Risk assessment for arsenic-contaminated groundwater along River Indus in Pakistan

Selenium improved arsenic toxicity tolerance in two bell pepper (Capsicum annuum L.) varieties by modulating growth, ion uptake, photosynthesis, and antioxidant profile

Bell pepper (Capsicum annuum L.); an important spice crop of the region is a rich source of vitamins and antioxidants having many health benefits. Many biotic and abiotic factors contribute towards growth and yield losses of this crop. Arsenic (As) toxicity is a global issue, but it is particularly critical in developing countries. The current study was designed to evaluate the efficacy of selenium (Se) in mitigating the toxic effects of As in two varieties (HSP-181 A and PS09979325) of Capsicum annuum L. Different concentrations of As (0, 50, and 100 µM) and Se (0, 5, and 10 µM) were tested using 14 days old seedlings of C. annuum L. The As stress caused a significant (P ≤ 0.001) reduction in growth, uptake of nutrients, and eco-physiological attributes in both varieties however, the response was specific. While the overproduction of osmo-protectants and antioxidants intensified the symptoms of oxidative stress. The maximum reduction in shoot length (45%), fresh weight (29%), and dry weight (36%) was observed in under 100 µM As stress. The organic acids exudation from the roots of both cultivars were significantly increased with the increase in As toxicity. The Se treatment significantly (p ≤ 0.001) improved growth, nutrient uptake, gas exchange attributes, antioxidant production, while decreased oxidative stress indicators, and As uptake in the roots and shoots of all the subjects under investigation. It is concluded from the results of this study that Se application increased photosynthetic efficiency and antioxidant activity while decreasing As levels, organic acid exudation, and oxidative stress indicators in plants. Overall, the var. PS09979325 performed better and may be a good candidate for future pepper breeding program.

Elevated arsenic concentrations in groundwater of the Upper Indus Plain of Pakistan across a range of redox conditions

Groundwater of the Ravi River floodplain is particularly elevated in arsenic (As) on both sides of the Pakistan-India border. To understand this pattern, 14 sites were drilled to 12-30 m depth across floodplains and doabs of Pakistan after testing over 20,000 wells. Drill cuttings were collected at 1.5 m intervals, 132 of which were sand overlain by 77 intervals of clay and/or silt. Radiocarbon dating of clay indicates deposition of the aquifer sands tapped by wells 20-30 kyr ago. Most (85 %) of the sand samples were gray in color, indicating partial reduction to Fe(II) oxides, whereas most (92 %) of the clay and/or silt samples were orange. Associations between groundwater electrical conductivity, dissolved Fe, sulfate, and nitrate suggest that wells can be elevated (>10 μg/L) in As in the region due to either reductive dissolution of Fe oxides, evaporative concentration, or alkali desorption. In the Ravi floodplain, 47 % of 6445 wells tested contain >10 μg/L As compared to only 9 % of 14,165 tested wells in other floodplains and doabs. The As content of aquifer sands in the Ravi floodplain of Pakistan averages 4 ± 4 mg/kg (n = 66) and is higher than the average of 2 ± 2 mg/kg (n = 51) for aquifer sands outside the Ravi. Synchrotron spectroscopy and column-based speciation indicate predominance of As(V) over As(III) in both aquifer sands and groundwater. Whereas multiple processes may be responsible for elevated levels of As in groundwater across the region, spatial heterogeneity in groundwater As concentrations in the Ravi floodplain seems linked to variations in As concentrations in aquifer sands. Regulation by the solid phase may limit variations in groundwater As over time in response to natural and human-induced changes in hydrology. This means spatial heterogeneity could be taken advantage of to lower the exposure across the region with more testing and targeted drilling.

Arsenic level in groundwater and biological samples in Khanewal, Pakistan

Groundwater is the most valuable natural source in our earth's planet, being contaminated in various regions worldwide. Despite considerable research, there are scarce data regarding arsenic (As) levels in groundwater and its build-up in biological samples in Pakistan. The current investigation analyzed As contamination in four tehsils of District Khanewal (Kabirwala tehsil, Jahaniyan tehsil, Mian Channu tehsil, and Khanewal tehsil). For that, 123 groundwater samples, 19 animal milk samples, 20 human nails, and 20 human hair samples were collected from the study area. Arsenic concentration in groundwater was up to 51.8 µg/L with an average value of 7.2 µg/L. About 28 water samples (23%) had As contents > WHO limit and 38 samples (31%) > DEP-NJ limit. Low levels of As were detected in biological samples. Average As levels were 23 µg/L in the milk samples and 298 µg/kg in human hair. Arsenic contents were not detected in nail samples, except in one sample from Kabirwala tehsil. The maximum values of hazard quotient and cancer risk in District Khanewal were 4.9 and 0.0022, respectively. It is anticipated that long-term use of As-containing water may led to poisoning of humans in the study area, especially in Kabirwala. Therefore, it is necessary to monitor As contamination in the groundwater of Kabirwala tehsil to reduce the potential health hazards.

Arsenic adsorption by different Fe-enriched biochars conditioned with sulfuric acid

In this study, ferric chloride and sulfuric acid were used to increase the Fe-containing minerals on the biochar surface before a pyrolysis at 600 °C. The pristine and Fe-modified biochars prepared at different concentrations of sulfuric acid (50FBC and 72FBC) were characterized and analyzed, and their capacity of As(V) adsorption under various pH and ionic strength were evaluated. The results showed that the maximum adsorption capacities of As(V) calculated by the Langmuir model for 50FBC and 72FBC are 10.33 and 15.61 mg g-1, respectively, which are enhanced by 5.0 and 7.8 times compared with the pristine biochar. The higher dosage of H2SO4 (72%) used in the modification leads to a better adsorption capacity of As, especially under neutral to alkaline conditions (7.0 < pH < 10.0). It might result from the increased amounts of Fe-containing minerals formed on the biochar surface, and the enriched functional groups such as phenolic hydroxyl and carboxyl, resulting in the resistance to alkaline conditions. Overall, the Fe-modified biochar, especially 72FBC, had good potential as an environmentally friendly adsorbent for removing As from contaminated water under a wider pH range.

Health risk assessment and geospatial analysis of arsenic contamination in shallow aquifer along Ravi River, Lahore, Pakistan

The exposure variation of arsenic from different ground and surface water sources has remained unpredictable which may cause severe human health problems. The current study is, therefore, designed to analyze the spatial variability of arsenic contamination in shallow aquifer and assess the potential human health risks. For this purpose, a total of 55 groundwater, 10 drain water, 4 river water, and 6 sediment samples were collected along zero to 5 km stretch of the River Ravi, Lahore. All water samples were tested for As, pH, and total dissolved solids (TDS), whereas sediments were only tested for As. Health risk models were used to predict cancer and non-cancer risk in adults and children. Among water samples, highest median (minimum-maximum) concentrations (µg/L) of As were recorded 53.32 (1.98-1555) in groundwater, followed by 53.04 (1.58-351.5) in drain water, and 4.80 (2.13-8.67) in river water, respectively, whereas As concentration (mg/kg) in river sediments was 6.03 (5.56-13.92). Variation of As in groundwater was non-significant (P > 0.05) among every 1-km stretch from the Ravi River. However, maximum median concentrations (µg/L) of 60.18 and 60.08 were recorded between 2-3 and 0-1 km from River Ravi, respectively, reflecting possible mixing of river water with shallow aquifers. A very high cancer and non-cancer risk (HI > 1.0 × 10^-4) through groundwater As exposure was predicted for both children and adults. The current study concluded that prevalence of As above WHO prescribed limits in shallow aquifer along the urban stretch of the River Ravi is posing serious health risk to the exposed population.

Evolution Mechanism of Arsenic Enrichment in Groundwater and Associated Health Risks in Southern Punjab, Pakistan

Arsenic (As) contamination in groundwater is a worldwide concern for drinking water safety. Environmental changes and anthropogenic activities are making groundwater vulnerable in Pakistan, especially in Southern Punjab. This study explores the distribution, hydrogeochemical behavior, and pathways of As enrichment in groundwater and discusses the corresponding evolution mechanism, mobilization capability, and health risks. In total, 510 groundwater samples were collected from three tehsils in the Punjab province of Pakistan to analyze As and other physiochemical parameters. Arsenic concentration averaged 14.0 μg/L in Vehari, 11.0 μg/L in Burewala, and 13.0 μg/L in Mailsi. Piper-plots indicated the dominance of Na+, SO42-, Ca2+, and Mg2+ ions in the groundwater and the geochemical modeling showed negative saturation indices with calcium carbonate and salt minerals, including aragonite (CaCO3), calcite (CaCO3), dolomite (CaMg(CO3)2), and halite (NaCl). The dissolution process hinted at their potential roles in As mobilization in groundwater. These results were further validated with an inverse model of the dissolution of calcium-bearing mineral, and the exchange of cations between Ca2+ and Na+ in the studied area. Risk assessment suggested potential carcinogenic risks (CR > 10-4) for both children and adults, whereas children had a significant non-carcinogenic risk hazard quotient (HQ > 1). Accordingly, children had higher overall health risks than adults. Groundwater in Vehari and Mailsi was at higher risk than in Burewala. Our findings provide important and baseline information for groundwater As assessment at a provincial level, which is essential for initiating As health risk reduction. The current study also recommends efficient management strategies for As-contaminated groundwater.

Assessment of U and As in groundwater of India: A meta-analysis

More than 2.5 billion people depend upon groundwater worldwide for drinking, and giving quality water has become one of the great apprehensions of human culture. The contamination of Uranium (U) and Arsenic (As) in the groundwater of India is gaining global attention. The current review provides state-of-the-art groundwater contamination with U and As in different zones of India based on geology and soil texture. The average concentration of U in different zones of India was in the order: West Zone (41.07 μg/L) > North Zone (37.7 μg/L) > South Zone (13.5 μg/L)> Central Zone (7.4 μg/L) > East Zone (5.7 μg/L) >Southeast Zone (2.4 μg/L). The average concentration of As in groundwater of India is in the order: South Zone (369.7 μg/L)>Central Zone (260.4 μg/L)>North Zone (67.7 μg/L)>East Zone (60.3 μg/L)>North-east zone (9.78 μg/L)>West zone (4.14 μg/L). The highest concentration of U and As were found in quaternary sediments, but U in clay skeletal and As in loamy skeletal. Results of health risk assessment showed that the average health quotient of U in groundwater for children and adults was less than unity. In contrast, it was greater than unity for As posing a harmful impact on human health. This review provides the baseline data regarding the U and As contamination status in groundwater of India, and appropriate, effective control measures need to be taken to control this problem.

Mechanistic understanding of the toxic effects of arsenic and warfare arsenicals on human health and environment

Worldwide, more than 200 million people are estimated to be exposed to unsafe levels of arsenic. Chronic exposure to unsafe levels of groundwater arsenic is responsible for multiple human disorders, including dermal, cardiovascular, neurological, pulmonary, renal, and metabolic conditions. Consumption of rice and seafood (where high levels of arsenic are accumulated) is also responsible for human exposure to arsenic. The toxicity of arsenic compounds varies greatly and may depend on their chemical form, solubility, and concentration. Surprisingly, synthetic organoarsenicals are extremely toxic molecules which created interest in their development as chemical warfare agents (CWAs) during World War I (WWI). Among these CWAs, adamsite, Clark I, Clark II, and lewisite are of critical importance, as stockpiles of these agents still exist worldwide. In addition, unused WWII weaponized arsenicals discarded in water bodies or buried in many parts of the world continue to pose a serious threat to the environment and human health. Metabolic inhibition, oxidative stress, genotoxicity, and epigenetic alterations including micro-RNA-dependent regulation are some of the underlying mechanisms of arsenic toxicity. Mechanistic understanding of the toxicity of organoarsenicals is also critical for the development of effective therapeutic interventions. This review provides comprehensive details and a critical assessment of recently published data on various chemical forms of arsenic, their exposure, and implications on human and environmental health.

Hydrogeochemical and health risk evaluation of arsenic in shallow and deep aquifers along the different floodplains of Punjab, Pakistan

The current study delineated the distribution, (hydro)geochemical behavior and health risk of arsenic (As) in shallow (depth < 35 m; handpumps and electric pumps) and deep (depth > 35 m; tube wells) aquifers in five areas along the Indus River (Bhakar, Kallur Kot), Jhelum River (Jhelum) and Chenab River (Hafizabad, Gujranwala) floodplains of Punjab, Pakistan. Relatively, greater As concentration was observed in deep wells (mean: 24.3 µg L^-1) compared to shallow wells (19.4 µg L^-1), with groundwater As spanning 0.1-121.7 µg L^-1 (n = 133) in three floodplains. Groundwater from Hafizabad (Chenab River floodplain) possessed the highest As (121.7 µg L^-1), Na⁺ (180 mg L^-1), Ca²⁺ (95 mg L^-1), Cl^- (101 mg L^-1) and SO₄^2- (1353 mg L^-1) concentrations. Arsenic health risk modeling indicated the potential carcinogenic (value > 10^-4) and non-carcinogenic (hazard quotient > 1.0) risks for groundwater of all areas, with the utmost risk estimated for Chenab floodplain and deep aquifers. Positive saturation index values for Fe oxide mineral phases may suggest their potential role in As mobilization/release in these aquifer environments. This study provides critically-important and baseline knowledge for a widespread groundwater As examination along these three floodplains, which is vital for launching suitable As mitigation and remediation programs to reduce the potential health risk.

Hydrogeochemical investigation of arsenic in drinking water of schools and age dependent risk assessment in Vehari District, Punjab Pakistan: a multivariate analysis

Globally, a large number of school-aged children is suffering from water-borne diseases, particularly in low-income countries. Arsenic (As) is a hazardous and potentially carcinogenic metal(loid) in drinking water. Nowadays, alarming levels of As have been reported in the groundwater of Vehari District, Punjab Pakistan. In this study, drinking water supplies for high and higher secondary schools were examined in Vehari District. A total of 164 water samples were collected from schools and subjected to heavy metal(loid) analysis (As) and basic water physicochemical parameters. The results were analyzed with respect to sampling area, school type, school education level, sources of sample collection, and the depth of the source. The results revealed that As concentration of water samples in boys' and girls' schools was 12.8 μg/L and 9.2 μg/L, respectively. However, when the As concentration in drinking water was evaluated at the school education level, a notable higher concentration of As was observed in the higher secondary schools than the high schools with an average of 19.5 and 9.7 μg/L, respectively. The risk assessment indices were calculated based on education level and different age groups of the children (primary, elementary, high, and higher secondary). High carcinogenic (cancer risk = 0.001) and non-carcinogenic (hazard quotient = 2.0) risks were noted for the children in higher secondary school. The current findings anticipated that the drinking water of schools in Vehari District did not meet the requirement of the World Health Organization (WHO) drinking water quality guidelines. Safe drinking water is crucial for the development and growth of children. Therefore, it is important for educational authorities to take steps for provision of As free safe drinking water to students and local inhabitants.

Portable and rapid arsenic speciation in synthetic and natural waters by an As(V)-selective chemisorbent, validated against anodic stripping voltammetry

Inorganic arsenic speciation, i.e. the differentiation between arsenite and arsenate, is an important step for any program aiming to address the global issue of arsenic contaminated groundwater, whether for monitoring purposes or the development of new water treatment regimes. Reliable speciation by easy-to-use, portable and cost-effective analytical techniques is still challenging for both synthetic and natural waters. Here we demonstrate the first application of an As(V)-selective chemisorbent material for simple and portable speciation of arsenic using handheld syringes, enabling high sample throughput with minimal set-up costs. We first show that ImpAs efficiently removes As(V) from a variety of synthetic groundwaters with a single treatment, whilst As(III) is not retained. We then exemplify the potential of ImpAs for simple and fast speciation by determining rate constants for the photooxidation of As(III) in the presence of a TiO₂ photocatalyst. Finally, we successfully speciate natural waters spiked with a mix of As(III) and As(V) in both Indian and UK groundwaters with less than 5 mg L^-1 dissolved iron. Experimental results using ImpAs agreed with anodic stripping voltammetry (ASV), a benchmark portable technique, with analysis conditions optimised here for the groundwaters of South Asia. This new analytical tool is simple, portable and fast, and should find applications within the overall multi-disciplinary remediation effort that is taking place to tackle this worldwide arsenic problem.

Health risk assessment of drinking arsenic-containing groundwater in Hasilpur, Pakistan: effect of sampling area, depth, and source

Currently, several news channels and research publications have highlighted the dilemma of arsenic (As)-contaminated groundwater in Pakistan. However, there is lack of data regarding groundwater As content of various areas in Pakistan. The present study evaluated As contamination and associated health risks in previously unexplored groundwater of Hasilpur-Pakistan. Total of 61 groundwater samples were collected from different areas (rural and urban), sources (electric pump, hand pump, and tubewell) and depths (35-430 ft or 11-131 m). The water samples were analyzed for As level and other parameters such as pH, electrical conductivity, total dissolved solids, cations, and anions. It was found that 41% (25 out of 61) water samples contained As (≥ 5 μg/L). Out of 25 As-contaminated water samples, 13 water samples exceeded the permissible level of WHO (10 μg/L). High As contents have been found in tubewell samples and at high sampling depths (> 300 ft). The major As-contaminated groundwater in Hasilpur is found in urban areas. Furthermore, health risk and cancer risk due to As contamination were also assessed with respect to average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR). The values of HQ and CR of As in Hasilpur were up to 58 and 0.00231, respectively. Multivariate analysis revealed a positive correlation between groundwater As contents, pH, and depth in Hasilpur. The current study proposed the proper monitoring and management of well water in Hasilpur to minimize the As-associated health hazards.

A comprehensive review on current status, mechanism, and possible sources of arsenic contamination in groundwater: a global perspective with prominence of Pakistan scenario

Arsenic(As)-mediated contamination of groundwater resources in different parts of the world is a consequence of natural or anthropogenic sources, leading to adverse effects on the environment and human health. Millions of people from different countries are unfortunately consuming groundwater contaminated with alarming levels of As. Exposure to the high concentration of As for an extended period of time can cause devastating effects on human health such as skin lesions, cardiac disorders, discolouration and cancer. Until 2018, about 11 districts of Sindh and Punjab provinces in Pakistan had been found with As contamination in groundwater beyond the national defined permissible level, i.e. 50 µg/L. Tharparkar and Hyderabad (in Sindh province) along Indus river and Lahore and Kasur (in Punjab province) are well-known hotspots sites of natural geogenic As contamination in groundwater. Higher levels of Sulfates (SO₄^2-), Chloride (Cl^-) and Carbonate (CO₃^2-) along with the elevated values of electrical conductivity and basic pH, as well as augmented presence of "As V" species, were all an indication of oxidizing condition in groundwater, and these oxidizing conditions are identified as the primary mechanism of As contamination into aquifers of Pakistan via oxidative dissolution. The main aim of this review is to summarize and discuss the current contamination status of As in groundwater water globally with a special focus on Pakistan scenario, isotopic evidence to track sources of groundwater recharge and its effects on As contamination in groundwater with various redox conditions prevailing in Pakistan. In addition, public health consequences of As contamination and mitigation strategies for As removal from water resources have been also highlighted. In this review, the data were extracted from various cutting edge studies published in national and international journals.

Vertical mixing with return irrigation water the cause of arsenic enrichment in groundwater of district Larkana Sindh, Pakistan

Stable isotopes ratios (‰) of Hydrogen (δ²H) and Oxygen (δ¹⁸O) were used to trace the groundwater recharge mechanism and geochemistry of arsenic (As) contamination in groundwater from four selected sites (Larkana, Naudero, Ghari Khuda Buksh and Dokri) of Larkana district. The stable isotope values of δ²H and δ¹⁸O range from 70.78‰ to -56.01‰ and from -10.92‰ to -7.35‰, relative to Vienna Standard for Mean Ocean Water (VSMOW) respectively, in all groundwater samples, thus indicating the recharge source of groundwater from high-salinity older water. The concentrations of As in all groundwater samples were ranged from 2 μg/L to 318 μg/L, with 67% of samples exhibited As levels exceeding than that of World Health Organization (WHO) permissible limit 10 μg/L and 42% of samples expressed the As level exceeding than that of the National Environmental Quality Standard (NEQS) 50 μg/L. The leaching and vertical mixing with return irrigation water are probably the main processes controlling the enrichment of As in groundwater of Larkana, Naudero, Ghari Khuda Buksh and Dokri. The weathering of minerals mostly controlled the overall groundwater chemistry; rock-water interactions and silicate weathering generated yielded solutions that were saturated in calcite and dolomite in two areas while halite dissolution is prominent with high As area.

A meta-analysis of the distribution, sources and health risks of arsenic-contaminated groundwater in Pakistan

Globally, millions of people who rely on groundwater for potable purposes and agriculture have been inadvertently exposed to toxic arsenic (As) because of its natural occurrence in groundwater in several countries of Asia, Europe and America. While the presence of As in groundwater and its impacts on human health have been documented in many countries, there is little information on As contamination in Pakistan. This review highlights, for the first time, the extent and severity of As-induced problems in Pakistan based on relevant published papers; discusses possible sources of As contamination of aquifers; and estimates As-induced potential health hazards in the country in relation to global data. Data from 43 studies (>9882 groundwater samples) were used to describe As variability in groundwater of Pakistan and for comparison with global data. The mean groundwater As content reported in these studies was 120 μg/L (range: 0.1-2090 μg/L; SD: ±307). About 73% of the values for mean As contents in the 43 studies were higher than the World Health Organization (WHO) permissible limit (10 μg/L) for drinking water, while 41% were higher than the permissible limit of As in Pakistan (50 μg/L). It was observed that groundwater samples in some areas of Punjab and Sindh provinces contained high As concentrations which were almost equal to concentrations reported in the most contaminated areas of the world. We predicted that the mean values of ADD, HQ and CR were 4.4 μg kg^-1day^-1 (range: 0-77 μg kg^-1day^-1), 14.7 (range: 0-256) and 0.0029 (range: 0-0.0512), respectively, based on mean As concentrations reported in Pakistan. In addition, this article proposes some integrated sustainable solutions and future perspectives keeping in view the regional and global context, as well as the on-ground reality of the population drinking As-contaminated water, planning issues, awareness among civil society and role of the government bodies. Based on available data, it is predicted that almost 47 million people in Pakistan are residing in areas where more than 50% of groundwater wells contain As concentrations above the WHO recommended limit of As in drinking water.

The evaluation of arsenic contamination potential, speciation and hydrogeochemical behaviour in aquifers of Punjab, Pakistan

In this study, we tested 123 groundwater wells from five different areas of Punjab, Pakistan for arsenic (As) contamination level and species, as well as delineated hydrogeochemical behaviour of As in aquifers. Results revealed that 75% and 41% of the groundwater wells exceeded the safe As limit of World Health Organisation (WHO, 10 μg L^-1) and Pakistan-EPA (50 μg L^-1), respectively. Arsenite (As(III)) and arsenate (As(V)) spanned 0-80% and 20-100% of total As (1.2-206 μg L^-1), respectively. The mean As content (5.2 μg L^-1) of shallow wells at 9-40 m depth did not exceed the WHO safe limit, representing a safe aquifer zone for pumping of groundwater compared to deeper wells at 41-90 m (51 μg L^-1) and >90 m (23 μg L^-1) depths. Piper-plot elucidated that the aqueous chemistry was dominated with Na-SO₄, Na-Ca-SO₄, Na-Mg-SO₄ type saline water. Principal component analysis grouped As concentration with well depth, pH, salinity, Fe and CO₃, exhibiting that these hydrogeochemical factors could have potential role in controlling As release/sequestration into the aquifers of study area. Geochemical modeling showed positive saturation indices only for iron (Fe) oxide-phases, indicating Fe oxides as the major carriers of As. Overall, this study provides insights to tackle emerging As threat to the communities in Punjab, Pakistan, as well as help develop suitable management/mitigation strategies - based on the baseline knowledge of As levels/species and factors governing As contamination in the study area.

Extensive arsenic contamination in high-pH unconfined aquifers in the Indus Valley

Arsenic-contaminated aquifers are currently estimated to affect ~150 million people around the world. However, the full extent of the problem remains elusive. This is also the case in Pakistan, where previous studies focused on isolated areas. Using a new data set of nearly 1200 groundwater quality samples throughout Pakistan, we have created state-of-the-art hazard and risk maps of arsenic-contaminated groundwater for thresholds of 10 and 50 μg/liter. Logistic regression analysis was used with 1000 iterations, where surface slope, geology, and soil parameters were major predictor variables. The hazard model indicates that much of the Indus Plain is likely to have elevated arsenic concentrations, although the rest of the country is mostly safe. Unlike other arsenic-contaminated areas of Asia, the arsenic release process in the arid Indus Plain appears to be dominated by elevated-pH dissolution, resulting from alkaline topsoil and extensive irrigation of unconfined aquifers, although pockets of reductive dissolution are also present. We estimate that approximately 50 million to 60 million people use groundwater within the area at risk, with hot spots around Lahore and Hyderabad. This number is alarmingly high and demonstrates the urgent need for verification and testing of all drinking water wells in the Indus Plain, followed by appropriate mitigation measures.