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Hydrogeochemical controlling variables for the high rate of groundwater contamination in a shallow hard rock aquifer of the semi-arid region of Medchal District, Telangana State, South India, and its associated health risk to children and adults were studied in detail. A total of 56 groundwater samples were analysed for major ion chemistry in pre- and post-monsoon seasons in 2019 year. Spatial distribution, hydrochemical facies, water–rock interaction, health risk assessment, carcinogenic risk, and principal component analyses were carried out to assess the water quality. Spatial distribution of nitrate and fluoride concentrations, high values were observed in the northern, southern, central, and south-western parts of the region. In terms of NO 3  − , about 88% and 63% and for F −  45% and 32% of the groundwater samples are non-acceptable limits of nitrate 45 mg/l and fluoride 1.5 mg/l during pre- and post-monsoon seasons, respectively. Modified Gibb’s plot showed the majority of the area is dominated by rock dominance and evaporation mechanisms. Statistical analysis reveals that water chemistry is governed by weathering of feldspar minerals and the cation exchange reaction mechanism. The petro-graphical studies revealed the dominance of plagioclase, orthoclase, quartz, biotite, apatite, and hornblende minerals in the host rock. The factor analysis results reveal that the geogenic and anthropogenic activities contribute to groundwater chemistry. Health risk assessment was carried out by calculating the hazard quotient (HQ) on the basis of intake exposure of groundwater, as per the USEPA. Results were obtained for total hazard index value greater than 1 for adults and children, which causes non-cancerous health effects.

Health risk assessment of nitrate and fluoride toxicity in groundwater contamination in the semi-arid area of Medchal, South India