Potential health risk of fluoride in groundwater of CKDu endemic areas in Cuttack district of Odisha, India

Abstract

Abstract In Odisha, chronic kidney disease of unknown aetiology (CKDu) has become a major health concern. The disease is particularly prevalent in farming communities and among individuals who rely on groundwater as their primary source of drinking water. Kidney damage is directly associated with excessive fluoride levels in drinking water. The fluoride concentration of 66 typical groundwater samples were analysed throughout 17 gram panchayats in the Narasinghpur block of Cuttack district, Odisha, India, which is considered a hotspot for CKDu. The research area's groundwater fluoride concentration ranged from 0.58 to 4.95 mg/L, with an average of 1.8 mg/L. The content of fluoride in more than 57% of drinking water samples exceeded the WHO recommendation of 1.5 mg/L. The study also assessed the residents' health risks based on exposure pathways through ingestion and dermal contact using the USEPA human health risk assessment model. The values of chronic daily intake (CDI) and Hazard Quotient (HQ) indicated that excessive drinking of fluoride-rich groundwater poses a higher risk of non-carcinogenic health problems to local residents. In the research location, infants and children are more susceptible to the non-carcinogenic health risks of fluoride than adults. This takes place mainly through direct ingestion route where the dominance order of the total hazard index (THI) of population was infants > children > men > women for all sampling locations, suggesting significantly higher risk than the permissible limits (> 1). Based on the results, the area can be classified as a high-risk zone for fluoride-related issues and requires immediate intervention to protect the health and safety of the local population. This study indicates that long-term exposure to fluoride in drinking water may pose harm to human health and disrupt kidney functions. Thus, continuous monitoring and improved management of water supplies in CKDu-affected regions are crucial for determining the contamination load and mitigating the adverse health effects caused by excessive and prolonged exposure to the fluoride found in ground water.