Social consequences of arsenicosis and mental health of arsenicosis patients: evidence from an arsenic-affected area of Bangladesh

Introduction: Arsenic contamination of groundwater along with millions of affected people is a challenge to global public health. Unfortunately Bangladesh is the most arsenic-affected country in the history of humankind. Thousands of arsenicosis patients suffer not only from multiple health sequelae but also from a number of social problems e.g. discrimination, stigmatisation, and hazardous family issues. These triggering factors can interrupt social harmony and networks and can cause anxiety for both patients and their families. This study aimed to report patients' perceptions and satisfactions regarding arsenicosis-related issues, family and social supports and their association with mental health. Methods: We analysed the data of 171 arsenicosis cases (aged 18+ years, males=88, females=83) who were interviewed from an affected-area of Faridpur district in 2009 using a semi-structured questionnaire. Mental health was assessed by asking a simple question „how do you rate your overall mental health (OMH)?“ and by employing five Likert-scale questions called „WHO (Five) Well-Being Index (WBI) (1998 version)“. We modelled poor mental health (not defined) by multivariable adjusted logistic regressions (MALR) using SPSS 17.0. Results: The poor OMH and poor WBI reported by the patients were 22.2% and 33.9% respectively. Poorer mental health were found among those patients e.g. who reported that they were considered as family burden, ignored by friends/relatives, excluded from social activities, and arsenicosis disease can increase poverty. A large number of patients expressed their dissatisfactions regarding e.g. their personal income (44%), supports from family members (38%), and supports from relatives/friends/community (42%). The MALR analyses also revealed significant associations between poor mental health and variables reflecting perceptions and satisfactions. Conclusion: At least one-fifth of arsenicosis patients suffered from poor mental health and associated with poor perceptions and dissatisfactions. Comprehensive strategies are needed to reduce wrong perceptions regarding arsenicosis-related issues and to improve their satisfactions by increasing e.g. family and social supports.