Use of Heavy Metal Content and Modified Water Quality Index to Assess Groundwater Quality in a Semiarid Area

Mapping and assessment of groundwater pollution risks in the main aquifer of the Mostaganem plateau (Northwest Algeria): utilizing the novel vulnerability index and decision tree model

Water plays a pivotal role in socio-economic development in Algeria. However, the overexploitations of groundwater resources, water scarcity, and the proliferation of pollution sources (including industrial and urban effluents, untreated landfills, and chemical fertilizers, etc.) have resulted in substantial groundwater contamination. Preserving water irrigation quality has thus become a primary priority, capturing the attention of both scientists and local authorities. The current study introduces an innovative method to mapping contamination risks, integrating vulnerability assessments, land use patterns (as a sources of pollution), and groundwater overexploitation (represented by the waterhole density) through the implementation of a decision tree model. The resulting risk map illustrates the probability of contamination occurrence in the substantial aquifer on the plateau of Mostaganem. An agricultural region characterized by the intensive nutrients and pesticides use, the significant presence of septic tanks, widespread illegal dumping, and a technical landfill not compliant with environmental standards. The critical situation in the region is exacerbated by excessive groundwater pumping surpassing the aquifer's natural replenishment capacity (with 115 boreholes and 6345 operational wells), especially in a semi-arid climate featuring limited water resources and frequent drought. Vulnerability was evaluated using the DRFTID method, a derivative of the DRASTIC model, considering parameters such as depth to groundwater, recharge, fracture density, slope, nature of the unsaturated zone, and the drainage density. All these parameters are combined with analyses of inter-parameter relationship effects. The results show a spatial distribution into three risk levels (low, medium, and high), with 31.5% designated as high risk, and 56% as medium risk. The validation of this mapping relies on the assessment of physicochemical analyses in samples collected between 2010 and 2020. The results indicate elevated groundwater contamination levels in samples. Chloride exceeded acceptable levels by 100%, nitrate by 71%, calcium by 50%, and sodium by 42%. These elevated concentrations impact electrical conductivity, resulting in highly mineralized water attributed to anthropogenic agricultural pollution and septic tank discharges. High-risk zones align with areas exhibiting elevated nitrate and chloride concentrations. This model, deemed satisfactory, significantly enhances the sustainable management of water resources and irrigated land across various areas. In the long term, it would be beneficial to refine "vulnerability and risk" models by integrating detailed data on land use, groundwater exploitation, and hydrogeological and hydrochemical characteristics. This approach could improve vulnerability accuracy and pollution risk maps, particularly through detailed local data availability. It is also crucial that public authorities support these initiatives by adapting them to local geographical and climatic specificities on a regional and national scale. Finally, these studies have the potential to foster sustainable development at different geographical levels.

Hydrogeochemical evolution processes, groundwater quality, and non-carcinogenic risk assessment of nitrate-enriched groundwater to human health in different seasons in the Hawler (Erbil) and Bnaslawa Urbans, Iraq

The main objectives of this research are to assess groundwater, a primary source of drinking water in the urban areas of Hawler (Erbil) and Bnaslawa in northern Iraq, and the non-carcinogenic human health risks of nitrate contamination associated with drinking water quality. For this purpose, twenty-seven groundwater samples were collected from wells to assess the hydrogeochemical characteristics and groundwater quality for both natural and anthropogenic purposes during the wet (May 2020) and dry (September 2020) seasons. During the wet and dry seasons, NO3- in groundwater ranged from 14.00 to 61.00 mg/L and 12.00 to 60.00 mg/L, with an average value of 35.70 and 29.00 mg/L, respectively. Approximately 25.92% of the samples exceeded the permissible limit of the WHO (2011) drinking water standard. The ratios of NO3-/Na+ vs. Cl-/Na+ and SO42-/Na+ vs. NO3-/Na+ indicate the effect of agricultural activities and wastewater leaking from cesspools or septic tanks on the quality of groundwater during the wet and dry seasons. The entropy weighted water quality index method ranked 62.5% and 75% of the urban groundwater as not recommended for drinking, and the remaining samples are moderately suitable in both wet and dry seasons. The non-carcinogenic human health risk assessment displayed that during the wet and dry seasons, 29.6% and 25.9% of adults, 48% and 30% of children, and 48.1% and 29.6% of infants were exposed to increased concentrations of nitrate in groundwater. Due to high nitrate in drinking water, non-carcinogenic human health risk levels vary as infant > child > adults. The main findings obtained from this study can assist policymakers in better understanding the hydrogeochemical properties of groundwater in terms of drinking water safety, thereby facilitating the management of water resources to take the necessary measures.

Arsenic and fluoride exposure in drinking water caused human health risk in coastal groundwater aquifers

Groundwater (GW) is a precious resource for human beings as we depend on it as a source of fresh drinking water, agricultural practices, industrial and domestic uses, etc. Extreme exposure of arsenic (As) and fluoride (F-) concentrations along the coastal GW aquifers of "South 24 Parganas and East Medinipur" diluted the quality of GW and created serious health issues. Various chronic health disorders such as - black foot disease, fluorosis skin cancer, cardiac problems, and other water borne diseases have been noticed in these two coastal districts. The comprehensive entropy-weighted water quality index (EWQI) and health risk assessment (HRA) were applied to evaluate the quality of GW and probable health risks in the coastal districts. Monte Carlo simulation and sensitivity analysis methods were simultaneously adopted to identify the non-carcinogenic health risk assessment due to regular ingestion of contaminated GW. As the study region is densely populated and part of the Sundarbans Ramsar site, it has greater importance at the international level along with regional importance to address the GWQ of this region. The major findings of the present study highlight that almost 55% of the study area is confronting serious GW quality issues and associated probable health risk (HR) due to the intense accumulation of As and F- in the GW aquifers of the study area. Children's health is more vulnerable due to the consumption of As containing GW, and adults are highly affected due to the intake of F- bearing GW in the coastal districts. The findings of the current study will draw the attention of hydrologists, groundwater management authorities, government bodies, and NGOs to regulate and monitor the GW aquifers routinely, enhance GW quality, minimizing the health hazards and sustainable water management in a more scientific and sustainable way which must be advantageous for coastal people.

Geospatial assessment of groundwater quality using entropy-based irrigation water quality index and heavy metal pollution indices

Groundwater contamination has become a serious environmental threat throughout the world in the era of Anthropocene. Thus, the present study examined the groundwater quality for irrigation purposes based on the entropy method and heavy metal pollution indices. To compute the entropy-based groundwater irrigation quality index (EIWQI), physicochemical parameters such as pH, chloride (Cl-) and nitrate (NO3-), irrigation indices including electrical conductivity (EC), sodium absorption ratio (SAR), sodium percentage (%Na), soluble sodium percentage (SSP), residual sodium carbonate (RSC), magnesium hazard (MH), Kelley's ration (KR), permeability index (PI) and heavy metals such as manganese (Mn), iron (Fe), zinc (Zn) and arsenic (As) have been employed for the 37 sample wells of the Damodar fan delta (DFD), India, which is a semi-critical agriculture-dominated region. Shannon's entropy method has been used to assign the weights of the different parameters for constructing the EIWQI. The results portray a spatial variation of the irrigation water quality in the DFD. The EIWQI revealed that 27.03%, 59.46%, 8.11%, 2.7% and 2.7% of the sample wells, respectively, contain excellent, good, moderate, poor and very poor quality of irrigation water. On the other hand, heavy metal pollution indices (modified degree of contamination, pollution load index, Nemerow index and modified heavy metal pollution index) show that 15-20% of sample wells of the DFD are contaminated by heavy metal pollution. The pockets of pollution are concentrated in the southwestern, northeastern and central parts of the DFD. The study found that the spatial variation in groundwater quality is controlled by the higher sodium concentration, carbonate weathering and expansion of agricultural and urban-industrial areas.

Hydrogeochemical characterization and geochemical modeling for the evaluation of groundwater quality and health risk assessment in the Varuna River basin, India

This study focuses on determining significant controlling factors of chemical consequences, inverse geochemical modeling, water quality, and human health risk in the Varuna River basin of India. The study interprets that according to pH, total dissolved solids, and total hardness, the maximum number of groundwater samples are alkaline, fresh, and have substantial hardness. The abundance of major ions follows a pattern: Na > Ca > Mg > K, and HCO3 > Cl > SO4 > NO3 > F. Piper diagram shows that Ca-Mg-HCO3 facies are predominant during both seasons. Na-normalized molar ratios of HCO3/Na, Mg/Na, and Ca/Na are 0.62, 0.95, and 1.82 (pre-monsoon) and 0.69, 0.91, and 1.71 (post-monsoon), respectively, elucidating the coupled silicate and carbonate weathering (dolomite dissolution) sources. The Na/Cl molar ratio is 5.3 (pre-monsoon) and 3.2 (post-monsoon), indicating silicate alteration as the primary process rather than halite dissolution. The chloro-alkaline indices confirm the presence of reverse ion- exchange. Geochemical modeling using PHREEQC identifies the formation of secondary kaolinite minerals. The inverse geochemical modeling categorizes the groundwaters along the flow path from recharge area waters (Group I: Na-HCO3-Cl), transitional area waters (Group II: Na-Ca-HCO3), and discharge area waters (Group III: Na-Mg-HCO3). The model demonstrates the prepotency of water-rock interactions in pre-monsoon justified by the precipitation of Chalcedony and Ca-montmorillonite. The mixing analysis shows that in the alluvial plains, groundwater mixing is a significant hydrogeochemical process that affects groundwater quality. The Entropy Water Quality Index ranks 45% (pre-monsoon) and 50% (post-monsoon) of samples as an excellent category. However, the non-carcinogenic health risk assessment shows that children are more susceptible to fluoride and nitrate contamination.

Effects of NaCl and CaCl2 as Eustress Factors on Growth, Yield, and Mineral Composition of Hydroponically Grown Valerianella locusta

Corn salad (Valerianella locusta) is a popular winter salad, cultivated as an ingredient for ready-to-eat salads. The application of mild salinity stress (eustress) can increase the flavor and reduce the nitrate content of certain crops but, at the same time, a wrong choice of the eustress type and dose can negatively affect the overall productivity. In this research, the effects of different isosmotic salt solutions, corresponding to two different electrical conductivity (EC) levels, were investigated on the yield and mineral composition of hydroponically grown Valerianella locusta "Elixir". Five nutrient solutions (NS) were compared, including a basic NS used as the control, and four saline NS were obtained by adding to the basic NS either NaCl or CaCl2 at two rates each, corresponding to two isosmotic salt levels at a low and high EC level. Corn salad proved moderately susceptible to long-term salinity stress, suffering growth losses at both low and high EC levels of saline solution, except from the low NaCl treatment. Hence, it appears that mild salinity stress induced by NaCl could be employed as an eustress solution and corn salad could be cultivated with low-quality irrigation water (20 mM NaCl) in hydroponic systems.

Short−Term Assessment of Heavy Metals in Surface Water from Xiaohe River Irrigation Area, China: Levels, Sources and Distribution

The aims of this study were to determine the pollution characteristics of heavy metals and their potential harm to human health in the surface water of agricultural irrigation areas, China, over a short term. In this study, Cu, Zn, Pb, Hg, Ni, Cr, Cd, and As in surface water of the Xiaohe River irrigation area were detected and analyzed. The results showed that the concentrations of Pb, Hg, Ni, Cr, Cd, and As exceeded the national environmental quality standard for surface water in varying degrees. The concentrations of heavy metals in surface water in October were significantly lower than that in November and December due to the impact of extreme precipitation events. Point source pollution (industrial sewage, etc.) was the main factor affecting the spatial distribution of heavy metals. The main source of heavy metals in October was domestic sewage. Domestic sewage and industrial sewage were the main sources of heavy metals in November. The sources of heavy metals in surface water in December were relatively diverse, and industrial sewage was the main source. The temporal variation of heavy metal pollution sources changed significantly. Industrial sewage was the main pollution source of heavy metals in surface water in the study area. The impact of urban domestic sewage and agricultural activities cannot be ignored. The health risk of heavy metals in surface water mainly depends on Cr, Cd, and As. Policy recommendations were also proposed for better control of heavy metal pollution in the surface water of river ecosystems involving agricultural irrigation areas.

Discussion on the existing methodology of entropy-weights in water quality indexing and proposal for a modification of the expected conflicts

The present research focuses on addressing various ambiguities in the existing method of integrating information entropy and water quality, thereby presenting a novel approach for an entropy-weighted water quality index. A three-dimensional water quality dataset is considered in the proposed method, the third dimension being the sampling frequency factor. The probability of observed values adhering to desirable limits prescribed by a standard code is estimated, leading to the computation of information entropy and, eventually, entropy weights. These weights are then used for the computation of the Modified Entropy-weight Water Quality Index (MEWQI) values. To verify the proposed method's applicability, the water quality dataset of Deepor Beel, India, was considered. IS 10500: 2012 was used for estimating MEWQI values. Results showed an excellent correlation with the observed dataset and their uncertainties of occurrence. The reliability and correctness of the proposed methodology were finally confirmed through both cluster analysis and sensitivity analysis. The cluster analysis showed remarkable associations with the computed MEWQI values, while the sensitivity analysis proved that no particular parameter was accountable for the contribution of MEWQI values; instead, all parameters exhibited equal contributions. The proposed methodology was thus found to be the most reasonable and reliable as it considered both factors, i.e., measured values concerning standard limits and the uncertainty, necessary for a consistent water quality monitoring program.

Monitoring and Assessment of Groundwater Quality at Landfill Sites: Selected Case Studies of Poland and the Czech Republic

In order to protect the components of natural environment, each landfill must be properly secured and the monitoring program should be adopted. This study aims to present a comparative analysis of groundwater quality at selected landfill sites in Poland and the Czech Republic, with a special attention given to the levels and temporal changes of heavy metals (HMs) concentrations measured in collected groundwater samples. A secondary objective was to detect possible leakages of pollutants from the landfill body, into the groundwater, and further into the environment. The assessment of groundwater quality was based on a comparison of HMs concentrations with standards provided by the European environmental laws. On the basis of the long-term monitoring period, it was revealed, for the Polish landfill site, that the groundwater quality is improving over time, especially due to remedial works applied. For the Czech landfill, it was observed that the quality of groundwater is not negatively affected by the operation of the landfill, but in the immediate vicinity of the landfill, the groundwater quality is significantly affected by the agricultural use of neighbouring lands, as well as by the storage of construction and demolition wastes. The results showed that the leachate did not leak outside the landfills, especially due to minimal concentrations of HMs, measured in groundwater samples, taken from the piezometers located in the outflow direction from the landfills.

INSIDE-T: A Groundwater Contamination Transport Model for Sustainability Assessment in Remediation Practice

Current sustainability assessment (SA) tools to help deal with contaminated groundwater sites are inherently subjective and hardly applied. One reason may be lack of proper tools for addressing contaminant spread which are basically objective. To fill this gap, there is a need for contaminant transport models that provide site managers with needed room for applying their judgments and considerations about the efficiency of each remediation method based on their experiences in similar cases. INSIDE-T uses trend analysis and inverse modeling to estimate transport parameters. It then simulates contaminant transport both with and without the inclusion of remedial actions in a transparent way. The sustainability of each remedy measure can then be quantified based on the underlying SA tool (INSIDE). INSIDE-T was applied to a site in south Sweden, contaminated with pentachlorophenol. Simulation scenarios were developed to enable comparison between various remediation strategies and combinations of these. The application indicated that natural attenuation was not a viable option within the timeframe of interest. Although pump-and-treat combined with a permeable reactive barrier was found to be just as effective as bioremediation after five years, it received a much lower sustainability score overall. INSIDE-T outcomes enable site managers to test and evaluate different scenarios, a necessity in participatory decision-making practices such as remediation projects.

Hydrogeochemical characteristics and groundwater quality assessment in the plain area of Yarkant River Basin in Xinjiang, P.R. China

The deteriorating groundwater quality due to natural genesis and anthropogenic activities has prevented the sustainable use of groundwater. The characteristics and factors affecting groundwater quality for drinking in shallow aquifers (depth ≤ 100 m) in the plain area of Yarkant River Basin in Xinjiang were analyzed using water quality index (WQI), geostatistics, and geochemical methods. Results showed that the groundwater was weak-alkaline with neutral pH, with dominant water types being SO₄•HCO₃-Ca•Mg, SO₄•Cl•HCO₃-Na•Ca, SO₄•HCO₃•Cl-Ca•Na, Cl•SO₄-Na•Ca, and HCO₃•SO₄-Mg•Ca. WQI ranged between 31.79 and 549.37, and about 14.43%, 31.96%, 18.56%, 22.68%, and 12.37% of the all samples were excellent, good, medium, poor, and extremely poor quality, respectively. The proportion of excellent quality was the highest in single structure phreatic aquifer (SSPA, 50.00%) and good quality were the highest in multilayered structure phreatic aquifer (MSPA, 34.21%) and multilayered structure confined aquifer (MSCA, 28.89%). With the extension of the river, the groundwater quality gradually degenerated from south to north in phreatic aquifer (PA, including SSPA and MSPA). The further away from the Yarkant river, the worse the groundwater quality of PA. Furthermore, the WQI showed excellent, good, and an alternation of medium and poor quality (including extremely poor quality) from south to north in the MSCA. The groundwater quality deterioration might have been affected by the dissolution of evaporite minerals, such as halite, gypsum, and anhydrite and ion exchange process. In addition, local effects of anthropogenic activities and land usage patterns on the groundwater quality should be reckoned as well.

Evaluation of heavy metal contamination and groundwater quality along the Red Sea coast, southern Saudi Arabia

To evaluate the heavy metal contamination and groundwater quality in southern Saudi Arabia, 105 groundwater samples were analyzed for EC, pH, TDS, major ions (NO₃^-, Cl^-, HCO₃^-, SO₄^2-, F^-, Ca²⁺, Mg²⁺, Na⁺, and K⁺), and heavy metals (Fe, Li, As, B, Al, Cr, Cu, Mo, Ni, Se, Sr, V, Zn, and Mn). Groundwater quality index (GWQI), degree of contamination (C_d), heavy metal pollution index (HPI), ecological risks of heavy metals (ERI), salinity hazard (EC), sodium adsorption ratio (SAR), sodium percentage (Na%), and Kelly's ratio (KR) were calculated and compared, and multivariate statistical techniques were applied. The results revealed that the major cations and anions followed the orders of Na⁺ > Ca²⁺ > Mg²⁺ > K⁺ and Cl^- > SO₄^2- > HCO₃^- > NO₃^- > F^-, respectively. The maximum values of As, Mn, Cr, Ni, Se, and Zn were above the permissible limits for drinking water purposes. Pollution indices indicated that 20 to 52% of the groundwater samples were suitable for agricultural and domestic purposes. The unsuitable samples were distributed mostly in the western part along the Red Sea coast. Multivariate statistical analyses revealed that the dissolution of halite and gypsum (in sabkha deposits), carbonates, and the agricultural activities were the possible sources of the major cations and anions, and heavy metals in the study area.

Assessment of hydro-geochemical properties of groundwater under the effect of desalination wastewater discharge in an arid area

Desalination to increase irrigation water supply for agricultural production is becoming important in water-scarce regions. While desalination has positive effects on the potential irrigation water quantity and quality, the technique may also be a considered potential source of groundwater pollution. The present study investigated the effects of desalination wastewater discharge on groundwater quality in an arid area in southern Iran for the 2012-2017 period. The chemical composition of the groundwater samples was evaluated considering pH, EC, Na⁺, Ca²⁺, Mg²⁺, SO₄²⁺, Cl^-, and HCO₃^-. The suitability of groundwater for drinking and irrigation purposes as well as spatial pattern of groundwater pollution was analyzed. The results showed that mean concentration of Na⁺, Ca²⁺, Mg²⁺, SO₄^2-, and Cl^- in all investigated wells increased from 148, 94, 46, 247, and 257 mg/L in 2012 to 282, 146, 71, 319, and 582 mg/L in 2017, respectively. Using Gibb's diagram, it was shown that the groundwater quality is slightly alkaline and primarily controlled by evaporation. Based on our findings, about 78% of the study aquifer displayed groundwater with good to excellent water quality that can be used for drinking and irrigation purposes. However, the eastern part of the aquifer was classified as unsuitable for use due to the disposal of desalination plant wastewater. The spatial distribution of WQI and other indices such as SAR, TDS, and TH showed that groundwater in the eastern part of the aquifer has deteriorated since the establishment of the desalination plants. To reverse this trend, it is important to implement regulations against wastewater discharge from desalination plants.

Assessment of groundwater safety surrounding contaminated water storage sites using multivariate statistical analysis and Heckman selection model: a case study of Kazakhstan

Petrochemical enterprises in Kazakhstan discharge polluted wastewater into special recipients. Contaminants infiltrate through the soil into the groundwater, which potentially affects public health and environment safety. This paper presents the evaluation of a 7-year monitoring program from one of the factories and includes nineteen variables from nine wells during 2013-2019. Several multivariate statistical techniques were used to analyse the data: Pearson's correlation matrix, principal component analysis and cluster analysis. The analysis made it possible to specify the contribution of each contaminant to the overall pollution and to identify the most polluted sites. The results also show that concentrations of pollutants in groundwater exceeded both the World Health Organization and Kazakhstani standards for drinking water. For example, average exceedance for total petroleum hydrocarbons was 4 times, for total dissolved solids-5 times, for chlorides-9 times, for sodium-6 times, and total hardness was more than 6 times. It is concluded that host geology and effluents from the petrochemical industrial cluster influence the groundwater quality. Heckman two-step regression analysis was applied to assess the bias of completed analysis for each pollutant, especially to determine a contribution of toxic pollutants into total contamination. The study confirms a high loading of anthropogenic contamination to groundwater from the petrochemical industry coupled with natural geochemical processes.

Occurrence of Heavy Metals in Groundwater Along the Lithological Interface of K/T Boundary, Peninsular India: A Special Focus on Source, Geochemical Mobility and Health Risk

Evaluation of the hydrogeochemical processes governing the heavy metal distribution and the associated health risk is important in managing and protecting the health of freshwater resources. This study mainly focused on the health impacts due to the heavy metals pollution in a known Cretaceous-Tertiary (K/T) contact region (Tiruchinopoly, Tamilnadu) of peninsular India, using various pollution indices, statistical, and geochemical analyses. A total of 63 samples were collected from the hard rock aquifers and sedimentary formations during southwest monsoon and analysed for heavy metals, such as Li, Be, Al, Rb, Sr, Cs, Ba, pb, Mn, Fe, Cr, Zn, Ga, Cu, As, Ni, and Co. Ba was the dominant element that ranged from 441 to 42,638 μg/l in hard rock aquifers, whereas Zn was the major element in sedimentary formations, with concentrations that ranged from 44 to 118,281 μg/l. The concentrations of Fe, Ni, Cr, Al, Cr, and Ni fell above the permissible limit in both of the formations. However, the calculated heavy metal evaluation index (HEI), heavy metal pollution index (HPI), and the degree of contamination (C_d) parameters were higher in the sedimentary formation along the contact zone of the K/T boundary. Excessive health risks from consumption of contaminated groundwater were mostly confined to populations in the northern and southwestern regions of the study area. Carcinogenic risk assessment suggests that there are elevated risks of cancer due to prolonged consumption of untreated groundwater. Ba, Sr, and Zn were found to be geochemically highly mobile due to the partitioning between the rock matrix and groundwater, aided by the formation of soluble carbonato-complexes. Factor analysis indicates that the metals are mainly derived from the host rocks and anthropogenic inputs are relatively insignificant. Overall, this study indicated that groundwater in K/T contact zones is vulnerable to contamination because of the favorable geochemical factors. Long-term monitoring of such contact zones is required to avert the potential health hazards associated with consumption of the contaminated groundwater.

Drinking Water Quality Mapping Using Water Quality Index and Geospatial Analysis in Primary Schools of Pakistan

Primary school children in the developing world often lack potable water, which may result in a high burden of water-related diseases and poor school performance. The present study aimed to characterize the drinking water quality in primary schools of Pakistan. We used a multistage random-sampling method to select 425 primary schools from selected districts of Sindh province. Standard methods were used to characterize water quality. The results were compared with maximum acceptable values recommended by the Pakistani National Environmental Quality Standards (Pak NEQS) and the World Health Organization (WHO) drinking water quality standards. Groundwater (62%) and surface water (38%) were identified as two major drinking water sources in the selected schools with varying levels of water quality. Among all parameters, dissolved oxygen (DO), pH, and nitrate remained within WHO and Pak NEQS water quality standard limit, while total dissolved solids (TDS) (33%), electrical conductivity (EC) (46%), chloride (34%), turbidity (27%), and hardness (11%) samples exceeded standard limits. All dissolved salts had moderate to strong positive correlations with TDS and EC values. Based on a water quality index (WQI), 74% of primary schools had access to excellent or good quality drinking water compared to 26% of schools that had access to either poor, very poor or unsuitable drinking water. Among all three regions, more schools from South Sindh had either poor, very poor or unsuitable drinking water (33%) compared to the Central (25%) and North zones (15%). Hence, water from these locations is unfit for human consumption and these schools need better water quality management plans to stop the spread of water-related diseases in primary school children.