A comprehensive review of human health risks of arsenic and fluoride contamination of groundwater in the South Asia region

The present study found that ∼80 million people in India, ∼60 million people in Pakistan, ∼70 million people in Bangladesh, and ∼3 million people in Nepal are exposed to arsenic groundwater contamination above 10 μg/L, while Sri Lanka remains moderately affected. In the case of fluoride contamination, ∼120 million in India, >2 million in Pakistan, and ∼0.5 million in Sri Lanka are exposed to the risk of fluoride above 1.5 mg/L, while Bangladesh and Nepal are mildly affected. The hazard quotient (HQ) for arsenic varied from 0 to 822 in India, 0 to 33 in Pakistan, 0 to 1,051 in Bangladesh, 0 to 582 in Nepal, and 0 to 89 in Sri Lanka. The cancer risk of arsenic varied from 0 to 1.64 × 1-1 in India, 0 to 1.07 × 10-1 in Pakistan, 0 to 2.10 × 10-1 in Bangladesh, 0 to 1.16 × 10-1 in Nepal, and 0 to 1.78 × 10-2 in Sri Lanka. In the case of fluoride, the HQ ranged from 0 to 21 in India, 0 to 33 in Pakistan, 0 to 18 in Bangladesh, 0 to 10 in Nepal, and 0 to 10 in Sri Lanka. Arsenic and fluoride have adverse effects on animals, resulting in chemical poisoning and skeletal fluorosis. Adsorption and membrane filtration have demonstrated outstanding treatment outcomes.