1. Evaluation of the Efficacy of a School-Based Educational Intervention for Reducing Arsenic Exposure in Bangladesh Joseph Graziano, Khalid Khan, Faruque Parvez Department of Environmental Health Sciences Pam Factor-Litvak Department of Epidemiology Xinhua Liu Department of Biostatistics Lex van Geen Lamont-Doherty Earth Observatory Kazi Matin Ahmed Department of Geology, Dhaka University

2. Known Health Effects of Arsenic Early/Immediate –Skin Lesions: Melanosis Keratosis Other Conditions –Diabetes Mellitus –Non-pitting edema –Respiratory lesions –Cognitive deficits –Black-foot Disease Late –Cancers: Skin Bladder Lung Liver –Neuro/Vascular: Hypertension Stroke Neuropathy

3. Purpose of the Earth Clinic Funding Install deep, safer wells at 18 elementary schools that have water As concentrations as high as 500 ug/L, far in excess of the WHO guideline of 10 ug/L. Evaluate a school-based educational intervention that encourages the use of wells that are relatively low in As and Mn.

4. Arsenic in 5,966 wells

7. Relationship Between Water Arsenic Concentrations and Intellectual Function

8. The Focus of this Earth Clinic Project is Education Concerning Arsenic and Health Arsenic has numerous adverse health effects, including effects on cognitive development of children. There is a lack of systematic education on arsenic in schools in Bangladesh. Until now, teachers have not been trained to disseminate knowledge about arsenic in class.

9. Baseline Questionnaire Survey School Based Intervention in Intervention Groups (B1, B2 & A) Classroom Based Education B1, B2 & A Follow Up (Urine Collection & Well Switching Info) Heavy Intervention (A) JG’s Child Study (Urine) N5=140 Intervention Groups B1 (Urine ) B2 (No Urine) N1=210 N2=210 Control Groups C1 (Urine) C2 (No Urine) N3=210 N4=210

10. Study Area: Elementary Schools in Araihazar Total Number of Schools = 28 18 Schools have As- contaminated wells!!

11. Educational Intervention: Basic Steps Teachers Children in Schools Study Trainer Posters, Books, Photographs, Art Competition

12. Update: Baseline Work Questionnaire Survey, Urine Collection and Well Testing for As & Mn Completed in December 2008, Data Entry is in Progress

13. Update: Intervention School Based Education Program has already started. Safer wells will soon be installed at the 18 schools and in both intervention and control villages, to provide them with safer drinking water.

14. Thank You