Arsenic (As) contamination in groundwater is emerging as a significant global concern, posing serious risks to the safety of drinking water and public health. To understand the release mechanisms, mobilization processes, spatial distribution, and probabilistic health risks of As in western Bangladesh, forty-seven samples were collected and analyzed using an atomic absorption spectrometer (AAS). The As concentrations in groundwater ranged from 1.97 to 697.4 μg L⁻1 (mean: 229.9), significantly exceeding recommended levels. The dominant hydrochemistry of As-enriched groundwater was Ca–Mg–HCO₃, with the primary sources of arsenic in groundwater being the dissolution of arsenic-bearing minerals in sediment and the recharge of aquifers from the Ganges River Basin. The assessment using the Entropy Water Quality Index revealed that the groundwater is unsuitable for drinking, with 89.36% (n = 42) of the samples surpassing the WHO's limit for arsenic. Rock-water interactions, including calcite dissolution and silicate weathering within the confined aquifer, predominantly influenced hydrochemical properties. The significant relationships among Fe, Mn, and As indicate that the reductive dissolution of FeOOH and/or MnOOH considerably contributes to the release of As from sediment into groundwater. Geochemical modeling analysis revealed that siderite and rhodochrosite precipitate into aquifer solids, suggesting a weak to moderate relationship among As, Fe, and Mn. The long residence time of groundwater, combined with the presence of a clayey aquitard, likely controls the mobilization of arsenic in the aquifer. For the first time, Monte Carlo simulations have been used in arsenic-prone areas to assess the severity of arsenic contamination in western Bangladesh. The analysis indicates that out of 100,000 people, 10 may develop cancer as a result of drinking arsenic-contaminated water, with children being more susceptible than adults.
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