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        Fluoride Occurrences in 
        Drinking Water,  
        Health Problems and Remediation Methods   
        
        Water is the most fundamental requirement for the living species to 
        endure livelihood. However, the exponentially growing contamination is a 
        significant area to focus on regarding environmental health and its 
        degradation [1]. For instance, around 783 million people have no access 
        to potable drinking water [2]. In the same string, the fluoride-based 
        salts naturally occur in the groundwater. It is persistent distress and 
        hazardous pollutant when present beyond the permissible limit according 
        to World Health Organisation [3]. Groundwater is a predominantly 
        affected water source as compared to surface water which may be due to 
        the volcanic disasters, weathering or conveyed by air/water [4]. Also, 
        existence of fluoride in rocks and minerals, namely, fluorspar, sellaite, 
        fluoroapatite, villiaumite, etc. leads to the dissolution in water 
        stream.  
         
        The presence of fluoride has been highly aggravated due to increased 
        anthropogenic pursuits emerging as an outcome from industrial sectors 
        like aluminium, semiconductor, steel, bricks, pesticides and 
        fertilizers. It was inferred that fluoride contamination is severely 
        inevitable [5]. Besides this, some researcher observed that fluoride 
        content may vary from 250 mg/L to 1,500 mg/L and in extreme situations 
        can vary up to 10,000 mg/L in industrial effluent [6]. Accretion of 
        fluoride influences could also be due to organic tissues from living 
        beings, soil, and water, which result in detrimental health issues [7]. 
        Therefore, it is emerging as a significant issue for the environment and 
        public health. The Bureau of Indian Standards (IS 10500, 2012) and World 
        Health Organisation (WHO 2011) prescribe an upper limit of 1.0 and 1.5 
        mg/L, respectively. It exceeds beyond the desired level in various 
        places from the world, namely, China, Argentina, Middle East, Italy, 
        Mexico, Mongolia, India, Netherlands, Poland, Norway, West Indies, 
        Pakistan, Spain, UK, and various areas of the African continent and few 
        regions of America. Therefore, this issue can be categorised as global 
        problem [8].  
         
         Moreover, some investigation revealing the geographical statistics of 
        Indian regions prone with the huge contamination of fluoride include 
        Jalalabad and Fazilka of Punjab [9], major part of Rewari, Hisar, 
        Gurgaon, Faridabad and Fatehabad regions of Haryana [1012], Rae 
        Bareilly, Unnao and Sonbhadra of Uttar Pradesh [1315], some districts 
        of Madhya Pradesh (Sidhi, Tikamgarh), Maharastra (Beed), Andhra Pradesh 
        (Nalgonda), and Tamil Nadu (Dindigul). Other moderately marked regions 
        include Karbi, Golaghat, Karimganj, Naugaon, Kaimur, Munger, Bundi, 
        Chhitorgarh, Udaipur, Jalgaon among others [16-22]. Furthermore, it has 
        been established that fluoride rich water is present in 19 Indian 
        states, with Rajasthan topping the list with the most affected areas. 
        The state has some of the worst affected areas in the country. 
         
        Digging into the root level issues of fluoride problems, it has been 
        reported to affect the metabolism in the living body, leading to various 
        severe health-related problems [23]. It is also anabolic species 
        stimulating cell classifications and could attach with organic elements 
        like enzymes, which inhibit its pursuits at both milli and micro levels. 
        Dental and skeletal fluorosis is a severe problem, and arthritis, bone 
        damage, osteoporosis, etc., are highly evident diseases. Initially, 
        there could be muscular damages, fatigue, joint-related issues and 
        chronicle issues. In extreme conditions, it could adversely damage the 
        heart, arteries, kidney, liver, endocrine glands, neuron system, and 
        several other delicate items [2426].  
         
        Stated drawbacks led to severe demand for fluoride removal which is a 
        challenging part in water treatment and recovery field because fluoride 
        is highly reactive. Its ionic measurements also make it difficult to be 
        treated [8]. Several investigators attempted to treat fluoride rich 
        streams by enormous engineering processes including coagulation, 
        adsorption, electrocoagulation, reverse osmosis, nano-filtration, and 
        electro dialysis [8,27]. But these conventionally established approaches 
        have limitations such as complexity, the chemical agents additions, 
        huge operational economics, and voluminous generation of sludge leading 
        to secondary pollutions. This problem is prevailing across the country 
        with very high severity being reported in Rajasthan and Uttar Pradesh. 
        For the same reason, thousands of de-fluoridation plants have been 
        installed based on coagulation (Alum coagulant) and adsorption 
        (activated alumina) based processes.  
         
        However, coagulation-based plants were examined with the limitations 
        such as high maintenance cost, large amount of sludge generation, large 
        space requirements, and an increase in total dissolved salts and 
        residual aluminium concentrations in the treated water. In rural area 
        adsorption techniques are emerging as the major processes for 
        de-fluoridation due to their simplicity over the other techniques, but 
        it has constraints moderate residual aluminium, high cost of adsorbents, 
        complexity of regeneration process of adsorbent and issues of waste 
        disposal, which make this technique difficult to sustain. Another 
        predominantly used approach for de-fluoridation is Nalgonda technique, 
        which is banned in Rajasthan due to the high aluminium residual content.
         
         
        Therefore, there is a dire need to develop such a unit which could be 
        cost effective and easy to handle with a potential of sustainable 
        long-term use.■ 
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        Yogendra Singh Solanki 
        yssolanki@devalt.org 
          
        
        
        
        
        
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