Fluoride and health hazards: community perception in a fluorotic area of central Rajasthan (India): an arid environment

India is among the 23 nations around the globe where health problems occur due to excess ingestion of fluoride (>1.5 mg/l) by drinking water. In Rajasthan, 18 out of 32 districts are fluorotic and 11 million of the populations are at risk. An exploratory qualitative survey was conducted to describe perception of the community regarding fluoride and related health problems in Central Rajasthan. A study on distribution and health hazards by fluoride contaminate in groundwater was performed in 1,030 villages of Bhilwara district of Central Rajasthan. One thousand thirty water samples were collected and analyzed for fluoride concentration. Fluoride concentration in these villages varies from 0.2 to 13.0 mg/l. Seven hundred fifty-six (73.4%) villages have fluoride concentration above 1.0 mg/l. Sixty (5.83%) villages have fluoride concentration above 5.0 mg/l with maximum numbers (24, 19.5%) from Shahpura tehsil. A detailed fluorosis study was carried out in 41 villages out of 60 villages having fluoride above 5.0 mg/l in the study age, sex, and occupation data were also collected. Four thousand, two hundred fifty-two individuals above 5 years age were examined for the evidence of dental fluorosis, while 1998 individuals above 21 years were examined for the evidence of skeletal fluorosis. The overall prevalence of dental and skeletal fluorosis was found to be 3,270/4,252 (76.9%) and 949/1,998 (47.5%), respectively. Maximum of 23.9% (1,016) individuals have mild grade of Dean’s classification. Three hundred seventy-four (8.8%) individuals have severe type of dental fluorosis. The Dean’s Community Fluorosis Index for the studied area in total is 1.62. Maximum CFI 3.0 was recorded from Surajpura of Banera Tehsil. Five hundred sixty-six (28.3%) individuals have Grade I type of skeletal fluorosis while only 0.6% (12) individuals have Grade III skeletal fluorosis. In conclusion, the prevalence and severity of fluorosis increased with increasing fluoride concentration. It was interesting to note that in some villages, the prevalence and severity of fluorosis were highest in subjects belonging to the economically poor community. Similarly, male laborers showed highest prevalence of fluorosis. Prevalence and severity of fluorosis were observed higher in subjects using tobacco, bettle nuts, and alcoholic drinks. In contrast, subjects using citrus fruits and having good nutritional status showed low prevalence.     

Health risk assessment of fluoride in drinking water from Anhui Province in China

This study analyzes the concentrations and health risks of fluoride in 249 drinking water samples collected from different regions of Anhui Province in China. Results indicated that fluoride content in drinking water ranged from 0.12 to 1.94 mg L^?1 (mean?=?0.57 mg L^?1) in the following order: Huaibei plain region > Jianghuai hill region ≈ Dabieshan mountainous region > plain along the Yangtze River region > southern Anhui mountainous region. The fluoride contents were less than 0.50 mg L^?1 in 66.66 % of the drinking water samples, 0.51–1.0 mg L^?1 in 23.29 %, and higher than 1.0 mg L^?1 in 12.04 %. The fluoride levels in some samples were lower than the recommended values for controlling dental caries (0.50–1.0 mg L^?1). The total fluoride intake from drinking water was between 0.14 and 2.33 mg per day in different regions of the province, supposing an individual consumes 1.2 L of water per day. Therefore, measures should be taken to increase fluoride intake in the Jianghuai hill region, Dabieshan mountainous region, plain along the Yangtze River, and southern Anhui mountainous region to control dental caries. On the other hand, the fluoride levels must be reduced in the Huaibei plain region to decrease endemic fluorosis. The results serve as crucial guidelines for managing fluoride safety in drinking water and controlling endemic fluorosis in different regions of Anhui Province.     

石家庄市农村饮用水中氟化物健康风险评估

利用中国疾病预防控制信息系统农村饮用水水质监测数据,对2010年18个项目县的水质监测结果进行分析,评估石家庄市农村饮用水氟化物对人群危害的风险。 石家庄市农村饮用水中氟化物浓度为0.01~0.98 mg/L,平原县和山区县饮用水氟化物浓度差异无显著性(t=-1.403,P>0.05),只有72份氟化物浓度超过0.5 mg/L,占9.7%。石家庄市农村患龋齿风险性较大,及时增加氟的摄入量非常必要。     

Lead (Pb) and arsenic (As) bioaccessibility in various soils from south China

Serious problems are faced in several parts of the world due to the presence of high concentration of fluoride in drinking water which causes dental and skeletal fluorosis to humans. Nalgonda district in Andhra Pradesh, India is one such region where high concentration of fluoride is present in groundwater. Since there are no major studies in the recent past, the present study was carried out to understand the present status of groundwater quality in Nalgonda and also to assess the possible causes for high concentration of fluoride in groundwater. Samples from 45 wells were collected once every 2 months and analyzed for fluoride concentration using an ion chromatograph. The fluoride concentration in groundwater of this region ranged from 0.1 to 8.8 mg/l with a mean of 1.3 mg/l. About 52% of the samples collected were suitable for human consumption. However, 18% of the samples were having less than the required limit of 0.6 mg/l, and 30% of the samples possessed high concentration of fluoride, i.e., above 1.5 mg/l. Weathering of rocks and evaporation of groundwater are responsible for high fluoride concentration in groundwater of this area apart from anthropogenic activities including irrigation which accelerates weathering of rocks.     

Risk factors and prevalence of dental fluorosis and dental caries in school children of North India

The aim of the study was to assess the prevalence of dental fluorosis, dental caries, and associated risk factors in the school children of district Fatehgarh Sahib, Punjab, India, using a cross-sectional study design. Oral health status of children aged between 8 and 15 years was assessed using World Health Organization (WHO) 2013 criteria. Dental fluorosis was assessed using Dean’s index, and dental caries were recorded using decayed, missing, filled/decayed, extracted, filled (DMF/def) indices. Four hundred school children were examined, of which 207 were in the 8–11-year-old group and 193 were in the 12–15-year-old group. The overall prevalence of dental fluorosis was 4.1%, which might be linked to a high concentration of fluoride in drinking water at certain locations of rural Punjab. The prevalence of dental caries was 36.5% with a mean DMF score of 0.3 and def score of 0.6. Risk factors for dental caries include oral hygiene behavior and sugar consumption patterns. The study highlights the need to increase awareness about the oral health and hygiene among the school children in India.     

Urinary fluoride as a monitoring tool for assessing successful intervention in the provision of safe drinking water supply in five fluoride-affected villages in Dhar district, Madhya Pradesh, India

Endemic fluorosis was detected in 31 villages in the Dhar district of Madhya Pradesh, Central India. Out of the 109 drinking water sources that were analyzed, about 67 % were found to contain high concentration of fluoride above the permissible level of 1.0 mg/l. Dental fluorosis among the primary school children in the age between 8 and 15 served as primary indicator for fluoride intoxication among the children. Urinary fluoride levels among the adults were found to be correlated with drinking water fluoride in 10 villages affected by fluoride. Intervention in the form of alternate safe water supply in five villages showed significant reduction in the urinary fluoride concentration when compared to the control village. Urinary fluoride serves as an excellent marker for assessing the effectiveness of intervention program in the fluoride-affected villages.     

Fluoride contamination in drinking water in rural habitations of Northern Rajasthan, India

This study was carried out to assess the fluoride concentration in groundwater in some villages of northern Rajasthan, India, where groundwater is the main source of drinking water. Water samples collected form deep aquifer based hand-pumps were analysed for fluoride content. Fluoride in presently studied sites was recorded in the ranges of 4.78 and 1.01 mg/l. The average fluoride concentration for this region was recorded 2.82 mg/l. As per the desirable and maximum permissible limit for fluoride in drinking water, determined by WHO or by Bureau of Indian Standards, the groundwater of about 95 of the studied sites is unfit for drinking purposes. Due to the higher fluoride level in drinking water several cases of dental and skeletal fluorosis have appeared at alarming rate in this region. The middle and eastern parts of the Hanumangarh, a northern most district of the state, can be classified as higher risk area for fluorosis; due to relatively high concentrations of fluoride (3-4 mg/l) in groundwater of this region. After evaluating the data of this study it is concluded that there is an instant need to take ameliorative steps in this region to prevent the population from fluorosis.     

Prevalence of certain inorganic constituents in groundwater samples of Erode district, Tamilnadu, India, with special emphasis on fluoride, fluorosis and its remedial measures

A total of 60 drinking water samples collected from Erode district, Tamilnadu, India were analysed for fluoride contamination, besides water quality parameters such as pH, electrical conductivity, total dissolved solids, total alkalinity, total hardness, fluoride, bicarbonates, calcium, magnesium, nitrate, sulphate, phosphate, sodium and potassium. The results obtained were found to exceed the permissible limits. The concentration of fluoride in the water samples ranged between 0.5 and 8.2 mg/l and revealed that 80% of the water samples contain fluoride above the maximum permissible limit. Similarly, the concentrations of nitrate, hardness, calcium and magnesium in some samples were also more than the permissible level. Pearson’s correlation coefficient among the parameters showed a positive correlation of fluoride with total hardness and calcium. It is inferred from the study that these water sources can be used for potable purpose only after prior treatment.     

Fluoride in groundwater in selected villages in Eritrea (North East Africa)

A study was undertaken to estimate fluoride content in thegroundwater in certain parts of rural Eritrea, North-East Africa,along the River Anseba. Standard procedure was adopted for fluoride detection. Results indicate elevated concentration offluoride in groundwater. The highest concentration was found tobe 3.73 mg L^-1, well above the safety level for consumption.Geological basis for the high concentration of high fluoride hasbeen established; it is presumed to be the pegmatite intrusion hosted by a granitic batholith. Extensive dental fluorosis has been observed in the population exposed to drinking water of highfluoride content.     

Fluoride contamination in drinking water in rural habitations of Central Rajasthan, India

Fluoride concentration in groundwater sources used as major drinking water source in rural area of block Nawa (Nagaur District), Rajasthan was examined and the toxic effects by intake of excess fluoride on rural habitants were studied. In block 13, habitations (30%) were found to have fluoride concentration more than 1.5 mg/l (viz. maximum desirable limit of Indian drinking water standards IS 10500, 1999). In five habitations (11%), fluoride concentration in groundwater is at toxic level (viz. above 3.0 mg/l). The maximum fluoride concentration in the block is 5.91 mg/l from Sirsi village. As per the desirable and maximum permissible limit for fluoride in drinking water, determined by World Health Organization or by Bureau of Indian Standards, the groundwater of about 13 habitations of the studied sites is unfit for drinking purposes. Due to the higher fluoride level in drinking water, several cases of dental and skeletal fluorosis have appeared at alarming rate in this region. There is an instant need to take ameliorative steps in this region to prevent the population from fluorosis. Groundwater sources of block Nawa can be used for drinking after an effective treatment in absence of other safe source. The evaluation of various defluoridation methods on the basis of social and economical structure of India reveals that the clay pot chip, activated alumina adsorption, and Nalgonda techniques are the most promising.     

Assessment of ground water quality for drinking purpose, District Nainital, Uttarakhand, India

The ground water quality of District Nainital (Uttarakhand, India) has been assessed to see the suitability of ground water for drinking and irrigation applications. This is a two-part series paper and this paper examines the suitability of ground water including spring water for drinking purposes. Forty ground water samples (including 28 spring samples) were collected during pre- and post-monsoon seasons and analyzed for various water quality constituents. The hydrochemical and bacteriological data was analyzed with reference to BIS and WHO standards and their hydrochemical facies were determined. The concentration of total dissolved solids exceeds the desirable limit of 500 mg/L in about 10% of the samples, alkalinity values exceed the desirable limit of 200 mg/L in about 30% of the samples, and total hardness values exceed the desirable limit of 300 mg/L in 15% of the samples. However, no sample crosses the maximum permissible limit for TDS, alkalinity, hardness, calcium, magnesium, chloride, sulfate, nitrate, and fluoride. The concentration of chloride, sulfate, nitrate, and fluoride are well within the desirable limit at all the locations. The bacteriological analysis of the samples does not show any sign of bacterial contamination in hand pump and tube-well water samples. However, in the case of spring water samples, six samples exceed the permissible limit of ten coliforms per 100 ml of sample. It is recommended that water drawn from such sources should be properly disinfected before being used for drinking and other domestic applications. Among the metal ions, the concentration of iron and lead exceeds the permissible limit at one location whereas the concentration of nickel exceeds the permissible limit in 60 and 32.5% of the samples during pre- and post-monsoon seasons, respectively. The grouping of samples according to their hydrochemical facies indicates that majority of the samples fall in Ca–Mg–HCO₃ hydrochemical facies.     

Bovine calves as ideal bio-indicators for fluoridated drinking water and endemic osteo-dental fluorosis

Relative susceptibility to fluoride (F) toxicosis in the form of osteo-dental fluorosis was observed in an observational survey of 2,747 mature and 887 immature domestic animals of diverse species living in areas with naturally fluoridated (>1.5 ppm F) drinking water. These animals included buffaloes (Bubalus bubalis), cattle (Bos taurus), camels (Camelus dromedarius), donkeys (Equus asinus), horses (Equus caballus), goats (Capra hircus), and sheep (Ovis aries). Of these mature and immature animals, 899 (32.7 %) and 322 (36.3 %) showed evidence of dental fluorosis with varying grades, respectively. Their incisor teeth were stained with light to deep brownish color. On clinical examination, 31.2 % mature and 10.7 % immature animals revealed periosteal exostoses, intermittent lameness, and stiffness of tendons in the legs as signs of skeletal fluorosis. The maximum susceptibility to fluoride toxicosis was found in bovines (buffaloes and cattle) followed by equines (donkeys and horses), flocks (goats and sheep), and camelids (camels). The bovine calves were found to be more sensitive and highly susceptible to F toxicosis and revealed the maximum prevalence (92.2 %) of dental fluorosis. This indicates that bovine calves are less tolerant and give early sign of F poisoning (dental fluorosis) and therefore, they can be considered as bio-indicators for fluoridated water as well as for endemicity of osteo-dental fluorosis. Causes for variation in susceptibility to F toxicosis (fluorosis) in various species of domestic animal are also discussed.     

电解铝企业阳极残渣、阳极残极浸出毒性鉴别及管理建议

对电解铝企业产生的阳极残渣、阳极残极浸出毒性进行了鉴别。鉴别结果表明：电解铝企业产生阳极残渣浸出液中氟化物（不含氟化钙）平均质量浓度为140 mg／L，最高达244 mg／L，且超标试样数达到《危险废物鉴别标准浸出毒性鉴别》中相应规定，鉴别该废物属于危险废物，应按照危险废物进行管理；阳极残极浸出液中氟化物（不含氟化钙）平均质量浓度为74 mg／L，无超标试样数，该废物不属于具有氟化物浸出毒性的固体废物，建议仍按一般固体废物进行管理。     

Fluorine contamination in groundwater: a major challenge

Fluoride in high concentration in groundwater has been reported from many parts of India. However, a systematic study is required to understand the behavior of fluoride in natural water in terms of local hydrogeological setting, climatic conditions, and agricultural practices. The present study is an attempt to assess hydrogeochemistry of groundwater in parts of Palar river basin pertaining to Kancheepuram district Tamil Nadu to understand the fluoride abundance in groundwater and to deduce the chemical parameters responsible for the dissolution activity of fluoride. The study area is geologically occupied by partly sedimentary and partly crystalline formations. A total of 50 dug cum borewell-water samples, representing an area of 2,628.92 km². The results of the chemical analyses in September 2009 show fluoride abundance in the range of 1 to 3.24 mg/l with 86% of the samples in excess of the permissible limit of 1.5 mg/l. Presence of fluoride-bearing minerals in the host rock, chemical properties like decomposition, dissociation, and dissolution, and their interaction with water are considered to be the main causes for fluoride in groundwater. Chemical weathering with relatively high alkalinity favors high concentration of fluoride in groundwater. Villagers who consume nonpotable high fluoride water may suffer from yellow, cracked teeth; joint pains; and crippled limbs and also age rapidly.     

Groundwater Quality Assessment of Tehsil Kheragarh, Agra (India) with Special Reference to Fluoride

Fluoride concentration and other parameters in groundwater from 261 villages in Tehsil Kheragarh of District Agra were assessed and attempts were made to observe the relationship between fluoride and other water quality parameters. Of 658 groundwater samples (collected from separate sources) analysed for fluoride, 27% were in the range of 0–1.0 mg/L, 25% in 1.0–1.5 mg/L, 32% in1.5–3.0 mg/L and 16% above 3.0 mg/L. The highest fluoride concentration recorded was 12.80 mg/L. Significant correlation of fluoride with pH, alkalinity, Na, SiO₂ and PO₄ were observed. Factor analysis was also attempted in order to identify the contributing sources.     

The occurrence and hydrochemistry of fluoride and boron in carbonate aquifer system, central and western Estonia

Silurian–Ordovician (S–O) aquifer system is an important drinking water source of central and western Estonia. The fluoride and boron contents of groundwater in aquifer system vary considerably. The fluoride concentration in 60 collected groundwater samples ranged from 0.1 to 6.1 mg/l with a mean of 1.95 mg/l in the study area. Boron content in groundwater varied from 0.05 mg/l to 2.1 mg/l with a mean value of 0.66 mg/l. Considering the requirements of EU Directive 98/83/EC and the Estonian requirements for drinking water quality, the limit value for fluoride (1.5 mg/l) and for boron (1.0 mg/l) is exceeded in 47 and 28 % of wells, respectively. Groundwater with high fluoride and boron concentrations is found mainly in western Estonia and deeper portion of aquifer system, where groundwater chemical type is HCO₃–Cl–Na–Mg–Ca, water is alkaline, and its Ca²⁺ content is low. Groundwater of the study area is undersaturated with respect to fluorite and near to equilibrium phase with respect to calcite. The comparison of TDS versus Na/(Na?+?Ca) and Cl/(Cl?+?HCO₃) points to the dominance of rock weathering as the main process, which promotes the availability of fluoride and boron in the groundwater. The geological sources of B in S–O aquifer system have not been studied so far, but the dissolution of fluorides from carbonate rocks (F?=?100–400 mg/kg) and K-bentonites (F?=?2,800–4,500 mg/kg) contributes to the formation of F-rich groundwater.     

Evaluation of surface water quality in aquatic bodies under the influence of uranium mining (MG, Brazil)

The quality of the water in a uranium-ore-mining area located in Caldas (Minas Gerais State, Brazil) and in a reservoir (Antas reservoir) that receives the neutralized acid solution leaching from the waste heaps generated by uranium mining was investigated. The samples were collected during four periods (October 2008, January, April and July 2009) from six sampling stations. Physical and chemical analyses were performed on the water samples, and the data obtained were compared with those of the Brazilian Environmental Standards and WHO standard. The water samples obtained from waste rock piles showed high uranium concentrations (5.62 mg L^?1), high manganese values (75 mg L^?1) and low average pH values (3.4). The evaluation of the water quality at the point considered the limit between the Ore Treatment Unit of the Brazilian Nuclear Industries and the environment (Consulta Creek) indicated contamination by fluoride, manganese, uranium and zinc. The Antas reservoir showed seasonal variations in water quality, with mean concentrations for fluoride (0.50 mg L^?1), sulfate (16 mg L^?1) and hardness (20 mg L^?1) which were low in January, evidencing the effect of rainwater flowing into the system. The concentrations for fluoride, sulfate and manganese were close or above to the limits established by current legislation at the point where the treated mining effluent was discharged and downstream from this point. This study demonstrated that the effluent discharged by the UTM affected the quality of the water in the Antas reservoir, and thus the treatments currently used for effluent need to be reviewed.     

Investigations on boron levels in drinking water sources in China

To evaluate boron contamination of public drinking water in China, both dissolved and total boron contents in 98 public drinking water sources from 49 cities, 42 brands of bottled water samples from supermarkets in several cities, and 58 water samples from boron industrial area were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Our experimental results showed that boron existed in public drinking water sources mainly in dissolved status with total concentrations ranging from 0.003 to 0.337 mg/L (mean = 0.046 mg/L). The mean boron concentrations in mineral and pure bottled water were 0.052 and 0.028 mg/L, respectively. The results obtained in this work showed that there was no health risk on view of boron in public drinking water sources and bottled water. In boron industrial area, boron concentrations in surface water and ground water were 1.28 mg/L (range = 0.007–3.8 mg/L) and 18.3 mg/L (range = 0.015–140 mg/L), respectively, which indicated that boron industry caused boron pollution in local water system.     

Ground water quality in the Kathmandu valley of Nepal

A study was undertaken to assess the quality of groundwaters in the Kathmandu Valley, Nepal. The groundwater samples were randomly collected from shallow well, tube well, and deep-tube wells located at different places of Kathmandu, Lalitpur, and Bhaktapur districts in the Kathmandu valley. Physical, chemical, and microbiological parameters of the samples were evaluated to estimate the groundwater quality for drinking water. It was found that the groundwater in the valley is vulnerable to drink due to presence of iron and coliform bacteria. Iron was estimated to be much higher then the acceptable limit of World Health Organization (WHO) drinking-water quality guidelines (1.9 mg/L). Total coliform bacteria enumerated in groundwaters significantly exceeded the drinking-water quality standard and observed maximum coliform (267 CFU/100 mL) in shallow wells. The electrical conductivity and turbidity were found to be 875 ??S/cm and 55 NTU, respectively, which are above the WHO recommendations for drinking water guidelines. However, pH value was measured within the acceptable limit. Arsenic, chloride, fluoride, and hardness concentrations were found to be in agreement with the recommendations of WHO drinking-water quality guidelines.     

Hydrogeochemical processes controlling the high fluoride concentration in groundwater: a case study at the Boden block area,Orissa, India

The present investigation reports the assessment of hydrochemical/geochemical processes controlling the concentration of fluoride in groundwater of a village in India (Boden block, Orissa). Boden block is one of the severely affected fluoride-contaminated areas in the state of Orissa (India). The sampling and subsequent analysis of water samples of the study area was carried out following standard prescribed methods. The results of the analysis indicate that 36.60% groundwater F⁻ concentration exceeds the limit prescribed by the World Health Organization for drinking water. The rock interaction with groundwater containing high concentration of HCO₃⁻ and Na⁺ at a higher pH value of the medium could be one of the important reasons for the release of F⁻ from the aquatic matrix into groundwater. Geochemical classification of groundwater based on Chadha rectangular diagram shows that most of the groundwater samples having fluoride concentration more than 1.5 mg L⁻¹ belongs to the Na-K-HCO₃ type. The saturation index values evaluated for the groundwater of the study area indicated that it is oversaturated with respect to calcite, whereas the same is undersaturated with respect to fluorite content. The deficiency of calcium ion concentration in the groundwater from calcite precipitation favors fluorite dissolution leading to excess of fluoride concentration. The risk index was calculated as a function of fluoride level in drinking water and morbidity of fluorosis categorizes high risk for villages of Amera and Karlakote panchayat of Boden block.