Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 12;16(6):e62272.
doi: 10.7759/cureus.62272. eCollection 2024 Jun.

Groundwater Hardness and Alkalinity As Risk Factors for Kidney Stone Disease in Alwar, India: An Ecological Study

Souvik Manna  1 , Usharani Rathnam  2 , Arun Udayaraj  3 , Rajesh  4 , Tuhina Shree  5
Affiliations

Groundwater Hardness and Alkalinity As Risk Factors for Kidney Stone Disease in Alwar, India: An Ecological Study

Souvik Manna et al. Cureus. .

Abstract

Introduction: Rajasthan is a semi-arid state in India where people still use groundwater for drinking purposes. However, the quality of groundwater as compared to standards have not been studied in any details. This ecological study was done to study the groundwater quality parameters in the stone-belt states, compare the quality of groundwater in Alwar with the rest of Rajasthan, and study the morbidity profile of surgical in-patients in the same district, with special emphasis on kidney stone disease (KSDs).

Methods: The morbidity profile of patients coming to the surgery department of a tertiary teaching hospital between January 2002 and June 2023 was obtained from the medical records department, and water quality data was obtained from the publicly available Water Resources Information System (WRIS) groundwater dataset for the year 2023. The dataset provided detailed information on the chemical parameters of water samples throughout the country that were evaluated to estimate the quality of groundwater.

Results: It was found that the groundwater in Alwar is non-potable due to the presence of iron, alkalinity, magnesium, and total dissolved solids (TDS). Iron was estimated to be much higher than the acceptable limit of the Bureau of Indian Standards (BIS) drinking-water quality guidelines (0.3 mg/L). Similarly, most of the chemical parameters in the groundwaters of Rajasthan significantly exceeded the national average. The median electrical conductivity, fluoride, magnesium, sodium, hardness, alkalinity, and turbidity were found to be 1680 μS/cm, 1.05 parts per million (PPM), 41 PPM, 233 PPM, 330 PPM, 310 PPM, 988 PPM, respectively, which are above the WHO recommendations for drinking water guidelines.

Conclusions: The levels of iron and total alkalinity were significantly higher in the study district as compared to the rest of the state. Also, magnesium hardness and TDS levels were very high in the groundwater of the entire state of Rajasthan, making the population vulnerable to KSDs in the long run.

Keywords: groundwater quality; hardness; kidney stone disease; total alkalinity; total dissolved solids.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Institute Ethics Committee, Employees' State Insurance Corporation (ESIC) Medical College & Hospital, Alwar issued approval ESIC/MCH/Alwar/2023/IEC/Proj121. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Map of India showing the stone-belt states.
WRIS: Water Resources Information System. The amount of total hardness is the sum of calcium and magnesium hardness, expressed as carbonates in parts per million (PPM). The figure was originally created by the authors from data uploaded by the Ministry of Jal Shakti, Government of India on the National Data Analytics Portal.
Figure 2
Figure 2. Median hardness in groundwater in various states of India.
PPM: Parts per million. The figure was originally created by the authors from data uploaded by the Ministry of Jal Shakti, Government of India on the National Data Analytics Portal.
See this image and copyright information in PMC

References

    1. Water quality standards. [ Apr; 2024 ]. 2019. https://cpcb.nic.in/wqstandards/ https://cpcb.nic.in/wqstandards/
    1. 2008. Vol. 1. www.who.int/publications/i/item/9789241549950: 1-668; [ Apr; 2024 ]. 2008. Guidelines for drinking-water quality, third edition incorporating the first and second addenda; pp. 1–668.
    1. Prevalence of gallbladder cancer in arsenic endemic areas. Ghosh A, Roy M. NACS. 2020;4:374–376.
    1. Arsenic causing gallbladder cancer disease in Bihar. Kumar A, Ali M, Raj V, et al. Sci Rep. 2023;13:4259. - PMC - PubMed
    1. Geographical pattern of carcinoma gallbladder in Bihar and its association with river Ganges and arsenic levels: retrospective individual consecutive patient data from Regional Cancer Centre. Madhawi R, Pandey A, Raj S, Mandal M, Devi S, Sinha PK, Singh RK. South Asian J Cancer. 2018;7:167–170. - PMC - PubMed

LinkOut - more resources