Groundwater Arsenic and Fluoride and Associated Arsenicosis and Fluorosis in China: Occurrence, Distribution and Management

Arsenic and fluoride are two natural components affecting human health. Long-term exposure to arsenic and fluoride, mainly through drinking water intake, can lead to arsenicosis and fluorosis. In this paper, we summarized the distribution and hydrochemical characteristics of high-arsenic and high-fluoride groundwater, and reviewed the arsenicosis and fluorosis distribution due to consumption of high-arsenic and high-fluoride groundwater in China. The results show that there are 20 major provinces//autonomous regions (about 60%) in China suffering from high-arsenic groundwater, and these high-arsenic groundwater provinces are mainly located in the fluvial/alluvial-lacustrine plains and basins located in arid/semi-arid regions and alluvial plains/basins and river deltas in humid/semi-humid regions. Drinking water arsenicosis has been found in 13 provinces/autonomous regions, with Shanxi and Inner Mongolia being the two most seriously affected areas. High-fluoride groundwater is widely distributed in north, northeast and northwest parts of China, occurring mainly in shallow groundwater. Fluorosis has been found in 29 provinces/autonomous regions. With the continuous implementation of water quality improvement projects, drinking water fluorosis and arsenic poisoning have been effectively controlled. However, the long-term maintenance and operation of the water quality improvement project need to be further strengthened.