Surface water pollution: an emerging health threat

Surface water pollution: an emerging health threat
Photo by Tarek Badr / Unsplash

The primary natural resource of surface water is continually threatened by pollution brought on by anthropogenic human activity. The problem of water contamination is mostly caused by rapid population increase, urbanization, industrialisation, etc. The use of contaminated water is closely related to a number of deadly diseases. This essay gives a general review of the ailments brought on by using contaminated water in India as well as the causes of water pollution.


In India, behind air pollution, unsafe water is one of the largest health and environmental issues. The leading environmental concern in 2019—unsafe water and sanitation—is responsible for 4.39 percent of the overall disease burden. Unsafe water alone is responsible for 3.46 percent of the illness burden (Indian Council of Medical Research, 2019). The rapid growth of population and urbanization in India during the recent decades has given rise to several environmental problems such as water scarcity, wastewater generation and its collection, treatment and disposal. The prominent source of surface water pollution is through different sources such as, domestic sewage, industrial wastewater and agricultural run-off, including plastics being discharged into surface waters continuously (World Health Organization, 2016).

About 122 million people, or 2% of the world's population, get their drinking water directly from rivers, dams, lakes, and other surface water sources. With more than 20 significant rivers, several tributaries, and 14 major river basins, India has an extensive river system that meets the demands of 80% of the population and provides 85% of the country's total surface water. Over 8.2 million people, or 0.6% of India's total population, utilise surface water on a regular basis; however, most of these people live in rural areas, and about 80% of India's surface water resources are polluted (WHO/UNICEF, 2021).

Hotspot for emerging pollutants

In urban areas, rivers, streams, lakes, ponds, wells, etc. provide water for domestic and commercial usage. Water provided for household use loses over 80% of its volume as wastewater. Most of the time, this wastewater is not treated, which results in significant surface water pollution (Rakhecha, P.R., 2020). Surface water in Punjabi rivers has been shown to be heavily contaminated by metal effluents as a result of sewage discharge and other industrial, municipal, agricultural, and municipal sources (Setia, R., Dhaliwal, S.S., Kumar, V., et al., 2020). Surface water (rivers, ponds) is frequently used in rural areas as their main source of drinking water. Numerous investigations of different rivers in India demonstrate that the concentration of heavy metals was high and frequently exceeded the BIS limits for surface water. With the exception of the Ajay River in India, the Ganga River is higher than the majority of the rivers examined. The population will soon be seriously threatened by the rising levels of inorganic pollutants, particularly carcinogens, which indicate an increased risk to human health (Prasad, S., Saluja, R., Joshi, V. and Garg, J.K., 2020). Because of this, emergent pollutants like microplastics, endocrine disruptors, antibiotic-resistant genes, and other chemicals from cosmetics, pharmaceuticals, and urban households are increasingly found in surface waters. Endocrine disruptors and other chemicals found in treated and surface water enter the food chain and impact wildlife through direct or indirect interaction, adding a new level of health risks (UNEP, 2016).

Emerging Health Issues

Surface water chemical contaminates, whether they are human (nitrate) or natural (arsenic and fluoride) pollutants, are a major cause of disease in the nation. According to the Indian Council of Medical Research's 2019 Health of the Nation's States report, the states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan, Uttarakhand, Uttar Pradesh, Odisha, and Assam have the highest burden of water-related disorders (Indian Council of Medical Research, 2019). The primary danger to water and sanitation in India is diarrheal disease, which accounts for more than 80% of the country's overall disease burden.

The diseases that can be spread through water include developing ones like Cryptosporidium, Legionella, Escherichia coli, rotavirus, hepatitis E virus, and norovirus (formerly known as Norwalk virus). Typhoid, cholera, gastroenteritis, and jaundice are gastrointestinal conditions that can result in fever, nausea, vomiting, and gastrointestinal inflammation. Coliform bacteria, such as Escherichia coli, a pathogen brought on by sewage contamination in water, can also cause these conditions. Heavy metals from industrial effluents present in rivers may harm the kidneys, the central nervous system, and other metabolic processes. Rocks rich in fluorine have contaminated drinking water supplies, leading to issues like endemic fluorosis.

However, high concentrations can result in dental fluorosis (tooth enamel discoloration), skeletal fluorosis (severe bone deterioration), anaemia, back stiffness, and trouble completing natural motions (Sharma, R.K., Yadav, M. and Gupta, R., 2017). Leptospirosis and Helicobacter pylori (H. pylori) are two recently discovered pathogens that can spread through water. Life-threatening typhoid and paratyphoid fevers are caused by pathogens like Salmonella enterica subsp. enterica serovar Typhi (S. Typhi), which continue to be a major public health concern in India. In India, contamination of rivers receiving untreated home wastewater showed a significant concentration of Salmonella (Cho, S., Jackson, C.R. and Frye, J.G., 2020).

The concentration of pathogens in surface water

The pathogens-faecal-oral pathway is responsible for the majority of disease cases associated to drinking water use (i.e., originating in faecal material and subsequently ingested by a host). Waterborne infections provide the greatest public health danger to all water systems that use surface water or groundwater impacted by surface water. Many waterborne disease outbreaks have been linked to pathogen contamination in surface water. Pathogens enter surface waterways from human sources via open defecation sites via overland run-off of rainfall or from wastewater systems via overflows of untreated wastewater and discharges of (partially) treated wastewater.

Other routes include human waste disposal from boats or buildings, individuals working in or near surface waters, and swimmers and other recreational activities. The run-off of animal manure following its application on land is likely to contribute the most zoonotic infections. Pathogens in manure enter surface waters via run-off from manure-fertilized agricultural areas, grazing pastures, and direct defecation to stream margins used for stock drinking, notably feedlots. Wild animal faeces may reach surface waters through natural emission into the water or overland run-off produced by rainfall (World Health Organization, 2016).

The World Health Organization (WHO) has classified the growth of antibiotic-resistant bacteria in surface waters as the most serious threat to global health. Conserving surface water for health, Target 6.6, accepts the concept advanced by Goal 6 of the Sustainable Development Goals, recognising that protecting water quality and water-related ecosystems contributes to providing safe drinking water and thereby protecting public health (World Health Organization, 2016). This goal is measured by the proxy indicator "improved" water supply; however, only 62% of India's population has access to improved drinking water anytime it is needed (UNICEF/World Health Organization, 2021). Pollution should be decreased to improve water supplies by eliminating dumping and minimising the release of dangerous chemicals and materials, as well as substantially increasing recycling and safe reuse globally (World Health Organization 2003).


In India, surface water is often used for irrigation and drinking. It is quite alarming that more and more wastewater is being thrown into our surface waters, causing pollution of the water. For human development and health, access to high-quality water is crucial. On the one side, the sewers have lessened the health danger posed by improper sanitation techniques on the land by removing the effluent from populated areas. However, dumping untreated sewage into surface waters has moved health dangers from the subsurface to the water's surface. This contaminated water is causing the spread of bacterial, viral, and parasitic diseases.

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