A Review Assessment of Ground Water Quality and Its Impact on Human Health: A Case Study

Abstract

Background: Groundwater serves as the primary drinking water source for approximately 85% of rural and 60% of urban populations in India, yet its quality has deteriorated significantly due to both geological processes and anthropogenic pressures. In semi-arid hard-rock aquifer regions of peninsular India, naturally occurring fluoride enrichment driven by calcite-fluorite dissolution mechanisms coexists with anthropogenic nitrate contamination from agricultural intensification, creating a compound contamination burden that threatens public health. Existing water quality assessments have documented widespread exceedances of Bureau of Indian Standards (BIS) and World Health Organization (WHO) permissible limits for key contaminants, yet the literature remains geographically concentrated, methodologically inconsistent, and inadequately linked to population health outcomes. Objectives: This review synthesises evidence from thirteen peer-reviewed studies published between 2008 and 2021 to: (i) characterise the physicochemical and hydrogeochemical profile of groundwater quality across diverse Indian hydrogeological settings, with particular focus on Karnataka, Andhra Pradesh, Tamil Nadu, Gujarat, and Uttar Pradesh; (ii) evaluate the comparative application and methodological limitations of Water Quality Index (WQI) frameworks in translating multi-parameter data into actionable quality classifications; (iii) assess quantitative health risk evidence, with specific attention to age-stratified vulnerability among infants, children, and adults; and (iv) identify critical research gaps in geographic coverage, methodological standardisation, and health-climate linkage that constrain the field\'s capacity to inform evidence-based policy. Methods: A systematic thematic synthesis was conducted across thirteen studies spanning six Indian states (Gujarat, Karnataka, Tamil Nadu, Andhra Pradesh, Madhya Pradesh, Uttar Pradesh) and one international comparative study from Nigeria. Studies were selected based on their assessment of physicochemical parameters (pH, electrical conductivity, total dissolved solids, hardness, fluoride, nitrate, chemical oxygen demand) against BIS IS:10500-2012 and WHO 2017 drinking water guidelines. The review employed thematic organisation across four interconnected dimensions: geographic and physicochemical baseline, fluoride contamination as a geological hazard, nitrate pollution and health risk assessment, and WQI methodologies. Particular emphasis was placed on studies that integrated WQI with quantitative health risk modelling or multivariate statistical source attribution. Key Findings: Fluoride concentrations in Karnataka\'s crystalline basement aquifers ranged from 0.86 to 4.63 mg/L, with 40–52% of samples exceeding the BIS permissible limit of 1.5 mg/L, driven by Ca-Mg-HCO? hydrochemical facies and alkaline pH conditions (mean pH 8.36). Nitrate contamination in Andhra Pradesh\'s agricultural regions ranged from 25 to 198 mg/L (mean: 66.14 mg/L), with 61% of samples exceeding the WHO safe limit of 50 mg/L. Quantitative health risk assessment revealed age-stratified vulnerability: infants faced non-carcinogenic health risks 1.75 times greater than adults, and children faced risks 1.15 times greater than adults (Adimalla & Qian, 2019). Total dissolved solids and hardness systematically exceeded BIS limits in semi-arid and agricultural zones, with groundwater consistently of poorer quality than surface water in the same catchments. WQI values ranged from 39 to 295 across studies, but methodological inconsistencies in parameter selection, weighting schemes, and reference standards limited cross-study comparability. The literature documented a clear methodological progression from physicochemical description (2008–2013) to multivariate source attribution (2014–2017) to quantitative health risk assessment (2019), yet only one study conducted age-disaggregated health risk modelling, and none employed geospatial analysis or longitudinal monitoring. Conclusions: Groundwater quality deterioration in India\'s semi-arid and agricultural regions is driven by a dual contamination burden — geological fluoride enrichment and anthropogenic nitrate pollution — with spatially heterogeneous contamination patterns and age-stratified health consequences.

Introduction

The text reviews groundwater quality and its implications for human health in India, with particular emphasis on contamination, regulatory standards, Water Quality Index (WQI) methods, and research gaps. Groundwater is a critical freshwater resource, providing a major share of drinking water and irrigation supplies globally and an even greater proportion in India. However, rapid population growth, industrialisation, agricultural intensification, limited recharge, and semi-arid climatic conditions have increased groundwater contamination.

The major contaminants identified are fluoride, nitrate, total dissolved solids (TDS), hardness, chloride, COD, and BOD. Fluoride is predominantly a geogenic contaminant, especially in the hard-rock aquifers of Karnataka and other parts of peninsular India. Alkaline conditions, calcite precipitation, and fluorite dissolution promote fluoride enrichment, resulting in risks of dental and skeletal fluorosis. Nitrate is primarily anthropogenic, originating from fertilisers, sewage, animal waste, and septic systems. High nitrate concentrations are particularly dangerous for infants because of the risk of methemoglobinemia.

The reviewed studies show that TDS and hardness frequently exceed drinking-water standards, reducing palatability and increasing scaling and treatment requirements. Chloride, COD, and BOD are also indicators of urban, industrial, and agricultural pollution. These contaminants demonstrate that groundwater deterioration results from an interaction between natural geological processes and human activities.

The Water Quality Index (WQI) is presented as an important tool for integrating multiple water-quality parameters into a single score. Additive and multiplicative WQI approaches, as well as the Canadian Water Quality Index (CWQI), are discussed. However, the review identifies a major methodological problem: Indian studies use different parameters, weights, standards, and classification systems. Consequently, WQI values from different studies are often difficult to compare. The development of a standardised India-specific WQI based on BIS IS:10500-2012 is therefore identified as an important research priority.

The review synthesises studies from several Indian states, including Gujarat, Karnataka, Tamil Nadu, Andhra Pradesh, Madhya Pradesh, and Uttar Pradesh, together with an international comparison from Nigeria. Across these studies, groundwater quality varies according to geology, land use, climate, and urbanisation, but recurring problems include elevated TDS, hardness, fluoride, nitrate, and salinity. Karnataka provides strong evidence of geogenic fluoride contamination, while Andhra Pradesh demonstrates the health risks associated with agricultural nitrate pollution. The study by Adimalla and Qian is particularly significant because it quantitatively demonstrates greater non-carcinogenic nitrate risk among infants and children compared with adults.

Overall, the review concludes that groundwater contamination in India represents both a water-security and public-health challenge. The literature has progressed from basic physicochemical assessment toward hydrogeochemical modelling, WQI assessment, multivariate statistics, and quantitative health-risk analysis. Nevertheless, important gaps remain, including inadequate geographic coverage, limited longitudinal monitoring, insufficient geospatial analysis, lack of standardised WQI methodology, weak connections between groundwater measurements and epidemiological outcomes, limited climate-change assessment, and inadequate evaluation of treatment technologies.

References

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Copyright

Copyright © 2026 Dr. Prakash Sulebhavi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.