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Socio-Economic Differences in Public View Associated with the Fluoride in Drinking Water: A Case Study of Mundaragi Taluk, Gadag District, Karnataka, India

Aswini Arali, K. Lokesh, Manjappa S, Suresh B*

Department of Civil Engineering, Bapuji Institute of Engineering & Technology, Davangere-577 005, Karnataka, India

Abstract: The aim of the present work is to understand the socio-economic status of rural region of the Mundaragi taluk of Gadag district, associated with the effect of fluoride in drinking water. Research Approaches: to develop and create an awareness water quality with reference to fluoride content and significance of fluorosis disease. Some innovative and best practices have been adopted in and around the study area keeping in mind that “Supply of good quality of water”. The present study was conducted to figure out the association between the socio-economic differences of defendants and fluorosis in out of twenty five fluorosis-identified villages of Gadag district in Karnataka. It was noticed that 100 percent of the defendants were suffering from various degree of skeletal and dental fluorosis. Mundaragi taluk of Gadag district is more affected by fluoride where 3.28 mg/litre level of fluoride polluted tube well is identified and by using such polluted water a comfortable of people are suffering from dental, skeletal and non-skeletal fluorosis diseases. In the present study, group of family survey has been conducted to find out socio-economic properties of the affected communities and the type of fluorosis diseases associated by the public. The survey results predict that out of total fluorosis patients, dental and skeletal fluorosis are maximum which are 55% and 38% respectively. Statistical approach indicates that people of less than 20 years age are more suffering from dental fluorosis and people above 20 years age group are more suffering by skeletal and dissimilar non skeletal fluorosis diseases.

Keywords: socio-economic, fluoride, community, public view, attitude

Received July 22, 2021; Revised August 23, 2021; Accepted September 03, 2021

Citation: Aswini Arali, K. Lokesh, Manjappa S, Suresh B, Socio-Economic Differences in Public View Associated with the Fluoride in Drinking Water: A Case Study of Mundaragi Taluk, Gadag District, Karnataka, India. Journal of Environment Pollution and Human Health, 9 (2). 44-49. January 2021. doi:10.12691/jephh-9-2-3

1. Introduction

Fluorosis is a medical disorder, It caused by usage of fluoride contaminated water and food gradients in excessive form [1]. It directly affect the lungs, cells and limbs in the human body. Over consumption of fluoride indirectly demonstrates, overlapping the other diseases like Osteoporosis and gouts [2]. Consumption of fluoride contaminated water is the major problem and it may causes joins pain and heavy back pain modifications in the stiffness and vertebral problem like Regardless of the cause, your neck may hurt or be harder to move [3,4].

Suthar, et al., [5] reported, in India earth crust contains about 12 million tons of fluoride deposits as per that 14% of total fluoride. UNICEF, [6] and previous studies published in India 13 states of ground water is indicating high fluoride content during 1991 but then increased upto 17 states due to natural available in the geological layers in 1999 [7,8]. List of states contaminated by fluoride content are given in Table 1.

As per survey conducted by Government of India, In India about 66 million people were suffering from Fluorosis, out of 6 million are below 14 years age children’s [9]. This measures about 5% of total population in India. Currently, fluoride in ground water has a serious problem and 65% of villages are exposed fluoride risk in India [6].

Gopalakrishnan et al., [8] reported about 90% rural people are consuming fluoride contaminated ground water it measures 50% of the people are depending on fluoride contaminated water in India, this may be due to metamorphic and igneous rocks like gneisses and granite [4,10,11]. If the fluoride contaminated (1.0 ppm) water is used for long time in cooking purpose it also cause fluorosis [12]. According to BIS-2003 and ICMR-1975, the maximum desirable limit of fluoride is 1.0 mg/L and the maximum accessible limit is 1.5 mg/L. According to WHO [13], the accessible limit for fluoride is 1.5 mg/L. During 1930s in Nellore district of AP state first case of flourosis disease was identified in India later other symptoms like head ache and joints pains in most of the villages. First medical report was published during 1937 in Indian Journal of Medical Research fluoride affected villages [14]. The current study to investigate the causes for fluorosis. Effects and socio-economic problems related fluorosis and suggest the remedies to eradicate those problems.

2. Materials and Methods

2.1. Study Area

The study region Mundaragi taluk (Figure 1) is situated at 15.207°N 75.884°E. Mundaragi is a Taluk and a municipality in Gadag district, Karnataka state of India. Mundargi is adjacent to two area headquarters, being 35 kms (21 miles) from Gadag and 49 kms (30 miles) from Koppal. It is 98 kilometers from Gajendragad. Most of the villages in the study region depends on the ground water as a sources for drinking.

Twelve villages were selected from the study area: Water fluoridation status, residence remoteness, and socio-economic status were collected for each family recorded residential postcode area. Four locations from Dambal, three from Narayanpur, Kalkeri village respectively, two from Hirewaddatti, Mundargi respectively and one Harogeri, Mushtikoppa, Chikkavaddatti, Guddada Budihal, Virupapur, Budihal and Meundi respective village, which are shown more than 1.5 ppm fluoride content and given in Table 1.

Figure 1. Location details of the study area (Sampling and Selection of Villages)

Table 1. Content of Fluoride in study area and its effects on Human being

2.2. Selection of Participants

The response decisions were collected for each question: “Yes”, “No” and “Don’t know”. A range of population data was collected during the study period and interview period, including age, gender, existence of children in the family, and the postcode of the habitation [4,15]. For the door-to-door survey questionnaire, 5 participants were selected in small villages and 10 respondents in big villages. In total, 90 respondents (male: 43; female: 47). The majority of households had female heads due to their husband’s death. Very few male heads had higher education in colleges. Percentages of female heads attending senior secondary classes were low compared to male heads in the study area were identified for the door-to-door review. The selection was done randomly from all directions of the village [16]. The participants are only adults and each member was confined to only one household. Both quantitative and qualitative methods were adopted in the current survey.

2.3. Methods

2.3.1. Quantitative - Door to Door Survey

Door-to-door survey is research interviewing is a form of qualitative research whereby a respondent is asked questions on their doorstep, face-to-face. Door to-door survey may be adopted for several aims. The most common aim for undertaking this technique is to understand problem by discussion with specific person. Authors conducted the door-to-door survey. In the door-to-door survey, each respondent was approached at their doorstep and was interviewed with the help of a prepared questionnaire. Each interview made for about 12-15 minutes. The respondent was asked questions related to three chief fields viz. socio-economic details, sources of water for drinking and presence of fluorosis sign. For identifying the signs of fluorosis, the respondents were asked to perform certain physical movements, which are known to detect symptoms of skeletal fluorosis (Susheela, 2001). An illustration of the various types of exercises/tests as per the standard methodology.

2.3.2. Qualitative - Group Discussion

Group discussions is helpful tool that employ guided, interactional conversation as a means of generate the rich details of complex practices and the reasoning behind actions, beliefs, awareness, opinions, and attitudes [17]. A minimum of one and a maximum of two group discussions were conducted by me in selected twenty villages. The purpose was to understand the awareness and opinions of families about the different ways in which fluorosis has affected their socio-economic status and vice versa. The quality of questions asked in a group can make a large dissimilarity in the kind of information collected [17].

2.3.3. Questionnaire

Hence, a semi-generated questionnaire was used in the group discussion. Each group discussion for about 45-60 minutes until data saturation was attained. Data saturation presents when no new themes are emerging from successive focus groups and interviews [18]. Notes were taken simultaneously in order to increase the quality of data management.

3. Results and Discussion

In Mundaragi taluk, more than 45% bore wells are contaminated with fluoride and above the level of 1.5 mg/liter. Out of 25 locations during the study period 11 locations of 48% locations namely MGK-9, MGK-13, MGK-14, MGK-15, MGK-16, MGK-17, MGK-18, MGK-19 and MGK-20 are fluoride polluted. During the study period out of 25 location MGK-20 (Mushtikoppa cross) location shown maximum 4.63 mg/L and minimum (0.98 mg/L) in Doni (MGT-24) Figure 2 [19].

Figure 2. Fluoride content in the study area

The 90 respondents studied here have 21 family members in total with 275 depending agriculture practices in the family. Farming is the primary source of income, followed by agricultural labour and few persons are engaged as skilled workers such as small business, services etc. Among the 90 households, only 37 households own land with an average of 2.3 acres per household. Of the total 90 households, 40 (44%) houses have assets [9]. The scoring approach indicates that 40, 28 and 22 respondents are suffering with mild, moderate and severe forms of fluorosis respectively (Figure 3).

Figure 3. Self-reports of respondents' drinking water sources

According to the participated members, the common problem is fluorosis suffering by the villagers in the study region is pain and stiffness in the body joints, gastro-intestinal problems, incapacity to do sit ups, and difficulty in stretch their arms. In some severe problem, members were expressed unable to walk without stick and any other support. Few of the members also expressed depending upon wheel chair.

The majority of the members in the study area are alert of the fact that their health is being affected by drinking water from the fluoride contaminated bore wells. Moreover, many of the members are alert that the drinking water sources in their villages have been tested for fluoride in the recent past. However, it is interesting to learn that very few participants are expressed that there is no cure for fluorosis. Hence, due to lack of awareness on this ground, they continue to spend amounts on medical treatments rather than paying for clean water. Most of the participants held the opinion that the rich people do not suffer an equal amount of risk because they can give to use filters for de-fluoridation of water.

82% respondents (74) use bore wells for drinking water purpose followed by only 14% respondents (13) using pipeline water supply. The remaining 4% of the respondents (4) use other drinking water sources such as open wells [20]. Of the 82% respondents using bore wells, 44%, 31% and 24% respondents have mild, moderate and severe fluorosis respectively. Similarly, of the 14% respondents using pipe line water supply, only 86%, 11% and 3% respondents have mild, moderate and severe fluorosis respectively [21].

Figure 4 and Figure 5 predicts that the percentage of members with severe fluorosis increases steeply with age, especially after the age of 35. However, it has a severe double after 55 age. The largest number of troubled people is found in the age group of 41 to 50, accounting for 53.6% of males and 46.4% of female of the total members in that age group. Furthermore, fluoride weakness cases are more among females with (57.5%) in the age group of 21-40 whereas after the age of 45, the cases are more among males (62.6%), however, after the age of 65, there are negligible cases of fluorosis among females (0.8%) [18,23,24].

Figure 4. % of members suffering from Fluorosis

Figure 5. % of male and female members suffering fluorosis at different age group

Statistical correlation was also plotted with age group and proportion of fluorosis indicates, the positive relationship between the higher the numbers of people of above 30 years age maximum is the proportion [25] of skeletal and non-skeletal fluorosis patients in the family (Figure 6). Correlation relationship between total percentage of fluorosis victims per family and number of male, female and total family member of more than 30 years age indicates positive significant relationship that means the skeletal and non-skeletal fluorosis patients are found in age group between 30-50 years.

Figure 6. Relationship between number of skeletal and non-skeletal fluorosis disease found in between 30 to 50 age

4. Suggestions

There are many problems which area stands in the way of the agenda. Large numbers of people of Mundaragi taluk are caused by skeletal fluorosis due to usage of ground water sources for drinking since long time. Hence, people face many problems connecting to their health and socio-economic situations of their families. To solve the burning problems, Water from the tube wells are tested frequently to know the fluoride and variables. Dental checking to be done at Primary level using UNICEF along with PHE section, Gadag. Contaminated bore well locations have to mark in Red colour indicating danger sign. Fluoride free water to be provided and taps to be created at different parts of the village. One water filtration plant to initiated, medical measures to introduce to check patents who are suffering from basic indicators of Fluorosis. Finally awareness programmes to be conducted to educate the public.

5. Conclusion

From the study determinants, that the dental and skeletal fluorosis may play a critical role in the prevention and control of fluorosis in the community. The unavailability of fresh drinking water, people are forced to drink the fluoride polluted ground water above the accessible limit. As a part of the analytical values, most of the respondents in the study area are affected with various degree of dental and skeletal fluorosis. According to community perception, fluorosis has deteriorated their health, thereby changing their work efficiency, income and quality of life and on another hand, the fluoride impact severity changed according to sex, age, weight, education and income of the respondents. So, distribution of alternate safe drinking water, remedial treatment, provide fluoride filter, create awareness among them and implementation of alternative treatment for fluoride content. Involvement of Doctors, NGOs, and local societies may help the acute problem of the communities of the area. Present work predicts, determining factors while introducing de-fluoridation programs in the study area along with the traditional ones. This calls for a vital need of establishment of safe and fluoride-free drinking water through pipeline water supply and other practicable alternatives.

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