Health Risk Assessment of Groundwater in Cold Regions Based on Kernel Density Estimation–Trapezoidal Fuzzy Number–Monte Carlo Simulation Model: A Case Study of the Black Soil Region in Central Songnen Plain

The quality of groundwater, a crucial freshwater resource in cold regions, directly affects human health. This study used groundwater quality monitoring data collected in the central Songnen Plain in 2014 and 2022 as a case study. The improved DRASTICL model was used to assess the vulnerability index, while water quality indicators were selected using a random forest algorithm and combined with the entropy-weighted groundwater quality index (E-GQI) approach to realize water quality assessment. Furthermore, self-organizing maps (SOM) were used for pollutant source analysis. Finally, the study identified the synergistic migration mechanism of NH4+ and Cl−, as well as the activation trend of As in reducing environments. The uncertainty inherent to health risk assessment was considered by developing a kernel density estimation–trapezoidal fuzzy number–Monte Carlo simulation (KDE-TFN-MCSS) model that reduced the distribution mis-specification risks and high-risk misjudgment rates associated with conventional assessment methods. The results indicated that: (1) The water chemistry type in the study area was predominantly HCO3−–Ca2+ with moderately to weakly alkaline water, and the primary and nitrogen pollution indicators were elevated, with the average NH4+ concentration significantly increasing from 0.06 mg/L in 2014 to 1.26 mg/L in 2022, exceeding the Class III limit of 1.0 mg/L. (2) The groundwater quality in the central Songnen Plain was poor in 2014, comprising predominantly Classes IV and V; by 2022, it comprised mostly Classes I–IV following a banded distribution, but declined in some central and northern areas. (3) The results of the SOM analysis revealed that the principal hardness component shifted from Ca2+ in 2014 to Ca2+–Mg2+ synergy in 2022. Local high values of As and NH4+ were determined to reflect geogenic origin and diffuse agricultural pollution, whereas the Cl− distribution reflected the influence of de-icing agents and urbanization. (4) Through drinking water exposure, a deterministic evaluation conducted using the conventional four-step method indicated that the non-carcinogenic risk (HI) in the central and eastern areas significantly exceeded the threshold (HI > 1) in 2014, with the high-HI area expanding westward to the central and western regions in 2022; local areas in the north also exhibited carcinogenic risk (CR) values exceeding the threshold (CR > 0.0001). The results of a probabilistic evaluation conducted using the proposed simulation model indicated that, except for children’s CR in 2022, both HI and CR exceeded acceptable thresholds with 95% probability. Therefore, the proposed assessment method can provide a basis for improved groundwater pollution zoning and control decisions in cold regions.