The Telegraph
Monday , April 30 , 2012
Since 1st March, 1999
CIMA Gallary
Down to the bone

During a recent Air Force recruitment drive at Barrackpore, a large percentage of the 10,000 candidates who turned up were found to be suffering from bone ailments such as swan neck (deformed position of fingers), scoliosis (unnatural curving of the spine) and cubitus valgus (a condition where elbows are abnormally turned in).

“Insofar as candidates from Bengal are concerned, we are observing a worrying pattern over the past few years,” says a defence spokesperson for the region, who does not wish to be named. “Most candidates show various kinds of bone problems which can be considered a hurdle to recruitment.”

Apparently, in an earlier recruitment drive this year, about 50 per cent of the posts could not be filled as many failed the medical test because of deficiencies in bone structure. “Since most candidates were from the arsenic affected districts, we suspect groundwater contamination from the heavy metal can be responsible for the deficiencies,” says the spokesperson.

But scientists who have been studying the arsenic problem for decades disagree. While arsenic contamination is a problem, it is not known to affect bones, they argue.

Scientists have been ringing the alarm bells over dangerous levels of arsenic in groundwater in Bengal for the past 30 years or so. While the World Health Organisation stipulates that 10 microgram per litre is the accepted level of arsenic in water, researchers have found concentrations hovering around 50 microgram/litre and beyond in several districts of Bengal, including Murshidabad, Nadia, Malda, North 24-Parganas, South 24-Parganas, Howrah, Hooghly and Calcutta.

“We have found arsenic as high as 4,000 microgram per litre in some areas,” says Dipankar Chakraborti, director of the School of Environment al Studies at Jadavpur University, Calcutta. He adds that arsenic contamination starts at the Himalayas and its surrounding areas and is not confined to Bengal — it is rampant in the northern and eastern parts of the country as well. Arsenic poisoning is a grave cause of concern in Asian countries such as China, Taiwan, Bangladesh and Thailand as well.

Chakraborti has been a crusader against arsenic contamination for over 25 years. But he dismisses the armed forces’ claim that arsenic poisoning can lead to bone defects. “The most obvious manifestation of arsenic poisoning is skin lesion,” says Chakraborti. “There’s no direct effect on bones.”

Other medical experts also stress that there’s no documentary evidence to prove that arsenic is directly responsible for bone deformities. “There’s no correlation whatsoever — no skeletal or bone changes due to arsenic,” says K.C. Saha, former head of the department of dermatology, School of Tropical Medicine, Calcutta, who’s regarded as one of the pioneers of arsenic research in India.

Says Dr M.M. Roy, head of the orthopaedics department, Calcutta Medical College and Hospital, “We get many such cases sent to us by courts (candidates can appeal against the army’s rejection on medical grounds) to re-examine aspirants for bone deficiencies.”

Orthopaedic surgeon Dr Samar Gupta, who also dealt with such cases when he was attached to SSKM Hospital, says, “We didn’t find any bone problems in army aspirants that can be attributed to arsenic — malnutrition is the more likely source of these problems.”

All in all, experts maintain that there’s rarely any research that gives damning proof that arsenic directly attacks bones. But a team of researchers at Taiwan’s Kaohsiung Medical University has come up with a paper showing arsenic trioxide interfering with bone remodelling. This experiment however, involves rats only and is yet to be accepted internationally.

Chakraborti thinks it unfair of the armed forces to reject candidates because of an assumption that arsenic is affecting bone structure. “On what scientific basis are they rejecting candidates from Bengal? They can just point out deformities without attributing these to arsenic without valid proof,” he says.

The defence spokesperson admits that they didn’t have the wherewithal during the recruitment rallies to scientifically prove that bone deformities were mainly due to arsenic. “We screen thousands of applicants in a very short span of time,” he explains.

So if not arsenic, what can be the cause of these bone deformities? Some feel fluorosis can play a role. Fluoride in the groundwater causes fluorosis and its clinical effects can include abnormal tooth enamel in children and joint pain and deformity of the limbs and spine in adults.

According to a paper authored by Dr Roy, who is studying fluorosis, 19 states in India are fluoride-affected and the number is likely to increase. “Fluoride directly affects bones,” he says. Dr Roy adds that in some villages in Birbhum he has found fluorosis co-existing with arsenic contamination.

A rather tenuous link with arsenic but there it is.