Lok Sabha Question No. 3343 (UNSTARRED), answered on 2016-08-05
Subject: Flouride in Water
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KIRRON KHER

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

## LOK SABHA UNSTARRED  QUESTION NO. 3343 TO BE ANSWERED ON 5 TH AUGUST, 2016

## FLOURIDE IN WATER

## 3343. SHRIMATI KIRRON KHER: SHRI NANDI YELLAIAH:

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

- (a) whether many districts are heavily affected with extreme fluoride in water causing fluorosis, if so, the details thereof, State/UT - wise including Telangana and Chandigarh;
- (b)  the number  of  persons  affected  by fluorosis,  including  the  children  suffer  from dental, skeletal and non - skeletal fluorosis in the country, State/UT - wise;
- (c) whether the Government implements a National Programme for Prevention and Control of Fluorosis;
- (d)if so, the details thereof and the funds allocated/released/utilised during the last three years, State/UT - wise; and
- (e) the steps taken by the Government to save the people from contaminated drinking water and from such diseases?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a): Several  districts  in  the  country  have  Fluoride  in  excess  of  the  permissible  l drinking  water,  leading  to  condition  known  as  Fluorosis (Dental,  Skeletal  an d  Non- Skeletal Fluorosis).  As per Integrated Management Information System (IMIS) of Ministry of Drinking Water and Sanitation as on date, there are about 13,907 habitations in various States w Fluoride content in the drinking water.  About 114.6 lakh persons living in these areas are at risk of Fluorosis . The details of such habitations and persons living in these areas, State/UT -wise including Telangana and Chandigarh are at Annexure - I.
- (b): As  per  school  and  community  surveys  conducted  by  the States  under  National Programme for Prevention and Control of Fluorosis (NPPCF), approximately 2.46 lakh persons including  the  children  are  suspected  to  be  affected  by  Fluorosis.    State - wise  details  are  at Annexure - II.

(c) & (d) Yes. The Government of India initiated the National Programme for Prevention and Control of Fluorosis (NPPCF) in 2008 - 09  with an aim to prevent and control fluorosis in the country.  At present, the programme is under implementation in 116 districts of 19 States.

The  important  components  of  the  programme  are  surveillance  of  fluorosis  in  t community, capacity building in the form of training and manpower support, establishmen diagnostic facilities, health education and management of fluorosis cases including t reatment, surgery, rehabilitation.   Statement showing funds released/utilized from 2008 - 09 onwards, State -wise, under the programme is at Annexure - III.

(e): Ministry of  Drinking Water  and Sanitation has  informed all the States to commiss surface water based piped water supply schemes in all water quality affected habitatio long  term  sustainable  solution.    However,  since  these  projects  may  take  a  long gestation period(say 3 - 5 years) and the people cannot be put to risk of consuming contaminated water, States have been advised to install community water purification plants, especially in ar fluoride affected habitations, as a short term imm ediate measure for providing 8 - 10 lpcd(litre per capita  per  day)  of  safe  water  for  drinking  and  cooking  purpose  only.      Niti  Ayog  ha provided funds to the tune of Rs.800.00 Crores during financial year 2015 -16 for commissioning community water purifi cation plants in all remaining arsenic and fluoride affected habitati short terms immediate measures.

Efforts are also made to spread awareness regarding problems due to water contaminat such as Fluoride through mass media as well as local media in affected areas.

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| Format C17 A- No Of Quality Affected Habitations   | Format C17 A- No Of Quality Affected Habitations   | Format C17 A- No Of Quality Affected Habitations   | Format C17 A- No Of Quality Affected Habitations   | Format C17 A- No Of Quality Affected Habitations   | Format C17 A- No Of Quality Affected Habitations   |
|----------------------------------------------------|----------------------------------------------------|----------------------------------------------------|----------------------------------------------------|----------------------------------------------------|----------------------------------------------------|
| S.No.                                              | State                                              | Total                                              | Total                                              |                                                    |                                                    |
|                                                    |                                                    | Habitations                                        | Population                                         | Habitations                                        | Population                                         |
| 1                                                  | ANDAMAN and NICOBAR                                | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 2                                                  | ANDHRA PRADESH                                     | 571                                                | 440600                                             | 491                                                | 344134                                             |
| 3                                                  | ARUNACHAL PRADESH                                  | 57                                                 | 13872                                              | 0                                                  | 0                                                  |
| 4                                                  | ASSAM                                              | 8840                                               | 3365518                                            | 155                                                | 69520                                              |
| 5                                                  | BIHAR                                              | 5574                                               | 5277801                                            | 1087                                               | 1356585                                            |
| 6                                                  | CHANDIGARH                                         | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 7                                                  | CHATTISGARH                                        | 1148                                               | 364649                                             | 75                                                 | 27669                                              |
| 8                                                  | DADRA& NAGAR HAVELI                                | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 9                                                  | DAMAN&DIU                                          | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 10                                                 | GOA                                                | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 11                                                 | GUJARAT                                            | 17                                                 | 24347                                              | 11                                                 | 20086                                              |
| 12                                                 | HARYANA                                            | 209                                                | 525604                                             | 200                                                | 505875                                             |
| 13                                                 | HIMACHAL PRADESH                                   | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 14                                                 | JAMMU AND KASHMIR                                  | 5                                                  | 2336                                               | 0                                                  | 0                                                  |
| 15                                                 | JHARKHAND                                          | 6834                                               | 2261672                                            | 998                                                | 519604                                             |
| 16                                                 | KARNATAKA                                          | 2136                                               | 1522187                                            | 1065                                               | 628397                                             |
| 17                                                 | KERALA                                             | 656                                                | 1497936                                            | 73                                                 | 210067                                             |
| 18                                                 | LAKSHADWEEP                                        | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 19                                                 | MADHYA PRADESH                                     | 193                                                | 72111                                              | 148                                                | 52751                                              |
| 20                                                 | MAHARASHTRA                                        | 394                                                | 823019                                             | 100                                                | 221161                                             |
| 21                                                 | MANIPUR                                            | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 22                                                 | MEGHALAYA                                          | 10                                                 | 7621                                               | 0                                                  | 0                                                  |
| 23                                                 | MIZORAM                                            | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 24                                                 | NAGALAND                                           | 43                                                 | 21597                                              | 0                                                  | 0                                                  |
| 25                                                 | ODISHA                                             | 2799                                               | 836031                                             | 70                                                 | 27325                                              |
| 26                                                 | PUDUCHERRY                                         | 0                                                  | 0                                                  | 0                                                  | 0                                                  |
| 27                                                 | PUNJAB                                             | 3770                                               | 4420716                                            | 285                                                | 339117                                             |
| 28                                                 | RAJASTHAN                                          | 20895                                              | 8618557                                            | 6855                                               | 4773509                                            |
| 29                                                 | SIKKIM                                             | 0                                                  |                                                    | 0                                                  | 0                                                  |
| 30                                                 |                                                    | 351                                                | 0 167926                                           | 0                                                  | 0                                                  |
| 31                                                 | TAMIL NADU TELANGANA                               | 1484                                               | 2175382                                            | 1041                                               | 1420415                                            |
| 32                                                 | TRIPURA                                            | 4019                                               | 1739987                                            | 0                                                  | 0                                                  |
| 33                                                 | UTTAR PRADESH                                      | 361                                                | 523745                                             | 200                                                | 328219                                             |
| 34                                                 | UTTARAKHAND                                        | 18                                                 | 89951                                              | 0                                                  | 0                                                  |
| 35                                                 | WEST BENGAL                                        | 10004                                              | 8174134                                            | 1053                                               | 618002                                             |
|                                                    | Total                                              | 70388                                              | 42967299                                           | 13907                                              | 11462436                                           |

## State wise details of Fluorosis cases as per information received from States

| S.No.   | State              | No. of districts under NPPCF #   | No. of Fluorosis cases (Suspected cases)   | No. of Fluorosis cases (Suspected cases)   |         |
|---------|--------------------|----------------------------------|--------------------------------------------|--------------------------------------------|---------|
|         |                    |                                  | Dental                                     | Skeletal                                   | Total   |
| 1.      | West Bengal        | 5                                | 13483                                      | 433                                        | 13916   |
| 2.      | Uttar Pradesh      | 5                                | -                                          | -                                          | 34541 * |
| 3.      | Jharkhand          | 4                                | 836                                        | 270                                        | 1106    |
| 4.      | Rajasthan          | 25                               | 20976                                      | 558                                        | 21534   |
| 5.      | Andhra Pradesh     | 3                                | 6607                                       | 171                                        | 6778    |
| 6.      | Telangana          | 3                                | 31324                                      | 2397                                       | 33721   |
| 7.      | Bihar              | 10                               | 13455                                      | 3079                                       | 21598   |
| 8.      | Gujarat            | 4                                | 2460                                       | -                                          | 2460    |
| 9.      | Odisha             | 3                                | 2848                                       | 1762                                       | 4610    |
| 10.     | Madhya Pradesh     | 14                               | 43574                                      | 96                                         | 43670   |
| 11.     | Karnataka          | 18                               | 8095                                       | 728                                        | 8823    |
| 12.     | Assam **           | 4                                | 6047                                       | 480                                        | 6527    |
| 13.     | Chhattisgarh **    | 4                                | 1449                                       | 05                                         | 1454    |
| 14      | Haryana **         | 2                                | 3852                                       | 55                                         | 3907    |
| 15.     | Kerala **          | 2                                | 9637                                       | 1                                          | 9638    |
| 16.     | Maharashtra **     | 6                                | 8983                                       | 1577                                       | 10560   |
| 17.     | Punjab **          | 2                                | 11501                                      | 58                                         | 11559   |
| 18.     | Tamilnadu **       | 1                                | 35591                                      | 13834                                      | 49425   |
| 19.     | Jammu & Kashmir ** | 1                                | -                                          | -                                          | -       |
|         | TOTAL              | 116                              | 220718                                     | 25504                                      | 246222  |

## Statement showing the Fund released and Expenditure under NPPCF

## Annexure-III

| Name of the State   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Fund released (Rs. in lakh)   | Total Released   | Total Expenditure   |
|---------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|-------------------------------|------------------|---------------------|
| Name of the State   | 2008-09                       | 2009-10                       | 2010-11                       | 2011-12                       | 2012-13                       | 2013-14                       | 2014-15                       | 2015-16                       | Total Released   | Total Expenditure   |
| 1.Andhra Pradesh.   | 31.66                         | 0.00                          | 42.10                         | 42.10                         | 0.00                          | 0.00                          | 16.30                         | 0.00                          | 132.16           | 63.00               |
| 2. Telangana*       | 0.00                          | 25*                           | 42.10*                        | 65.02*                        | 0.00                          | 0.00                          | 14.80                         | 0.00                          | 14.80            | #108.76             |
| 3.Assam             | 0.00                          | 25.00                         | 84.20                         | 0.00                          | 0.00                          | 9.97                          | 18.78                         | 92.32                         | 230.27           | 230.27              |
| 4.Bihar             | 0.00                          | 25.00                         | 294.70                        | 84.20                         | 0.00                          | 0.00                          | 0.00                          | 3.66                          | 407.56           | 37.90               |
| 5.Chhattisgarh      | 0.00                          | 25.00                         | 0.00                          | 0.00                          | 0.00                          | 29.50                         | 0.00                          | 0.00                          | 54.50            | 17.65               |
| 6.Gujarat           | 31.66                         | 0.00                          | 42.10                         | 0.00                          | 0.00                          | 37.30                         | 15.00                         | 119.56                        | 245.62           | 152.84              |
| 7.Haryana           | 0.00                          | 0.00                          | 84.20                         | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 84.20            | 44.03               |
| 8.Jharkhand         | 0.00                          | 25.00                         | 84.20                         | 42.10                         | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 151.30           | 37.82               |
| 9.Karnataka         | 0.00                          | 50.00                         | 168.40                        | 505.20                        | 0.00                          | 3.82                          | 32.24                         | 0.00                          | 759.66           | 450.00              |
| 10.Kerala           | 0.00                          | 25.00                         | 0.00                          | 42.10                         | 0.00                          | 1.26                          | 14.57                         | 0.00                          | 82.93            | 54.33               |
| 11.Madhya Pd.       | 31.66                         | 0.00                          | 168.40                        | 25.88                         | 378.90                        | 0.00                          | 0.00                          | 280.00                        | 884.84           | 361.44              |
| 12.Maharashtra      | 0.00                          | 50.00                         | 126.30                        | 42.10                         | 0.00                          | 0.00                          | 32.86                         | 0.00                          | 251.26           | 64.26               |
| 13. Odisha          | 31.66                         | 0.00                          | 84.20                         | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 115.86           | 27.13               |
| 14.Punjab           | 0.00                          | 25.00                         | 42.10                         | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 67.10            | 39.24               |
| 15. Rajasthan       | 31.66                         | 0.00                          | 210.50                        | 421.00                        | 0.00                          | 60.40                         | 75.00                         | 460.00                        | 1258.56          | 1113.02             |
| 16. Tamilnadu       | 31.66                         | 0.00                          | 0.00                          | 9.30                          | 0.00                          | 17.93                         | 0.00                          | 0.00                          | 58.89            | 58.63               |
| 17. Uttar Pradesh   | 0.00                          | 50.00                         | 84.20                         | 42.10                         | 0.00                          | 0.00                          | 18.81                         | 0.00                          | 195.11           | 124.04              |
| 18. West Bengal     | 0.00                          | 25.00                         | 126.30                        | 42.10                         | 28.00                         | 0.00                          | 0.00                          | 92.00                         | 313.40           | 275.12              |
| 19. Jammu & Kashmir | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 0.00                          | 22.50                         | 0.00                          | 0.00                          | 22.50            | 0.00                |

* Though Telangana State was not in existence from 2009-10 to 2012-13 , funds were released to District Nalgonda of the then Andhra Pradesh and now this district is in Telangana.

#The total expenditure of Rs.108.76 lakh is out of the releases made to the different districts, which are presently in Telengana, but were earlier in Andhra Pradesh.