Pan India fluoride hazard assessment in groundwater.

Fluoride (F¯) contamination in groundwater in India has gained global attention due to human health hazards. India's hydrogeological heterogeneity, spatio-temporal variability of F¯, and health hazards due to geogenic and geo-environmental control pose unique challenges. Addressing these with only a single region-specific study is not possible. Therefore, this study provides an in-depth, holistic analysis of pan India F¯ contamination, controlling factors, and health hazards using a coupled advanced geostatistical and geospatial approach. Alarming F¯ contaminations are identified in Rajasthan, Telangana, Western Andhra Pradesh, Eastern Karnataka, Parts of Haryana, Gujarat, Madhya Pradesh, Tamil Nadu, Uttar Pradesh, Jharkhand, Bihar, and Chhattisgarh. Probabilistic health-risk evaluation using hot-spot, showed similar spatio-temporal distribution of F¯ contamination. The hazard quotient (HQ) for high F¯ shows more adversity to children than adults. Nationally, 8.65 % and 7.10 % of pre- and post-monsoon sites exceed the recommended safe limit of 1.50 mg/L. The highest average F¯ concentration is in Rajasthan. Very high-risk skeletal fluorosis is possible at around ≤ 2 %, whereas dental caries due to deficiency in F¯ concentration is approximately 40 %. A decisive hierarchy of lithology, geomorphology, soils, and lineaments control are identified on F¯ contamination. Climatic conditions are pivotal in governing all these controlling variables. Thus, in arid/semi-arid dry western regions, F¯ contamination is much higher than in the humid areas. Integration of strengths, weaknesses, opportunities, and threats (SWOT) analysis with the results can aid policymakers and government authorities in achieving sustainable remedial measures for future adaptability.