| Fluoride - Tackling the Rising Menace Meghna Das mdas@devalt.org
W ater quality has become a major global concern due to the increasing human development activities that overexploit and pollute finite water sources. In many developing countries, only a small percentage of population has access to treated piped water supply. To provide safe water to rural population, groundwater is often sought as a source of drinking water. However, natural and anthropogenic (man-made) chemical pollution of ground water can lead to chronic health effects. One such element that has become a cause for concern is - Fluoride. Excessive presence of Fluoride in groundwater and its health effects has become a major geo-environmental issue in many parts of the world. Many parts of Africa including Kenya, Egypt, Ethiopia and other countries like Argentina, Australia, India, Bangladesh, Sri Lanka and many more are affected. In India, the presence of Fluoride in groundwater is quite widespread. Further, overexploitation of groundwater aggravates the problem of Fluoride concentration in water even more. According to a study commissioned by UNICEF in 1992, an estimated 66 million people (including 6 million children below the age of 14) in 199 endemic districts, in 17 states of India, are at risk from drinking water with excess Fluoride. Rajasthan and Andhra Pradesh are two of the worst hit states. Sources of Fluoride may be geological or anthropogenic. Weathering of Fluoride bearing minerals (Fluorite, Fluorspar, Cryolite, Fluorapatite, Ralstonite and others) in the Earth’s crust, as well as volcanic processes, can lead to higher fluoride levels in groundwater. Man made sources include Fluorides added to certain pharmaceutical products (for treating hyperthyroidism), medicines, tooth pastes, insecticides, disinfectants, preservatives, super phosphate fertilizer, and vitamin supplements. Fluorides are also used in dyeing and printing industries, in production of uranium hexafluoride (UF6), Freon (CFCs), high temperature plastics such as Teflon. Health Effects of Fluoride Main source of Fluoride intake is water. Ingestion of Fluoride can also be through food and other sources e.g. Tobacco, tooth powder etc. Long term excess Fluoride intake (less than 1.5 mg/l) leads to 3 types of abnormalities | 4 | Dental Fluorosis (teeth): Leads to damaged discoloured teeth as Fluoride poisons the enamel forming cells | | 4 | Skeletal Fluorosis (bones): Leads to backache, pain in neck, shoulders and knee joints. In higher concentrations, it leads to crippling | | 4 | Non Skeleton manifestations (soft tissues and organs): Muscle fatigue, stomach problems, anemia and neurological manifestations | Manifestations of Fluorosis are very slow. In fact, years pass by before the severity of the disease takes its toll on the person. Hence, the manifestations of Fluorosis are many and need to be tackled in all possible ways, be it through water management, dietary intake or technological interventions. Fluoride Mitigation To overcome these health hazards, safe, Fluoride-free, water has to be provided to people as early as possible. Many interventions are possible in this regard: | 1. | Provision of a new or alternative source of water: Search for a safe water source locally or transport from a distant safe source through a piped water supply system. | | 2. | Blending of the existing water with another source containing lower concentration of Fluoride. | | 3. | Recharging the groundwater through rainwater harvesting and hence diluting the contents of fluoride in water | | 4. | Nutritional dietary intake: Balanced diet with focus on adequate calcium, vitamin C, E and anti-oxidants can help negate the effect of fluorosis. | | 5. | Defluoridation or Fluoride-removal, especially where other options are not feasible or as an interim measure, if the other options take a long time for planning and implementation. | | | 4 | Household treatment: One of the options for treatment of fluoride in water in the rural set up is the use of Domestic Defluoridation Units (DDUs). Treatment may be based on the principle of adsorption using Activated Alumina technology or Nalgonda technology. DDUs are the "point of use" units with a higher degree of individual ownership, as they have to be wholly or partly paid for. This helps in ensuring better maintenance of these units if adequate regeneration (recharging of the exhausted adsorbent) facilities are simultaneously set up at the village level. Mass awareness is still necessary for users to be convinced of the importance of periodical regeneration. A number of such DDUs are set up in many districts of Rajasthan and Andhra Pradesh | | | 4 | Community treatment: This involves treatment of water at its source, using Hand Pump Attached Defluoridation Unit (HPADU) and other community installations. Such systems, based on Activated Alumina, have been put up in many districts of Rajasthan. Two models viz. DST (Dept. of Science and Technology) and PHED (Public Health and Engineering Department) are prevalent in the state | The choice of Defluoridation technology is governed by many variables and each should be carefully considered before the final choice is made. Many factors like raw water characteristics, infrastructure, level of application (household or community), acceptability, cost and sustainability guide the choice of appropriate technology. Population criterion also appears to be reasonable to govern the deployment of Domestic Defluoridation Unit (DDU) and Hand Pump Attached Defluoridation Unit (HPADU). Population up to 50 persons may be covered by DDUs. Population more than 50 (but not more than 250 persons) may be provided with a HPADU (Source: Theme paper for SLMFCC – Rajasthan Integrated Fluorosis Mitigation Programme- Strategies and Issues).  |  |  | | Deltal Fluorosis | Skeletal Fluorosis | |  | | Community Level Handpump Attached defluoridation Unit | Domestic Defluoridation Unit | Hence, an appropriate technology would be one that is socially acceptable, simple, and affordable by the community and is also sustainable as well as manageable in that particular rural environment. Sustainability here would mean the continuous flow of benefits to the rural people, preferably without any active involvement of the organizations that have stimulated these benefits in the first place. Development Alternatives, under the aegis of UNICEF, is currently involved in providing Capacity Building Consultancy for Domestic Defluoridation Units in the states of Rajasthan and Andhra Pradesh. A project on performance evaluation of Domestic and Hand Pump Attached Defluoridation Units (HPADUs) is also being carried out. q | Fluoride Monitoring | | Water Quality Monitoring is often overlooked, but it is an integral
part of water management system, especially for tackling Fluoride. WQM helps: | 4 | To check whether Fluoride is within the permissible limits (less than1.5 mg/l) in raw drinking water. |  | | 4 | To know whether water with higher Fluoride concentration is suitable for purposes other than drinking like washing, bathing etc. | | 4 | Jal TARA Fluoride testing kit | | | To check whether water needs treatment for Fluoride and to suggest appropriate treatment methods based on other raw water characteristics like pH, Alkalinity, TDS etc | | 4 | To evaluate the effectiveness of the treatment system by comparing the Fluoride content in raw untreated water and defluoridated water. (In this case, either Activated Alumina based DDUs or hand pumps). | Jal TARA Fluoride testing kit developed by Development Alternatives is a simple, scientific and portable field monitoring kit that can test for a wide range of Fluoride concentration (mg/l) viz. less than 0.6, 1.2, 1.5 and more than 3.0. For more information, mail us at
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