Groundwater can become polluted naturally when water flows through soils and rocks, dissolving substances like fluoride compounds. The Bureau of Indian Standards states permissible fluoride levels in drinking water are between 0.5 and 1.5 mg/l; levels above this can cause dental and skeletal fluorosis. Approximately 6.6 crore Indians are affected by fluorosis from high fluoride levels in groundwater in 19 states across India, which can impact livelihoods, income, health costs and poverty. Harvesting and recharging groundwater with rainwater can help address areas with fluoride levels above permissible limits.

1. Fluoride in
Water

2. Surface Water
Is what you see in rivers, lakes, streams
etc.

3. Groundwater is water that is found in aquifers below the surface of
the Earth. To get groundwater, one must dig wells or borewells.
Groundwater

4. Water pollution of surface water
bodies is visible in many places

5. But is groundwater clean?

6. When water seeps into the ground, it dissolves different substances
depending on the type of soil and rock that it flows through.
Groundwater can get polluted naturally

7. Some of these substances like fluoride compounds can be harmful to
health, if amounts greater than permissible limits are ingested over
long periods of time.
Natural pollution is a non-point source of pollution

8. The Bureau of Indian Standards states that in
drinking water, fluoride levels are
0 0.5
mg/l
1.0
mg/l
1.5
mg/l
2.0
mg/l
Desirable
Permissible

9. Fluoride
• Low levels of fluoride in drinking water (0.5 to 1 mg/l) protect
against dental caries
• High levels of fluoride in drinking water (above 1.5 mg/l) will
lead to adverse health impacts ranging from dental fluorosis
to skeletal fluorosis
• Fluoride levels in water beyond desirable / permissible limits
is typically found in groundwater and not surface water

10. Fluorosis
©Ruhani Kaur/UNICEF India
http://www.fannz.org.nz
19 states in India have groundwater that is rich in
fluoride
Dental Fluorosis
Skeletal Fluorosis
Excess fluoride in the body
(above 1.5 – 2 ppm)

11. Other symptoms
• Fatigue
• Low hemoglobin count
• Irritation
• Loss of appetite
• Excessive thirst and urination
• Miscarriage
• Inability to conceive due to defective sperm
• Depression

12. Impacts of skeletal fluorosis
• Loss of livelihood since affected persons
cannot work
• Loss of income
• High medical costs
• Poverty
• Social outcasts since facilities for the
handicapped are lacking in India

13. Fluoride levels in
groundwater are
higher than
permissible limits in
19 states of India

14. Over 6.6 crore Indians are affected by fluorosis
Mild fluorosis
Moderate/severe
fluorosis

15. What can be done?

16. Where fluoride in water is between
1.5 to 2.0mg/l, avoid:
Canned fish
Dental products such as
fluoridated toothpaste
& mouth wash
Products containing
black salt
(kalanamak)

17. Eat more of fruits and vegetables rich in
Vitamin C, Iron and Calcium
Orange
Lemon
Guava
Gooseberry (Amla)
Tomato
Grapefruit
Almonds
Apple
Brinjal
Banana
Beetroot
Spinach
Coriander leaves

18. In all fluoride affected areas, recharge the groundwater with rainwater
Harvest
rainwater
Recharge groundwater

19. Thank you!