Community De-fluoridation - Experience in Kaiwara Village, Chikkaballapur District, Karnataka, India - Open Journal Systems
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Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 85
Community De-fluoridation - Experience in Kaiwara Village,
Chikkaballapur District, Karnataka, India
Arjunan Isaac1, S Pruthvish2, Radhika3, N S Murthy4
1
Professor, 2Professor, Department of Community Medicine, 3Assistant Professor, Department of Biostatistics,
4
Professor, Department of Biostatistics, MS Ramaiah Medical College, Rajiv Gandhi University of Health
Sciences, Bangalore, Karnataka
Abstract
Background and objective: Reverse osmosis technique is an adequate method for treating ground water
for reducing the burden of abnormal levels of fluorides. The method protects the general population from
diseases associated with high fluoride levels in the body. The objective of the present study was to assess the
suitability and sustainability of reverse osmosis technology for community de-fluoridation of water used for
cooking and drinking purposes in Kaiwara village, Karnataka.
Methodology: This interventional study was conducted between July 2012 and June 2014 at Kaiwara
village, Karnataka using reverse osmosis technique for de-fluoridation of water used for drinking and
cooking. Complete chemical analysis of water was done before intervention, and processed water supplying
the village was tested every six months after intervention for about two years. The variation in chemical
concentrations of various components were analysed.
Results: The mean baseline level of fluoride in untreated water was 2.075 mg/dl (above the safety limit),
which dropped to 0.08 mg/dl at the end of first six months following the intervention, 0.042 mg/dl in 12
months, 0.1 mg/dl at 18 months and 0.01 mg/dl at 24 months after intervention, which were all below the
safety limits for India in the treated water. The mean total dissolved solids in the water was 542.25 mg/dl in
the untreated water, which dropped to zero after the first six months, remained at zero in the next six months,
rose to 120 mg/dl at 18 months and then dropped to 70 mg/dl at 24 months in the treated water. The observed
values were reduced significantly.
Discussion: The study concluded that it is possible to set up a community de-fluoridation plant using reverse
osmosis technique at Kaiwara village, Karnataka which is economically sustainable and acceptable by local
population.
Keywords: Water pollution, Fluorides, Reverse osmosis, Community participation.
Introduction million people are currently affected, and 66 million
people are at risk of developing fluorosis.3
Water as we know, is one among the most important
components for all forms of life and safe drinking water Over the last few years, domestic purification
is the primary requirement for every human being. There techniques came into use to minimise both inorganic
is scarcity in the availability of portable water as natural and organic pollutants in water thereby maintaining the
sources or industrial wastes may contaminate water. One quality of water supplied to the urban society.4 There are
such contaminant is fluoride.1 various basic types of water purification systems that can
be used alone or in combination, e.g., reverse osmosis,
Fluorosis is one among the severe health problems cation exchange softening, oxidation, filtration, activated
faced by the public in India. Two-third of the states in carbon, disinfection, distillation, anion exchange etc.4,5
India are fluoride endemic,2 while approximately 2586 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7
Fluoride concentration present at low levels (< identified next to the main water tank of Kaiwara village
0.5 ppm) in drinking water could cause lack of formation which had a storage capacity of 100,000 litres of water.
of dental enamel, dental caries and reduced bone The Zilla Panchayath was approached for the electricity
mineralisation whereas high fluoride levels in drinking connection required for running the Reverse Osmosis
water could lead to adverse health effects ranging from plant (3Phase and 10KVA) from Kaiwara village. It was
mild dental fluorosis to crippling skeletal fluorosis, proposed that a sum of Rs 5/- would be collected for 25
depending upon level of fluoride present and its duration litres of processed water from each household who were
of exposure.6,7 willing to purchase the processed water from January 1,
2012 for cooking and drinking purposes. 99.4% of heads
Karnataka is among the fluoride endemic states
of the families were willing to contribute and 89.8% of
in India.8 In Karnataka, districts endemic for fluorosis
the heads of the family expressed acceptance for de-
are Belgaum, Raichur, Bijapur, Gulbarga (districts
fluoridation of water in the village. The money collected
in northern Karnataka) as well as Tumkur, Mandya,
by selling the processed water was used to run and
Mysore, Chitradurga, Shimogga, Chikmagalur,
maintain the R O plant. The cost of Rs 5/- per household
Bangalore-rural and Kolar (districts of southern and
was calculated considering Rs 3/- towards electricity and
central Karnataka).9 Kaiwara village now comes under
water charges for running of the R O Plant, maintenance
Chikkaballapur district but used to be part of Kolar
charges for the R O Plant (filter replacement, pump
district previously, forming a part of the fluoride belt
repair etc) and salaries for the watch man, plant operator
bordering Andhra Pradesh. The weather conditions in
and electrician. Rs 2/- was further collected towards
Kaiwara village are like that of Chikkaballapur district.9
payment for the water distribution vehicle maintenance
Results from some of the exploratory bore wells in and petrol for the running of the vehicle as well as salary
Chikkaballapur region have recorded the concentration for the water distributer.
of fluoride to 2 ppm and above.10 As Kaiwara has no
A road map of Kaiwara was prepared and 20 spots
alternate source of water, it is dependent solely on ground
for water collection were identified in five areas of
water through bore wells for its water supply which have
the village, which were less than 100 meters from the
unacceptable levels of fluoride. The present study aimed
farthest house from the identified point (usual water
to study the acceptability and sustainability of reverse
collection points included). A vehicle with a 1000 litres
osmosis technology for community defluoridation of
tank fixed to it, which could be sealed from the top after
water used for drinking and cooking purposes in Kaiwara
filling with processed water and fitted with four taps, was
village, Karnataka.10
used for the transport and distribution of the processed
water to the collection point at a fixed time each day.
Methodology
Complete chemical analysis of untreated and processed
The present interventional study was conducted water was made before intervention and processed water
between July 2012 and June 2014 at Kaiwara village, was tested every six months after intervention for about
Karnataka. The study was approved by the Ethical two years and the mean concentration levels before and
Review Board. Having gone through a number of after the intervention were compared.
studies on comparison of different methods for fluoride
removal,11 the Council for Scientific and Industrial Results
Research Government12 offered a 40,000 litres capacity
The opinion given for all four samples of water
reverse osmosis unit custom made for community
after complete chemical analysis (Table 1) was that the
defluoridation to pilot in the village, and report the
water was found to be unfit for potable purpose, as all
feasibility of operating and sustaining such a technology
the four samples showed excess of fluoride. The mean
within a village which can be replicated anywhere else
baseline levels of fluoride in untreated water were found
in rural India.
to be 2.075 mg/dl and the mean total dissolved solids in
Installation of the reverse osmosis plant was done in untreated water was found to be 542.25 mg/dl.
a plot granted by the Kaiwara Gram Panchayath that wasIndian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 87
Samples of the Feed, Product and Reject water in the processed water were found to be significantly
obtained from the reverse osmosis plant and tested reduced.
which will form a baseline data for our reverse osmosis
Also, it was observed that the mean total dissolved
process (refer Table 2).
solids in the untreated water which was 542.25 mg/dl in
The water sample after the intervention was the untreated water which dropped to zero after the first
submitted to Public Health Institute Bangalore for six months, remained at zero in the next six months, rose
complete chemical analysis (Table 3) and was found to to 120 mg/dl at 18 months and then dropped to 70 mg/
be useful for potable purposes. It was observed that the dl at 24 months in the treated water. The total dissolved
mean fluoride levels in the water which was 2.705 mg/ solid in processed water was significantly reduced.
dl in the untreated water, clearly above acceptable limits
The changes in the various parameters seen in the
for India (0.5 mg/dl to 0.9 mg/dl) dropped to 0.08 mg/
four reports are because at different times of the year,
dl after the first six months, 0.042 mg/dl in the next six
the conditions in bore wells supplying the main village
months, 0.1 mg/dl in the next six months and 0.01 mg/
tank also change, depending on the availability of water
dl in the last six months which were all below the safety
in the various bore wells.
limits for India in the treated water. The fluoride levels
Table 1: Complete chemical analysis of baseline water available at Kaiwara village
Concentration in Concentration in
Component Concentration in Concentration in
measured Chamundashwari Hill Chikkaballapur
Vivekananda Tank Main Bore-well
Tank Tank
Turbidity as
0.0 0.0 0.0 0.0
(NTU)
PH value 7.7 8 7.6 7.4
Dissolved solids 538 481 539.5 611
Total hardness 320 260 292 344
Calcium 54.4 65.6 76.8 94.4
Sodium 55.38 64.71 57.95 74.26
Potassium 4.87 3.6 7.82 5.26
Sulphate 68.6 43.93 184.1 70.2
Alkalinity 250 292 212 260
Chlorides 106 52 74 130
Iron 0.09 0.09 0.08 0.01
Fluoride 1.72 2.08 2.26 2.24
Nitrate 2.56 9.90 5.8 5.5
Physical
Clear Clear Clear Clear
appearance
All components were measured in mg/dl88 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7
Table 2: Results of the test run-At 250 PSI pressure in the membrane filter
Type of water in RO unit Total dissolved solids (ppm) Flow rate (litres/minute)
Feed water 270 -
Product water 10 96
Reject water 1100 24
Table 3: Complete chemical analysis of processed water done every six months from July 2012 to June
2013
Mean Mean Mean Mean
Sl. concentration concentration concentration concentration
Component measured (July 2012) (December 2012) (January 2013) (June 2013)
No
1 Turbidity as (NTU) 0.0 0.0 0.0 0.0
2 PH value 6.8 7.8 6.30 7.40
3 Dissolved solids --- --- 120 70
4 Total hardness 76 36.0 58 10
5 Calcium 8.0 1.6 14.82 4.8
6 Sodium 7.2 --- 17 ---
7 Potassium 0.3 --- 0.30 ---
8 Sulphate 0.343 2.38 10 0.01
9 Alkalinity 22 8.0 60 48
10 Chlorides 22 22.0 17.72 10.70
11 Iron .022 Not detected 0.06 0.01
12 Fluoride .024 0.08 0.10 0.01
13 Nitrate 0.015 1.29 1.20 0.60
14 Physical appearance Clear Clear Clear Clear
All components were measured in mg/dlIndian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 89
Discussion osmosis plants in Kaiwara village and five other reverse
osmosis plants in the surrounding villages following our
Fluoride is one of the normal constituents in
model today.
groundwater in this region. The concentration of
fluoride is variable, and it depends on the source of Disclaimer: Not applicable.
water. Provision of safe drinking water with optimal
fluoride levels is the solution to protect against diseases Funding: MS Ramaiah Medical College, Bangalore,
associated with abnormal fluoride content in water used Karnataka
for drinking and cooking. In this study, reverse osmosis
Conflicts of Interest: Nil
technology was applied for community de-fluoridation
of water in Kaiwara village, Karnataka. Ethical Clearance: Taken from Institutional Ethics
Committee (MS Ramaiah Medical College, Bangalore,
In this study, it was also observed that the mean
Karnataka)
fluoride levels in the water which was 2.705 mg/dl in the
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