Environmental health: arsenic in groundwater: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Environmental health: arsenic in groundwater

Sample item

A 40-year-old man from a village in the Ganga delta, who has drunk tube-well water for 15 years, has raindrop hyperpigmentation of the trunk and thickening of the palms and soles. Which is the best public health measure for his community?

AAdd fluoride to the water supplyBGive mass iron and folic acid supplementsCRaise the chlorine dose of the tube-wellsDProvide an alternative arsenic-safe water source

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Provide an alternative arsenic-safe water source

Chronic arsenicosis presents with hyperpigmentation, palmar and plantar hyperkeratosis, and later skin, bladder and lung cancers. Groundwater arsenic in the Ganga-Brahmaputra delta is a major problem, and the guideline limit is 10 micrograms per litre. Chlorination and boiling do not remove arsenic, so the remedy is a safe alternative source or arsenic removal plants.

Option by option

A. Add fluoride to the water supply
Fluoride is not an arsenic remedy and excess fluoride causes fluorosis.
B. Give mass iron and folic acid supplements
Iron and folic acid treat anaemia and have no effect on arsenic exposure.
C. Raise the chlorine dose of the tube-wells
Chlorine does not remove dissolved arsenic.
D. Provide an alternative arsenic-safe water source (correct)
Correct. Preventing further exposure by a safe source is the core intervention.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, Provide an alternative arsenic-safe water source. Chronic arsenicosis presents with hyperpigmentation, palmar and plantar hyperkeratosis, and later skin, bladder and lung cancers.

Why is "Add fluoride to the water supply" not the answer?

Fluoride is not an arsenic remedy and excess fluoride causes fluorosis.

Why is "Give mass iron and folic acid supplements" not the answer?

Iron and folic acid treat anaemia and have no effect on arsenic exposure.

Why is "Raise the chlorine dose of the tube-wells" not the answer?

Chlorine does not remove dissolved arsenic.

What concept does this question test?

It tests Environmental health: arsenic in groundwater in PSM. Groundwater arsenic in the Ganga-Brahmaputra delta is a major problem, and the guideline limit is 10 micrograms per litre. Chlorination and boiling do not remove arsenic, so the remedy is a safe alternative source or arsenic removal plants.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Environmental health: arsenic in groundwater?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.