Manganese, arsenic, and infant mortality in Bangladesh: an ecological analysis

Recent studies in Bangladesh indicate that arsenic and manganese in tube-well water may increase the incidence of infant mortality. The study reported here examined whether these findings could be replicated. Data available from some 600 villages under the care of the nongovernmental organization (NGO) Gonoshasthaya Kendra included details of 29744 live births and 934 infant deaths in a 2-year period, with age and cause. These were analyzed by mean well levels of arsenic and manganese as reported by the British Geological Survey for the 12 upazillas. Odds ratios were calculated by age at death and cause. The effect of arsenic on all-cause infant mortality, although small and not significant, was consistent with earlier reports. The previous finding of an increased risk of infant mortality at concentrations of manganese > or =0.4 mg/L was not evident.