A Public Health Perspective on Uranium-Contaminated Groundwater in District Karak

Abstract

Uranium contamination in groundwater has emerged as a significant public health concern, particularly in rural regions of Pakistan where contamination levels are increasing. District Karak, located in the Khyber Pakhtunkhwa province, presents a unique case due to its geological proximity to uranium-bearing formations. This study investigates the relationship between uranium-contaminated groundwater and associated public health impacts in District Karak by assessing metal concentrations, health outcomes, and demographic patterns. A cross-sectional, quantitative study was conducted from March 2024 to January 2025. A total of 285 groundwater samples were collected from various sources across the three tehsils of District Karak. Additionally, health data were gathered from 1,247 households. Statistical analysis was performed using SPSS version 28.0, and uranium concentrations were determined using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Health risk assessments were conducted following the United States Environmental Protection Agency (USEPA) guidelines. The mean uranium concentration in groundwater samples was 47.32 ± 23.8 µg/L, with 68.4% of samples exceeding the World Health Organization (WHO) permissible limit of 30 µg/L. Significantly higher contamination was observed in shallow aquifers (<60 m depth) (p < 0.001). The health survey revealed increased prevalence of kidney dysfunction (OR = 2.34; 95% CI: 1.67–3.28), bone disorders (OR = 1.89; 95% CI: 1.34–2.67), and liver diseases (OR = 1.56; 95% CI: 1.12–2.18) in high-exposure regions. Cancer risk assessment indicated that 72% of the study sites exceeded the acceptable lifetime cancer risk threshold (>10⁻⁴). These findings highlight a strong association between uranium exposure and adverse health outcomes in District Karak. Immediate mitigation strategies, including the provision of alternative drinking water sources and ongoing community health monitoring, are urgently recommended. Note: 100-200% uncertainty in the results is expected due to inadequate sample preparation, instruments reliability and lack of accuracy in analytical technique.