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An Effective Dietary Survey Framework for the Assessment of Total Dietary Arsenic Intake in Bangladesh: Part-a—ffq Design

Nasreen Islam Khan
Department of Geography and Environment, Dhaka University, Dhaka 1000, Bangladesh

Gary Owens
Centre for Environmental Risk Assessment and Remediation (CERAR), University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA 5095, Australia

David Bruce
The Barbara Hardy Centre for Sustainable Urban Environments, School of Natural and Built Environments, University of South Australia, City East Campus, Adelaide, SA 5095, Australia

Ravi Naidu
Centre for Environmental Risk Assessment and Remediation (CERAR), University of South Australia, Mawson Lakes Campus, Mawson Lakes, SA 5095, Australia

Abstract/ Executive Summary:

The accurate assessment of dietary intake patterns is important for the determination of total dietary arsenic (As) exposure in As-contaminated regions of Bangladesh. Food intake questionnaires are a common means of assessing food intake. A food frequency questionnaire (FFQ) was designed to assess the daily intake of frequently consumed food items and was successfully implemented to assess dietary patterns and intake of the rural populations in 18 villages from three Districts of Bangladesh (Comilla, Manikganj Sadar, and Munshiganj). The FFQ presented in this paper comprises a complete set of tools which allowed not only collection of information on dietary patterns but also information on the spatial characteristics of the landscape, socio-demographic indicators, and geographic locations of the identified environmental media of the contaminants, which resulted in As exposure to humans. The FFQ was designed in three sections: (1) general household information, (2) household water and rice information, and (3) individual dietary intake of other foods. The dietary intake of other food was then further subdivided into five different food subgroups: (i) grain intake, (ii) protein intake, (iii) fruit intake (iv), vegetable intake, and (v) dal (pulse) intake. During the design and development of the FFQ, emphasis was given to the source of food, the frequency (day/week/ month) of consumption, and the daily amount of food consumed by each adult male, adult female, and child to accurately determine the dietary pattern and intake of arsenic in the rural population of Bangladesh.

Keywords: Food frequency questionnaire (FFQ), Dietary intake, Dietary pattern, Bangladesh, Arsenic

Location: 18 different villages from Laksham, Sirajdikhan, and Manikganj Sadar thanas in Bangladesh.

Start Date:

End Date:

Program Area: Risk Management in Agriculture

Commodity: Arsenic

Objectives:

This paper (Part A) reports on the detailed design and development of a semi-quantitative FFQ. The companion paper (Part B) addresses application of FFQ as a dietary survey tool to collect a realistic estimation of As exposure from the rural Bangladeshi communities.

Methodology:

Study areas: An FFQ was designed for implementation in 18 different villages from Laksham, Sirajdikhan, and Manikganj Sadar thanas in Bangladesh. The Laksham thana is located in the Comilla district with an area of 429 km² bounded by Dakatia and the Little Feni River. The geographical location extends between 23040 and 23220 latitude and 90590 and 91140 longitude. The Sirajdikhan thana is situated in the Munshiganj district with an area of 180 km2 bounded by the Ichamati and Dhaleshwari Rivers in the north. The geographical extent of the thana is 23300 and 23410 latitude and 90140 and 90270 longitude. The Manikganj Sadar thana is located in the Manikganj district and the total land area is 215 km² bounded by the Kaliganga, Dhaleswari, Ichamati, and Gazikhali Rivers. The geographic location of this thana extends between 23420 and 23560 latitude and 89570 and 90080 longitude. The population is evenly distributed between males and females, with females being generally less literate than their male counterparts. The main occupations of almost half the population were related to agriculture, which is the predominant landuse in the regions studied. Potential As exposure pathways Identification of the potential exposure pathways and exposure media in a landscape is an important first step in assessing the intake of As that may pose a potential human health risk. The potential exposure pathways in the study areas considered were groundwater, food, and soil. As the main interest in this study was to quantify human health risk associated with direct ingestion of drinking water and consumption of rice and other foods, indirect exposure pathways such as soil ingestion and inhalation of dust were not considered in the risk assessment. These indirect exposure pathways are not generally significant in the study areas considered. Likewise, secondary exposure pathways, such as the ingestion of animals ingesting As-contaminated foods/grasses was not considered in detail due to the potentially low contribution of meat in total dietary intake. Rainwater intake was not considered because it was not commonly used in the studied villages and rainwater is considered to be arsenic-free (Owens et al. 2004). Thus after consideration of the major exposure pathways, the direct food ingestion pathways, were considered to be the most critical. Likewise, water, rice, and other food (vegetables, dal) were considered as the most important environmental media through which a population experienced exposure to As in the study areas. Therefore, in designing the survey, it was considered essential to focus on water and rice intake in detail and to support this by information on other edible foods. Questionnaire design Inadequate dietary assessment of various foods can produce negative or inconsistent association between dietary exposure of various metals and health effects (Chen et al. 2004). The design of the questionnaire for the measurement of dietary pattern and daily intake of As was based on an interviewer-administrated FFQ method. Chen et al. (2004), has illustrated the applicability of this method for the assessment of dietary intake of rural Bangladeshi populations. The semi-quantitative FFQ developed for this study was a substantially modified version of an earlier questionnaire originally developed for an ACIAR funded project. This questionnaire was subsequently revised by the AusAID project team (Owens et al. 2004). The current questionnaire was designed to obtain information related to dietary pattern and daily intake of As through direct ingestion of food and water with the aim of developing a Geographical Information System (GIS) based landscape level human health risk model. During the design and development of the current FFQ, the AusAID (Owens et al. 2004) questionnaire was critically reviewed and missing variables identified and additional questions added to the questionnaire to enable development of a GIS-based landscape level As exposure risk scenario. In the current version of the questionnaire, emphasis was given to the collection of individual daily intake of water, rice, and other food.

Source of Information: Environ Geochem Health (2009) 31:207–220

Article Link (Online Journal): DOI 10.1007/s10653-008-9234-1

Funding Source:

Budget:

Total Budget (Tk.) :

Achievement/Findings:

The developed FFQ illustrates effective methods for collecting dietary intake of rural populations together with demographic, socio-economic, spatial, and field samples-related data. The simple and homogeneous nature of diet in rural areas in Bangladesh made it possible to successfully implement the FFQ in three different regions of Bangladesh without difficulty. Data collected through the FFQ shows a promising means of obtaining input data for the assessment of daily intake of As which can provide the basis for the measurement of human health risk associated with As exposure.

Knowledge Management: Journal