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 calcitefluorite 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 multiparameter data into actionable quality classifications; (iii) assess quantitative health risk evidence, with specific attention to agestratified 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-HCO₃ 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 agestratified 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. International Journal for Research in Applied Science & Engineering Technology (IJRASET) ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538 Volume 14 Issue VII July 2026- Available at www.ijraset.com ©IJRASET: All Rights are Reserved | SJ Impact Factor 7.538 | ISRA Journal Impact Factor 7.894 2644 | Three critical research gaps constrain the field's capacity to inform evidence-based policy: (i) geographic coverage gap, with no studies from northern India (Gangetic Plain), eastern India (Bengal Basin arsenic belt), coastal aquifers, or Himalayan foothills; (ii) methodological gap, with limited quantitative health risk assessment, absence of geospatial analysis, lack of longitudinal monitoring, and no standardised India-specific WQI; and (iii) health-climate linkage gap, with no direct connection between water quality measurements and epidemiological health outcomes, no climate change scenario modelling, and no treatment efficacy evaluation. Addressing these gaps requires coordinated multi-regional studies using standardised WQI protocols, GIS-based spatial mapping, longitudinal monitoring networks, epidemiological cohort studies, climate impact modelling, and technology assessment of low-cost defluoridation and denitrification systems for rural communities.