Fish represent a significant source of nutrients but also cause negative health effects due to their bioaccumulation capacity for pollutants. The aim of this study was to examine the transfer of metals from the water of several rivers (Somes, Tisa, Sasar, Lapus, Lăpusel) to fish (Caras sp) tissue (subcutaneous fat, muscles, liver, intestines, kidneys, gills, brain, and eyes) and to identify and assess the carcinogenic and non-carcinogenic health risks of Arsenic (As), Cadmium (Cd), Nickel (Ni), Manganese (Mn), Cooper (Cu), Lead (Pb), Chromium (Cr) and Zinc (Zn) through the ingestion of fish (muscles and subcutaneous fat tissues). The obtained results indicated that a diet consisting of fish is particularly vulnerable, particularly in children compared to adults. The risk assessment results were below the threshold limit, although the fish samples contained heavy metals, with values exceeding the permitted limits of Fe (4.41–1604 mg/kg), Cr (727–4155 µg/kg), Zn (4.72–147 mg/kg), and Ni (333–2194 µg/kg). The studied surface waters are characterized by low and high degrees of pollution with heavy metals, as indicated by the heavy metal pollution index scores (HPI: 12.4–86.4) and the heavy metal evaluation index scores (HEI: 1.06–17.6). The considerable pollution levels are attributed to the high Mn content (0.61–49.7 µg/kg), which exceeded the limit up to fifty times. A consistent set of physico-chemical analysis (pH, electrical conductivity, total hardness, turbidity, chloride, sulphate, nitrate, nitrite, ammonium, Ca, Mg, Na, K) was analysed in water samples as well. Considering the water quality index scores (WQI: 16.0–25.2), the surface waters exhibited good quality. Microbiological results indicated the presence of Listeria monocytogenes and atypical colonies of coagulase-positive staphylococcus in fish. In contrast, the surface waters from which fish samples were collected were positive for Escherichia coli, and coliform bacteria intestinal Enterococci. Based on the study’s results, it is recommended to exercise caution in the case of children related to the consumption of fish and using the waters for drinking purposes. This study provides important data of considerable novelty to the riparian population, researchers, and even policy makers on the quality status and potential levels of contamination of river waters, fish and the bioaccumulation of heavy metals in fish that may cause adverse effects on human health if consumed, and similarly the heavy metal pollution degree of waters and the non-carcinogenic risk of heavy metals through ingestion and skin absorption of water in children and adults (the study area is a significant source of fisheries).
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