Ipsa Tripathy
Bhubaneswar: Groundwater can look perfectly safe and still contain substances that pose a serious risk to human health. A tube well may provide clear, cool water with no unusual smell or taste, yet contain fluoride at levels that can cause health problems after years of consumption. Unlike visible contamination, excess fluoride offers no obvious warning. By the time its effects become noticeable, some of the damage may already be permanent.
For many families in western Odisha, this is not a distant concern. Fluoride contamination has been documented in several parts of the state, and reports from districts beyond the western region suggest that the problem may be more widespread than official records have indicated.
The Central Ground Water Board’s Annual Groundwater Quality Report 2024 identified fluoride concentrations above 1.5 mg/l in groundwater samples from ten Odisha districts: Angul, Bolangir, Bargarh, Jharsuguda, Nayagarh, Nuapada, Puri, Sambalpur, Subarnapur and Sundargarh.
Nuapada is among the districts most frequently associated with fluoride contamination. A study of the district reported average fluoride concentrations of 6.17 mg/l in Boden block, 4.79 mg/l in Khariar, 4.47 mg/l in Komna and 3.93 mg/l in Sinapali. These levels are several times higher than the permissible limit for drinking water. The area’s geology is an important factor. Rocks beneath parts of the district contain fluoride-bearing minerals such as fluorspar and fluorapatite. As these minerals gradually weather and dissolve, fluoride can enter groundwater. Intensive extraction of groundwater may further influence its concentration in some locations.
The problem is not confined to western Odisha. Research in parts of Khordha and Nayagarh found elevated fluoride in nearly 40 per cent of groundwater samples, with some concentrations exceeding 3.5 mg/l. Around certain hot springs, levels were reported to reach as high as 12 mg/l. Residents in the Atri and Tarabalo areas have also shown signs of dental and skeletal fluorosis.
More recently, water testing has identified possible new hotspots. In December 2025, an NGO tested samples from three villages in Budhikhamari panchayat of Mayurbhanj and reported fluoride concentrations ranging from 2.4 to 8.2 mg/l. At the time, official records listed only two fluoride-affected villages in the entire district. Fluoride contamination has also been documented in Remuna block of Balasore and Harbhanga block of Boudh.
These findings raise an important concern: official lists of affected areas may not always reflect the conditions at every individual water source. Groundwater quality can vary considerably over relatively short distances. A safe reading from one well does not necessarily mean that a nearby tube well is equally safe.
The Bureau of Indian Standards sets 1 mg/l as the acceptable limit for fluoride in drinking water. A concentration of up to 1.5 mg/l is permitted when no alternative source is available. Regular consumption of water containing fluoride above this level can increase the risk of fluorosis, particularly where exposure continues for many years.
The effects often become visible first in the teeth. Dental fluorosis usually develops during childhood, while permanent teeth are forming. Early signs may appear as faint white streaks or patches. With greater exposure, the teeth can develop brown staining and surface damage. The condition can affect the appearance and structure of the teeth.
Long-term exposure to excessive fluoride can also affect the bones and joints. This condition, known as skeletal fluorosis, may cause stiffness, joint pain and restricted movement. In advanced cases, changes to the bones can lead to severe disability. The risk depends on factors such as the concentration of fluoride, the duration of exposure, age and nutritional conditions.
The consequences can be particularly severe in communities that depend on a contaminated source for years. In Hatasahi village in Mayurbhanj, 45-year-old Harihar Nayak, who once worked on his own farm, has reportedly been unable to move for the past 10 to 12 years. In Dunguripada, a small settlement in Nuapada with a population of around 60, 21 residents have reportedly been affected by skeletal fluorosis. Such cases show why access to safe drinking water is not simply an infrastructure issue. It is a matter of long-term public health.
The first step towards protecting a household is to find out what is in its drinking water. Appearance and taste cannot establish whether fluoride is present at a safe concentration. Testing is essential.
Government records provide a useful starting point. The Jal Jeevan Mission’s water quality portal allows users to select their state, district, block and village to view available test results for fluoride, nitrate, arsenic and other parameters. The Ministry of Jal Shakti’s Water Quality Management Information System also provides information about nearby testing laboratories through its laboratory search facility. These include state, district, sub-divisional and mobile laboratories, along with details of the parameters they can test.
However, village-level records should not be treated as a substitute for testing the water actually used by a household. Different wells in the same village may have different fluoride concentrations. If a family depends on a particular tube well, that source should be tested directly.
Residents can also approach their village water and sanitation committee or gram panchayat. Under the Jal Jeevan Mission, women from self-help groups and village water and sanitation committees have been trained to use field test kits in several areas. In Nuapada, for example, trained women representatives have been involved in testing local water sources and forwarding results to district laboratories. The gram panchayat can help residents identify who is responsible for water testing in their village.
For a more reliable assessment, households can take a sample from their regular drinking water source to the district water testing laboratory operated under the Rural Water Supply and Sanitation system. The sample should come from the actual tube well or open well used by the family, rather than an unrelated source. It should be collected in a clean bottle, labelled with the source and date, and submitted according to the laboratory’s instructions. Field test kits are useful for preliminary screening, but laboratory testing provides a more dependable measurement.
Health symptoms can also prompt families to investigate their water source. White streaks, brown stains or surface changes in children’s teeth may warrant a dental assessment and water testing, particularly if several children in the same locality show similar signs. Persistent joint stiffness and restricted movement in adults who have consumed water from the same source for many years should also be assessed by a medical professional. These symptoms alone do not confirm fluorosis, but they should not be ignored.
If a test confirms excessive fluoride, boiling the water is not a solution. Fluoride does not evaporate with water during boiling. As some water is lost through evaporation, its concentration may even increase slightly. The most reliable options are to switch to a verified safe water source or use an appropriate treatment system.
Nuapada offers an example of how changing the water supply can reduce exposure. Under the National Water Quality Sub-Mission and later the Jal Jeevan Mission, efforts were made to move drinking water supplies away from contaminated groundwater towards surface water drawn from the Lower Indra and Jonk river dams. Earlier measures included defluoridation units installed on 526 hand pumps and tube wells, but these were not sufficient to address the problem across the district. In Dunguripada, residents also took the initiative to dig a well within two months, using their own funds.
At the household level, reverse osmosis systems and activated alumina filters can reduce fluoride when they are properly designed for the purpose and maintained regularly. However, installing a filter does not automatically guarantee safe water. The treated water should be tested to confirm that fluoride levels have fallen below the acceptable limit. Filters also require periodic maintenance and replacement of treatment media as recommended by the manufacturer.
Nutrition is another part of managing the health effects of long-term fluoride exposure. Adequate intake of calcium and other essential nutrients is important for general bone health. People diagnosed with fluorosis may need medical assessment and nutritional guidance based on their individual condition. Dietary changes, however, cannot make contaminated drinking water safe or replace the need to remove the source of exposure.
Fluoride contamination is difficult to detect without testing. It cannot be reliably identified by looking at water, smelling it or tasting it. For families that have depended on the same tube well for years, particularly in districts where elevated fluoride has been reported, checking the water quality is a sensible precaution.
The wider responsibility lies with public authorities as well. Regular testing, transparent publication of results, reliable alternative water supplies and follow-up monitoring are essential in affected communities. A test result is useful only when it leads to action.
The first question is simple: what is in the water your family drinks every day? In Odisha’s fluoride-affected areas, finding the answer could help prevent years of exposure and protect children from health problems that may be difficult to reverse.