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Ning Y, Wang C, Li S, Chen S, Zhang F, Zhou R, Yuan Y, Lv X, Wu Y, Zhang Y, Fan Z, Li X, Guo X, Shi Z, Liu Y, Chen F, Bai G, Liu X, Li Y, Bai A, Zhang Q, Dai H, Wang Y, Chen P, Wang X. Combating coal-burning-borne endemic arsenism in Shaanxi Province, Northwest China: The impact of high-arsenic coal ban, improved cook-stoves, and health education. JOURNAL OF HAZARDOUS MATERIALS 2024; 478:135421. [PMID: 39126853 DOI: 10.1016/j.jhazmat.2024.135421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/03/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
To eliminate the epidemic of coal-burning-borne endemic arsenism (CBBA), our study organized and implemented comprehensive measures including high-arsenic coal ban, improved cook-stoves, and health education. We also aimed to promote the application value of these measures in preventing and controlling CBBA to the world. From 2004 to 2005, through a stratified random sampling method, we selected 58,256 individuals to investigate the prevalence of CBBA and the arsenic levels in 1287 environmental and biological specimens. The prevalence of CBBA was 19.26 % and significantly associated with the arsenic levels in coal, pepper, corn and hair, which were at or exceeded national upper limits. To timely prevent and control the disease, the comprehensive measures have been implemented since 2005 to present. Comparison and correlation analyses were utilized to evaluate the effectiveness of these measures in reducing the prevalence of CBBA. According to statistics, 73 high-arsenic coal mines were banned and over 99 % households in endemic areas accepted stove improvements and diversified health education. Monitoring studies during 2010-2019 has confirmed that these measures led to a decrease in urine arsenic levels among endemic residents, and they developed novel dietary practices, such as properly drying, storage, and washing of food. Additionally, the awareness rate of CBBA increased from less than 70 % to over 95 %. Finally, the prevalence of CBBA has decreased to 0.153 % investigated by a census involving 2.076 million endemic residents in 2019. In summary, CBBA in northwest China has been successfully controlled through banning on high-arsenic coal, introducing improved cook-stoves, and providing health education.
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Affiliation(s)
- Yujie Ning
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Chaowei Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Shujin Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Sijie Chen
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Feiyu Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Rong Zhou
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Yuequan Yuan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Xi Lv
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China
| | - Yifan Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China
| | - Yu Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China
| | - Zhongxue Fan
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China.
| | - Xiaoqian Li
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China.
| | - Xiong Guo
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; NHC Key Laboratory of Environment and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P. R. China; Clinical Research Center for Endemic Disease of Shaanxi Province, the Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xi Wu Road, Xi'an, Shaanxi 710004, P. R. China
| | - Zhi Shi
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Yanli Liu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China
| | - Feihong Chen
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China
| | - Guanglu Bai
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Xiaoli Liu
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Yue Li
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Aimei Bai
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Qingping Zhang
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Hongxing Dai
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Yaofei Wang
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Ping Chen
- Shaanxi Provincial Centre for Disease Control and Prevention, Xi'an 710054, P. R. China
| | - Xi Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, P. R. China.
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