A study on fluoride risk assessment was carried out in the semi-arid region of North Gujarat, India. The intricate link between groundwater fluoride and human health, lack of awareness, limited access to fluoride treatment facilities, and poor socio-economic conditions of the ~5.0 million rural population in the studied region make them vulnerable to fluoride. This study aimed to evaluate non-carcinogenic health risk, its severity, and the total population at risk in these regions due to chronic fluoride exposure. Fluoride in our samples (n=132) exhibits large spatial variability, and it ranges from ~0.13-8.64 mg.L-1 (average: 1.64 ± 1.50 mg.L-1) and 43% of them are more than the WHO limit of 1.5 mg.L-1. Hazard Quotient (HQ) was used to assess health risks through the ingestion exposure route. The comparison of the range (0.1-8.55 versus 0.06-4.11), average (1.63 ± 1.49 versus 0.78 ± 0.72), and median (1.26 versus 0.60) of HQ between children and adults highlights that the former are at more risk compared to latter. Our conservative estimates suggest that ~0.45 million children and ~1.06 million adult population, ~55% and ~20% of the respective population classes, of the region, are potentially at risk. The empirical Bayesian Kriging model was used to produce risk-assessments maps. These can help policymakers in prioritizing the application of mitigation funding and resources, and in increasing testing efforts in high-risk areas. We believe this study should guide policymakers to adopt strategies in ensuring the public health safety of the rural population, children in particular, of the studied region.
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