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Adverse Reproductive and child health outcomes among people living near highly toxic waste water drains in Punjab, India
  1. Jarnail Singh Thakur1,*,
  2. Shankar Prinja1,
  3. Dalbir Singh1,
  4. Arvind Rajwanshi1,
  5. Rajendra Prasad1,
  6. Harjinder Kaur Parwana2,
  7. Rajesh Kumar1
  1. 1 Post Graduate Institute of Medical Education and Research, Chandigarh, India;
  2. 2 Punjab Pollution Control Board, Punjab, India
  1. Correspondence to: Dr Jarnail Singh Thakur, Community Medicine, PGIMER Chandigarh, PGIMER Chandigarh, Sector 12, Chandigarh, 160012, India; jsthakur64{at}


Background: Punjab has been reported to be having high degree of water pollution due to heavy metals from untreated industrial effluent discharge and high pesticides consumption in agriculture. Present study ascertained the association of heavy metal and pesticide exposure on reproductive and child health outcomes in Punjab, India.

Methods: A cross sectional community based survey was conducted in which 1904 women in reproductive age group and 1762 children below 12 years age from 35 villages in Punjab were interviewed for systemic and general health morbidities. Medical doctors conducted clinical examination and review of records where relevant. Out of 35 study villages, 25 served as target (exposed) and 10 as non-target (less-exposed or reference). Effluent, ground and surface water, fodder, vegetables and milk (bovine and human) samples were tested for chemical composition, heavy metals and pesticides.

Results: Spontaneous abortion (20.6 per 1000 live births) and premature births (6.7 per 1000 live births) were significantly higher in area affected by heavy metal and pesticide pollution (p<0.05). Children in target area reported higher delayed milestones, language delay, blue line in gums, mottling of teeth and gastrointestinal morbidities (p<0.05). Mercury was found in more than permissible limits (MPL) in 84.4% samples from target area. Heptachlor, Chlorpyriphos and β-endosulphan were found to be more than MPL in 23.9%, 21.7% and 19.6% ground water samples respectively.

Conclusion: Although no direct association could be established in this study, heavy metal and pesticide exposure may be potential risk factors for the adverse reproductive and child health outcome.

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