Human Health and Industrial Pollution - PDF document

Human Health and Industrial Pollution AcknowledgementsMany of the researchers at the Bangladesh Centre for AdvancedStudies (BCAS) were involved in collecting, translating, summarisingand analyzing the data for this study.In particular, Lucky and Rita shouldbe thanked for doing much of the fieldwork, as should Jilani whocoordinated the work.The research owes much to the input of Sufia Islam, the leadresearcher, for her training of the team and the long hours she spenttranslating and writing up the findings.Th

anks also go to Dr.Moinul Islam Sharif who has provided advice andguidance during the work.The researchers also wish to express their gratitude to the communitiesand health workers who gave up their valuable time to be interviewed.Their honesty over delicate medical subjects and their willingness toshare their experiences and knowledge was invaluable.It is hoped thatthis short and limited study will be a start in raising awareness of thehealth impacts of pollution in Bangladesh and may lead to somesolutions.N

uffield Centre for International Health and Development, Institute of HealthSciences and Public Health Research, University of Leeds, United KingdomStockholm Environment Institute, University of York, United KingdomCentre for Natural Resources Studies, Bangladesh Bangladesh Centre for Advanced Studies, Bangladesh Acronyms and AbbreviationsARIAcute Respiratory InfectionBOD5Biological Oxygen DemandBRACBangladesh Rural Advancement CommitteeCODChemical Oxygen DemandEPZExport Processing ZoneFCPSFellow College of

Physicians and SurgeonsDFIDDepartment for International DevelopmentDoEDepartment of EnvironmentGDPGross domestic productGNPGross national productGOBGovernment of BangladeshiPRSPInterim Poverty Reduction Strategy PaperMACHManagement of Aquatic Ecosystems through CommunityHusbandryMBBSBatchelor of Medicine and Surgery (MBBS) PAHPolyaromatic hydrocarbons PCBPolychlorinated biphenyls PCPpolychlorinated phenols PRAParticipatory rural appraisalPHCPrimary health careRMGReady-made garmentRRARapid rural appraisalSEHDS

ociety for Environment and Human DevelopmentTHCThana Health ComplexUHCUpazila Health Complex USAIDUnited States Agency for International DevelopmentBeel Shallow, seasonal lakeKhalCanalImamIslamic priest 8 Choosing an Effluent Treatment Plant and Clemett, 2002).Consequently, whilst Bangladesh is, in industrialterms, a relatively undeveloped country, Òthe problem of localisedpollution is alarmingÓ(SEHD, 1998);a situation that is compounded bythe high population density of the country.Kaliakoir Thana in Gazipur

District to the north-east of Dhaka is onesuch industrial cluster where rapid, unplanned industrial expansion hasled to serious local pollution.This area was historically an important ricegrowing area but its close proximity to Dhaka has gradually led to moreindustries locating there over the past 15 years.There are now severaltypes of industry in the area including a tannery, poultry farms andpharmaceutical industries but it is dominated by textile manufacturers,including dyeing and printing units.The Manage

ment of Aquatic Ecosystems through CommunityHusbandry (MACH) project, funded by the GOB and USAID, which aimsto enhance community-based wetlands and water resourcemanagement, first reported water pollution5 problems in the Kaliakoirarea in 1999 (MACH, 2001).The project undertook some initial pollutionstudies of the area, which identified the local industries as the mainpolluters.Further water quality analysis was conducted under the Department forInternational Development (DFID) funded project ÒManaging Pollu

tionfrom Small Scale Industries in BangladeshÓ.Samples were taken atvarious stages of the production process, at the outlets of factories, thekhal (canal) that forms the main conduit for waste for the industries, andMokesh Beel (shallow lake), into which the khal discharges.During thedry season the khal is the only source of water to the beel.The beelthen links to the Turag-Bangshi River.The results of sampling from theproduction processes show that effluent from the factories generallyhave high biological ox

ygen demand (BOD), very high chemical oxygendemand (COD) levels, and also contain high levels of sodium sulphate,ethanoic acid, reactive dyes, and detergents (Chadwick et al., 2003).Sampling in the beel also shows high levels for the same pollutants, 10 Choosing an Effluent Treatment PlantWater pollution is the degradation of water quality, as measured by biological,chemical, or physical criteria, that can make water unsuitable for desired usessuch as bathing, drinking or fishing, and can have serious effects

on the healthof humans and animals through contact or ingestion (Mason, 2002) 12 Choosing an Effluent Treatment Plant 14 Choosing an Effluent Treatment Plant an overview of the key environmental issues in Bangladesh.It showedthat treatment of industrial waste was considered a low priority and thatdue to the absence of strong preventative measures and lack ofawareness, the practice of discharging untreated industrial waste intowater bodies was almost universal.The serious public health problemsthat this coul

d create have so far been minimized as the waste wasdiluted and flushed from water bodies during the rainy season.Howeveras industrial expansion has continued since the 1980s, acute localizedpollution is now threatening the sustainability of the resource base andTo address rising concern the National Environmental Policy wasapproved in 1992 and the National Environmental Action Plan wasdeveloped.In 1995, the Bangladesh Environment Protection Ordinancewas enacted.Environmental objectives were also contained in

thegovernmentÕs Fourth Five Year Plan (1990-1995) and are present in thePerspective Plan (1996-2010).A plan of action for food safety and aninter-ministerial committee for coordinating and monitoring food safetyare operational.Yet, despite these policy initiatives, little has changedin practice.One of the main difficulties is that environmentalgovernance is limited with the principle institution, the Department of theEnvironment, having limited human and financial resources to tackle theproblem. Choosing an

Effluent Treatment Plant 18 Choosing an Effluent Treatment Plant facilities, and the FGDs and in-depth interviews with the localcommunities and health care professionals, were undertaken.Following analysis of the data, a series of consultation workshops wereheld with local communities to present the findings.3.1.1 Community Perceptions of Health TrendsThe project identified 15 villages in the Kaliakoir area that are locatedwithin a few kilometres of the industries and whose residents are partlyor wholly depen

dent, directly and indirectly, on Mokesh Beel, KalidohoBeel and adjacent water sources.A total of 15 FGDs were conductedincluding one in each of the 15 villages (Table 1), of which three werewith women in Shinaboho, Kaliadoho and Sholahati villages.Sixteen in-depth interviews were also conducted, one in each village and one withthe Upazila Health and Family Planning Officer from the KaliakoirUpazila Health Complex (UHC).Table 1:Selected Villages and Population in 2001VillageTotal populationMaleFemaleHarin Hat

i394722461701Ratanpur6---Purba Chandra745443353119Shafipur1088358835000Mazukhan1399715684Karalsurichala1495817678Amdair1196601595Sholahati520263257Matikata1279686593Bagambor665340325Kaliadaho460240220Gobindapur/Gopinpur919486433Taltali760405355Kouchakuri431222209Sinaba/Sinaboho1548799749Source:Bangladesh Bureau of Statistics (BBS), 2001 20 Choosing an Effluent Treatment PlantNo data was available for Ratanpur visit the pharmacy or local doctor for minor complaints such asdiarrhoea and skin problems, but trave

l to the UHC for more serioushealth problems.There are also two Thana Health Complexes (THCs)in the area but discussions with community members suggested thatthe villagers living around Mokesh Beel rarely visited these.Ten healthprofessionals were interviewed in the study area and one from a nearbyarea where the local population do not use the water bodies impactedby the industrial waste.The respondents were asked to identify the five most common healthproblems that they saw in the past year.They were then gi

ven 50counters and were asked to make piles next to each disease accordingto its prevalence.For those health workers who had been in the areafor several years, this process was repeated for five and 10 years ago 22 Choosing an Effluent Treatment Plant 24 Choosing an Effluent Treatment Plant The disease pattern recorded in the UHC reflects the prevalence andtrend of the diseases identified during interviews.Diarrhoea, acuterespiratory infection (ARI), skin diseases and ulcers were amongst thehealth problems ex

perienced by the most number of people who attendthe health complex (Table 3).However, the total number of patients inthe UHC does not reflect the magnitude of the problem, because thevast majority of the patients in the study area were found to be usinglocal private doctors, traditional doctors or pharmacists as the first pointFigure 1:Number of times a health problem was listed in the top fivemost common in the 15 FGDs Figure 2:Percentage of villages ranking common health problemsby perceived frequency 26

Choosing an Effluent Treatment Plant The situation is of course also dependent on population growth, migrationand levels of awareness, which makes it impossible to conclude there haspopulation.National statistics do show a substantial increase in thepopulation but unfortunately these statistics are not available for the sametime periods - the UHC data being for the period 1998 to 2002 and thenational census for 1991 and 2001 (Figure 4).Calculation of a linear annual population increase between 1991 and2001 ho

wever gives an annual increase of six percent.This translatesinto a population increase between 1998 and 2001 of approximately 19percent.Over the same period there has been an overall decline in thenumber of reported cases of diarrhoea (down 19 percent) and ofmalnutrition (down by 35 percent) but an increase in the reported casesdiseases, which was up by 42 percent.This implies that the rate ofincrease in cases of peptic ulcer and anaemia may have been above therate of population increase but that other healt

h problems have declinedin relative terms.Figure 4:Trend of population in Kaliakoir between 1974-2001 based 28 Choosing an Effluent Treatment PlantSee Annex A for the village data used to compile this figure.Source:Bangladesh Bureau of Statistics, 2001 The health workers then scored these, distributing a possible total scoreof 50 across the five health problems.The mean of these scores showsthat skin disease, diarrhoea and gastric ulcer are not only cited the mostnumber of times but also gain the highest mean

score (Table 4),therefore being perceived as both frequent within villages and commonTable 4:Average score given by health workers for prevalence of healthproblemsHealth problemSum of scoreMeanRankscore ±SDaSkin disease787.80±3.521Diarrhoea 767.60 ±4.622Gastric ulcer757.50 ±8.093Fever504.10±5.674Cold, cough 444.40±5.825Dysentery404.00 ±5.726Cold cough and feverb80.80 ±2.537A.R.I161.60±5.068Pneumonia151.50±3.179Indigestion141.40±2.9510Amoebiosis121.20 ±3.711Chicken pox101.00 ±3.1612Hypertension101.00±3.1612Ac

ute abdomen101.00±3.1612Spermatorrhoea80.80±2.5313Gout80.80±2.5313Pregnancy80.80±2.5313Dysentery and diarrhoea60.60±1.9014Head ache50.50±1.5815Shigela50.50±1.5815n = 10 total number of interviewsSD- standard deviationMean score and standard deviation was calculated using Minitab 12In this interview cold, cough and fever was treated as a single healthproblem as even after questioning the health worker was unable toseparate them and considered them to be a problem that alwaysoccurred together. 30 Choosing an Ef

fluent Treatment Plant fishermen are mainly affected as they work in the water.The pollutantsfrom industries are responsible for it.Pollutants from industries enter inthe Turag River through the khal and beel and end up here.LocalHealth Complex and Department of Environment should take theinitiative to stop the pollutionÓ(Barai bari health worker).4.3.2 Diarrhoea and DysenteryThe majority of the respondents also blamed the lack of propersanitation systems, poultry farm waste and lack of knowledge abouthygiene

for diarrhoea and dysentery, which are frequent amongchildren, slum dwellers and factory workers.Diarrhoea is one of themost prevalent health problems reported to be suffered by children,being ranked first in six of the FGDs.Gastric ulcers have been identified as a common health problem forworkers in the area, including factory workers.The doctors and healthworkers interviewed felt that this was due to irregular eating habits andthe length of time between meals.Many studies confirm theoccupational health pro

blems associated with working in the textiledyeing industry in Sanganer, including that by Usha (1984) which notesthe high incidences of not only skin problems but also asthma, chronicbronchitis, tuberculosis, bladder cancer and irritation of the eyes.The trend of health problems over the past 10 years was alsoresearched in the interviews and it appears that the five health problemscited as being the most prevalent now have increased in their relativeprevalence over that period (Figure 6).Some of the health w

orkers feltthat in absolute terms there were fewer cases of health problems suchas dysentery and diarrhoea simply because there were fewer peopleliving in the area, as many people have migrated to work in the factories.However, in relative terms they felt that diseases have increased.ÒI did not see many patients with skin diseases in the past, anddysentery and diarrhoea have increased a lot in the area...The lack ofcleanliness and also eating fish from polluted water is the main causeof this disease...Pollute

d water from industry is responsibleÓ(Sinabohointerview).The disparity between this anecdotal evidence relating to diarrhoea anddysentery and the data collected from the UHC may be that the UHCcovers an area much larger than the Mokesh Beel area and includes 32 Choosing an Effluent Treatment Plant 4.3.4 Malnutrition The majority of participants in the FGDs claimed that the diseases thatof contaminated water or because of reduced food intake, which someattribute to the pollution.Respondents said rice productio

n haddecreased in the area and fish catches in the beel had declined this is,in their opinion, due to water pollution and is causing a depletion of foodand nutrition for the community.ÒWe were well-off because we used to supply fish to the whole region ofDhaka and Gazipur but now there is less fish in the Mokesh-Kalidohobeels.Moreover, if people know that these fish are from Mokesh Beel,they do not buy because the taste is not good.We are now suffering -both physically (due to illnesses and lack of fish) and

financiallyÓ(Fisherman in Gupinpur).The respondents generally agreed that the fish from Mokesh Beel donot taste good and smell of a Òkerosene-likeÓsubstance.Participantssaid that this problem started about 10 to 15 years ago after theestablishment of the industries.Data collected by the MACH project on fish catch and consumptionsuggest that fish yields and consumption in the villages has in factincreased but this is not the perception of the local community membersinterviewed.One explanation may be that altho

ugh fish production maynow be increasing due to interventions by the MACH project, the marketfor fish from the area is facing difficulties.What is clear is over the lasttwo dry seasons major fish kills have taken place in the project fishsanctuaries that are generally thought to be the consequence ofindustrial pollution (Daily Star, 6th April 2004).Effects of malnutrition such as anaemia, protein deficiency syndromeand general weakness were reported in the interviews to be commonamongst adults and children in

the study area.Malnutrition can alsoaggravate the risks of other diseases caused by water pollution and mayincrease vulnerability to the effects of exposure.4.3.5 Maternal and Child HealthSpecific questions asked about maternal health care suggested thatthere has been an increase in complications during childbirth. 34 Choosing an Effluent Treatment Plant due to the rise in the problems being faced by them.People in 11 of the15 FGDs stated that the majority of births now took place at medicalcentres, with man

y respondents saying that approximately 80 percent ofbirths take place there, whereas in the past they would have beendelivered at home.The community members with whom discussionswere held in the villages of Amdair, Harinhati and Sinabaha, specificallysaid that the reason for going to hospital was the rise in the number ofcaesareans that were required.However, discussions at the UHCrevealed that caesareans have only taken place there since 2001.There are cases of physically deformed children in the study area

butwith out comparison with statistics across Bangladesh it is difficult todetermine whether these were above average.The participants of thefemale FGDs in Sinaboho said that there were three cases of deformedchildren in their village.In Taltoli village the FGD participants reportedthat there were at least three disabled babies (two were unable to stand,walk or speak) born in their village but they later died at the age of one,three and five years.In Amdair the participants mentioned that a childhad been bor

n one month before the interviews with only one leg andhand.There were several such cases report across the village but it isdifficult to determine the cause or true extent of the problem.Evidencefrom empirical studies in India and elsewhere however demonstrate thattextile waste does have mutagenic activity.Mathur et al.(2004)performed mutagenicity tests samples of ground water, surface waterand effluent discharge from factories using the Salmonella/microsomereversion assay using the plate incorporation proce

dure.They foundthat both surface water and end of pipe samples had mutagencicityratios higher than 2.0 and therefore indicate that they may havemutagenic effects.Similar finding were reported by McGeorge et al.(1984) for textile effluents and a study by Sanchez et al.(1988) showedthat of various industrial categories tested, the textile industrycontributed the highest percentage (67 percent) of mutagenic effects(Mathur et al., 2004).4.4 Domestic Water-related Activities Currently more than 95 percent of the v

illagers were found to be usingtube well water for drinking and day-to-day household activities, andrespondents said that there were no problems collecting water from atubewell if they did not have their own.Only in Gupinpur was it found thatthe number of tube wells was less than adequate and people were usingbeel and river water for household activities including washing cloths 36 Choosing an Effluent Treatment Plant and in this way agricultural production is being impacted by theindustrial pollution and may

be accumulating pollutants.Severalrespondents involved in agriculture stated that the polluted sediment isresponsible for their poor crop yields.Similarly in Jaipur, India it wasfound that drainage water and the dry bed of the drainage channel fromindustries, including textile industries, could not be used for agricultureor recreational purposes (Mathur et al., 2004).4.5 Economic Migrants and Lack of Infrastructure The population around Mokesh Beel ecosystem is about 300,000 withan average family size of 5.3

.The inhabitants are mostly farmers orfishermen but there are an increasing number of economic migrantsliving in the villages.An important trend appears to be peopleembarking on new income generating activities.For example, somepeople are shifting away from agricultural production and instead areestablishing, and renting out, semi-pucca Òbarrack-typeÓaccommodation to factory workers on land that was previouslycultivated.However, the accommodation is generally of poor quality andfacilities such as sanitation a

re inadequate.As a result, the localenvironment is being polluted due to the waste and excreta created bythe additional people in the village.It was observed by the field teamsthat certain areas around villages appear to be acting as areas for opendefecation with large amounts of excreta visible.ÒWe had only 13 families with average 6 or 7 members per family in ourvillage about 10 years ago, now we have more than 500 inhabitants,most of them are industry-related workers and traders who have comefrom outside.T

hey are living in overcrowded, congested, rentedaccommodation with limited facilities.In some cases, around 50 peopleshare only one tube-well and two or three latrinesÓ(Elderly resident,Harinhati village).Several respondents also referred to the problem of increasingpromiscuity and an increase in sexually transmitted infections.Thehealth workers also mentioned genitor-urinary problems but were moreinclined to relate this to women sitting for too long in factories, notemptying their bladders regularly enough a

nd not practicing adequatepersonal hygiene, due to lack of facilities.4.6 Health Services Delivery and Awareness Raising Activities 38 Choosing an Effluent Treatment Plant 40 Choosing an Effluent Treatment Plant 42 Choosing an Effluent Treatment Plant dysentery are unlikely to be caused directly by the industrial effluent, asthey are usually the result of microbial contamination.However, thehigh level of in-migration to the area is putting considerable pressure onpoor sanitation infrastructure and may be incr

easing the risk ofcontracting communicable diseases.None of these findings have been confirmed with rigorousepidemiological studies.Further research studies, includingepidemiological studies, are necessary to determine better the impactthat industry is having on the environment and the people who interactwith it.Such evidence is crucial in if policy makers and industry ownersare going to be influenced to control and mitigate for environmentalIn order to improve the situation interventions both at the national

andlocal levels are required.The implementation of legislation on safetyprecautions, banning toxic chemicals and pollutant concentrations inindustrial discharges into water sources are all required.Currently, mostdyeing units in the Kaliakoir area and across Bangladesh are in breachof the Environmental Conservation Act.However, the Department ofEnvironmental due to financial, human and political reasons does notAn Information, Education and Communication campaign would bebeneficial in providing an understand

ing in the community about risksand possible ways to minimise them, and to inform the Bangladeshpublic of the problems. 44 Choosing an Effluent Treatment Plant Bureau of Statistics, Dhaka, Bangladesh.BBS (2004) Fisheries Statistical Yearbook 2003-2004.BangladeshBaxter, P.(1990) Review of major chemical incidents and their medicalmanagement.In:Murray V (Ed) Major Chemical Disasters- medicalaspects of treatment.Royal Society of Medicine, 1990, pp 7-20, London,Berry, B.J.L.and F.E.Horton (1974) Urban Environment

alManagement.Prentice Hall International Inc., London, UK.Bhattacharya, D., Kabir, B.N.and K.Ali (1995), Industrial Growth andPollution in Bangladesh:A sectoral Analysis, Paper presented in theSymposium ÒEnvironment and Sustainable Development with SpecialReference to BangladeshÓ.North-South University, Dhaka, Bangladesh.Bhattacharya, R.N.(2001) Environmental Economics:An IndianPerspective (Eds).Oxford University Press, 2001 ISBN:01956556-7,New Delhi, India.Chadwick M.T.and A.E.V.Clemett (2002) Managing Pollu

tion fromSmall- and Medium-Scale Industries in Bangladesh:Project Proposal.Stockholm Environment Institute, York, UK.Chadwick M.T.and A.E.V.Clemett (2003) Managing Pollution fromSmall- and Medium-Scale Industries in Bangladesh:Inception Report.Stockholm Environment Institute, York, UK.CPREEC (2001) Pollution and Health:A CPREEC Booklet Series.C.P.REnvironmental Education Centre (CPREEC), 2001.Available at:http://cpreec.org, New Delhi, India.Daily Star (6th April 2004) Turag Fish Die as Mills Dump Waste, Dhaka

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ries of Sanganer,Jaipur (India):a case study.Ecotoxicology and Environmental Safety,61, pp.105-113.OhioEPA (2002) Pollution Prevention Opportunities for PBT Chemicals:Chromium and Chromium Compounds.State of Ohio EnvironmentalProtection Agency, Ohio, USA.http://www.epa.state.oh.us/opp/mercury_pbt/fact91.pdfOkada, M.and S.A.Peterson (2000) Water Pollution Control Policy andManagement:The Japanese Experience.Gyosei, (ISBN4-324-06240-4), Japan.Penney, J.(1993) Report ÒBackground Information on CadmiumPoisoning i

n Support of a Fact Sheet for Lay adjudicatorsÓPrepared forthe Occupational Disease Panel (Industrial Disease Standards Panel)Ministry of Labour, July 1993.Ontario, Canada.http://www.canoshweb.org/odp/html/cadmium.htm#p1Revenga, C., Brunner, J., Henniger, N., Kassem, K., and R.Payne(2000) Pilot Analysis of Global Ecosystems:Freshwater Systems.WorldResource Institute, Washington DC, USA.SEHD (1998) Bangladesh Environment:Facing 21st Century, FirstEdition.Society for Environment and Human Development (SEHD)Publ

ications, Dhaka, Bangladesh.Sheridan, W.D.(1996) Reference Data Sheet for Aluminium.MeridianEngineering and Technology Inc., Glenview, IL, USA.Shiklamanov, I.A.(1997) Comprehensive assessment of theFreshwater Resources of the World:Assessment of Water Resourcesand Water Availability in the World.World Meteorological Organisationand Stockholm Environment Institute (SEI) Stockholm, Sweden.Smith, W.E.and Smith, A.M.(1975) Minamata.Holt, Rinehart andWinston.New York, USA.Taylor, R.and Smith, I.(1997) State of New

ZealandÕs Environment1997.The Ministry for Environment.Wellington, New Zealand.http://www.mfe.gov.nz/about/publications/ser/front.pdf Choosing an Effluent Treatment Plant Total populationYear1974 1981 1991 2001 unpublishedVillage :Harin HatiNot available2033303947Union :MouchakThana :KaliakairDistrict :GazipurVillage :RatanpurNot availableNot availableNotavailableNot availableUnion :MouchakThana :KaliakairDistrict :GazipurVillage :Purba ChandraNot available53815247454Union :MouchakThana :KaliakairDistric

t :GazipurVillage :Shafipur6152362278810883Union :MouchakThana :KaliakairDistrict :GazipurVillage :Mazukhan113958714121399Union :MouchakThana :KaliakairDistrict :GazipurVillage :Karalsurichala5016789671495Union :MouchakAnnex A:Population Census 50 Choosing an Effluent Treatment Plant Village:Taltali416528684760Union:MouchakDistrict:GazipurVillage:Kouchakuri112958210350431Union:MouchakDistrict:GazipurVillage:Sinaba/Sinaboho8169289641548Union:MouchakDistrict:GazipurTOTAL719587871257632956 Choosing an Efflue