Assessing Water Fluoride Levels in Rural Rajasthan, India
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INTRODUCTION: Skeletal and dental fluorosis are crippling diseases associated with consumption of water with excess fluoride. The diseases manifest with symptoms such as severe staining, pitting, enamel damage and cracking of teeth in dental fluorosis to stiffness, joint pain, crippling, kyphosis, invalidism, and GI complications in skeletal fluorosis. Fluorosis is an endemic public health issue in many developing regions around the world, including areas of India. A study conducted in Rajasthan, India shows the prevalence of dental fluorosis to be 70.6-100% in village children and 68-100% in village adults. Prevalence of skeletal fluorosis was 5.2% among children and ranged from 7.4% to 37.7% in adults. The present study hopes to address the underlying problem of fluorosis in Rajasthan, India by analyzing water quality in the region. METHODS: This study is a retrospective observational study based on water data collected over a ten month period by the Jal Bhagirathi Foundation (JBF) in Jodhpur, India for a European Union funded water monitoring project. The water data are from the nearby Jalore, Barmer and Jaisalmer Districts, with water samples from all drinking water sources including handpumps, deep bore wells, tube wells, government run pipelines, ponds, lakes, and reverse osmosis water purification systems. The water samples were collected by trained JBF staff in sterile 1L containers, and the water quality testing was carried out by the on-site chemistry lab manager. Fluoride levels were tested within 24 hours of water sampling using a benchtop multiparameter meter and a fluoride electrode in 100 mL water. Additional tests for color, odor, turbidity, pH, alkalinity, total dissolved solutes, and presence of fecal bacteria were performed on each sample. RESULTS/OUTCOMES: The data were analyzed for frequency of fluoride levels above the recommended level of 1 parts per million (ppm). Of the water samples tested for fluoride concentration, 57 of 156 samples (36.5%) showed concentrations above 1ppm. The mean fluoride concentration of all tested water samples was .81ppm, with a standard deviation of .73ppm. CONCLUSION: The results demonstrate over one-third of the sampled drinking water is potentially toxic to the health of its consumers. This incidence is particularly alarming in the arid conditions of Rajasthan where rural inhabitants have limited water resources, leading them to rely heavily on these harmful supplies. These results provide an impetus to approach the problem by increasing community education of unsafe drinking water sources and methods of purification, including home systems and community-wide solutions like reserve osmosis plants.