Fluorosis in Jharkhand: From Contaminated Groundwater to a Preventable Public Health Problem

Abstract

Background: Rocks and groundwater carry fluoride naturally. Small amounts protect teeth; years of drinking water with higher levels damage teeth and, later, bones. Cases of dental and skeletal fluorosis have turned up in different parts of Jharkhand, and new high-fluoride sources keep being found. That alone is reason enough to bring the issue into public health planning.

Methods: We went through published studies and government reports on fluoride, fluorosis and groundwater in Jharkhand, searching PubMed, Scopus, Web of Science and Google Scholar and adding official documents from WHO and Indian agencies. Fluoride terms were paired with groundwater, drinking water and Jharkhand, and with district names where local work existed. Papers from 2000 to October 2026 were considered, with extra attention to recent ones that reported measured fluoride or health findings. The material was summarized narratively. We did not pool data.

Results: Jharkhand's fluoride problem is uneven. Early studies found up to 5.92 mg/L in Garhwa and 4.2 mg/L in Palamu. At Berhait in Sahibganj, 29% of 89 well-water samples crossed the Indian permissible level, and both children and adults had fluorosis. Later studies from the mica belt, East Singhbhum, Giridih and Dhanbad show that more high-fluoride sources are still coming to light. In Baliapur, Dhanbad, 36% of the 315 groundwater samples tested in 2026 exceeded 1.5 mg/L, and the highest reading was 16.2 mg/L. A statewide study in 2025 recorded a maximum of 18.5 mg/L. CGWB's 2024 trend sampling, by contrast, found only 9 of 138 samples above 1.5 mg/L.

Conclusion: Fluoride exposure remains a live environmental health concern in Jharkhand. Finding contaminated water and treating existing cases of fluorosis will not be enough by themselves. Water sources have to be tested, the risky locations marked, safe water provided and exposed people followed up over the years. If these steps are joined together, the state would have a prevention system that works better than any of them alone.