Utility of check dams in dilution of fluoride concentration in ground water and the resultant analysis of blood serum and urine of villagers,Anantapur District,Andhra Pradesh,India

High levels of fluoride (beyond 1.5 ppm) in ground water as source of drinking water are common in many parts of Andhra Pradesh, India, causing fluorosis. The study carried out in endemic Nalgonda District, Andhra Pradesh, has indicated that the fluoride-rich ground water present in the wells located down stream and close to the surface water bodies is getting diluted by the low-fluoride surface water. Encouraged by this result, check dams were constructed upstream of the identified marginally high fluoride bearing ground water zones in Anantapur District to reduce fluoride levels as an alternate solution for safe drinking water.In this paper, an attempt is made to study the utility and effect of these check dams in dilution of fluoride concentration in drinking water and its resultant impact on the health aspects of certain villagers of Anantapur District through the analysis of their blood serum and urine. Ground water samples from three fluoride-affected villages, blood and urine of males and females from the same villages were collected and analyzed for fluoride using ion selective electrode method. The results indicated that the fluoride levels in blood serum and urine of males in the age group of 5–11 years are found to be the highest. The concentration of fluoride in ground water is directly proportional to the concentration of fluoride in blood serum and urine. The concentration of fluoride in ground water with depth of the aquifer is a function of lithology, amount and duration of rainfall, rate of infiltration, level of ground water exploitation in the area etc. The construction of check dams upstream of the identified marginally high fluoride waters will not only cause additional recharge of ground water but also reduces the fluoride concentration eventually improving the health of the villagers.     

Fluoride distribution in groundwater and survey of dental fluorosis among school children in the villages of the Jhajjar District of Haryana,India

Fluoride concentration of groundwater reserves occurs in many places in the world. A critical area for such contamination in India is alluvial soil of the plain region, consisting of five blocks (Jhajjar, Bahadurgarh, Beri, Matanhail, and Sahalawas) of the Jhajjar District adjacent to the National Capital Territory of India, New Delhi. The purpose of this study was to assess the association between water fluoride levels and prevalence of dental fluorosis among school children of the Jhajjar District of Haryana, India. The fluoride content in underground drinking water sources was found to vary in villages. Hence, the villages were categorized as high-fluoride villages (1.52–4.0 mg F/l) and low/normal-fluoride villages (0.30–1.0 mg F/l). The source of dental fluorosis data was school-going children (7–15 years) showing different stages and types of fluorosis who were permanent resident of these villages. The fraction of dental fluorosis-affected children varied from 30% to 94.85% in the high-fluoride villages and from 8.80% to 28.20% in the low/normal-fluoride villages. The results of the present study revealed that there existed a significant positive correlation between fluoride concentration in drinking water and dental fluorosis in high-fluoride villages (r = 0.508; p < 0.001) and insignificant correlation in low-fluoride villages.     

Dental fluorosis associated with drinking water from hot springs in Choma district in southern province,Zambia

This study was conducted to investigate the high incidence of mottled teeth among residents of an area with hot springs in the Choma District of the Southern Province of Zambia. A survey involving 128 pupils was conducted at a Basic School to collect data on pupil’s backgrounds and their main sources of drinking water between birth and age 7. A dental specialist examined the pupils’ teeth and samples of drinking water were collected from locations where the majority of the pupils lived. It was analysed for fluorides and other drinking water quality parameters. Results of the survey showed a highly significant (P < 0.001) association between pupils’ main sources of drinking water between birth and age 7 and the incidence of discoloured teeth. All (100%) pupils who drank water from hot springs before age 7 had moderate to severe fluorosis, while the majority (96.7%) of the pupils who drank water from other sources had no dental fluorosis. Fluoride concentrations ranged from 5.95 to 10.09 mg/l in water from hot springs, and from 0.03 to 0.6 mg/l in water from other sources. Fluoride levels in water from hot spring water samples exceeded the 1.5 mg/l WHO guideline value for drinking water, while those in water from other sources were significantly (P < 0.05) lower than this. We conclude that the high prevalence of mottled teeth among residents of the study area is a case of endemic dental fluorosis associated with drinking water from hot springs containing high concentrations of fluoride.     

地形地貌对豫东平原浅层高氟地下水分布的控制

氟是人体内所必须的微量元素,但过多的摄入会引发氟中毒.豫东平原在全国来说是个氟中毒严重的地区,高氟水分布范围广,背景值高,当地居民往往通过饮用浅层地下水而导致氟中毒.浅层高氟水的分布总体上呈由西北向东南逐渐增多的态势,而局域的地形地貌使得高氟水的分布呈现出斑状、条带状的形态.一般来说,洼地有利于高氟水的富集.     

Influence of climate on groundwater fluoride in different climatic domains in a hard rock terrain of Sri Lanka: implications to community health

Health risks associated with excessive intake of fluoride through drinking water are one of the geoenvironmental health problems observed in many parts of the world, mainly in countries of the humid tropical belt, including Sri Lanka. Fluoride-related health problems are widespread in the dry climatic region compared to the wet climatic zone of Sri Lanka. The potential health risks of fluoride for communities in a river basin which drains through two climatic zones, viz. wet and dry zones, were investigated in this study. Sixty-three groundwater samples were collected from wells in the Walawe river basin during pre- and post-monsoon periods. From collected samples, ten selected samples were analyzed for their tritium (³H) levels to find out the approximate resident time of groundwater. In the river basin, the dry zone segment is characterized by elevated levels of fluoride (>?1.0 mg/L) in groundwater. Groundwater fluoride in the region was primarily of geogenic origin. The tritium values showed older groundwater contained higher fluoride levels, showing a increased dissolution of fluoride-bearing minerals. The hazard quotient (HQ_fluoride) showed that about 45% of pre- and 55% of post-monsoon groundwater samples in the dry zone area were unsuitable for drinking purposes for school children who are vulnerable to non-carcinogenic risks and dental fluorosis. This study emphasizes the need for continuous water quality monitoring and mitigation measures to ensure the health of residents.

     

Inferring the fluoride hydrogeochemistry and effect of consuming fluoride-contaminated drinking water on human health in some endemic areas of Birbhum district,West Bengal

This research work is carried out to evaluate fluoride (F) hydrogeochemistry and its effect on the population of two endemic villages of Birbhum district, West Bengal. Fluoride concentration in drinking water varies from 0.33 to 18.08 mg/L. Hydrogeochemical evolution suggests that ion-exchange mechanism is the major controlling factor for releasing F in the groundwater. Most of the groundwater samples are undersaturated with respect to calcite and fluorite. Health survey shows that out of 235 people, 142 people suffer from dental fluorosis. According to fluoride impact severity, almost 80 and 94 % people in an age group of 11–20 and 41–50 suffer from dental and skeletal fluorosis, respectively. Statistically drinking water F has a positive correlation with dental and skeletal fluorosis. Bone mineral density test reveals that 33 and 45 % of the studied population suffer from osteopenic and osteoporosis disease. IQ test also signifies that F has a bearing on the intelligence development of the study area school children. The existence of significant linear relationship (R ² = 0.77) between drinking water F and urinary F suggests that consumption of F-contaminated drinking water has a major control over urinary F (0.39–20.1 mg/L) excretion.     

Daily dietary fluoride intake in rural villages of the Ethiopian Rift Valley

Dental and skeletal fluorosis is widespread in the Ethiopian Rift Valley region. Drinking water has been considered the main reason for the development of fluorosis, but dietary intake may also be a contributor in areas with high concentration of fluoride in water, soil, and biota. The purpose of this study is to assess the total daily dietary fluoride intake by adults in a rural part of the Ethiopian Rift Valley. The food, beverage, and water samples were collected from selected households of three neighboring villages with similar dietary pattern, but with different fluoride content in their water sources. Village A uses water with 1.0 mg L^?1 fluoride, village B uses water with 3.0 mg L^?1 fluoride, and village C uses water with 11.5 mg L^?1 fluoride both for food preparation and for drinking. The level of fluoride was determined in all food ingredients, in the prepared food, beverages, and in the water used for food preparation and drinking. Recipe and food frequency questionnaires were used to gather household food preparation and consumption patterns. An alkali fusion method was used for digestion of food samples and for subsequent determination of fluoride with ion-selective electrode. The daily fluoride intake varied depending on its concentration in the water used for cooking and drinking. In households using water with 1 mg L^?1, 3 mg L^?1, and 11.5 mg L^?1 fluoride, the total personal intake was found to be 10.5, 16.6, and 35.3 mg d^?1, respectively. Contribution of the water to the daily fluoride intake was 33%, 58%, and 86%, respectively. Even in households using water containing fluoride at a concentration of 1 mg L^?1, the daily intake was higher than the recommended safe intake of 1.5–4.0 mg d^?1 for adults, which indicates that the fluoride intake through food may cause health risks. Minimizing the fluoride concentration in water to the lowest possible level will greatly reduce the daily intake. The form of fluorine (organic or inorganic) in the food items and the associated health risk factors need further investigation.     

Assessment of natural arsenic in groundwater in Cordoba Province,Argentina

Groundwater in the central part of Argentina contains arsenic concentrations that, in most cases, exceed the value suggested by international regulations. In this region, Quaternary loessical sediments with a very high volcanic glass fraction lixiviate arsenic and fluoride after weathering. The objectives of this study are to analyze the spatial distribution of arsenic in different hydrogeological regions, to define the naturally expected concentration in an aquifer by means of hydrogeochemistry studies, and to identify emergent health evidences related to cancer mortality in the study area. The correlation between arsenic and fluoride concentrations in groundwater is analyzed at each county in the Cordoba Province. Two dimensionless geoindicators are proposed to identify risk zones and to rapidly visualize the groundwater quality related to the presence of arsenic and fluoride. A surface-mapping system is used to identify the spatial variability of concentrations and for suggesting geoindicators. The results show that the Chaco-Pampean plain hydrogeologic region is the most affected area, with arsenic and fluoride concentrations in groundwater being generally higher than the values suggested by the World Health Organization (WHO) for drinking water. Mortality related to kidney, lung, liver, and skin cancer in this area could be associated to the ingestion of arsenic-contaminated water. Generated maps provide a base for the assessment of the risk associated to the natural occurrence of arsenic and fluoride in the region.     

Fluoride content and distribution pattern in groundwater of eastern Yunnan and western Guizhou, China

For study, the fluoride (F) content and distribution pattern in groundwater of eastern Yunnan and western Guizhou fluorosis area in southwestern China, the F content of 93 water samples [groundwater (fissure water, cool spring, and hot springs), rivers water] and 60 rock samples were measured. The result shows the F content of the fissure water and cold spring water is 0.027–0.47 mg/L, and river water is 0.048–0.224 mg/L. The F content of hot spring water is 1.02–6.907 mg/L. The drinking water supplied for local resident is mainly from fissure water, cool spring, and river water. And the F content in all of them is much lower than the Chinese National Standard (1.0 mg/L), which is the safe intake of F in drinking water. The infected people in eastern Yunnan and western Guizhou fluorosis area have very little F intake from the drinking water. The hot spring water in fluorosis area of eastern Yunnan and western Guizhou, southwest China has high F content, which is not suitable for drinking.     

Effect of excess fluoride ingestion on human thyroid function in Gaya region,Bihar, India

Fluoride (F) is mainly ingested through drinking water and food. In addition to producing dental and skeletal fluorosis, excess fluoride may affect the functioning of many organs including the thyroid gland. The present study investigated the thyroid function of subjects with dental fluorosis from F-endemic areas of Gaya region, Bihar, India and compared it with control individuals from Bodh Gaya. The mean F concentration in groundwater of F-endemic area was 2.82 ± 0.18 mg/L (range 0.62–7.2 mg/L), while that of control area was 0.49 ± 0.04 mg/L (range 0.21–0.76 mg/L). Abnormal levels of T3, T4, and TSH were found in the study subjects from both control and F-endemic areas.     

A health risk assessment for fluoride in Central Europe

Like many elements, fluorine (which generally occurs in nature as fluoride) is beneficial to human health in trace amounts, but can be toxic in excess. The links between low intakes of fluoride and dental protection are well known; however, fluoride is a powerful calcium-seeking element and can interfere with the calcified structure of bones and teeth in the human body at higher concentrations causing dental or skeletal fluorosis. One of the main exposure routes is via drinking water and the World Health Organisation currently sets water quality guidelines for the element. In Central Europe, groundwater resources that exceed the guideline value of 1.5 mg l⁻¹ are widespread and effects on health of high fluoride in water have been reported. The aim of the current project was to develop a geographic information system (GIS) to aid the identification of areas where high-fluoride waters and fluorosis may be a problem; hence, where water treatment technologies should be targeted. The development of the GIS was based upon the collation and digitisation of existing information relevant to fluoride risk in Ukraine, Moldova, Hungary and Slovakia assembled for the first time in a readily accessible form. In addition, geochemistry and health studies to examine in more detail the relationships between high-fluoride drinking waters and health effects in the population were carried out in Moldova and Ukraine demonstrating dental fluorosis prevalence rates of 60–90% in adolescents consuming water containing 2–7 mg l⁻¹ fluoride.     

Groundwater fluoride contamination,probable release,and containment mechanisms: a review on Indian context

Fluoride contamination in the groundwater has got great attention in last few decades due to their toxicity, persistent capacity and accumulation in human bodies. There are several sources of fluoride in the environment and different pathways to enter in the drinking water resources, which is responsible for potential effect on human health. Presence of high concentration of fluoride ion in groundwater is a major issue and it makes the water unsuitable for drinking purpose. Availability of fluoride in groundwater indicates various geochemical processes and subsurface contamination of a particular area. Fluoride-bearing aquifers, geological factors, rate of weathering, ion-exchange reaction, residence time and leaching of subsurface contaminants are major responsible factors for availability of fluoride in groundwater. In India, several studies have reported that the groundwater of several states are contaminated with high fluoride. The undesirable level of fluoride in groundwater is one of the most natural groundwater quality problem, which affects large portion of arid and semiarid regions of India. Rajasthan, Andhra Pradesh, Telangana, Tamil Nadu, Gujarat, and West Bengal are the relatively high-fluoride-contaminated states in India. Chronic ingestion of high doses of fluoride-rich water leads to fluorosis on human and animal. Over 66 million Indian populations are at risk due to excess fluoride-contaminated water. Therefore, groundwater contamination subject to undesirable level of fluoride needs urgent attention to understand the role of geochemistry, hydrogeology and climatic factors along with anthropogenic inputs in fluoride pollution.     

Hydrogeochemical processes identification and groundwater pollution causes analysis in the northern Ordos Cretaceous Basin,China

It is necessary to identify the hydrogeochemical processes and analyze the causes of groundwater pollution due to the lack of knowledge about the groundwater chemical characteristics and the endemic diseases caused by groundwater pollution in the northern Ordos Cretaceous Basin. In this paper, groundwater chemical facies were obtained using the piper trilinear diagram based on the analysis of 190 samples. The hydrogeochemical processes were identified using ionic ratio coefficient, such as leaching, evaporation and condensation. The causes and sources of groundwater pollution were analyzed by correspondence analysis, and the spatial distribution and enrichment reasons of fluoride ion were analyzed considering the endemic fluorosis emphatically. The results show that leaching, evaporation and condensation, mixing, and anthropogenic activities all had significant impact on hydrogeochemical processes in the study area. However, cation exchange and adsorption effects were strong in the S2 and S3 groundwater flow systems, but weak in S1. Groundwater is mainly polluted by Mn and COD_Mn in the study area. The landfill leachate, domestic sewage, and other organic pollutants, excessive use of pesticides and fertilizers in agriculture, and pyrite oxidation from long-term and large-scale exploitation of coal are the sources of groundwater pollution. The S1 has the highest degree of groundwater pollution, followed by S2 and S3. High concentration of fluoride ion is mainly distributed in the north and west of study area. Evaporation and condensation and groundwater chemistry component are the most important causes of fluoride ion enrichment. The results obtained in this study will be useful for understanding the groundwater quality for effective management and utilization of groundwater resources and assurance of drinking water safety.     

Dental fluorosis in bovine of Nayagarh district of Orissa

Chronic fluoride toxicity in the form of dental fluorosis was observed in cattle from nine (9) villages under two (2) blocks of Nayagarh district of Orissa. Out of 1117 cattle, 221 (18.09%) showed the signs of dental fluorosis. In all affected villages, the prevalence of dental fluorosis in calves (< 1 year age) was greater than adults. There was significant difference in prevalence in respect to age. The commonly observed signs of dental fluorosis were brown discoloration, mottling, attrition or uneven wearing of teeth with or without pitting. None of the affected animals showed characteristic signs of osteofluorosis. The mean serum and urine fluoride concentration of affected animals were significantly (P < 0.05) higher than those of control animals. Fluoride levels (mean) of ground water and surface water in two blocks were 1.30 +/- 0.16 ppm, 0. 66 +/- 0.08 ppm and 1.12 +/- 0.19 ppm, 0. 48 +/- 0.05 ppm respectively. The fluoride content of grass samples of affected and control (non-endemic) area was comparable. There was a highly positive correlation (r = + 0.664) between prevalence of dental fluorosis and fluoride content of ground water. It was concluded that fluoride intake through the water especially ground water contributed to the development of fluorosis in cattle.     

The Contribution of Drinking Water towards Dental Fluorosis: A case study of Njoro Division, Nakuru District, Kenya

This study was carried out to measure the fluoride levels of water consumed in the Njoro division of Nakuru district, Kenya. The sources of drinking water, methods of water storage and utilisation, as well as the perceptions of the local community towards dental fluorosis and the percentage of children with moderate to severe dental fluorosis were also determined. Rainwater had mean fluoride levels of 0.5 mg L^-1, dams 2.4 mg L^-1, wells 4.1 mg L^-1, springs 5.5 mg L^-1, and boreholes 6.6 mg L^-1. Water stored in plastic and cement containers did not show appreciable reduction in fluoride content with storage time; water stored in metal containers reduced fluoride by up to 8.2%; water stored in clay pots had the highest reduction in fluoride content, ranging between 34.3 and 64.7%;. Forty eight point three percent of children observed in the area had moderate to severe dental fluorosis, even though most people in the area did not know the cause of the problem.There is need to educate the community on the causes of fluorosis, and to lay strategies for addressing the issue, such as encouraging more rainwater harvesting, treating drinking water with alum, or using clay pots for storage of drinking water.     

Arsenic and fluoride in the groundwater of Mexico

Concentrations of arsenic and fluoride above Mexican drinking water standards have been detected in aquifers of various areas of Mexico. This contamination has been found to be mainly caused by natural sources. However, the specific processes releasing these toxic elements into groundwater have been determined in a few zones only. Many studies, focused on arsenic-related health effects, have been performed at Comarca Lagunera in northern México. High concentrations of fluoride in water were also found in this area. The origin of the arsenic there is still controversial. Groundwater in active mining areas has been polluted by both natural and anthropogenic sources. Arsenic-rich minerals contaminate the fractured limestone aquifer at Zimapán, Central México. Tailings and deposits smelter-rich fumes polluted the shallow granular aquifer. Arsenic contamination has also been reported in the San Antonio-El Triunfo mining zone, southern Baja California, and Santa María de la Paz, in San Luis Potosí state. Even in the absence of mining activities, hydrogeochemistry and statistical techniques showed that arsenopyrite oxidation may also contaminate water, as in the case of the Independencia aquifer in the Mexican Altiplano. High concentrations of arsenic have also been detected in geothermal areas like Los Azufres, Los Humeros, and Acoculco. Prevalence of dental fluorosis was revealed by epidemiological studies in Aguascalientes and San Luis Potosí states. Presence of fluoride in water results from dissolution of acid-volcanic rocks. In Mexico, groundwater supplies most drinking water. Current knowledge and the geology of Mexico indicate the need to include arsenic and fluoride determinations in groundwater on a routine basis, and to develop interdisciplinary studies to assess the contaminant's sources in all enriched areas.     

A review of global outlook on fluoride contamination in groundwater with prominence on the Pakistan current situation

Several million people are exposed to fluoride (F^?) via drinking water in the world. Current review emphasized the elevated level of fluoride concentrations in the groundwater and associated potential health risk globally with a special focus on Pakistan. Millions of people are deeply dependent on groundwater from different countries of the world encompassing with an elevated level of fluoride. The latest estimates suggest that around 200 million people, from among 25 nations the world over, are under the dreadful fate of fluorosis. India and China, the two most populous countries of the world, are the worst affected. In Pakistan, fluoride data of 29 major cities are reviewed and 34% of the cities show fluoride levels with a mean value greater than 1.5 mg/L where Lahore, Quetta and Tehsil Mailsi are having the maximum values of 23.60, 24.48, > 5.5 mg/L, respectively. In recent years, however, other countries have minimized, even eliminated its use due to health issues. High concentration of fluoride for extended time period causes adverse effects of health such as skin lesions, discoloration, cardiovascular disorders, dental fluorosis and crippling skeletal fluorosis. This review deliberates comprehensive strategy of drinking water quality in the global scenario of fluoride contamination, especially in Pakistan with prominence on major pollutants, mitigation technologies, sources of pollution and ensuing health problems. Considering these verities, health authorities urgently need to establish alternative means of water decontamination in order to prevent associated health problems.     

Fluoride contamination in groundwater of central Rajasthan,India and its toxicity in rural habitants

This study was carried out to assess fluoride (Fl) concentration in groundwater in some villages of central Rajasthan, India, where groundwater is the main source of drinking water. Water samples collected from deep aquifer-based hand pumps were analyzed for Fl content. Fluoride in groundwater of 121 habitations of Bhilwara tehsil of Bhilwara district of Rajasthan was determined to examine the potential Fl-induced toxicity in rural locations. Fluoride concentrations in the tehsil ranged from 0.5 to 5.8 mg/l. In the tehsil, 69 villages (57%) were found to have Fl concentration beyond the maximum desirable limit recommended in Bureau of Indian Standards (BIS), 10500, 1991. Fifty-eight percent population of these villages was under the threat of fluorosis. One percent population of tehsil living in two villages ingested more than 5 mg/l Fl in each liter of drinking water and at maximal risk for dental and skeletal fluorosis. 142 individuals of these villages were examined for fluorosis. Data indicated that only four individuals (2.82%) did not exhibit dental fluorosis. Most individuals were found to suffer from mild (34.51% or 49 individuals) and moderate (31.69% or 45 individuals) fluorosis. Severe dental fluorosis was recorded in only 16 individuals (11.27%). In 104 individuals above 21 years of age examined for the prevalence of skeletal fluorosis, 66 were positive for skeletal fluorosis with a maximum 36.5% with grade I skeletal fluorosis. Grade II skeletal fluorosis was recorded in 28 individuals (26.9%). Data in this study demonstrate that there is a need to take ameliorative steps in this region to prevent fluorosis.     

Groundwater fluoride and dental fluorosis in southwestern Nigeria

This study was carried out to assess the fluoride levels of groundwater from open wells, consumed by the residents of three communities located in two distinct geological terrains of southwestern Nigeria. Fluoride concentration was determined using spectrophotometric technique, while analysis of other parameters like temperature, pH and total dissolve solids followed standard methods. Results of the analysis indicated that groundwater samples from Abeokuta Metropolis (i.e., basement complex terrain) had fluoride content in the range of 0.65?±?0.21 and 1.20?±?0.14. These values were found to be lower than the fluoride contents in the groundwater samples from Ewekoro peri-urban and Lagos metropolis where the values ranged between 1.10?±?0.14-1.45?±?0.07 and 0.15?±?0.07-2.20?±?1.41?mg/l, respectively. The fluoride contents in almost all locations were generally higher than the WHO recommended 0.6?mg/l. Analysis of Duncan multiple range test indicated that there is similarity in the level of significance of fluoride contents between different locations of same geological terrain at p?≤?0.05. It was also observed that fluoride distribution of groundwater samples from the different geological terrain was more dependent on factors like pH and TDS than on temperature. The result of the analyzed social demographic characteristics of the residents indicated that the adults (between the age of 20 and >40?years) showed dental decay than the adolescent (<20?years). This signifies incidence of dental fluorosis by the high fluoride content in the drinking water of the populace. Further investigation on all sources of drinking water and other causes of tooth decay in the area is suggested.     

Monitoring,mapping and health risk assessment of fluoride in drinking water supplies in rural areas of Maku and Poldasht,Iran

The aim of this study was to investigate and determine fluoride concentrations in drinking water supplies in rural areas of Maku and Poldasht in West Azerbaijan Province, the northwest of Iran. Fluorosis risk assessment and characterization was also investigated. Fluoride concentrations mapping was accomplished by using the GIS system. Totally, 356 water samples, including one sample in each season, were collected from 89 water supplies providing water for 95 and 61 rural areas of Maku and Poldasht, respectively. According to the results, in Maku and Poldasht, 25 and 30 rural areas had contaminated water sources, respectively. Average annual fluoride concentrations ranged from 3.04 to 7.31 mg/l in the contaminated villages of Maku, which is about 2–4.8 times higher than the maximum standard level of the Iranian drinking water standard, and 4.52–8.21 mg/l in the contaminated areas of Poldasht, which is about 3–5.47 times higher than the maximum standard level. The maximum fluoride level was determined 11.12 mg/l and 10.98 mg/l in one of villages of Maku and Poldasht Counties in summer, respectively. Neither in Maku nor in Poldasht, water resources showed dental cavity risk, while dental fluorosis risk and skeletal fluorosis risk were very significant in some villages of both cities. Children were at most risk of fluorosis. New alternative water supplies for the contaminated villages if possible, consumption of bottled water and application of reverse osmosis are recommended as remedial actions in the contaminated areas.