Population Risk Estimation From Fluoride Exposure Through Drinking Water in Puruliya District, West Bengal (India)

Main Article Content

Juthika Mandal
Srabani Sanyal


The menace of fluorosis is quite anticipatable for the people of the Puruliya district because of the excessive fluoride level in the groundwater. More than 80% of the population is rural, and 85% depend on groundwater as their single means of drinking water. Therefore, the current paper aims to determine the block-wise distribution of villages and populations based on the fluoride level of groundwater and associated health risk in the Puruliya district. The study is based on the report on village-level fluoride concentration from the National Rural Drinking Water Mission Survey. Blocks of Puruliya District are categorized according to the World Health Organization's classes of different fluoride concentrations and related health impacts. For each category, the population is calculated based on the census of India 2011 data. The mapping of the severity of fluoride-exposed villages and populations is prepared using Arc. GIS 10.5. Our study found that 35.39% of the population is in danger of getting fluorosis through ingesting fluoride-rich water. Applying a geospatial approach to study the fluoride distribution is very significant in identifying the endemic fluoride region and safe areas for the entire district, which will help to take proper management remedies regarding prevention and control of fluorosis in the concerned district.


Download data is not yet available.

Article Details

Research Articles
Author Biography

Juthika Mandal, Geography Department, Institute of Science, Banaras Hindu University, Varanasi, India

Corresponding author


• Adimalla, N., & Li, P. (2019). Occurrence, health risks, and geochemical mechanisms of fluoride and nitrate in groundwater of the rock-dominant semi-arid region, Telangana State, India. Human and Ecological Risk Assessment: An International Journal, 25(1–2), 81–103. https://doi.org/10.1080/10807039.2018.1480353

• Adler, P., & World Health Organization. (‎1970)‎. Fluorides and human health. World Health Organization. https://apps.who.int/iris/handle/10665/41784

• ArcGIS. (2015). [GIS software]. Version 10.5. Environmental Systems Research Institute, Inc.

• Arveti, N., Sarma, M. R. S., Aitkenhead-Peterson, J. A., & Sunil, K. (2011). Fluoride incidence in groundwater: a case study from Talupula, Andhra Pradesh, India. Environmental Monitoring and Assessment, 172(1–4), 427–443. https://doi.org/10.1007/s10661-010-1345-3

• Athavale, R. N., & Das, R. K. (1999). Beware! Fluorosis is zeroing in on you. Down to Earth, 8(6), 24–25.

• Bailey, K., Chilton, J., Dahi, E., Fewtrell, L., Magara, Y., & Fawell, J. (2006). Fluoride in drinking-water. World Health Organization; IWA Publishing.

• Bhagavan, S. V. B. K., & Raghu, V. (2005). 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. Environmental Geochemistry and Health, 27(1), 97–108. https://doi.org/10.1007/s10653-004-0786-4

• Bhattacharya, H. N., & Chakrabarti, S. (2011). Incidence of fluoride in the groundwater of Purulia District, West Bengal: A geo-environmental appraisal. Current Science, 101(2), 152–155. https://www.currentscience.ac.in/Volumes/101/02/0152.pdf

• Bhattyacharya, D. (2009). Pachimbanger bhugarvastha jole fluoride sankraman o tar pratikar [Fluoride contamination and remediation in West Bengal's ground water]. Amit Bari, 5, 8–11.

• Bo, Z., Mei, H., Yongsheng, Z., Xueyu, L., Xuelin, Z., & Jun, D. (2003). Distribution and risk assessment of fluoride in drinking water in the west plain region of Jilin province, China. Environmental Geochemistry and Health, 25(4), 421–431. https://doi.org/10.1023/b:egah.0000004560.47697.91

• Bose, S., Yashoda, R., & Puranik, M. P. (2019). Novel materials for defluoridation in India: A systematic review. Journal of Dental Research and Review, 6(1), 3–8. https://doi.org/10.4103/jdrr.jdrr_55_18

• Bretzler, A., & Johnson, C. A. (2015). The geogenic contamination handbook: Addressing arsenic and fluoride in drinking water. Applied Geochemistry, 63, 642–646. https://doi.org/10.1016/j.apgeochem.2015.08.016

• Central Ground Water Board. (1989). Groundwater resource development plan for the drought-prone Puruliya. Ministry of Water Resources, West Bengal.

• Central Ground Water Board. (2019). States Wise Details of Partly Affected Districts with Select Contaminants in Ground Water of India. http://cgwb.gov.in/contaminated-areas.html

• Chakma, T., Singh, S. B., Godbole, S., & Tiwary, R. S. (1997). Endemic fluorosis with genu valgum syndrome in a village of district Mandla, Madhya Pradesh. Indian Pediatrics, 34, 232–236. https://www.indianpediatrics.net/mar1997/232.pdf

• Chakraborti, D., Das, B., & Murrill, M. T. (2011). Examining India’s groundwater quality management. Environmental Science and Technology, 45(1), 27–33. https://pubs.acs.org/doi/full/10.1021/es101695d

• Chatterjee, A., Roy, R. K., Ghosh, U. C., Pramanik, T., Kabi, S. P., & Biswas, K. (2008). Fluoride in water in parts of Raniganj Coalfield, West Bengal. Current Science, 94(3), 309–311. http://www.indiaenvironmentportal.org.in/files/cs1.pdf

• Chen, L., He, B. Y., He, S., Wang, T. J., Su, C. L., & Jin, Y. (2012). Fe―Ti oxide nano-adsorbent synthesized by co-precipitation for fluoride removal from drinking water and its adsorption mechanism. Powder Technology, 227, 3–8. https://doi.org/10.1016/j.powtec.2011.11.030

• Chen, W., Xu, R., Chen, G., Zao, J., & Chen, T. (1993). Changes of the prevalence of endemic fluorosis after changing water sources in two villages in Guangdong, China. Bulletin of Environmental Contamination and Toxicology, 51(4), 479–482. https://doi.org/10.1007/BF00192160

• Choubisa, S. L. (2001). Endemic fluorosis in southern Rajasthan, India. Fluoride, 34(1), 61–70. http://fluoridealert.org/wp-content/uploads/choubisa-2001.pdf

• Choubisa, S. L. (2012). Fluoride in drinking water and its toxicosis in tribals of Rajasthan, India. Proceedings of the National Academy of Sciences, India Section B: Biological Sciences, 82(2), 325–330. https://doi.org/10.1007/s40011-012-0047-8

• Choubisa, S. L., & Choubisa, D. (2015). Neighbourhood fluorosis in people residing in the vicinity of superphosphate fertilizer plants near Udaipur city of Rajasthan (India). Environmental Monitoring and Assessment, 187(8), Article 497. https://doi.org/10.1007/s10661-015-4723-z

• Choubisa, S. L., Choubisa, L., & Choubisa, D. (2009). Osteo-dental fluorosis in relation to nutritional status, living habits, and occupation in rural tribal areas of Rajasthan, India. Fluoride, 42(3), 210–215. http://fluoridealert.org/wp-content/uploads/choubisa-2009.pdf

• Choubisa, S. L., Choubisa, L., & Choubisa, D. K. (2001). Endemic fluorosis in Rajasthan. Indian Journal of Environmental Health, 43(4), 177–189. https://europepmc.org/article/med/12395525

• Dean, H. T. (1942). The investigation of physiological effects by the epidemiological method. American Association for the Advancement of Science, 19, 23–33.

• Dissanayake, C. B. (1991). The fluoride problem in the ground water of Sri Lanka—environmental management and health. International Journal of Environmental Studies, 38(2-3), 137–155. https://doi.org/10.1080/00207239108710658

• Dissanayake, C. B., & Chandrajith, R. (2009). Introduction. In Introduction to medical geology (pp. 1–18). Springer.

• Doig, A. T. (1963). Fluorosis. Practitioner, 190(1139), 622–627. https://doi.org/10.5005/jp/books/12869_28

• Edmunds, W. M., & Smedley, P. L. (2013). Fluoride in Natural Waters. In O. Selinus (Ed.), Essentials of medical geology (pp. 311–336). Springer.

• Falvey, D. A. (1999). Groundwater geochemistry. Earthwise, 13.

• Fan, X., Parker, D. J., & Smith, M. D. (2003). Adsorption kinetics of fluoride on low cost materials. Water Research, 37(20), 4929–4937. https://doi.org/10.1016/j.watres.2003.08.014

• Gautam, R., Bhardwaj, N., & Saini, Y. (2011). Dental fluorosis—a case study from Nawa tehsil in Nagaur district, Rajasthan (India). The Environmentalist, 31(4), 401–406. https://doi.org/10.1007/s10669-011-9354-5

• Goodarzi, F., Mahvi, A. H., Hosseini, M., Nodehi, R. N., Kharazifard, M. J., & Parvizishad, M. (2017). Prevalence of dental caries and fluoride concentration of drinking water: A systematic review. Dental Research Journal, 14(3), 163–168. https://doi.org/10.4103/1735-3327.208765

• Gopalakrishnan, P., Vasan, R. S., Sarma, P. S., Ravindran Nair, K. S., & Thankappan, K. R. (1999). Prevalence of dental fluorosis and associated risk factors in Allappuzha district, Kerala. National Medical Journal of India, 12(3), 99–102. http://archive.nmji.in/archives/Volume-12/issue-3/original-articles-1.pdf

• Hamilton, M. (1992). Water fluoridation: A risk assessment perspective. Journal of Environmental Health, 54(6), 27–32. https://www.jstor.org/stable/44534047

• Harrison, P. T. C. (2005). Fluoride in water: A UK perspective. Journal of Fluorine Chemistry, 126(11-12), 1448–1456. https://doi.org/10.1016/j.jfluchem.2005.09.009

• He, X., Li, P., Wu, J., Wei, M., Ren, X., & Wang, D. (2021). Poor groundwater quality and high potential health risks in the Datong Basin, northern China: research from published data. Environmental Geochemistry and Health, 43(2), 791–812. https://doi.org/10.1007/s10653-020-00520-7

• International Programme on Chemical Safety. (‎2002)‎. Fluorides. World Health Organization. https://apps.who.int/iris/handle/10665/42415

• Irigoyen-Camacho, M. E., Pérez, A. G., González, A. M., & Alvarez, R. H. (2016). Nutritional status and dental fluorosis among schoolchildren in communities with different drinking water fluoride concentrations in a central region in Mexico. Science of the Total Environment, 541, 512–519. https://doi.org/10.1016/j.scitotenv.2015.09.085

• Jacks, G., Bhattacharya, P., Chaudhary, V., & Singh, K. P. (2005). Controls on the genesis of some high-fluoride groundwaters in India. Applied Geochemistry, 20(2), 221–228. https://doi.org/10.1016/j.apgeochem.2004.07.002

• Jha, S. K., Mishra, V. K., Sharma, D. K., & Damodaran, T. (2011). Fluoride in the environment and its metabolism in humans. In D. Whitacre (Ed.), Reviews of environmental contamination and toxicology (pp. 121–142). Springer.

• Jha, S. K., Singh, R. K., Damodaran, T., Mishra, V. K., Sharma, D. K., & Rai, D. (2013). Fluoride in groundwater: toxicological exposure and remedies. Journal of Toxicology and Environmental Health, Part B, 16(1), 52–66. https://doi.org/10.1080/10937404.2013.769420

• Larsen, M. J., Kirkegaard, E., & Poulsen, S. (1987). Patterns of dental fluorosis in a European country in relation to the fluoride concentration of drinking water. Journal of Dental Research, 66(1), 10–12. https://doi.org/10.1177/00220345870660010101

• Li, P., He, X., Li, Y., & Xiang, G. (2019). Occurrence and health implication of fluoride in groundwater of loess aquifer in the Chinese Loess Plateau: A case study of Tongchuan, Northwest China. Exposure and Health, 11(2), 95–107. https://doi.org/10.1007/s12403-018-0278-x

• Mandal, J., & Sanyal, S. (2019). Geospatial analysis of fluoride concentration in groundwater in Puruliya district, West Bengal. Space and Culture, India, 6(5), 71–86. https://doi.org/10.20896/saci.v6i5.369

• Marghade, D., Malpe, D. B., & Subba Rao, N. (2021). Applications of geochemical and multivariate statistical approaches for the evaluation of groundwater quality and human health risks in a semi-arid region of eastern Maharashtra, India. Environmental Geochemistry and Health, 43(2), 683–703. https://doi.org/10.1007/s10653-019-00478-1

• Marghade, D., Malpe, D. B., Subba Rao, N., & Sunitha, B. (2020). Geochemical assessment of fluoride enriched groundwater and health implications from a part of Yavtmal District, India. Human and Ecological Risk Assessment: An International Journal, 26(3), 673–694. https://doi.org/10.1080/10807039.2018.1528862

• Mondal, D., Dutta, G., & Gupta, S. (2016). Inferring the fluoride hydrogeochemistry and effect of consuming fluoride-contaminated drinking water on human health in some endemic areas of Birbhum district, West Bengal. Environmental Geochemistry and Health, 38(2), 557–576. https://doi.org/10.1007/s10653-015-9743-7

• Narayanamurthy, S., & Santhuram, A. N. (2013). Prevalence of dental fluorosis in school children of Bangarpet taluk, Kolar district. Journal of Orofacial Sciences, 5(2), 105–108. https://doi.org/10.4103/0975-8844.124253

• National Rural Drinking Water Programme (NRDWP). (2020). Contamination area wise report, Ministry of Drinking Water and Sanitation, Government of India. https://ejalshakti.gov.in/IMISReports/NRDWP_MIS_NationalRuralDrinkingWaterProgramme.html

• Office of the Registrar General & Census Commissioner India. (2021). Population Finder – Census 2011 (Puruliya). https://censusindia.gov.in/census.website/data/population-finder

• Ozsvath, D. L. (2009). Fluoride and environmental health: A review. Reviews in Environmental Science and Bio/Technology, 8(1), 59–79. https://doi.org/10.1007/s11157-008-9136-9

• Rango, T., Bianchini, G., Beccaluva, L., Ayenew, T., & Colombani, N. (2009). A hydrogeochemical study in the Main Ethiopian Rift: New insights into the source and enrichment mechanism of fluoride. Environmental Geology, 58, 109–118. https://doi.org/10.1007/s00254-008-1498-3

• Rudra, S. (2012). Fluoride contamination of ground water: A geographical analysis Purulia Block-1 of Purulia District, West Bengal, India. Analyst, 2(1), 1–6. http://dx.doi.org/10.13140/RG.2.2.14537.95840

• Rukah, Y. A., & Alsokhny, K. (2004). Geochemical assessment of groundwater contamination with special emphasis on fluoride concentration, North Jordan. Geochemistry, 64(2), 171–181. https://doi.org/10.1016/j.chemer.2003.11.003

• Sivakumar, B., & Krishnamachari, K. A. V. R. (1976). Circulating levels of immunoreactive parathyroid hormone in endemic genu valgum. Hormone and Metabolic Research, 8(4), 317–319. https://doi.org/10.1055/s-0028-1093624

• Subba Rao, N. (2003). Groundwater quality: Focus on fluoride concentration in rural parts of Guntur district, Andhra Pradesh, India. Hydrological Sciences Journal, 48(5), 835–847. https://doi.org/10.1623/hysj.48.5.835.51449

• Subba Rao, N. (2009). Fluoride in groundwater, Varaha River Basin, Visakhapatnam District, Andhra Pradesh, India. Environmental Monitoring and Assessment, 152, Article 47. https://doi.org/10.1007/s10661-008-0295-5

• Subba Rao, N. (2011). High-fluoride groundwater. Environmental Monitoring and Assessment, 176, 637–645. https://doi.org/10.1007/s10661-010-1609-y

• Subba Rao, N. (2017). Controlling factors of fluoride in groundwater in a part of South India. Arabian Journal of Geosciences, 10, Article 524. https://doi.org/10.1007/s12517-017-3291-7

• Subba Rao, N. (2021). Spatial distribution of quality of groundwater and probabilistic non-carcinogenic risk from a rural dry climatic region of South India. Environmental Geochemistry and Health, 43, 971–993. https://doi.org/10.1007/s10653-020-00621-3

• Subba Rao, N., & John Devadas, D. (2003). Fluoride incidence in groundwater in an area of Peninsular India. Environmental Geology, 45, 243–253. https://doi.org/10.1007/s00254-003-0873-3

• Subba Rao, N., Dinakar, A., & Karuna Kumari, B. (2021). Appraisal of vulnerable zones of non-cancer-causing health risks associated with exposure of nitrate and fluoride in groundwater from a rural part of India. Environmental Research, 202, Article 111674, https://doi.org/10.1016/j.envres.2021.111674

• Subba Rao, N., Dinakar, A., Surya Rao, P., Rao, P. N., Madhnure, P., Prasad, K. M., & Sudarshan, G. (2016). Geochemical processes controlling fluoride-bearing groundwater in the granitic aquifer of a semi-arid region. Journal of the Geological Society of India, 88, 350–356. https://doi.org/10.1007/s12594-016-0497-3

• Subba Rao, N., Ravindra, B., & Wu, J. (2020). Geochemical and health risk evaluation of fluoride rich groundwater in Sattenapalle Region, Guntur district, Andhra Pradesh, India. Human and Ecological Risk Assessment, 26(9), 2316–2348. https://doi.org/10.1080/10807039.2020.1741338

• Subba Rao, N., Subrahmanyam, A., & Babu Rao, G. (2013). Fluoride-bearing groundwater in Gummanampadu Sub-basin, Guntur District, Andhra Pradesh, India. Environmental Earth Sciences, 70, 575–586. https://doi.org/10.1007/s12665-012-2142-9.

• Subba Rao, N., Surya Rao, P., Dinakar, A., Nageswara Rao, P. V., & Marghade, D. (2017) Fluoride occurrence in the groundwater in a coastal region of Andhra Pradesh, India. Applied Water Sciences, 7, 1467–1478. https://doi.org/10.1007/s13201-015-0338-3

• Susheela, A. K. (1984). Epidemiology and control of fluorosis in India. Journal of Nutrition Foundation of India, 1–3.

• Susheela, A. K. (2002). Fluorosis in developing countries: Remedial measures and approaches. Proceedings-Indian National Science Academy Part B, 68(5), 389–400.

• Viswanathana, G., Jaswantha, A., Gopalakrishnanb, S., Siva ilangoc, S. (2009). Mapping of fluoride endemic areas and assessment of fluoride exposure. Science of The Total Environment, 407(5), 1579–1589. https://doi.org/10.1016/j.scitotenv.2008.10.020

• West Bengal Public Health and Engineering Department. (2006). Summary of Test Results of Public Hand Pump Tube Wells Under the Joint Plan of Action with UNICEF. Public Health Engineering Department, Govt. of West Bengal.

• World Health Organization. (1994). Fluoride and Oral Health. https://apps.who.int/iris/bitstream/handle/10665/39746/WHO_TRS_846.pdf?sequence=1

• World Health Organization. (2004). Guidelines for drinking-water quality: Volume 1 - Recommendations (3rd ed.). https://apps.who.int/iris/handle/10665/42852

• World Health Organization. (2008). Guidelines for drinking-water quality: Volume 1 - Recommendations incorporating the first and second addenda (3rd ed.). https://www.who.int/publications/i/item/9789241547611

• Yadawe, M. S., Hiremath, SMT D. M., & Patil, S. A. (2010). Assessment of fluoride content in ground and surface water and its environmental impacts at Basavan-Bagewadi and Muddebihal Taluka of Bijapur District, Karnataka, India. Journal of Chemistry, 7, Article ID 120909. https://doi.org/10.1155/2010/120909

• Yeung, C. A. (2008). A systematic review of the efficacy and safety of fluoridation. Evidence-Based Dentistry, 9(2), 39–43. https://doi.org/10.1038/sj.ebd.6400578