specific arsenic mitigation of supplied waters was observed, illustrating the benefits of arsenic mitigation measures in the area studied.

water

Diarrhoeal Health Risks Attributable to Water-Borne-Pathogens in Arsenic-Mitigated Drinking Water in West Bengal are Largely Independent of the Microbiological Quality of the Supplied Water