title: Fate of over 480 million inhabitants living in arsenic and fluoride endemic Indian districts: Magnitude, health, socio-economic effects and mitigation approaches.
abstract: During our last 27 years of field survey in India, we have studied the magnitude of groundwater arsenic and fluoride contamination and its resulting health effects from numerous states. India is the worst groundwater fluoride and arsenic affected country in the world. Fluoride results the most prevalent groundwater related diseases in India. Out of a total 29 states in India, groundwater of 20 states is fluoride affected. Total population of fluoride endemic 201 districts of India is 411 million (40% of Indian population) and more than 66 million people are estimated to be suffering from fluorosis including 6 million children below 14 years of age. Fluoride may cause a crippling disease. In 6 states of the Ganga-Brahmaputra Plain (GB-Plain), 70.4 million people are potentially at risk from groundwater arsenic toxicity. Three additional states in the non GB-Plain are mildly arsenic affected. For arsenic with substantial cumulative exposure can aggravate the risk of cancers along with various other diseases. Clinical effects of fluoride includes abnormal tooth enamel in children; adults had joint pain and deformity of the limbs, spine etc. The affected population chronically exposed to arsenic and fluoride from groundwater is in danger and there is no available medicine for those suffering from the toxicity. Arsenic and fluoride safe water and nutritious food are suggested to prevent further aggravation of toxicity. The World Health Organization (WHO) points out that social problems arising from arsenic and fluoride toxicity eventually create pressure on the economy of the affected areas. In arsenic and fluoride affected areas in India, crisis is not always having too little safe water to satisfy our need, it is the crisis of managing the water.
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India. Electronic address: dcsoesju@gmail.com.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Chakraborti
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India; Global Centre for Environmental Remediation (GCER), Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
authors.forename: Mohammad Mahmudur
authors.initials: MM
authors.lastname: Rahman
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Chatterjee
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Das
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India; Department of Environment and Water Resources Engineering, School of Civil and Chemical Engineering (SCALE), VIT-University, Vellore, India.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Das
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Biswajit
authors.initials: B
authors.lastname: Nayak
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Arup
authors.initials: A
authors.lastname: Pal
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Uttam Kumar
authors.initials: UK
authors.lastname: Chowdhury
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Sad
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Bhajan Kumar
authors.initials: BK
authors.lastname: Biswas
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Mrinal Kumar
authors.initials: MK
authors.lastname: Sengupta
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Lodh
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Gautam
authors.initials: G
authors.lastname: Samanta
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Retired Professor, Department of Orthopaedics, Medical College, Kolkata, India.
authors.forename: M M
authors.initials: MM
authors.lastname: Roy
authors.affiliation: Retired Professor Department of Dermatology, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, India.
authors.forename: Rathindra Nath
authors.initials: RN
authors.lastname: Dutta
authors.affiliation: Retired Professor of Dermatology, School of Tropical Medicine, Kolkata, India.
authors.forename: Khitish Chandra
authors.initials: KC
authors.lastname: Saha
authors.affiliation: Retired Professor, Department of Neurology, Medical College, Kolkata, India.
authors.forename: Subhas Chandra
authors.initials: SC
authors.lastname: Mukherjee
authors.affiliation: Department of Obstetrics and Gynaecology, Calcutta National Medical College, Kolkata, India.
authors.forename: Shyamapada
authors.initials: S
authors.lastname: Pati
authors.affiliation: Surgical Oncologist, Barasat Cancer Research and Welfare Centre, Kolkata, India.
authors.forename: Probir Bijoy
authors.initials: PB
authors.lastname: Kar
mesh_terms: D001151:Arsenic / Q000009:adverse effects* / Q000032:analysis*; D004784:Environmental Monitoring; D005459:Fluorides / Q000009:adverse effects* / Q000032:analysis*; D006801:Humans; D007194:India; D009369:Neoplasms / Q000139:chemically induced*; D012959:Socioeconomic Factors; D014874:Water Pollutants, Chemical / Q000009:adverse effects* / Q000032:analysis*
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic; D005459:Fluorides
keywords: Affected children; Approaches for mitigation; Health effects; Magnitude of fluoride and arsenic contamination; Social issues; Socio-economic problem