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

本研究项目考察了暴露于砷污染饮用水的不断变化的地理位置，以及由此产生的呼吸系统疾病和肺功能受损对人类健康的影响。利用疾病政治生态学框架和空间统计方法，该项目的目标是调查导致和维持砷暴露及其对健康影响的社会、经济、政治和环境因素。研究结果预计将通过扩大对多个因素如何相互交叉以在空间和时间上创造和减轻有毒物质暴露风险的理解来推进健康和医学地理学知识。这种知识的进步将通过突出重点地点和风险群体，对政策评价和未来减灾战略的规划产生重要影响。虽然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地下水砷中毒的地区，包括智利，台湾和美国部分地区。 砷自然存在于孟加拉国的沉积物中，但由于当地地质的变化，其空间变异性很大。与此同时，家庭和个人对砷的暴露因社会、经济和政治因素而异，这些因素影响着威尔斯的使用和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以及它们在空间和时间尺度上的变化。在这种背景下，本研究是由三个主要问题：（1）如何砷暴露在孟加拉国农村地区的空间，时间和社会/人口因素的变化？(2)哪些因素影响家庭获取未受污染水源的行为？(3)慢性砷暴露对肺功能和呼吸系统疾病有什么影响？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。这些技术将共同强调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。除了新颖的结果，本研究的理论框架将提供一个例子，将地理理论的人与环境的相互作用和政治生态学的健康研究，提高未来的研究。

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.