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Effect of an Arsenic Mitigation Program on Arsenic Exposure in American Indian Communities: A Cluster Randomized Controlled Trial of the Community-Led Strong Heart Water Study Program.
- Source :
-
Environmental Health Perspectives . Mar2024, Vol. 132 Issue 3, p037007-1-037007-11. 11p. - Publication Year :
- 2024
-
Abstract
- BACKGROUND: Chronic arsenic exposure has been associated with an increased risk of cardiovascular disease; diabetes; cancers of the lung, pancreas and prostate; and all-cause mortality in American Indian communities in the Strong Heart Study. OBJECTIVE: The Strong Heart Water Study (SHWS) designed and evaluated a multilevel, community-led arsenic mitigation program to reduce arsenic exposure among private well users in partnership with Northern Great Plains American Indian Nations. METHODS: A cluster randomized controlled trial (cRCT) was conducted to evaluate the effectiveness of the SHWS arsenic mitigation program over a 2-y period on a) urinary arsenic, and b) reported use of arsenic-safe water for drinking and cooking. The cRCT compared the installation of a pointof- use arsenic filter and a mobile Health (mHealth) program (3 phone calls; SHWS mHealth and Filter arm) to a more intensive program, which included this same program plus three home visits (3 phone calls and 3 home visits; SHWS Intensive arm). RESULTS: A 47% reduction in urinary arsenic [geometric mean (GM)=13.2 to 7.0 μg/g creatinine] was observed from baseline to the final follow-up when both study arms were combined. By treatment arm, the reduction in urinary arsenic from baseline to the final follow-up visit was 55% in the mHealth and Filter arm (GM=14.6 to 6.55 μg/g creatinine) and 30% in the Intensive arm (GM=11.2 to 7.82 μg/g creatinine). There was no significant difference in urinary arsenic levels by treatment arm at the final follow-up visit comparing the Intensive vs. mHealth and Filter arms: GM ratio of 1.21 (95% confidence interval: 0.77, 1.90). In both arms combined, exclusive use of arsenic-safe water from baseline to the final follow-up visit significantly increased for water used for cooking (17% to 53%) and drinking (12% to 46%). DISCUSSION: Delivery of the interventions for the community-led SHWS arsenic mitigation program, including the installation of a point-of-use arsenic filter and a mHealth program on the use of arsenic-safe water (calls only, no home visits), resulted in a significant reduction in urinary arsenic and increases in reported use of arsenic-safe water for drinking and cooking during the 2-y study period. These results demonstrate that the installation of an arsenic filter and phone calls from a mHealth program presents a promising approach to reduce water arsenic exposure among private well users. [ABSTRACT FROM AUTHOR]
- Subjects :
- *WATER pollution prevention
*WATER analysis
*ARSENIC analysis
*ENVIRONMENTAL exposure prevention
*COOKING
*HOME care services
*RESEARCH funding
*EVALUATION of human services programs
*FILTERS & filtration
*STATISTICAL sampling
*RANDOMIZED controlled trials
*DESCRIPTIVE statistics
*WATER supply
*WATER security
*ODDS ratio
*ARSENIC poisoning
*MASS spectrometry
*ARSENIC
*CONFIDENCE intervals
*DATA analysis software
*NATIVE Americans
*COMMUNITY-based social services
*VIDEO recording
*REGRESSION analysis
Subjects
Details
- Language :
- English
- ISSN :
- 00916765
- Volume :
- 132
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Environmental Health Perspectives
- Publication Type :
- Academic Journal
- Accession number :
- 176607525
- Full Text :
- https://doi.org/10.1289/EHP12548