Making economic sense for arsenic mitigation: A case study of Comilla District, Bangladesh

A drinking water quality survey in 2009 provides an updated assessment of arsenic exposure in Bangladesh: an estimated 22 million remain exposed to concentrations above the national standard of 50 mu g/L. Recent epidemiological studies on local populations now demonstrate a dose-dependent response for arsenic exposure and all-cause mortality. Using these recently established mortality hazard ratios, as many as 1 in 14 adult deaths are attributable to arsenic exposure at 2009 levels, with fractions of deaths attributable to arsenic ranging from 0% to 17.1% among the 64 districts. This will incur a substantial economic burden: $ USD 5-16.5 billion in work output lost alone over the next 20 years. In hard-hit Comilla District the estimated economic losses due to arsenic exposure in drinking water at current levels are at least 10 times the costs of providing complete safe water coverage to the exposed population.