Arsenic, Kidney diseases and what to do about it.
Posted on April 21st, 2013

by Anura Alahakone, USA

I would like to make some comments on the article entitled `Arsenic and Lysenkoism‘ published by Dr. Anura Wijesekera in the Lankaweb (20-April)-2013). Dr. Wijesekera lists a number of possible causes proposed by various scientsts regarding `Chronic Kidney disease of Unkonwn origin’ (CKDU).  However, I think he has failed to mention one of the simplest and most plausible explanations (and the associated cure) for CKDU given by a reputed scientist that appeared in the Daily News, and indeed even in the Lankaweb (http://www.lankaweb.com/news/items/2012/09/08/ncp-kidney-disease-thinking-outside-the-box/) on September 8th, 2012.

The explanation suggested by Professor Chandre Dharmawardana in his Daily News (12-Sept-2012) and Lankaweb articles is that we have to go beyond looking at pollutants in drinking water to understand CKDU. Life-style issues are equally important. The same type of fertilizers (with small mounts of As, Lead, Cadmium etc.) are used all over the country, and especially in the tea growing districts. However, high levels of CKDU are NOT found in those areas. Furthermore, CKDU seems affect predominantly male workers in the age range of 18-65 years. The graphs for the incidence of the illness in very vulnerable groups like children, old-aged, and women are sharply and strikingly lower than for male workers, almost in very district where CKDU has been observed.

Today it is well known that many illnesses like Gout, kidney stones, nephrotoxic conditons, and even simple skin-dehydration etc., arise if you do not consume AT LEAST eight glasses of water a day. if you are a person who stands in the sun, then you need even more water. The simple suggestion is that workers (mostly male) sitting on their tractors (or otherwise) working in the fields and bearing the hot sun do not consume enough water (of whatever quality) to allow their kidneys to do their normal function of flushing out the bodily toxins. It is easy to understand that a man already in the middle of the field does not want to interrupt his work and come back to the `niyara’ (edge of the field) just to drink a glass of water. In the end, there are many workers who consume only about four glasses of water during a hot eight-hour work period. This is simply NOT enough for the healthy working of a human kidney of a normal man of, say  60 kilos.

So the simple solution is to encourage all workers in the fields to take a two-liter bottle of water (eight cups) when they go to the field, and keep sipping water. Since a male bladder can easily store about one liter of water, he/she does not need to urinate except at his lunch break and at the end of the afternoon. I found this solution to CKDU, as well the explantion of CKDU in terms of low-intake of drinking water by the working male to be the most plausible explanation of why CKDU mostly affects male workers, and not women, children and old people who stay at home and drink the usual amount of water, while not subject to the dehydrating influence of working in the sun.

of course, a lot of people have got hung up on there being polluants like As, Pd (lead), Cd (Cadmium) etc., in water, perhaps  because you can link it to a conspiracy theory. However, the WHO experimental results give us a different picture DE-emphaizing Arsenic to within the margin of error of about 2% of the samples.  Dr. Shanthi Mendis, spokesperson for  the WHO project on CKDU has  asserted that:

studies done so far on drinking water samples from Anuradhpura, Polonnaruwa and Badulla had shown that Cadmium and Lead were within normal limits. Arsenic and cadmium had been analyzed in 118 water samples and 99 of those samples had been taken from drinking water sources believed to cause CKDU. In three of those samples, arsenic levels were above WHO standards (Island Newspaper, 28-Aug-2012)“.

So, in three out of 118 samples, i.e., in 2.5% of the samples we have a slight excess of As. This is also within the scatter and error bars of such experiments. Hence Arsenic cannot be the main culprit or even a minor culprit. Furthemore, the WHO standard (in parts per billion)  is simply an arbitrary amount that they have put in to safe-guard their liability,  since we know that many naturally occurring water streams and fountains  that people have used from time immmemorial have ten times as much Arsenic. That is, the WHO standard has no scientific basis either!

What is required is not just continuing to debate about methodology, or politicizing the question (as was the case with Lysekno in Marxist Russia), but acting to save the male worker in CKDU striken areas. This requires (i) disrtibution of water bottles to the workers – please do not use polluting plastic bottles (ii) education of the workers about the minimum amount of water needed by a healthy person (at least eight glasses per working day, and more at night if possible). Professor Dharmawardana, as well as others like Prof. C. Weeraratne of Rajarata University who wrote following him have made similar, more detailed suggestions as to how to get water to the workers so that they DRINK IT while wroking in the hot sun.

So, CKDU specific to to working males is a result of their inadequate consumption of water during their working hours. I find this to be the most plausible of all the ideas so far presented about CKDU.

7 Responses to “Arsenic, Kidney diseases and what to do about it.”

  1. Lorenzo Says:

    If arsenic was there naturally WITHOUT AGROCHEMICALS, people would have died in millions in the past when our agriculture based capital was in Anuradhapura!!

    It never happened.

  2. jayasiri Says:

    Dear Mr.Anura Alahakone……….Very happy to meet you. I am also suffering some kidney problems, but have steady results for the last 4 years. I live in Canada, but originally from Colombo.

    YES I will also take your advice & drink plenty of water. Just a matter of interest that you sign with one K, where as I sign with two KK in my surname.

    Would like to know more about you………Thanks…..Jayasiri A

  3. Ben Silva Says:

    As AA pointed out, reduced water intake could be a possibility. This should be investigated. CKDu has been going on for over 20 years. It is now getting severe. Surely, doctors would have suspected, reduced fluid intake as the cause some time back. Doctors such aS DR COORAY ARE VERY SMART AND KNOW THE AREA.
    In Punjab, aggro chemicals caused an epidemic of cancer. People have stopped using agro chemicals there. Google cancer train punjab for more information.
    In NCP, thwe irrigation system is peculiar, that water contaminated by agrocxhemicals is circulated.
    Shame that Lanka, a so called Buddhist country, is aLLOWING MANY TO DIE DUE TO LACK OF CLEAN WATER!
    mORE SHOULD BE DONE TO HELP THE VICTIMS AND TO PREVENT ckd.

  4. KidneyStone Symptoms Says:

    Kidney stones painfully sent me to my knees multiple times..

    http://kidneystonesymptomguide.blogspot.com

  5. aloy Says:

    Anura A, USA
    SL was referred to as the granery of the east during Apura/Polonnaruwa days. If males were affected during that time also there should be some references somewhere that some mysterious thing affected people. However that area got depopulated due to invasions in the past.
    Perhaps there is an attempt by some people now in 20-21st century. The reason for doing that is easy to find. Just go to Kandalama hotal and sit in a room with a panoramic view; the scene is breathtakingly beautiful. That is what our forefathers left for us. Anybody with means would like to have it, and it up to us to safeguard it.
    To exclude that posibility please collect statistics how people were affected in other areas like the East and other countries using agric inputs from the same source. I am surprised that nobody attemped that up to now.

  6. Fran Diaz Says:

    Here is a scholarly article about CKD, Cadmium (another poison) this time derived from fertilizer & the Mahaveli River :

    (Source: gisandscience.com)
    Pollution of River Mahaweli and Farmlands Under Irrigation by Cadmium from Agricultural Inputs Leading to a Chronic Renal Failure Epidemic among Farmers in NCP, Sri Lanka
    OCTOBER 31, 2011
    Environmental Geochemistry and Health, 2011, Volume 33, Number 5, Pages 439-453

    J. M. R. S. Bandara, H. V. P. Wijewardena, Y. M. A. Y. Bandara, R. G. P. T. Jayasooriya, and H. Rajapaksha

    “Chronic renal failure (CRF) associated with elevated dietary cadmium (Cd) among farming communities in the irrigated agricultural area under the River Mahaweli diversion scheme has reached a significantly higher level of 9,000 patients. Cadmium, derived from contaminated phosphate fertilizer, in irrigation water finds its way into reservoirs, and finally to food, causing chronic renal failure among consumers. Water samples of River Mahaweli and its tributaries in the upper catchment were analyzed to assess the total cadmium contamination of river water and the possible source of cadmium. Except a single tributary (Ulapane Stream, 3.9 μg Cd/l), all other tested tributaries carried more than 5 μg Cd/l, the maximum concentration level accepted to be safe in drinking water. Seven medium-sized streams carrying surface runoff from tea estates had 5.1–10 μg Cd/l. Twenty larger tributaries (Oya), where the catchment is under vegetable and home garden cultivation, carried 10.1–15 μg Cd/l. Nine other major tributaries had extremely high levels of Cd, reaching 20 μg Cd/l.

    (map showing – Upper River Mahaweli catchment and the tributaries of the river, depicting the sampling points)

    “Using geographic information system (GIS), the area in the catchment of each tributary was studied. The specific cropping system in each watershed was determined. The total cadmium loading from each crop area was estimated using the rates and types of phosphate fertilizer used by the respective farmers and the amount of cadmium contained in each type of fertilizer used. Eppawala rock phosphate (ERP), which is mostly used in tea estates, caused least pollution. The amount of cadmium in tributaries had a significant positive correlation with the cadmium loading of the cropping system. Dimbula Tea Estate Stream had the lowest Cd loading (495.9 g/ha/year), compared with vegetable-growing areas in Uma Oya catchment with 50,852.5 g Cd/ha/year. Kendall’s τ rank correlation value of total Cd loading from the catchment by phosphate fertilizer used in all crops in the catchment to the Cd content in the tributaries was +0.48. This indicated a major contribution by the cropping system in the upper catchment area of River Mahaweli to the eventual Cd pollution of river water. Low soil pH (4.5–5.2), higher organic matter content (2–3%), and 18–20 cmol/kg cation exchange capacity (CEC) in upcountry soil have a cumulative effect in the easy release of Cd from soil with the heavy surface runoff in the upcountry wet zone. In view of the existing water conveyance system from upcountry to reservoirs in North Central Province (NCP) through diversion of River Mahaweli, in addition to their own nonpoint pollution by triple superphosphate fertilizer (TSP), this demands a change in overall upper catchment management to minimize Cd pollution through agriculture inputs to prevent CRF due to elevated dietary cadmium among NCP farmers”.

    So both pesticides & fertilisers provide the poisons to produce CKD. Beware of use of these items or the Mahaveli River waters will be polluted even further.

    How did our ancestors manage to make LANKA the GRANARY OF THE EAST in those times when commercial pesticides & fertilisers were NOT available ?

  7. Fran Diaz Says:

    Some more points to bear in mind :

    * Note that all the rivers of Lanka start Upcountry. Just how much contamination happens in the various Upcountry Plantations
    as run offs from Tea plantations that may be using Fertilisers & Pesticides ?

    * Water & Soil samples should be regularly monitored for contamination in every Province or preferably District. This must be done by GoSL. Immediate action should be taken whenever contamination levels are unacceptable.

    * Rules & Regulations imposed to stop contamination of Rivers & Soil.

    * A Science Advisory Committee formed to advise the entire Parliament how to safeguard the water, air food supply, environment etc. of Sri Lanka and the surrounding sea area allocated to Lanka. Preventive Care should be emphasized.

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