A community-led water testing project comprised of households using private well water with high arsenic levels found that after installing filters and implementing a digital health program, participants' urinary arsenic levels decreased by an average of 47 percent. The new study was led by researchers at the Johns Hopkins Bloomberg School of Public Health, according to the report. During the 2-year study period, participating households received phone calls encouraging filter use and reminding them to replace their filter cartridges.
The study, a randomized controlled trial in American Indian communities in the northern Great Plains, conducted a so-called “point-of-use” study in households with private wells that had arsenic concentrations above the Environmental Protection Agency's recommended limit of 10 μg/L. Arsenic filters have been installed. . Each of the 50 households in the study had two faucets at the kitchen sink. One was an arsenic filter faucet for drinking and cooking water installed by a local plumber for investigation, and the other was the main kitchen faucet used for hand-washing and dishwashing.
Study participants also reported a significant increase in the exclusive use of arsenic-filtered water for drinking and cooking at home.
Researchers worked closely with community members, tribal organizations, and the Indian Health Service throughout program design and implementation to ensure that the program met community needs and to assess the potential for use of filters. Addressed barriers.
The findings were published online on March 27th. Environmental health perspective.
“This trial demonstrates the potential of such digital health intervention programs to reduce environmental exposures, which may help alleviate the costs associated with home visits to deliver the intervention.”Bloomberg School said Dr. Christine Marie George, professor in the School of Global Health. Co-lead author of this study.
According to the Environmental Protection Agency, about 2 million people in the United States use private wells with high arsenic levels. Rural and American Indian communities that rely on well water are disproportionately affected. Previous studies have shown links between arsenic exposure and the development of cardiovascular disease, diabetes, kidney disease, impaired lung function, and various cancers in Native American communities.
Researchers recruited households through a community-led water arsenic testing project for the randomized controlled trial, which found arsenic levels above EPA guidelines in 29 percent of 440 wells tested. . Of these, 114 households met eligibility criteria to participate in the study. Of these 114 households, 84 people from 50 of his households participated in the study.
Participating households were divided into two study groups, with 51 participants in group 1 (27 households) and 33 participants in group 2 (23 households). Arm 1 consisted of her POS filter installation with follow-up phone messages to encourage filter use. Arm 2 consisted of point-of-use filters, follow-up phone calls and text messages, as well as home visits from community members, supporting printed materials, and video community testimonials supporting the filters.
The study was conducted from July 2018 to May 2021. Tracy Zucker RN, field office director at American Indian-owned Missouri Breaks Industries Research and co-lead author of the study, led the study's recruitment and evaluation activities and conducted arsenic testing.
Arsenic levels in study participants were checked by urine samples taken at the start of the study and two years later. Overall, urinary arsenic levels decreased by an average of 47% during the 2-year follow-up period, with no significant difference between the two study groups. Households that reported exclusively using arsenic-free water to prepare food and drinks increased significantly from 11 percent at the beginning of the survey to 42 percent at the end of the survey. Additionally, there was no significant difference in this result between the study groups.
“It's very interesting that it worked just as well in a less intensive research arm that only provided phones and filters,” George says. “Additional research is needed to evaluate this digital health approach in other arsenic-affected environments in the United States and around the world.”
The authors believe this is the first randomized controlled trial study of an arsenic mitigation program in the Americas. George attributes much of the program's success to the collaboration between affected communities and researchers.
“Effects of arsenic mitigation programs on arsenic exposure in American Indian communities: A Cluster Randomized Controlled Trial of the Community-Led Strong Heart Water Research Program” written by Christine Marie George, Tracy Zucker, Kelly Endres, Francine Richards, lisa bear robe, David Harvey, Lyle G. Best, Reno Red Cloud, Annabelle Black Bear, Leslie Skinner, Christa Cuny, Anna Rule, Kellogg J. Schwab, Joel Gittelsohn, Ronald Grabonjat, Kathryn Schilling, Marcia O'Leary, Elizabeth D. Thomas, Jason Youmans, Zhu Jianhui Lawrence H. Moulton and Ana Navas-Assien.
This research was supported by the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH R01ES025135).
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Media Contact: Brandon Howard brandonhoward@jhu.edu or chris henry khenry39@jhu.edu
