Exploring a multi-exposure-pathway approach to assess human health risk associated with groundwater fluoride exposure in the semi-arid region of east India

Hydrogeochemical properties, source provenance, distribution, and health risk of high fluoride groundwater: Geochemical control, and source apportionment

This study evaluated high fluoride (F-) levels, source distribution, provenance, health risk, and source apportionment in the groundwater of Sargodha, Pakistan. Therefore, 48 groundwater samples were collected and analyzed by ion-chromatography (DX-120, Dionex). The lowest concentration of F- was 0.1, and the highest was 5.8 mg/L in the aquifers. In this study, 43.76% of the samples had exceeded the World Health Organization's allowable limit of 1.5 mg/L. The hydrogeochemical facies in Na-rich and Ca-poor aquifers showed NaCl (66.6%), NaHCO3 (14.5%), mixed CaNaHCO3 (8.3%), CaCl2 (8.3%), mixed CaMgCl2 (2%), and CaHCO3 (2%) type water. Alkaline pH, high Na+, HCO3- concentrations, and poor Ca-aquifers promoted F- dissolution in aquifer. The significant positive correlations between Na⁺ and F- suggested cation exchange, where elevated Na⁺ occurs in Ca-poor aquifers. The cation exchange reduces the availability of Ca2+ would lead to higher F- concentrations. Meanwhile, the correlation between HCO₃- and F- indicates that carbonate minerals dissolution helps in increasing pH and HCO₃- as a result F- triggers in aquifers. Groundwater chemistry is primarily governed by the weathering of rock, water-rock interaction, ion-exchange, and mineral dissolution significantly control groundwater compositions. Cluster analysis (CA) determined three potential clusters: less polluted (10.4%), moderately polluted (39.5%), and severely polluted (50%) revealing fluoride toxicity and vulnerability in groundwater wells. Mineral phases showed undersaturation and saturation determining dissolution of minerals and precipitation of minerals in the aquifer. PCAMLR model determined that high fluoride groundwater takes its genesis from F-bearing minerals, ion exchange, rock-water interaction, and industrial, and agricultural practices. The health risk assessment model revealed that children are at higher risk to F- toxicity than adults. Thus, groundwater of the area is unsuitable for drinking, domestic, and agricultural needs.

Health risk modeling and risk factors of fluorosis in the fluoride endemic village of Maharashtra: A cross-sectional study

Fluorosis, a debilitating disease, causes dental mottling and bone deformities among other adverse health effects. The current epidemiological study focused on the prevalence and risk factors of fluorosis in the fluoride endemic village, Dongargaon, Maharashtra, India. The clinical diagnosis of subjects showed 96.49% prevalence of dental fluorosis, and 63.16% prevalence of skeletal fluorosis. Duration of exposure, age of subjects and physiological symptoms like chronic joint pain were found to be significantly correlated with skeletal fluorosis (p < 0.05). Fluoride in drinking water showed seasonal variation with highest level in winter (6.54 mg/L) and lowest level in monsoon (0.54 mg/L). Consequently, the mean urinary fluoride concentration was also highest in winter (9.37 mg/L) and lowest in monsoon (3.88 mg/L). Multilogit regression analysis demonstrated that subjects excreting urinary fluoride above 4 mg/L had 7.25 times higher odds of developing skeletal fluorosis (p < 0.05). Health risk assessment showed a high value of hazard quotient, indicating a high probability of adverse health effects. The estimated daily ingestion of 8.80 mg F and a predicted bone uptake of 0.19 mg/kg/day raised significant health concerns for the studied population. Exposure and bone F uptake modeling suggested that the predicted mean fluoride concentrations of 4018.77 ± 1762.45 mg/kg bone ash in asymptomatic, and 5535.12 ± 1526.30 mg/kg bone ash in symptomatic subjects were significantly different (p < 0.05). The comprehensive risk evaluation in the study clearly brings out the high risk of fluoride exposure and adverse effects in Dongargaon village for the first time. Further, urinary fluoride was shown to have significant association with the risk of skeletal fluorosis. The study warrants implementation of immediate control measures at the study site.

Evaluation of fluoride exposure using disability-adjusted life years and health risk assessment in south-western Iran: A novel Monte Carlo simulation

Consumption of fluoride-contaminated water is a worldwide concern, especially in developing countries, including Iran. However, there are restricted studies of non-single-value health risk assessment and the disease burden regarding fluoride intake nationwide. Prolonged exposure to excessive fluoride has been linked to adverse health effects such as dental and skeletal fluorosis. This can lead to under-mineralization of hard tissues, causing aesthetic concerns for teeth and changes in bone structure, increasing the risk of fractures. As such, we aimed to implement probability-based frameworks using Monte Carlo methods to explore the potential adverse effects of fluoride via the ingestion route. This platform consists of two sectors: 1) health risk assessment of various age categories coupled with a variance decomposition technique to measure the contributions of predictor variables in the outcome of the health risk model, and 2) implementing Monte Carlo methods in dose-response curves to explore the fluoride-induced burden of diseases of dental fluorosis and skeletal fractures in terms of disability-adjusted life years (DALYs). For this purpose, total water samples of 8053 (N=8053) from 57 sites were analyzed in Fars and Bushehr Provinces. The mean fluoride concentrations were 0.75 mg/L and 1.09 mg/L, with maximum fluoride contents of 6.5 mg/L and 3.22 mg/L for the Fars and Bushehr provinces, respectively. The hazard quotient of the 95th percentile (HQ>1) revealed that all infants and children in the study area were potentially vulnerable to over-receiving fluoride. Sobol' sensitivity analysis indices, including first-order, second-order, and total order, disclosed that fluoride concentration (Cw), ingestion rate (IRw), and their mutual interactions were the most influential factors in the health risk model. DALYs rate of dental fluorosis was as high as 981.45 (uncertainty interval: UI 95 % 353.23-1618.40) in Lamerd, and maximum DALYs of skeletal fractures occurred in Mohr 71.61(49.75-92.71), in Fars Province, indicated severe dental fluorosis but mild hazard regarding fractures. Residents of the Tang-e Eram in Bushehr Province with a DALYs rate of 3609.40 (1296.68-5993.73) for dental fluorosis and a DALYs rate of 284.67 (199.11-367.99) for skeletal fractures were the most potentially endangered population. By evaluating the outputs of the DALYs model, the gap in scenarios of central tendency exposure and reasonable maximum exposure highlights the role of food source intake in over-receiving fluoride. This research insists on implementing defluoridation programs in fluoride-endemic zones to combat the undesirable effects of fluoride. The global measures presented in this research aim to address the root causes of contamination and help policymakers and authorities mitigate fluoride's harmful impacts on the environment and public health.

Prediction of arsenic and fluoride in groundwater of the North China Plain using enhanced stacking ensemble learning

Chronic exposure to elevated geogenic arsenic (As) and fluoride (F-) concentrations in groundwater poses a significant global health risk. In regions around the world where regular groundwater quality assessments are limited, the presence of harmful levels of As and F- in shallow groundwater extracted from specific wells remains uncertain. This study utilized an enhanced stacking ensemble learning model to predict the distributions of As and F- in shallow groundwater based on 4,393 available datasets of observed concentrations and forty relevant environmental factors. The enhanced model was obtained by fusing well-suited Extreme Gradient Boosting, Random Forest, and Support Vector Machine as the base learners and a structurally simple Linear Discriminant Analysis as the meta-learner. The model precisely captured the patchy distributions of groundwater As and F- with an AUC value of 0.836 and 0.853, respectively. The findings revealed that 9.0% of the study area was characterized by a high As risk in shallow groundwater, while 21.2% was at high F- risk identified as having a high risk of fluoride contamination. About 0.2% of the study area shows elevated levels of both of them. The affected populations are estimated at approximately 7.61 million, 34.1 million, and 0.2 million, respectively. Furthermore, sedimentary environment exerted the greatest influence on distribution of groundwater As, with human activities and climate following closely behind at 29.5%, 28.1%, and 21.9%, respectively. Likewise, sedimentary environment was the primary factor affecting groundwater F- distribution, followed by hydrogeology and soil physicochemical properties, contributing 27.8%, 24.0%, and 23.3%, respectively. This study contributed to the identification of health risks associated with shallow groundwater As and F-, and provided insights into evaluating health risks in regions with limited samples.

Hydrochemical characterization and comprehensive water quality assessment of groundwater within the main stream area of Yishu River

To gain a comprehensive understanding of the hydrochemical characteristics, controlling factors, and water quality of groundwater in the main stream area of Yishu River (MSYR), a study was conducted using water quality data collected during both the dry and wet seasons. Through statistical analysis, hydrochemical methods, fuzzy comprehensive evaluation, and health risk evaluation modeling, the water chemical characteristics of the main stream area of Yishu River were studied, and the water quality of the area was comprehensively evaluated. The findings indicate that HCO3- and Ca2+ are the predominant anions and cations in the MSYR during the dry and wet seasons, respectively. Moreover, anion concentration in groundwater follows HCO3-  > SO42-  > NO3-  > Cl-, while cations are ranked as Ca2+  > Na+  > Mg2+  > K+. Overall, the groundwater manifests as weakly alkaline and is predominantly classified as hard-fresh water. During the wet season, there is greater groundwater leaching and filtration, with rock and soil materials more readily transferred to groundwater, and the concentrations of main chemical components in groundwater are higher than those during the dry season, and the hydrochemical types are primarily characterized as HCO3-Ca·Mg and SO4·Cl-Ca·Mg types. These results also suggest that the chemical composition of the groundwater in the MSYR is influenced mainly by water-rock interaction. The primary ions originate from the dissolution of silicate rock and carbonate rock minerals, while cation exchange plays a critical role in the hydrogeochemical process. Groundwater in the MSYR is classified mostly as class II water, indicating that it is generally of good quality. However, areas with high levels of class IV and V water are present locally, and NO3- concentration is a crucial factor affecting groundwater quality. In the wet season, more groundwater and stronger mobility lead to greater mobility of NO3- and wider diffusion. Therefore, the risk evaluation model shows that nitrate health risk index is higher in the wet season than it is in the dry season, with children being more vulnerable to health risks than adults. To study groundwater in this area, its hydrochemical characteristics, water quality, and health risk assessment are of great practical significance for ensuring water safety for residents and stable development of social economy.

Environmental arsenic (As) and its potential relationship with endemic disease in southwestern China

Many cases of an unknown disease exhibiting the clinical features of limb gangrene, blisters, ulceration, and exfoliation have been reported in Daping village (DV) in southwestern China. However, the pathogenesis is unknown and has puzzled doctors for many years. A preliminary study on heavy metals and symptoms indicated that arsenic might pose the greatest threat to the health of local residents. Here, to explore the sources of and factors influencing arsenic enrichment in DV, whose residents exhibit signs of arsenic poisoning, the As contents in soil, water, and plants were systematically measured. The results indicated high As contents in plant and soil samples obtained from the area, and the source of As may be linked to the weathering of black shale rock. Ingestion of soil and consumption of plants were the two main As exposure pathways among children and adults, respectively, and children exhibited a higher health risk than adults. We presume and emphasize that when extreme drought events occur, humans might face unusual risks resulting from exposure to toxic elements and the direct consumption of highly polluted water. Our study provides a new perspective and sheds light on the environmental geochemistry and health links of this disease.

Groundwater chemical evolution characteristics and human health risk assessment in Shicheng County, Jiangxi Province

Groundwater plays a pivotal role in the water resources of Shicheng County; however, the issue of excessive fluoride content in groundwater and its associated health risks often goes unnoticed. Groundwater assumes a crucial role in the hydrological dynamics of Shicheng County; nevertheless, the matter concerning elevated levels of fluoride within groundwater and its accompanying health hazards frequently evades attention. The hydrogeochemical analysis, obscure comprehensive water quality assessment based on cloud model, and probabilistic human health risk assessment using Monte Carlo simulation were conducted on 34 collected water samples. The findings indicate that the predominant groundwater hydrochemical types are SO4·Cl-Na and HCO3-Na. The processes of rock weathering and cation exchange play crucial roles in influencing water chemistry. Groundwater samples generally exhibit elevated concentrations of F-, surpassing the drinking water standard, primarily attributed to mineral dissolution. The concentrations of F- in more than 52.94% and 23.53% of the groundwater samples exceeded the acceptable non-carcinogenic risk limits for children and adults, respectively. Considering the inherent uncertainty in model parameters, it is anticipated that both children and adults will have a probability exceeding 49.36% and 30.50%, respectively, of being exposed to elevated levels of F ions in groundwater. The utilization of stochastic simulations, in contrast to deterministic methods, enables a more precise depiction of health risks. The outcomes derived from this investigation possess the potential to assist policymakers in formulating strategies aimed at ensuring the provision of secure domestic water supplies.

Health risk assessment in an area of dental fluorosis disease from high fluoride drinking water: a case study from southeastern Türkiye

This study focuses on identifying fluoride (F‒) concentrations and its health risk assessment (HRA) in drinking water sources in south-eastern Türkiye. Groundwater quality was assessed using some graphical approaches such as Schoeller and Piper diagrams and GIS mapping. Average daily exposure dosages through oral and dermal contact exposure routes were considered to determine the potential health risk of F‒ in groundwater. Groundwater samples were taken from 53 points in spring, summer, autumn, and winter seasons. The results showed that the average annual F‒ concentrations in water resources in the study area were 0.26‒3.62 mg/L. According to the HRA results, the highest F‒ health risk in this region was observed in children, followed by teenagers and adults. This study indicated that there is a strong relationship between the high health risk (4.28 > 3.5) in children and dental fluorosis caused by high F‒ concentration in groundwater.

Assessment of drinking water quality and health risk using water quality index and multiple computational models: a case study of Yangtze River in suburban areas of Wuhan, central China, from 2016 to 2021

Water quality, increasingly recognized for its significant impact on health, is garnering heightened attention. Previous studies were limited by the number of water quality indicators and the duration of analysis. This study assessed the drinking water quality and its associated health risk in suburban areas of Wuhan, a city in central China, from 2016 to 2021. We collected 368 finished water samples and 1090 tap water samples and tested these for 37 different indicators. The water quality was evaluated using the water quality index, with trends over time analyzed via the Mann-Kendall test. Furthermore, an artificial neural network model was employed for future water quality prediction. Our findings indicated that the water quality in rural Wuhan was generally good and had an improvement from 2016 to 2021. The qualification and excellent rates were 98.91% and 86.81% for finished water, and 97.89% and 78.07% for tap water, respectively. The drinking water quality was predicted to maintain satisfactory in 2022 and 2023. Additionally, principal component analysis revealed that the primary sanitary issues in the water were poor sensory properties, elevated metal contents, high levels of dissolved solids, and microbial contamination. These issues were likely attributable to domestic and industrial waste discharge and aging water pipelines. The health risks associated with the long-term consumption of this water have been steadily decreasing over the years, underscoring the effectiveness of Wuhan's ongoing water management efforts.

Unravelling groundwater contamination and health-related implications in semi-arid and cold regions of India

Groundwater, a vital global resource, is essential for sustaining life and various human activities. However, its quality and availability face increasing threats from both natural and human-induced factors. Widespread contamination, arising from both natural origins and human activities such as agriculture, industry, mining, improper waste disposal, and wastewater release, poses significant risks to human health and water security. India, known for its dense population and pronounced groundwater challenges, serves as a prominent case study. Notably, in most of its regions, groundwater resources have been found to be severely contaminated by various chemical, biological, and radioactive contaminants. This review presents an examination of contamination disparities across various states of semi-arid and cold regions, encompassing diverse assessment methods. The studies conducted in semi-arid regions of North, South, West, and East India highlight the consistent presence of fluorides and nitrates majorly, as well as heavy metals in some areas, with values exceeding the permissible limits recommended by both the Bureau of Indian Standards (BIS) and the World Health Organization (WHO). These contaminants pose skeletal and dental threats, methemoglobinemia, and even cancer. Similarly, in cold regions, nitrate exposure and pesticide residues, reportedly exceeding BIS and WHO parameters, pose gastrointestinal and other waterborne health concerns. The findings also indicated that the recommended limits of several quality parameters, including pH, electrical conductivity, total dissolved solids (TDS), total hardness, and total alkalinity majorly surpassed. Emphasising the reported values of the various contaminant levels simultaneously with addressing the challenges and future perspectives, the review unravels the complex landscape of groundwater contamination and its health-related implications in semi-arid and cold regions of India.

Fluoride in groundwater of industrial town of Sonbhadra district, Uttar Pradesh, India: probable release mechanism and potential health risk assessment

In the selected study region of Sonbhadra district, coal burning and mining activities are dominant. Previous studies reported F contamination in very few groundwater samples of this region. A detailed study is required to estimate the fluoride in groundwater of this area. Hence, a total of 128 groundwater samples were collected during post- and pre-monsoon seasons in the year 2017 to estimate the F-, its geochemistry, and health risk assessment from Renukoot and Anpara industrial clusters of Sonbhadra district, Uttar Pradesh, India. The pH of groundwater samples varied from slightly acidic to alkaline during both seasons. Almost all the major cations (Ca2+, Mg2+, Na+, and K+) and major anions (HCO3-, Cl-, SO42-, and F-) values in groundwater samples of both clusters were found within the permissible limit of World Health Organization (WHO) and Beauro of Indian standards except F- in both seasons. The scatter plots of F- with Ca2+, Na+, HCO3-, and pH are used to explain the release mechanism of fluoride in groundwater. Saturation indices (SI) calcite versus SI fluorite and SI dolomite versus SI fluorite plots of both clusters used to check the involvement of these minerals in fluoride enrichment of aquifers. F- contamination in groundwater due to coal burning in coal mining and thermal power plant dominated region is discussed globally and locally both. The non-carcinogenic health risk due to consumption of fluoride-contaminated water is estimated by using target hazard quotient (THQ). THQ values of F- showed that children are at high risk than adults in both clusters of the study area during both seasons. Pictorial representation is used to show the dental fluorosis cases in children of the study region.

Synthesis and application of alginate-nanocellulose composite beads for defluoridation process in a batch and fluidized bed reactor

Electronegative Fluorine has great reactivity and it exists as organic or inorganic fluoride compounds. Biosorption feasibility of fluoride onto alginate-cellulose composites was investigated in this study. Extracted cellulose has been utilized to synthesize calcium alginate impregnated composite beads for fluoride remediation process in batch and fluidized-bed reactors. Physiochemical characteristics were analyzed by FTIR, SEM, TGA and BET. From the BET properties analysis, the surface area of prepared composite beads was 87.13 m2/g. The point zero charge (PZC) value of composite beads was attained at pH 7.32. The relationship between biosorption efficiency and independent variables have been observed to evaluate the effects on the fluoride biosorption efficiency of composites and its components. The hypothetical development of the removal technique has been explained using various nonlinear model-fitting methods to evaluate Isotherm study, bio-sorption Kinetics, Thermodynamic parameters and Mass transfer study. Maximum monolayer adsorption capacity (qm) obtained by following Langmuir model for fluoride removal was found to be 23.809 mg/g at 30 °C using adsorbent dosage of 2 g/L for an initial fluoride concentration of 6 mg/L. The optimized condition for fluoride adsorption experiment was observed by evaluating response surface methodology (RSM) was pH-5.67, dose 1.89 g/L and time 85.71 min and removal was found as 82.79%. Experimental data of fluidized-bed study were evaluated by designing mathematical modeling. Fluidization velocities was adjusted in between Umf and 2Umf for optimizing external mass transfer and adsorbent loss. Regeneration study of fluoride loaded biosorbent and cost analysis of composite production have been estimated.

Occurrences, sources and health hazard estimation of potentially toxic elements in the groundwater of Garhwal Himalaya, India

High concentrations of potentially toxic elements (PTEs) in potable water can cause severe human health disorders. Present study examined the fitness of groundwater for drinking purpose based on the occurrence of nine PTEs in a heavy pilgrim and tourist influx region of the Garhwal Himalaya, India. The concentrations of analyzed PTEs in groundwater were observed in the order of Zn > Mn > As > Al > Cu > Cr > Se > Pb > Cd. Apart from Mn and As, other PTEs were within the corresponding guideline values. Spatial maps were produced to visualize the distribution of the PTEs in the area. Estimated water pollution indices and non-carcinogenic risk indicated that the investigated groundwater is safe for drinking purpose, as the hazard index was < 1 for all the water samples. Assessment of the cancer risk of Cr, As, Cd, and Pb also indicated low health risks associated with groundwater use, as the values were within the acceptable range of ≤ 1 × 10-6 to 1 × 10-4. Multivariate statistical analyses were used to describe the various possible geogenic and anthropogenic sources of the PTEs in the groundwater resources although the contamination levels of the PTEs were found to pose no serious health risk. However, the present study recommends to stop the discharge of untreated wastewater and also to establish cost-effective as well as efficient water treatment facility nearby the study area. Present work's findings are vital as they may protect the health of the massive population from contaminated water consumption. Moreover, it can help the researchers, governing authorities and water supplying agencies to take prompt and appropriate decisions for water security.

Fluoride induced metabolic disorder of endothelial cells

Endemic fluorosis is a global public health problem. Cardiovascular diseases caused by fluoride are closely related to endothelial cell injury. Metabolism disorder of endothelial cells (ECs) are recognized as the key factor of endothelial dysfunction which has been a hot topic in recent years. However, the toxic effect of fluoride on vascular endothelium has not been elucidated. The aim of this study was to explore the alteration of endothelial cell metabolites in Human Umbilical Vein Endothelial Cells (HUVECs) exposed to NaF using LC-MS/MS technique. The screening conditions were Variable Importance for the Projection (VIP) > 1 and P < 0.05. It was found that the expression of the metabolites Lumichrome and S-Methyl-5'-thioadenosine was upregulated and of the other metabolites, such as Creatine, L-Glutamate, Stearic acid was downregulated. Differential metabolites were found to be primarily related to FoxO、PI3K/Akt and apoptosis signaling pathways by Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. From the perspective of metabolism, this study explored the possible mechanism of fluoride induced endothelial cell injury which providing theories and clues for subsequent studies.

Geochemical evidence of fluoride behavior in loess and its influence on seepage characteristics: An experimental study

High background levels of fluorine in groundwater and soil in arid and semi-arid loess regions pose a severe threat to socio-economic development and human health, necessitating the evaluation of fluorine migration in loess. In this study, static leaching and dynamic seepage tests as well as scanning electron microscopy, mercury intrusion porosimetry, and X-ray fluorescence analyses were conducted using loess as the porous medium. Additionally, simulations using PHREEQC software were performed. The results indicated that the studied loess had a high background level of fluorine. Geochemical processes closely related to fluorine include dissolution of gypsum and dolomite, precipitation/dissolution of calcite and fluorite, and ion exchange between CaX and NaX. Under seepage of water with high fluorine levels, soil particles flocculated and formed aggregates; furthermore, the contact area between soil particles reduced, resulting in point-to-point contact between particles. Consequently, pores changed from small (intra- and inter-particle pores) to large (intra- and inter-granular pores) scale pores. Permeability initially decreased rapidly, then remained relatively stable, and subsequently rapidly increased with the passage of time. This was attributed to the dissolution of calcium minerals in loess, yielding Ca²⁺, which induced the precipitation of fluorite and promoted the dissolution of carbonates. Cation exchange and dissolution of other components were also important factors influencing permeability. The findings of this study can elucidate the coupling between loess microstructure, seepage behavior, and geochemical actions under the influence of high‑fluorine water, and are of great significance for in-situ regional research in loess areas.

Application of fuzzy C-means clustering and fuzzy EDAS to assess groundwater irrigation suitability and prioritization for agricultural development in a complex hydrogeological basin

The current research is focused on detecting a river basin suitable for agriculture and priority for management using a new clustering tool of groundwater quality with fuzzy logic technique in R and Geographical Information System. A new fuzzy clustering-soft computing technique has been executed to determine the different hydrochemical zones considering 13 essential parameters such as electrical conductivity, hardness, chloride, sodium adsorption ratio, residual sodium carbonate, soluble sodium percent, magnesium hazard, permeability index, potential salinity, residual sodium bicarbonate, Kelly's ratio, synthetic harmful coefficient, and exchangeable sodium percentage. The derived fuzzy C-mean clustering (FCM) outperformed other available hard computing techniques like hierarchical clustering, K-means clustering, and agglomerative clustering. It divided the sampling sites into 2 clustering groups (FCM I and FCM II) which has been validated using fuzzy silhouette index (0.85), the partition coefficient (0.76), the partial entropy (0.68), and the modified partition coefficient (0.52). The hydrogeochemical analysis confirmed that the rock-water interaction, chemical weathering, and ion exchange process are predominant in the aquifer system of the study area. According to the correlation plots, the studied groundwater samples largely evolved from [Formula: see text], mixed [Formula: see text] types, and [Formula: see text] types. The spatial distribution map and the hydrochemical analysis also gives a clear depiction of the fluoride (> 1.0 mg/l) and high iron (> 0.3 mg/l) contamination in groundwater quality, making it unsuitable for both drinking and irrigation. A fuzzy EDAS priority map has been prepared based on all the irrigation suitability parameters which concludes that the groundwater at the upstream and downstream section of the basin requires the most attention. Based on the highest priority for management, five zones have been delineated: very high (5.98%), high (22.31%), medium (16.39%), low (32.30%), and very low (23.02). The findings of this study will be beneficial to planners and policymakers as they can develop schemes to solve similar problems across the country.

Health‑risk assessment and distribution characteristics of fluoride in groundwater in six basins of Shanxi Province, Middle China

High-fluoride (F) pollution is an environmental problem that severely affects the growth of human beings, animals and plants. High-fluoride groundwater severely harms the health of Shanxi residents and leads to frequent endemic diseases. This study aims to analyze the differences and possible health risks of fluoride among six basins in Shanxi Province, North China, using 338 groundwater samples collected from wells, infer the main sources of fluoride in the groundwater, and provide valuable suggestions for fluoride contamination in regional groundwater. The results revealed that F in the Yuncheng basin had the highest health risk. In addition to the Changzhi basin, the groundwater at the sampling points in other basins had adverse effects on human health. The main source of fluoride in groundwater is the dissolution of fluoride-containing minerals, which has little to do with human activities. The groundwater in Shanxi Province tends to be alkaline, and the fluorite saturation index is less than 0 in most circumstances, indicating that fluorite is in an unsaturated state, and fluoride will continue to dissolve into groundwater under suitable conditions. Clustering analysis shows that the high-fluoride areas are mainly distributed in the Yuncheng basin and the southern part of the Xinzhou basin. Fluoride-rich groundwater in a basin often exists only in a certain area, and the distribution of confined water and unconfined water in high-fluoride areas is different. Fluoride contamination in the Changzhi basin is not severe. For the high-fluoride areas in the Datong basin, Xinzhou basin, Taiyuan basin and Linfen basin, utilizing water from other areas or exploiting groundwater from other aquifers to diminish the harm of high-fluoride groundwater intake for a long period is suggested. For the Yuncheng basin, adopting membrane-based processes or variable temperature drop fluoride technology to make groundwater contaminated by excessive fluoride potable is recommended.

Probabilistic potential health risk quantification, hydrochemistry, driving forces of groundwater nitrate and fluoride in a typical irrigation district, Northern China

Groundwater is the foremost water source of agricultural irrigation areas in northern China. However, the problem from excessive geogenic fluoride and anthropogenic nitrate in groundwater and its potential health risks are often neglected. This paper aims to identify the health threats, water quality and hydrochemistry in Weibei Plain, northern China. A total of 50 water samples collected in May 2021 were assessed by hydrogeochemical analysis, the entropy weight water quality index method and probabilistic human health risk assessment based on Monte Carlo stochastic simulation. The results showed that the hydrochemical type of surface water and groundwater was mainly SO₄·Cl-Ca·Mg type. The rock weathering and cation exchanges were found to the important processes influencing hydrochemistry. The quality of surface water was higher than that of groundwater, with Class IV and Class V groundwater samples concentrated in the northwest of the study area. The F^- concentration in groundwater samples generally exceeded the drinking water standard, which mainly came from mineral dissolution affected by excessive irrigation. Nitrate pollution in groundwater has regional characteristics, mainly from agricultural activities. Long-term use of groundwater might bring risks to residents' health, because more than 65% and 23% of groundwater samples exceeded the acceptable non-carcinogenic risk limits of F^- and NO₃^- to children, respectively. Considering the uncertainty of model parameters, children will have a probability of more than 46.9% and 12.6% to face F^- and NO₃^- risks in groundwater. Compared with NO₃^-, the high concentration of F^- in groundwater posed a higher threat to human health, and children faced higher risks. Compared with the deterministic method, the stochastic simulation can more accurately reflect health risks. The findings of this study can help policymakers devise strategies to ensure a safe supply of domestic water.

Water quality and probabilistic non-carcinogenic health risk of groundwater: a half decadal scenario change in Vadodara

Groundwater is essential to secure the safety of water supply in Vadodara, Gujarat. In this study, groundwater samples were collected from various part of the city which separated in 12 wards. The present study contains analyses of 720 groundwater samples gathered from various tube and open wells and analyzed for fluoride and other physicochemical parameters during 2014 and 2019. The results indicated that fluoride and TDS were high and the overall water quality was poor in the study area. Gastrointestinal and other health-related issues increased due to higher TDS in east, north and northeast regions. Likewise, hierarchical cluster analysis also indicated that TDS and chloride-rich water. Fluoride concentration was observed in the range of 0.66-1.61 mg/l (2014) and 0.86-1.77 mg/l (2019) which indicates that 62% samples are unfit for drinking purpose, which could cause dental and skeletal fluorosis. The water quality index (WQI) indicated lack of excellent water in the studied area in the last half-decade. As per WQI calculation suggest that 82.12% (2014) and 69.00% (2019) of groundwater samples represent poor, very poor and unsuitable categories, whereas remaining 17.85% (2014) and 31.00% (2019) of the samples represent good category for drinking purposes in entire Vadodara, Gujarat. Marginal improvement in the groundwater quality is reported due to good rainfall in 2019. Health risks associated with high fluoride drinking water were assessed for various age groups of inhabitants such as children, infants and adults. The non-carcinogenic hazard quotient estimated by oral intake was 1.38-3.36 (2014) and 1.79-3.70 (2019) for infants; 0.69-1.68 (2014) and 0.90-1.85 (2019) for children, whereas 0.07-0.18 (2014) and 0.10-0.20 (2019) for adults. Therefore, infant and children are relatively at higher health risk due to the intake of fluoride-rich drinking water than adult in the studied region. Both indices were indicated contaminated water or closer to contamination which induced non-carcinogenic health risk on citizens. Thus, the comprehensive results of present study can be used as a baseline data and valuable tool for government authorities for long-term monitoring, health monitoring and sustainable development of Vadodara, Gujarat.

Mean Fluoride Concentration in Drinking Water Sources of a Municipality: A Descriptive Cross-sectional Study

Introduction

Fluoride is essential for the growth and development of teeth and bone. Excess or less fluoride consumption can have harmful effects on our bodies. Fluoride level of 0.5-1.5 mg/l is said to be optimized according to the World Health Organization. The level of fluoride varies among the different geographical regions and water sources. It is essential to find out the fluoride content of various water sources used for drinking purposes. The aim of this study was to find the mean concentration of fluoride in drinking water sources of a municipality.

Methods

A descriptive cross-sectional study was conducted in a Municipality. The study was conducted from 1 December 2021 to 30 December 2021 after receiving ethical approval from the Ethical Review Board (Reference number: 1134). Water samples were collected and the fluoride content was estimated using 2-parasulfophenylazo-1,8-dihydroxy-3,6-napthalene-disulfonate colorimetric method. The data collected from the laboratory were calculated and presented in the form of a table. Point estimate and 95% Confidence Interval were calculated.

Results

The mean value of fluoride content in 160 collected water samples was 0.369±0.275 mg/l (0.33-0.41, 95% Confidence Interval). Among the different wards, the fluoride content was 0.708±0.27 mg/l in ward number 12 followed by a fluoride content of 0.57±0.19 mg/l in ward number 5.

Conclusions

In this study, the mean fluoride levels were lower when compared with similar studies conducted in similar settings. The levels were lower than that recommended by the World Health Organization. The various controlled methods of fluoridation have to be quickly initiated. Other means of fluoride consumption, like the use of fluoridated toothpaste, has to be recommended.

Keywords

dental caries; drinking water; fluoride.

Evaluation of groundwater quality for irrigation water supply using multi-criteria decision-making techniques and GIS in an agroeconomic tract of Lower Ganga basin, India

Groundwater irrigation has evolved the monocropping cultivation pattern to multi-cropping, especially in many arid/semi-arid tracts globally. Irrigation practices with the groundwater of poor quality can limit the selection of the crop, reduce crop yields and degrade the soil quality. The present study has been undertaken to identify the hydrogeochemical phenomena of groundwater systems in the south-western Birbhum district, India and to analyze groundwater suitability for irrigation during the pre-and post-monsoon cycles by adopting the Irrigation Water Quality Index (IWQI) using Multivariate Factor Analysis along with some traditional methods viz. sodium adsorption ratio, sodium percentage, magnesium hazards, residual sodium bicarbonate (RSBC) and carbonate (RSC), Wilcox's and USSL diagrams, permeability index and Kelly's index. The hydrogeochemical analysis revealed that chemical weathering and evaporation are predominant in the aquifer systems. Groundwater quality reflected soil salinity, sodicity and magnesium hazards risks and water toxicity to the sensitive plants at 0-46.4% of the post-monsoon samples and 0-38.4% of the pre-monsoon samples based on the individual traditional methods whereas about 97.73-98.88% of the total area was classified as moderate to severely unsuitable for irrigation during both seasons when integrated multiple parameters using the IWQI method. Prolonged use of such groundwater for irrigation is susceptible to causing moderate to severe infiltration problems at a greater extent of the study area. The study recommends adaptation of salinity, sodicity and RSC/RSBC reduction procedures (e.g., the use of acid and gypsum amendments in the irrigation lands and through water blending) and advanced irrigation practices (viz. drips, sprinklers and micro irrigations) to prevent soil degradation and increase crops productivity. Adopting Managed Aquifer Recharge procedures as well as rainwater harvesting in the areas bearing unsuitable water quality can dilute the ionic concentrations of the groundwater facies which in turn will improve the groundwater quality for irrigation.

High fluoride in groundwater and associated non-carcinogenic risks at Tiruvannamalai region in Tamil Nadu, India

The present investigation in the Tiruvannamalai region is about high fluoride contamination of groundwater samples from bore wells and open wells. About 75% of groundwater samples were found predominantly containing the fluoride content greater than the acceptable limit of 1.5 mg/L in the ranges 1.51 - 2.00 mg/L (23%), 2.01 - 3.00 mg/L (36%) and greater than or equal to 3.01 mg/L (16%) as per WHO. The other water quality parameters were found within the permissible limit of WHO. Taking the groundwater sources into consideration, the non - carcinogenic risk due to high fluoride concentration in groundwater sources revealed that teen - aged (98%), Children (92%) and Infant (98%) categories were at greater risk than those under Men (50%) and Women (69%) categories. The mapping was done on the spatial distribution of fluoride concentration in groundwater and the associated health risk by Ordinary Kriging. The correlation coefficients among the parameters witnessed that the hydro-chemical facies are interdependent. Box - Whisker plots illustrated the dispersion of various water quality parameters. The WQI data represented the quality of groundwater in view of potable nature due to dissolved ions. The Gibbs, bivariate mixing and the scatter plots ascribed the dissolution of carbonate and silicate minerals which dominate the groundwater chemistry. The factor analysis detailed the extracted loadings of different parameters of groundwater sources and differentiated the percentage variance values between bore well and open well sources.

Hydrogeochemical characterizations and quality evaluation of groundwater in the major river basins of a geologically and anthropogenically driven semi-arid tract of India

Access to clean drinking water has been acknowledged as a human right and assessing the hydrogeochemistry and groundwater quality status plays an important role in proving cleaner and safer water for human consumption. This study evaluated the sources and driving factors of the groundwater facies in the five major river basins (viz. Ajay, Mayurakshi, Kopai, Brahmani and Dwarka) of an agroeconomic semi-arid Indian tract through hydrogeochemical and principal component analyses based on 2200 groundwater samples (N_s = 2200) obtained during the pre- and post-monsoon cycles from 1100 wells (N_w = 1100). The results revealed that minerals weathering, ion/reverse ion exchange, mixing and evaporation processes along with anthropogenic inputs are responsible for the deteriorated groundwater quality of the river basins. The study has considered the cokriging approach that uses geostatistical and multivariate statistical techniques to interpolate a dataset. To determine the spatio-seasonal variabilities of the groundwater facies more accurately, the estimation accuracies of different interpolation techniques viz. inverse distance weighting, kriging/cokriging and splines techniques were compared and kriging/cokriging was found to represent the variability more accurately. Shannon's entropy theory was employed to assess the groundwater quality of the river basins as it eliminates the subjective bias and inherent uncertainties of the groundwater systems. Groundwater in ~37.45-38.42% of the total area was moderate to extremely poor for human consumption where 10.40-12.14%, 9.09-12.40%, 21.18-22.35%, 15.20-19.93% and 6.48-8.80% samples from the Ajay (N_w = 175), Brahmani (N_w = 175), Dwarka (N_w = 180), Kopai (N_w = 350) and Mayurakshi (N_w = 220) river basins exhibited unfit to drink water quality. The sensitivity of the water quality model was analyzed to identify the influences of the individual parameters which revealed that the outcome does not depend solely on one parameter. The study recommends adaptation of the treatment techniques to ensure clean drinking water for the residents. Managed aquifer recharge techniques might also improve the groundwater quality in certain areas.

Exploring a variance decomposition approach integrated with the Monte Carlo method to evaluate groundwater fluoride exposure on the residents of a typical fluorosis endemic semi-arid tract of India

This study appraised the groundwater fluoride (F^-) endemicity and the exposure levels under the Central Tendency Exposure (CTE) condition and the Reasonable Maximum Exposure (RME) condition on the residents of the semi-arid parts of the Birbhum district of Peninsular India using a Variance Decomposition (Sobol Sensitivity Indices) approach combined with Monte Carlo Simulations. The study finds the national scale drinking water standard limit for F^- (1.5 mg L^-1) is inappropriate for the present survey area where F^- concentration in groundwater varied between 0.26 and 11.82 mg L^-1 and ~54.5% of the samples (N = 400) exceeded this limit. Therefore, estimated the optimum F^- concentration of 0.733 mg L^-1 for the region using the method recommended by the World Health Organization (WHO) to calculate the optimum F^- limit at a regional scale. The average value of F^- concentrations for this region (1.71 mg L^-1) is considerably higher than the estimated optimum concentration or even the maximum permissible limits recommended for the subtropical regions (0.5-0.7 mg L^-1). The exposure analysis revealed the infants and children as potentially vulnerable populations compared to adolescents and adults of the study area for CTE and RME scenarios. The multi-exposure pathways indicated oral intake as the main exposure pathway whereas exposure through dermal contact was insignificant for the residents of all age groups of this region. Based on the first, second and total order Sobol Sensitivity Indices, F^- concentration (C) in groundwater, the groundwater ingestion rate and their combined interaction are the greatest significant parameters for the oral exposure model whereas C and its interaction effects with the proportion of the skin surface area in contact with groundwater as the utmost sensitive variables for the dermal health risks assessment model. The present study insists the inhabitants to intake defluoridated groundwater.

3,4-Dihydroxybenzaldehyde mitigates fluoride-induced cytotoxicity and oxidative damage in human RBC

BACKGROUND

Fluoride is an essential micronutrient that is needed for mineralization of bones and formation of dental enamel. It is a widely dispersed environmental pollutant and chronic exposure to it is toxic, resulting in malignancies and hematological damage in humans. Blood is a major and early target of environmental pollutants and toxicants like fluoride. Fluoride generates reactive oxygen species and free radicals which induce oxidative stress in target cells and mediate its toxic effects. The aim of this study was to determine the mitigating effect of plant antioxidant 3,4-dihydroxybenzaldehyde (DHB) on sodium fluoride (NaF) induced oxidative damage and cytotoxicity in isolated human red blood cells (RBC) METHOD: Isolated human RBC were treated with 0.5 mM NaF, in absence or presence of different concentrations of DHB (0.1-2.5 mM). Several biochemical parameters were analyzed in cell lysates and whole cells.

RESULTS

Treatment of RBC with NaF increased the formation of reactive oxygen and nitrogen species. It oxidized thiols, proteins and lipids and generated their peroxidative products. Methemoglobin level, heme degradation and lipid peroxidation were increased but cellular antioxidant status declined significantly in NaF alone treated RBC, compared to the control. NaF inhibited antioxidant, membrane bound and glycolytic enzymes in RBC. However, prior incubation of RBC with DHB significantly attenuated the NaF-induced alterations in all these parameters in a DHB concentration-dependent manner.

CONCLUSION

These results show that DHB mitigates NaF-induced oxidative damage in human RBC, probably because of its antioxidant character.

Water quality and health risk assessment of the water bodies in the Yamdrok-tso basin, southern Tibetan Plateau

Water resources in good quality guarantee the primary condition for the maintenance and development of the natural ecosystem and human society. Water quality status and health risk of the lake water bodies in the national nature reserve, the Yamdrok-tso basin, in the southern Tibetan Plateau are assessed by 25 water parameters including 12 heavy metal(loid)s. Results reveal that the lake water bodies possess relatively high pH (9.68), high concentrations of F (1.66 mg/L), Cu (13.92 μg/L), As (41.60 μg/L), Pb (26.69 μg/L), and U (19.53 μg/L), and a low value of dissolved oxygen (19.30%). The pollution indices (heavy metal pollution index of 0.88-22.88, heavy metal evaluation index of 0.18-3.75, and the degree of contamination of -8.82 to -5.25) demonstrate that the lake water bodies are in a low pollution level with respect to heavy metal(loid)s. The evaluation of water quality based on the fuzzy comprehensive assessment method suggests that 75.56% of the water samples meet the regulation of the China National Standard for water resources in national nature reserves. Health risk assessment shows that potential hazards exist on this region when the residents under long-term exposure to the lake water through oral and dermal pathways, of which children and adults are mostly exposed to As and F for non-carcinogenic and As for carcinogenic risks, especially for children. Results of this study contribute to targeted water resources management in the national nature reserves.

Hydrogeochemical evidence for fluoride behavior in groundwater and the associated risk to human health for a large irrigation plain in the Yellow River Basin

A hydrochemical analysis of groundwater (GW) was conducted to investigate the factors controlling GW fluoride (F) in a large irrigation plain in the Yellow River Basin, Guanzhong Plain, China. Area-dependent variations in F were observed in the study region. The F concentrations of 93% of samples on the south bank of the Weihe River and the western part of the Qishui River were <1 mg L^-1, whereas those of 73% of GW samples for the eastern part of the Qishui River exceeded the national limit. A forward model based on mass budget equations identified carbonate weathering as the dominant factor regulating hydrochemistry in low-F GW, whereas the factors in the high-F zone were evaporate dissolution and evaporation. The high-F GW displayed a distinctive major ion chemistry, which could be attributed to a high pH, low Ca²⁺, and high HCO₃^- and Na⁺ concentrations. An analysis of the correlation between F/Cl and F concentrations and fluid-mineral equilibria indicated distinct forces driving the behavior of F in the subparts of the high-F GW zone, including irrigation-induced F dilution, F enrichment through Na-Ca exchange, and adsorption of F on clay minerals. The order of vulnerable segments of the population in terms of risk posed by F in GW was: infants > children > adults. These results can enhance the understanding of F behaviors in GW and provide insights into the effect of irrigation practices on GW F concentration.

Sources, controls, and probabilistic health risk assessment of fluoride contamination in groundwater from a semi-arid region in Gujarat, Western India: An isotope-hydrogeochemical perspective

Fluoride contamination in groundwaters of a rural region in semi-arid Western India has been studied using combination of geochemical-and-isotopic techniques, in conjunction with Health Quotient assessment approach. The objective of this study is to determine the sources and controls on fluoride content and to evaluate probabilistic non-carcinogenic risk associated with its long-term consumption. F^- ranges from 0.3 to 12 mg L^-1, shows high spatial variability, and ~ 35% of the samples have F^-  > 1.5 mg L^-1 (WHO maximum limit for drinking). Two sources are identified: high F^- results from water-rock interaction of F-bearing minerals in granites and gneisses, while phosphate fertilizers can contribute up to ~ 0.46 mg L^-1 of groundwater F^- that can be significant for low F^- samples. High F^- samples are characterized by high pH, Na and alkalinity, and low Ca. Calcite precipitation drives the solubility of F-bearing minerals. Kinetic fractionation of water isotopes (¹⁸O and ²H) demonstrates that evaporation plays role in enriching groundwater F^-. Non-carcinogenic risk, estimated by Hazard Quotient ([Formula: see text]), ranges from 0.13-5.72 to 0.26-11.86 for adult and children, respectively. Conservative estimate shows that ~ 0.467 million of adults and~0.073 million of children in four sub-districts are under the risk of fluorosis-while the residents of other five sub-districts remain safe from it. Finally, we suggest stakeholders to install F^- treatment plants to ensure the health safety of local residents in the high-risk zones, create awareness in farmers for optimum use of fertilizers, and promote rainwater harvesting, for better management of groundwater resources and quality in the region.

Characterization of groundwater nitrate exposure using Monte Carlo and Sobol sensitivity approaches in the diverse aquifer systems of an agricultural semiarid region of Lower Ganga Basin, India

Prevalence of nitrate in different aquifer systems is a growing environmental and public health concern. Efforts were made for the first-time to achieve a higher accuracy in health risks characterization associated with the nitrate in groundwater of the diverse aquifer systems on the residents of a semi-arid rural tract of Lower Ganga Basin using Monte Carlo Simulations and Sobol Sensitivity analyses. The nitrate levels in groundwater varied between 0 and 508.3 mg/L with a mean of 19.79 ± 32.78 mg/L and 0-435.0 mg/L with a mean of 24.44 ± 35.15 mg/L during the pre-monsoon and post-monsoon periods, respectively. About 847.12-1000.25 km² area of the survey area (total area 4545 km²) exhibited nitrate concentrations (C) > the pre-intervention limits (45-50 mg/L). Minor populations, especially the infants from the granite gneiss, Rajmahal traps, laterite, recent alluvial and old alluvial aquifer zones under the Central Tendency Exposure (CTE) condition and all the aquifer zones (including the Gondwana supergroup aquifer zone) under Reasonable Maximum Exposure (RME) scenarios, were characterized as being at high risks of methemoglobinemia, primarily due to ingestion of untreated nitrate contaminated groundwater. Residents of the alluvial aquifer zones of the study area were found to the most vulnerable to the groundwater nitrate toxicity through oral and dermal exposures. The study validated the prediction accuracies of different interpolation methods including the Spline, Kriging, polynomial and Inverse Distance Weighted and revealed that Kriging predicted the Spatio-seasonal variations of groundwater nitrate of the district more accurately. Sobol Sensitivity analysis revealed C and the interaction effects of C and groundwater Ingestion Rate (IR), and C and Fraction of skin area contacted with groundwater (F) as the influential parameters for oral and dermal health risks exposure models. Therefore, the study recommends to residents of the study area to consume treated groundwater to mitigate nitrate related health morbidities.

Identifying fluoride endemic areas and exposure pathways for assessment of non-carcinogenic human health risk associated with groundwater fluoride for Gujarat state, India

Analytical data of fluoride concentration in groundwater collected from various geological formations in Gujarat, India, have been studied to assess their spatial distribution characteristics and related potential chronic health risks. Decadal analysis of groundwater was attempted for precise quantification and a realistic ground representation of fluoride concentration in the entire state. This exercise involved collection of 6407 samples over a period of 10 years (2009-2018), from 641 representative locations, distributed evenly throughout the state (6407 = 641 locations × 10 years). The analytical results indicate that 19% of the sample locations have fluoride concentration higher than the permissible limit and 42% of the locations have fluoride concentration much below the desirable limit, thereby exposing children to a higher risk of associated dental morbidities. Monte Carlo simulation integrated with sensitivity and uncertainty analysis was applied for an accurate and realistic assessment of the non-carcinogenic health risk. Model results indicated that groundwater fluoride exposure through consumption is way higher than the exposure due to dermal absorption pathway. It is inferred that 94 locations (15%) have total hazard index greater than the unity value for all population groups, thereby increasing the vulnerability of the local populace to dental and skeletal fluorosis. Total hazard index in 210 locations (36%) and 188 locations (29%) are beyond the permissible limit for the population comprising infants and children. Populaces living in these locations are susceptible to health hazards that stems from high fluoride concentration. Children and infants are at greater risk due to groundwater fluoride toxicity when compared to the adult populace. The order of the geographic stratification of vulnerability is Mainland regions > Saurashtra region > Kachchh region. Ingestion rate and fluoride concentration are the sensitive parameters with high impact and residents of these vulnerable locations should be advised to abstain from direct intake of groundwater and resort to defluoridised groundwater.

Investigation of health risks related with multipath entry of groundwater nitrate using Sobol sensitivity indicators in an urban-industrial sector of south India

In the present study, we used a variance decomposition based global sensitivity index to evaluate the sensitivity of input variables and their contribution for non-carcinogenic health risks via intake and dermal pathways. Groundwater samples were collected from an industrial sector (Tiruppur region) of south India during the month of January 2020. These samples were analysed for nitrate, which varied from 10 to 290 mg L^-1 having the mean of 87 mg L^-1. Nearly 58% of the samples surpassed the permissible limit (45 mg L^-1) defined by the World Health Organization. Total hazard index (THI) ranged from 0.29 to 8.52 for children, 0.28 to 8.26 for women, and 0.24 to 6.99 for men. The first-order effect (FOE) and second-order effect (SOE) were derived for the three different age groups using Sobol sensitivity approach. The FOE scores showed that nitrate concentration in groundwater is the most sensitive parameter followed by exposure frequency for children, men and women via oral pathway. The SOE scores showed that nitrate concentration along with ingestion rate had greater sensitiveness in the oral input model. The higher SOE was obtained for the interaction of nitrate with skin surface area for children via dermal pathway, but it was not significant for women and men. These results suggest that epidemiology due to nitrate risk should be studied taking into account of concentration of nitrate, exposure frequency, fraction of contact and body weight. Additionally, ingestion rate and skin surface area were considered for the assessment of health risks for children.

Chromium contamination in groundwater and Sobol sensitivity model based human health risk evaluation from leather tanning industrial region of South India

The present investigation was conducted to find the possible chromium contamination in groundwater and the related health risks in a leather industrial region of south India using Sobol sensitivity modeling. Thirty-five groundwater samples were sampled from the field sites and were analyzed for pH, TDS (Total Dissolved Solids), EC (Electrical Conductivity), F^- (Fluoride), NO₃^- (Nitrate) and Cr (Chromium). The concentration of nitrate varied from 3 to 81 mg/L with a mean of 48.6 mg/L. About 57% (n = 20) of the wells surpassed the drinkable limit (45 mg/L) for NO₃^- as per World Health Organization (WHO). The fluoride ion ranged from 0.1 to 2.7 mg/L with a mean of 1.5 mg/L. Around 51% (n = 18) of the samples crossed the recommended limit of WHO for F^- (1.5 mg/L). The chromium varied from 0.01 to 0.19 mg/L in groundwater with a mean of 0.1 mg/L. About 66% (n = 23) of the samples overshoot the permissible limit of WHO standards (0.05 mg/L) for Cr. The spatial distribution map of chromium in the groundwater showed that 271.76 km² area is under risk. Based on total hazard index (THI), 66%, 46%, and 43% of the groundwater samples surpassed the allowable limit (THI > 1) for children, women and men, correspondingly. Children pose severe health risks than women and men in this region. Using Sobol sensitivity indices, three different categories of risk effects were assessed: first order effect (FOE), total effect (TE) and second order effect (SOE). In the oral sensitivity model, concentration of Cr (C_w) in water and ingestion rate (IR) had the dominant role, whereas in the dermal model, skin surface area (SA) and contact fraction by skin (F) had vital role in addition to the concentration (C_w). Further, the outcome of this study insists the responsibilities of industrial, municipal and agricultural sectors to keep the environment pollution free and to ensure the supply of potable water to the people.

Spatial distribution and potential health risk of fluoride in drinking groundwater sources of Huaibei, Anhui Province

Fluoride enrichment in drinking groundwater at Huaibei leads to potential health risk to the residents. A total of 49 groundwater samples from groundwater sources were collected to evaluate the potential health risk of fluoride ingestion through drinking water for children and adults in Huaibei. Results shown that the average concentration of fluoride in centralized sources is less than that of decentralized sources, which may be attributed to different geological conditions including fluoride-rich minerals, environmental conditions and high fluoride waste discharge. The corresponding health risk value of fluoride in centralized source is lower than that in decentralized one, and the HI values of fluoride in the three exposed groups varied in the same order: infants > children > adults. Infants and children were more sensitive receptors to the non-carcinogenic health hazards of fluoride than adults. Special care should be taken to infants and children for the highly prone to health risk compared to adults.

Health risk assessment of total exposure from cadmium in South China

Heavy metal pollution and hazards are a global major concern. Heavy metals can be directly or indirectly harmful to humans through ingestion, inhalation, and deraml. According to the literature survey, cadmium (Cd) total exposure assessment and health risk assessment were performed in a population group from South China. Results showed that the Cd contents in PM_2.5 and vegetables exceeded national standard limits. The same sources of Cd pollution contributed to different media; the main sources were artificial industrial activities such as electroplating, mining and smelting. The average daily dose of Cd via ingestion exceeded the provisional tolerable monthly intake proposed by the Joint Expert Committee on Food Additives (JECFA). Multimedia exposure via all three pathways followed the order 0-5-year-old children (3.26 × 10^-3 mg kg^-1·d^-1)>6-17-year-old children (1.46 × 10^-3 mg kg^-1·d^-1)>adults (1.18 × 10^-3 mg kg^-1·d^-1). The exposure from point source pollution was quite different from the results for nonpoint sources. Ingestion was the exposure pathway that contributes the largest proportion of multipathway and multimedia total exposure, accounting for over 99% of the total exposure in different populations. Staple foods, vegetables and meat were the three main exposure media for ingestion. The hazard quotients of multipathway and multimedia exposure to Cd in different populations were 5.57, 2.87 and 2.26, respectively, all at unacceptable risk levels. This study highlights the importance of multipathway and multimedia in the health risk assessment of heavy metal exposure in South China, and provides risk management measures to reduce noncarcinogenic health risks.

Land-use change caused by anthropogenic activities increase fluoride and arsenic pollution in groundwater and human health risk

Groundwater pollution is becoming a more serious issue because of various anthropogenic activities. A large proportion of the population living in the urbanized and industrialized world is exposed daily to hazardous materials. However, despite the knowledge that protecting groundwater is necessary, little is known about the role of land-use change for human health risks. In this study, we analyzed the temporal and spatial variation of groundwater fluoride (F) and arsenic (As) during 2010-2018 in Shanxi Province of Northern China. Distribution areas of high F and As increased from 2010 to 2018 and spread over time. We assessed human health risk by calculating carcinogenic risk and non-carcinogenic risk. The results showed that F exposure, frequency of high concentration, and risk from 2016 to 2018 were higher than that in 2010-2015, and similar results were obtained for As exposure. Further, land-use change caused by anthropogenic activities increased F and As pollution in groundwater and placed humans at a higher health risk. Our study sheds light on anthropogenic activities that could increase human health risks caused by groundwater F and As via changing land-use. The study provides supports and suggestions for policy-makers to reduce groundwater pollution and prevent adverse health risks to residents.

Appraisal of subsurface hydrogeochemical processes in a geologically heterogeneous semi-arid region of south India based on mass transfer and fuzzy comprehensive modeling

The main aim of the present study was to examine the quality of the groundwater and decipher the sources of groundwater fluoride through mass balance modeling based on fluoride exposure in a geologically heterogeneous semi-arid region of southern India. This was achieved by hydrogeochemical analysis, graphical methods, and mass transfer modeling approaches. Fuzzy comprehensive technique was applied to evaluate the quality of groundwater for groundwater management. In this regard, 61 groundwater samples were obtained from open wells and bore wells and analyzed for different physicochemical parameters. The major cation and anion abundances follow the order Na⁺ > Ca²⁺ > Mg²⁺ > K⁺ and Cl^- > HCO₃^- > SO₄^2- > NO₃^- > PO₄^3-. About 88.4% and 34.4% of the total water samples were dominated with Na⁺ and Cl^- ions in this region, respectively. The fluoride level in groundwater ranged from 0.10 to 3.30 mg/l with a mean value of 1.04 mg/l. Nearly 25% of the groundwater samples collected from 15 villages showed fluoride concentrations exceeding the maximum permissible limit of 1.5 mg/l as per the World Health Organization recommendations for human intake. More than 85% of the samples fell under strong acid (Cl^- and SO₄^2-) type. The amount of groundwater salinization in this region was 70.5% since the Revelle index (RI) was excess in the groundwater samples (RI > 0.5 meq/l). Silicate weathering, cation exchange, and gypsum dissolution were the dominant geogenic processes in the aquifer system influencing groundwater chemistry and nullified the possibility of carbonate dissolution. Saturation indices revealed the contribution of sequestration of CaCO₃ in F^- enrichment. Total dissolved solids showed strong positive correlations with Na⁺, Ca²⁺, Mg²⁺, Cl^-, SO₄^2- and NO^3- indicating the contribution of anthropogenic inputs to groundwater chemistry in addition to geogenic sources. The results of the fuzzy comprehensive method indicated that 33% of the groundwater samples fell under fair water type, 2% and 11% of the samples fell under poor and very poor quality water types, respectively. Therefore, this work will be helpful for the decision-makers to plan for the sustainable management of groundwater resources.

Groundwater Pollution and Human Health Risks in an Industrialized Region of Southern India: Impacts of the COVID-19 Lockdown and the Monsoon Seasonal Cycles

Samples of groundwater were collected during a post-monsoon period (January) and a pre-monsoon period (May) in 2020 from 30 locations in the rapidly developing industrial and residential area of the Coimbatore region in southern India. These sampling periods coincided with times before and during the lockdown in industrial activity and reduced agricultural activity that occurred in the region due to the COVID-19 pandemic. This provided a unique opportunity to evaluate the effects of reduced anthropogenic activity on groundwater quality. Approximately 17% of the wells affected by high fluoride concentrations in the post-monsoon period returned to levels suitable for human consumption in samples collected in the pre-monsoon period. This was probably due to ion exchange processes, infiltration of rainwater during the seasonal monsoon that diluted concentrations of ions including geogenic fluoride, as well as a reduction in anthropogenic inputs during the lockdown. The total hazard index for fluoride in the post-monsoon samples calculated for children, adult women, and adult men indicated that 73%, 60%, and 50% of the groundwater samples, respectively, had fluoride levels higher than the permissible limit. In this study, nitrate pollution declined by 33.4% by the pre-monsoon period relative to the post-monsoon period. The chemical facies of groundwater reverted from the Na-HCO3-Cl and Na-Cl to the Ca-HCO3 type in pre-monsoon samples. Various geogenic indicators like molar ratios, inter-ionic relations along with graphical tools demonstrated that plagioclase mineral weathering, carbonate dissolution, reverse ion exchange, and anthropogenic inputs are influencing the groundwater chemistry of this region. These findings were further supported by the saturation index assessed for the post- and pre-monsoon samples. COVID-19 lockdown considerably reduced groundwater pollution by Na+, K+, Cl-, NO3¯, and F- ions due to shutdown of industries and reduced agricultural activities. Further groundwater quality improvement during lockdown period there is evidence that the COVID-19 lockdown by increased HCO3¯ ion concentration. Overall results illustrate the positive benefits to groundwater quality that could occur as a result of measures to control anthropogenic inputs of pollutants.

The application of geostatistical analysis and receptor model for the spatial distribution and sources of potentially toxic elements in soils

This study aimed to identify the spatial patterns of potentially toxic elements (PTEs), including the spatial distribution, spatial autocorrelation, and risk probability, and to quantify the sources of PTEs, to provide guidelines for soil management. Spatial distributions and probabilities of PTEs were determined by empirical Bayesian kriging (EBK), while spatial autocorrelation was estimated by Moran's I. Positive matrix factorization (PMF) was adopted for the quantitative source contributions of PTEs. More than 64.6% of Co, Cr, Mn, and Ni were derived from geogenic sources, with high regions and high-high clusters both correlated to sandstone. Thus, it can be deduced that parent materials dominated the spatial patterns of these PTEs. In addition, some hotspots were situated in urban areas, and the influence of human activities on these four PTEs should be considered. Industry-traffic discharge and parent materials both influenced As, Cu, Pb, and Zn. Nonetheless, the spatial patterns of As, Cu, Pb, and Zn were formed by anthropogenic emissions since hotspots and high-high clusters were contiguously situated in urban areas. 58.5% of Hg originated from atmospheric deposition related to industrial emissions, and 47.2% of Cd was controlled by the application of chemical fertilizers. High levels of Hg and Cd mainly corresponded with industrial sites and cultivated land, suggesting that industrial and geoponic production played major roles in the generation of spatial patterns for Hg and Cd, respectively. Furthermore, the Cd and Hg posed a severe risk to soils, with a high probability to surpass 1.5 times the backgrounds. The EBK, Moran's I, and PMF results showed that all ten PTEs were enriched to some degree due to natural or anthropogenic factors. The results of geostatistical analysis and the receptor model can be mutually verified, indicating the reliability of these methods.

Geospatial Distribution and Potential Noncarcinogenic Health Risk Assessment of Nitrate Contaminated Groundwater in Southern India: A Case Study

Groundwater nitrate pollution is a serious threat to human health in many regions of the world. The present study was performed to assess the nitrate contamination in groundwater in the region of Nirmal province, South India, where people purely depend on groundwater for drinking purposes. The associated human health risks for different age groups (male, female, and children) also were evaluated based on the United States Environmental Protection Agency model. Results indicate that nitrate concentration in groundwater is in the range of 0.8-130 mg/L with a mean of 36.51 mg/L. Furthermore, 26.47% of groundwater samples exceeded the WHO drinking water guidelines for NO₃^- in the study region. The contribution of oral ingestion is very higher than the dermal contact in the total hazard quotient or noncarcinogenic health risk. The total hazard quotient values ranged from 0.02 to 3.13 for adult males, 0.02 to 3.70 for adult females, and 0.03 to 4.32 for children. The health risk assessment highlights that children are more exposed to the noncarcinogenic health risks of nitrate than adult females and males in the study region. Therefore, specific groundwater quality measures should be formulated to address the health risk problems for children in the study region.

Does fluoride cause the mysterious chronic kidney disease of multifactorial origin?

A chronic kidney disease of multifactorial origin (CKDmfo), also known as CKD of unknown origin, started to manifest during the past four decades in certain economically poor, peri-equatorial agricultural countries. CKDmfo is an environmentally induced, occupationally-mediated, chronic tubulointerstitial disease. Prolonged exposure to environmental nephrotoxic agents and extenuating conditions are prerequisites for its manifestation. More than 30 causative factors have been postulated, but none one has been properly scientifically tested, to be able to include or exclude. In recent years, fluoride has come to be considered a key contender as a causative agent of CKDmfo. Therefore, this review examines the pros and cons of that theory and the potential plausibility that fluoride causes CKDmfo. It also examines the potential interactions and additive or synergistic effects of certain geogenic factors, especially, the plausibility of CaPO₄^-3 apatite and fluorapatite crystals and nanotube formation in concentrated tubular filtrate and within tubular cells, in renal tubules. The information presented is based on published work and data collected over the past two decades in Sri Lanka. However, the evidence and concepts are applicable to all CKDmfo-affected countries. Thus, the presented content might facilitate scientists to narrowed down causative factors to just a few and government departments to implement effective programs for preventing this disease. The findings suggest that in addition to the geogenic components, disease manifestation requires (A) prolonged exposure to environmental nephrotoxins and factors, (B) interactions among elements (Ca²⁺, PO₄^-3 , F^-, and Mg²⁺), and (C) vulnerability of the person, such as chronic dehydration, and antioxidant and micronutrient deficiencies. In vivo precipitation of nanominerals in renal tubular tissues that arising over several years causes tubulointerstitial disease-CKDmfo. Inherent vulnerabilities and conditions, together with nanomineral precipitation, trigger renal tubular cell oxidative stresses, inflammation, and fibrosis, and eventually causing tubulointerstitial chronic renal failure-CKDmfo.

Sobol sensitivity approach for the appraisal of geomedical health risks associated with oral intake and dermal pathways of groundwater fluoride in a semi-arid region of south India

The main objective of the present investigation is appraisal of human health hazard based on the intake and dermal contact of fluoride enriched potable groundwater used for rural water supply in a semi-arid region (Shanmuganadhi River basin) of south India. A variance decomposition based Sobol sensitivity method was used to assess the relative contribution as well as interaction of input variables for both oral and dermal models. Three different scores were evaluated: FOE (first order effect), SOE (second order effect) and TE (total effect) for different age groups of population including gender (kids, women and men). The spatio-temporal mapping indicates that about 26% of water supply wells exceeded the recommended limit (WHO) of fluoride (>1.5 mg l^-1) for safe intake. These wells spread over 104.03 km² area consisting 16 villages in the basin. To assess the human health risk related to fluoride enrichment in potable water, hazard index (HI) was calculated as per USEPA guidelines. The non-carcinogenic risk based on oral intake ranges from 0 to 1.81, from 0 to 1.59 and from 0 to 1.29 for kids, women and men respectively. Nearly 30%, 21% and 12% of well samples exceeded the upper permissible limit (HI > 1) for kids, women and men respectively. The Sobol sensitivity analysis reveals that, C_w (concentration of F^- in water) and IR (intake rate) combination plays a vital role in the HQ _oral model for the appraisal of health hazard in kids. However, these two parameters have negligible effect on health hazard for adult population (men and women). Therefore, lower age group people especially kids have significant ill effect due to the consumption of fluoride enriched potable water. The model output suggests that body weight (BW) has least effect on health hazard in the lower age group of population. Interestingly 'exposure frequency (EF)' and 'body weight (BW)' have not much effect on health hazards related to dermal contact, and 'skin surface area (SA)' has minimal effect for men (TE = 0.92) and women (TE = 1.26). However, 'SA' has vital effect for kids (TE = 17.39). Because of this, older age group people have more dermal risk than the younger people. Therefore, the HQ _dermal results indicate that 49%, 64% and 67% of samples possess non-carcinogenic risk to the kids, women and men respectively.

Characterization of heavy metal pollution in an anthropogenically and geologically influenced semi-arid region of east India and assessment of ecological and human health risks

The present study evaluated the heavy metal contamination in groundwater and associated ecological and human health risks of a geologically and anthropogenically diverse semi-arid region of Birbhum district, India. For a reliable evaluation, concentrations of nine heavy metals in 680 groundwater samples (N = 680) which were collected during premonsoon and postmonsoon seasons of consecutive two years from 170 wells were measured. The human health risk assessment using the USEPA model which is based on single value for each parameter may inherit certain inaccuracy and uncertainties in the evaluation. Unlike earlier studies, a higher degree of accuracy in carcinogenic and noncarcinogenic health risk assessments was achieved through Monte Carlo simulations, sensitivity analysis and uncertainty analysis. The study revealed the occurrence of the target heavy metals in groundwater with mean dominance order of Fe > Zn > Sr > Mn > Cr > Pb > Ni > Cu > Cd where mean concentrations of the carcinogens, Pb and Fe exceeded their maximum permissible limits. The water quality status evaluated using the modified heavy metal pollution index, Nemerow index and Heavy metal evaluation index methods resulted in medium to high heavy metal contamination in groundwater within a large portion of the study area which indicated its unsuitability for drinking purpose. The study suspects a moderate to very high risk for the groundwater dependent ecosystems in major part of the study area. The study further revealed cancer risks, ranging from high to very high within the residents due to accumulative exposure of the carcinogenic heavy metals in groundwater through ingestion and dermal contact. Minor populations of the study area were found to be more vulnerable to the carcinogenic and noncarcinogenic diseases than teenagers and adults, mainly through oral exposure. The study recommends the residents to consume treated groundwater since the primary route of heavy metal exposure was identified to be the ingestion route.

Fluoride contamination in groundwater and associated health risks in Karbi Anglong District, Assam, Northeast India

Health hazards due to excess intake of fluoride via groundwater contamination are a major concern worldwide. This study provides a comprehensive report on the human health risks associated with the consumption of groundwater contaminated by fluoride. Several groundwater samples were collected across 8 blocks of Karbi Anglong district of Assam, India. The concentration of fluoride was observed in the range of 0.15-17.13 mg/L. In 4 out of 8 studied blocks, the mean fluoride level exceeded the permissible limit (1.5 mg/L) as prescribed by the World Health Organization. Elevated fluoride levels in some parts of the district may be attributed mainly to dissolution from fluoride-containing minerals in the granitic rocks and regional geological settings. The health risk of fluoride was assessed in terms of hazard quotient (HQ). The HQ was observed in the ranges of 0.06-10.7 (adult) and 0.2-35 (children). Mean HQ values exceeded the safe level (HQ > 1) for children in all blocks, except B-6 and B-8. For adult population, the HQ value was above the safe limits in 13-40% of the sampled locations in different blocks and HQ values were within safe limits in B-6 and B-8. These findings suggest that some sites in the district need serious attention in order to ensure the health safety of local residents.