Groundwater has been an invaluable resource for humanity for centuries. India is the world’s largest user of groundwater. It is mostly used not only for drinking and cooking but also for miscellaneous domestic purposes and irrigation in agriculture. Hand-pumps, bore-wells, step-wells, and open deep dug-wells continue to be the primary and major sources of groundwater production in India. However, in rural areas of the country, hand-pumps are the most common and major drinking water sources for households. According to a survey, 42.9% of households in rural areas use hand- pumps as their main source of drinking water, while 40.9% of households in urban areas use piped or surface water as their main source. In rural India, >90% of drinking groundwater sources are naturally contaminated with varying amounts of fluoride. In India, groundwater of 23 out of 37 states and union territories is found to be fluoridated. Among these, 70-100% districts in the states of Andhra Pradesh, Gujarat, Rajasthan, and Telangana and 40-70% districts in the rest of the states have fluoride-contaminated groundwater with maximum permissible levels >1.0 ppm or 1.5 ppm. Such water is not at all safe for human health, even for the health of animals. In fact, drinking such water for a long period of time, a dangerous disease called fluorosis (hydrofluorosis) develops. Due to fluorosis, people's teeth become weak and discoloured (dental fluorosis) and their bones become hollow and weak (skeletal fluorosis). Due to the development of fluoride-induced deformities in various bones, people become hunchbacked and eventually start walking with a limp. These anomalies are, generally, permanent, irreversible, and incurable and persist throughout life. According to the National Programme for Prevention and Control of Fluorosis (NPPCF), the population at risk based on population in habitations with high fluoride in drinking water is >11.7 million in the country. However, NGOs have warned that the threat is far more widespread, affecting more than 60 million people across the country. In the current communication focuses on how safe drinking groundwater is for human health in India and also draws attention to those responsible for addressing this drinking water health problem.

Bore-wells, Dental fluorosis, Groundwater, Hand-pumps, Human health, Hydrofluorosis, Fluoride, Non-skeletal fluorosis, Open dug-wells, Rural India, Skeletal fluorosis, Step-wells