Lok Sabha Question No. 5031 (UNSTARRED), answered on 2022-04-01
Subject: Incidence of Fluorosis
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ramya  Haridas

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION No. 5031 TO BE ANSWERED ON 01.04.2022

## INCIDENCE OF FLUOROSIS

## 5031  MS. RAMYA HARIDAS

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- a) whether the Government has conducted any investigation or research on fluorosis, a water borne disease due to excessive fluoride in the drinking water, to ascertain the prevalence of the disease in all the States/UTs;
- b) if so, the details thereof, if not, the reasons therefor, and
- c) the steps taken by the Government to address and curb the incidence of fluorosis, across the country?;

## ANSWER

## THE MINISTER OF STATE FOR HEALTH AND FAMILY WELFARE (DR.BHARATI PRAVIN PAWAR)

(a) & (b): ICMR has carried out studies on fluorosis at several locations in the country, one of which is 'Prevalence of fluorosis in the community of selected districts of India and development of an appropriate intervention model for prevention and control of fluorosis' at 7 locations in the country (covering one district each in Odisha, Madhya Pradesh, Telangana, Punjab, Bihar, Rajasthan and Assam).

Besides the above, ICMR- National Institute For Research in Tribal Health, Jabalpur has also brought  out  a  Policy  Brief  'Knocking  Down  Fluorosis'  which  is  based  on  the  results  of  a successful  water  and  nutritional  interventional  strategy  in  several  districts  of  Madhya Pradesh.

- (c): The  important  steps  taken  to  address  the  health  problems  due  to  consumption  of fluoride including contaminated drinking water are as follows:
- (i) In  order  to  address  the  problem  of  Fluorosis  including  dental  fluorosis,  skeletal fluorosis and non-skeletal fluorosis, a National Programme for Prevention and Control of Fluorosis (NPPCF) was initiated by M/o Health & FW (GOI) in 11 th Five Year Plan (200809).  The  Programme  is  progressively  expanded  to  cover  the  affected  districts  and  is presently  implemented  in  163  districts  of  19  States/UTs.  The  list  of  Districts  under  the Programme is at Annexure- I.

(ii) Under NHM,financial assistance is provided at the District level for establishment of diagnostic facilities in the district, training (medical and paramedical workers), manpower support,  health  education,  management  of  Fluorosis  cases  including  supplementation, surgery and rehabilitation.

(iii) Capacity building for prevention, diagnosis and management of Fluorosis cases in the NPPCF implemented districts.

(iv) Comprehensive  management  of  Fluorosis  cases  including  supplementation  with Vitamins, surgery and rehabilitation in the implemented districts under NPPCF Programme is done by concerned District authorities.

(v) Health Education and Publicity is carried out to create awareness about Fluorosis and its prevention in the affected districts.

Further,  since  August  2019,to  make  provision  of  potable  tap  water  supply  in  adequate quantity, of prescribed quality and on regular and long-term basis to every rural household by 2024,  Ministry of Jal Shakti in partnership with States, is implementing Jal Jeevan Mission HarGhar Jal.  Under this, while allocating the funds to States/UTs, 10% weightage is given to the population residing in habitations affected by chemical contaminants including Fluoride. Also, States/UTs have been advised to install community water purification plants especially in Arsenic and Fluoride affected habitations to provide potable water to every household at the rate of 8-10 litre per capita per day to meet their drinking and cooking requirements.

Annexure-I States / Districts under National Programme for Prevention and Control of Fluorosis (NPPCF)

|   S.No. | State          |   Total districts in the State |   No. of districts under NPPCF | Districts under NPPCF                                                                                                                                                                                |
|---------|----------------|--------------------------------|--------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|       1 | Andhra Pradesh |                             13 |                              9 | Nellore, Guntur, Prakasam, Ananthapur, Kurnool, Krishna, Chittoor, Visakhapatnam Srikakulam                                                                                                          |
|       2 | Assam          |                             27 |                              7 | Nagaon, Kamrup, Karbi Anglong, Dhubri, Nalbari, Karimganj, Udalguri                                                                                                                                  |
|       3 | Bihar          |                             38 |                             11 | Nawada, Banka, Aurangabad, Bhagalpur, Gaya, Jammui, Nalanda, Shekhpura, Kaimur, Munger, Rohtas                                                                                                       |
|       4 | Chattisgarh    |                             27 |                              7 | Durg, now shifted to Balod , Kanker, Kondagaon, Korba, Mahasamund, Koriya and Raipur                                                                                                                 |
|       5 | Gujarat        |                             33 |                              4 | Jamnagar, Sabarkantha, Vadodara, Banaskantha,                                                                                                                                                        |
|       6 | Haryana        |                             21 |                              4 | Mehendragarh, Mewat, Jind and Rewari.                                                                                                                                                                |
|       7 | Jammu& Kashmir |                             22 |                              1 | Doda                                                                                                                                                                                                 |
|       8 | Jharkhand      |                             24 |                             13 | Palamu, Garhwa, Chatra, Hazaribagh, Ranchi, Pakur, Sahebgann, Ramgarh, Jamtara, Simdega, Dhanbad, Giriih, Godda                                                                                      |
|       9 | Karnataka      |                             30 |                             19 | Ballary, Mysore, Chikballalpur, Koppal, Davangere, Tumkur, Bagalkote, Bangaluru (Urban), Bangaluru (Rural), Bijapur, Raichur, Chitradurga,Gadag,Gulbarga, Hassan, Kolar, Mandya, Ramanagara, Shimoga |
|      10 | Kerala         |                             14 |                              2 | Palakkad, Alapuzha                                                                                                                                                                                   |
|      11 | Madhya Pd.     |                             51 |                             15 | Ujjain,Chindwada, Mandla, Dhar, Seoni, Betul, Jhabua, Raigarh, Sehore, Alirajpur,Dindori, Khargoan, Raisen, Shajapur, Ratlam                                                                         |

|   12 | Maharashtra   |   34 |   7 | Nanded, Chandrapur, Latur, Washim, Yavatmal. Beed, Nagpur                                                                                                                                                                                                                                |
|------|---------------|------|-----|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|   13 | Odisha        |   30 |   3 | Nayagarh, Angul, Nuapada                                                                                                                                                                                                                                                                 |
|   14 | Punjab        |   22 |   5 | Sangrur, Firozepur, Patiala, Fatehgarh Sahib and Fazilka.                                                                                                                                                                                                                                |
|   15 | Rajasthan     |   33 |  30 | Nagaur, Ajmer, Bhilwara,Churu (Ratangarh) Dausa, Dungarpur, Rajsamand, Tonk, Bikaner, Jalore, Jaisalmer, Jodhpur, Jaipur, Pali, Sikar Udaipur, Swaimadhopur, Banswara, Karauli, Chittaurgarh, Ganganagar, Jhalawar, Jhunjhunu, Barmer, Alwar, Bharatpur, Kota, Sirohi, Bundi, Pratapgarh |
|   16 | Tamil Nadu    |   31 |   1 | Dharmapuri                                                                                                                                                                                                                                                                               |
|   17 | Telangana     |   30 |   9 | Mehboobnagar, Nalgonda, Karimnagar, Jagityal, Sircilla,Suryapet, Yadagiri, Wernaparthy, Nagarkurnool                                                                                                                                                                                     |
|   18 | Uttar Pradesh |   75 |  10 | Unnao, Rae Bareli, Pratapgarh, Firozabad, Mathura, Sonbhadhra, Ghazipur, Jhansi, Varanasi, Agra                                                                                                                                                                                          |
|   19 | West Bengal   |   19 |   6 | Bankura, Purlia, Birbhum, Dakshin- Dinajpur, Malda, Uttar- Dinajpur                                                                                                                                                                                                                      |