Doctoral Dissertation Research: Social and Spatio-Temporal Patterns of Arsenic Exposure and Effects

这项研究项目调查了接触受砷污染的饮用水的地理位置的变化，以及由此导致的呼吸系统疾病和肺功能受损对人类健康的影响。利用疾病政治生态框架和空间统计方法，该项目的目标是调查导致和长期接触砷及其对健康影响的社会、经济、政治和环境因素。这些研究成果预计将通过扩大对多种因素如何相互交织以在空间和时间上创造和减轻有毒暴露风险的理解，促进健康和医学地理领域的知识。这一知识的进步将对政策评估和未来缓解战略的规划产生重要影响，因为它突出了优先地点和面临风险的群体。尽管这项研究的重点是孟加拉国，但其研究结果将广泛适用于世界上许多报告受污染的地下水造成砷中毒的地区，包括智利、台湾和美国的部分地区。砷自然存在于孟加拉国的沉积物中，尽管由于当地地质的变化，砷具有很高的空间变异性。与此同时，由于社会、经济和政治因素的影响，家庭和个人接触砷的情况各不相同，这些因素既影响水井的使用，也影响水井开采受污染含水层的可能性。因此，了解砷暴露与人类健康之间的关系需要了解人类与环境的相互作用及其在空间和时间尺度上的变化。在这种背景下，本研究以三个主要问题为指导：(1)孟加拉国农村地区的砷暴露在空间上、时间上和社会/人口因素之间是如何变化的？(2)哪些因素影响家庭获取未受污染的水源的行为？(3)慢性砷暴露对肺功能和呼吸系统疾病的后果是什么？这项研究将为砷与健康的研究提供一种新的方法，将贝叶斯聚类检测模型与空间回归技术相结合。这些技术将共同突出持续砷暴露的风险因素和领域，以及砷暴露在肺部疾病中的作用。除了新的结果，这项研究的理论框架将为将人-环境相互作用和政治生态的地理理论纳入健康研究，改进未来的研究提供一个范例。

This research project examines the changing geographies of exposure to arsenic-contaminated drinking water and the resulting human health effects of respiratory disease and impaired lung function. Utilizing a political ecology of disease framework and spatial statistical methods, the objective of the project is to investigate the social, economic, political and environmental factors that lead to and perpetuate exposure to arsenic and its resulting health effects. The research findings are expected to advance knowledge within health and medical geography by expanding understanding about how multiple factors intersect to both create and mitigate risk of toxic exposures over space and time. This advancement of knowledge will have important important implications for policy evaluation and the planning of future mitigation strategies by highlighting priority locations and groups at risk. Although this research focuses on Bangladesh, its findings will be broadly applicable to many areas of the world reporting arsenic poisoning from contaminated groundwater including Chile, Taiwan, and parts of the United States. Arsenic occurs naturally in the sediments of Bangladesh, though with high spatial variability due to changes in local geology. At the same time, household and individual exposure to that arsenic varies due to social, economic, and political factors that influence both access to wells and the likelihood that a well taps a contaminated aquifer. Therefore, understanding the relationship between arsenic exposure and human health demands an understanding of human-environment interactions and how they vary across spatial and temporal scales. Situated in this context, this research is guided by three main questions: (1) How does arsenic exposure in rural Bangladesh vary spatially, temporally, and with social/demographic factors? (2) What factors influence a household's behavior to access an uncontaminated water source? (3) What are the consequences of chronic arsenic exposure for lung function and respiratory disease? The research will contribute a new methodological approach to the study of arsenic and health that combines a Bayesian cluster detection model with spatial regression techniques. Together these techniques will highlight risk factors and areas of persistent arsenic exposure and the role of arsenic exposure in lung disease. In addition to novel results, the theoretical framing of this study will provide an example for incorporating geographic theory on human-environment interactions and political ecology into health studies, improving future research.