Fluoride Action Network

Exploring a variance decomposition approach integrated with the Monte Carlo method to evaluate groundwater fluoride exposure on the residents of a typical fluorosis endemic semi-arid tract of India

Source: Environmental Research | August 3rd, 2021 | Authors: Indrani Mukherjee and Umesh Kumar Singh.
Location: India


  • F exceeded its estimated optimum value in drinking water at 98.8% of the study area.
  • Infant and child age groups are more vulnerable to the toxicity of groundwater F.
  • The estimated optimum F level in drinking water for the study area is 0.733 mg L-1.
  • F exposure via direct ingestion route was much higher than dermal exposure.
  • C, IR and their interaction are the sensitive parameters of the oral exposure model.


This study appraised the groundwater fluoride (F) endemicity and the exposure levels under the Central Tendency Exposure (CTE) condition and the Reasonable Maximum Exposure (RME) condition on the residents of the semi-arid parts of the Birbhum district of Peninsular India using a Variance Decomposition (Sobol Sensitivity Indices) approach combined with Monte Carlo Simulations. The study finds the national scale drinking water standard limit for F (1.5 mg L-1) is inappropriate for the present survey area where F concentration in groundwater varied between 0.26 and 11.82 mg L-1 and ?54.5% of the samples (N = 400) exceeded this limit. Therefore, estimated the optimum F concentration of 0.733 mg L-1 for the region using the method recommended by the World Health Organization (WHO) to calculate the optimum F? limit at a regional scale. The average value of F concentrations for this region (1.71 mg L-1) is consider ably higher than the estimated optimum concentration or even the maximum permissible limits recommended for the subtropical regions (0.5–0.7 mg L-1). The exposure analysis revealed the infants and children as potentially vulnerable populations compared to adolescents and adults of the study area for CTE and RME scenarios. The multi-exposure pathways indicated oral intake as the main exposure pathway whereas exposure through dermal contact was insignificant for the residents of all age groups of this region. Based on the first, second and total order Sobol Sensitivity Indices, F concentration (C) in groundwater, the groundwater ingestion rate and their combined interaction are the greatest significant parameters for the oral exposure model whereas C and its interaction effects with the proportion of the skin surface area in contact with groundwater as the utmost sensitive variables for the dermal health risks assessment model. The present study insists the inhabitants to intake defluoridated groundwater.

*Original study online at https://www.sciencedirect.com/science/article/abs/pii/S0013935121009919?via%3Dihub