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In this review, we summarize the current knowledge on exposure, metabolism, and health effects of arsenic (As) in residents from As-contaminated groundwater areas of Vietnam and Cambodia based on our findings from 2000 and other studies. The health effects of As in humans include severe gastrointestinal disorders, hepatic and renal failure, cardiovascular disturbances, skin pigmentation, hyperkeratosis, and cancers in the lung, bladder, liver, kidney, and skin. Arsenic contamination in groundwater is widely present at Vietnam and Cambodia and the highest As levels are frequently found in groundwater from Cambodia. Sand filter system can reduce As concentration in raw groundwater. The results of hair and urine analyses indicate that residents from these As-contaminated areas are exposed to As. In general, sex, age, body mass index, and As exposure level are significantly associated with As metabolism. Genetic polymorphisms in arsenic (+III) methyltransferase and glutathione-S-transferase isoforms may be influenced As metabolism and accumulation in a Vietnamese population. It is suggested oxidative DNA damage is caused by exposure to As in groundwater from residents in Cambodia. An epidemiologic study on an association of As exposure with human health effects is required in these areas.

This study presents a transnational groundwater survey of the 62,000 km(2) Mekong delta floodplain (Southern Vietnam and bordering Cambodia) and assesses human health risks associated with elevated concentrations of dissolved toxic elements. The lower Mekong delta generally features saline groundwater. However, where groundwater salinity is <1 g L(-)(1) Total Dissolved Solids (TDS), the rural population started exploiting shallow groundwater as drinking water in replacement of microbially contaminated surface water. In groundwater used as drinking water, arsenic concentrations ranged from 0.1-1340 microg L(-)(1), with 37% of the studied wells exceeding the WHO guidelines of 10 microg L(-)(1) arsenic. In addition, 50% exceeded the manganese WHO guideline of 0.4 mg L(-)(1), with concentrations being particularly high in Vietnam (range 1.0-34 mg L(-)(1)). Other elements of (minor) concern are Ba, Cd, Ni, Se, Pb and U. Our measurements imply that groundwater contamination is of geogenic origin and caused by natural anoxic conditions in the aquifers. Chronic arsenic poisoning is the most serious health risk for the ~2 million people drinking this groundwater without treatment, followed by malfunction in children's development through excessive manganese uptake. Government agencies, water specialists and scientists must get aware of the serious situation. Mitigation measures are urgently needed to protect the unaware people from such health problems.