Investigation and mapping of fluoride-endemic areas and associated health riskA case study of Agra, Uttar Pradesh, India

The present study aimed at identifying the fluoride-endemic areas in five different blocks in Agra district, Uttar Pradesh, India. A total of 365 groundwater samples from 73 villages were analyzed for establishing the concentration range of fluoride in drinking water. The fluoride level in the study area varied from 0.14 to 4.88mg/L. Out of 73, the fluoride levels in 45 villages did not meet the permissible Word Health Organization standards. The Baroli Ahir block was found the highly fluoride-endemic area followed by Saiyan, Bichpuri, Achnera and Etmadpur. Chronic daily intake of fluoride in adults was 1.25 and 1.5times higher than those in children and infants, respectively. The probability of dental fluorosis in infants was higher (42%) while adults were more prone to bone and skeletal fluorosis (60%). The hazard quotient analysis revealed that children were found to be at maximum risk followed by infants and adults. Sensitivity analysis revealed that the fluoride concentration is the major influencing parameter responsible for different types of fluorosis in various age groups.