Fluoride Toxicity through Groundwater Consumption and Its Rural Health Consequences: Field Evidence from Western Uttar Pradesh

Abstract

Drinking water drawn from shallow aquifers across several belts of rural India carries dissolved fluoride at concentrations that silently damage teeth, bones, kidneys, and developing brains over years of daily consumption. In Western Uttar Pradesh, this problem is acute yet poorly documented at the district level, and most affected villages have no access to treatment or even basic information about the risk they face. This study was conducted across five districts — Agra, Mathura, Aligarh, Bulandshahr, and Etah — with the twin purpose of measuring fluoride concentrations in 214 groundwater sources and recording the health status of households that depend on them. Water was collected during April–May 2025, a period of peak groundwater stress, and analysed using the SPADNS colorimetric method. Simultaneously, 1,200 households across 42 villages were surveyed and children were clinically examined for signs of fluorosis. The data revealed that 52.3 percent of sources exceeded the 1.5 mg/L safety threshold, with a peak observation of 5.1 mg/L recorded in Aligarh district. Dental fluorosis was confirmed in 63.4 percent of children aged 5–14 years in high-exposure zones. Skeletal fluorosis was documented in 28.7 percent of middle-aged adults, while neurological screening flagged cognitive deficits in nearly one in five children under ten years of age in the most contaminated villages. Thyroid irregularities and early renal stress were also observed at clinically significant rates. The hydrochemical profile of contaminated sources — characterised by alkaline pH, low dissolved calcium, and elevated sodium bicarbonate — points to natural rock leaching as the primary source, compounded by intensive irrigation pumping that has deepened aquifer drawdown over decades. Practical, low-cost defluoridation approaches including the Nalgonda technique and community rainwater harvesting are evaluated and recommended for immediate deployment.