Spatial and seasonal variability, control factors and health risk of fluoride in natural water in the Loess Plateau of China

Hundreds of millions of people around the world are currently exposed to excessive amounts of fluoride (F-) in drinking water. Although the factors controlling the spatiotemporal distribution of F- contents have been analyzed, their contributions have rarely been quantified. In this study, 510 water samples were collected in the dry and wet seasons in China’s Loess Plateau to investigate the spatial and seasonal distribution, controlling factors, and potential health risks of F- in natural water. High-F- waters were mainly distributed in valley areas of the Loess Plateau, and more severe fluoride pollution of streamwater and groundwater was found in the wet and dry seasons, respectively. Mineral dissolution, competitive adsorption, adsorption/desorption and cation exchange jointly controlled F- enrichment. Spatiotemporal distribution of high-F- levels was mainly determined by climate and streamwater-groundwater connectivity in the dry season, with contribution rates of 41.7% and 37.6%, and by terrain and anthropogenic activities in the wet season, with contribution rates and 49.9–55.6% and 30.7%, respectively. Fluoride in groundwater through oral intake posed the greatest health risks to infants, followed by children, teenagers and adults in the dry and wet seasons. This study provides a scientific basis for the effective management of high-F- water in arid regions.