Conceptualizing Saline Exposure Model (SEM) for Health Impacts in the Delta Community in Bangladesh: A Systematic Literature Review and Field Observations

Salinity intrusion in coastal Bangladesh presents growing public health challenges, intensified by climate change and anthropogenic activities. This study combines a systematic literature review of 79 relevant studies and an observational field study in Gabura Union to examine the health impacts and adaptation responses to saline exposure. Based on the findings, a Saline Exposure Model (SEM) was conceptualized, incorporating four key components: environmental and anthropogenic drivers, exposure pathways, health mechanisms, and adaptive strategies. The SEM framework systematically identifies how salinity intrusion leads to water scarcity, poor sanitation, and socio-economic vulnerabilities, which in turn affect public health, particularly for marginalized groups. Adaptive practices such as pond sand filters and rainwater harvesting are widely used but face limitations in scalability, maintenance, and water quality. The SEM provides an evidence-based, structured tool to inform targeted policy interventions, strengthen climate-resilient health systems, and optimize resource allocation in high-risk coastal regions. While the model is qualitatively developed, it offers a practical foundation for public health practitioners and policymakers. Future research should focus on quantitative validation and integrating real-time environmental and health monitoring data to enhance its operational applicability.