Quality Risk Assessment Research Articles

A questionnaire study evaluating the completion and content of unlicensed medicines risk assessments in NHS Trusts

Abstract Introduction Unlicensed medicine (ULM) use is necessary and prevalent within the NHS. Compared to licensed medicines, there are no centralised assessments of safety, efficacy, and quality. The risks associated with using unlicensed medicines have been well documented: increased risk of adverse events, potentially poorer quality formulation and absence of regulated manufacturing and supply standards1. Therefore, there is a requirement for NHS organisations to risk assess the need and quality of unlicensed medicines to reduce harm2. There are currently minimal published data on whether NHS trusts complete these risk assessments and whether practice is standardised3. This study focuses on understanding how NHS trusts in England conduct Unlicensed Medicine Risk Assessments (ULMRA). Aim To determine whether there is variability in the completion, content, and volume of unlicensed medicines risk assessments for unlicensed medicines procured within NHS trusts. Methods An online and anonymous questionnaire was developed and distributed to procurement pharmacy professionals. The questionnaire assessed four key areas: quantity of ULMRA conducted; completion and content of ULMRA; completion of clinical ULMRA; and risk management and mitigation strategies for ULM. To increase response rates, potential respondents were contacted via regional procurement groups as well as the NHS Chief Pharmacist network. Approval for this study was granted by the NHS Health and Research Authority and the University of Reading Ethics Committee. Results Content validity was ensured by a panel of six secondary care pharmacy professionals, achieving a content validity index (CVI) of greater than 0.8 for each question. Thirty-seven responses were received, representing a 20% response rate. Most respondents (48.6%) were pharmacists, followed by pharmacy technicians (45.9%). The questionnaire revealed that 73% of respondents conducted quality and clinical risk assessments for all ULMs before use, and 94.4% had a ULM policy or procedure. Most respondents procured 1-3 ULMs per month, with some conducting over 12 ULMRA monthly. 97% specified procuring imported products licensed in the country of origin and 'Specials' from UK manufacturers, and 57% indicated they procure imported medicines not licensed in the country of origin. 68% of respondents indicated that quality checks were not completed upon receipt of ULMs. Discussion The study highlighted significant variation and duplication in the ULMRA processes across NHS trusts. Variations were identified in the content of ULMRA, professionals completing risk assessments and the volume of unlicensed medicines procured. While most trusts performed quality and clinical risk assessments, inconsistencies in practices and ULMRA content were evident. Standard methodologies for ULMRA and collaborative data sharing could improve reliability and efficiency, reducing patient risk and resource duplication. A limitation of this study is that the low response rate limits generalisability of data. Conclusion This study identified areas of variation within the NHS around the content and quantity of ULMRA completed, as well as some areas of duplication, particularly in the medicines risk assessed. Future research should explore the reasons for variation identified and evaluate the acceptability of current risks. Addressing these variations could lead to improved patient safety and optimised use of NHS resources.

Microbial Dynamics and Quality Monitoring in Biopharmaceutical Production

AbstractProkaryotic cells are pivotal in meeting the global demand for biopharmaceuticals. However, challenges such as the absence of advanced technology for real‐time monitoring, standardized testing methodologies, and quality risk assessment of microbial activity have led to increased production costs, delays, and shortages of biopharmaceutical products. A thorough understanding of how biomolecule production interacts with microbial population structure and function is vital for improving continuous manufacturing and process automation. In this review, we discuss the current microbiological techniques that meet good manufacturing practice requirements in industrial settings, explore the advantages of monitoring and measuring biomass growth efficiency and turnover rates beyond regulatory criteria for product release, and provide a critical assessment of the current state of knowledge on bioassays and engineering tools for biomolecule yield measurement and monitoring. Furthermore, we identify areas for future development, potential applications, and the need for interdisciplinary innovation to drive future research, including advancing bioassays for biopharmaceutical wastewater risk.

A comparative study concerning the sensory, physicochemical, bacteriological, nutritional quality, heavy metal content, and health risk assessment of some low-cost fish species

Investigating fish quality, nutritional content, and health risk assessment for heavy metals can provide important guidance on eating seafood and protecting human health. Accordingly, the current research aimed to assess the quality and safety of some extensively consumed fish and recognize more types of fish widely available in Egypt with reasonable costs, high nutritional values, good quality, and safe for human consumption. To achieve this goal, 100 fresh fish samples including red porgy, sardine, eel fish, grass carp, and common carp (20 from each) were taken from local fish markets in Giza and examined for chemical composition, bacteriological quality, deterioration criteria, sensory attributes, heavy metal contents, and health risk assessment. Among the examined fish, red porgy exhibited significantly higher protein and sensory scores along with significantly lower fat, bacterial count, pH, total volatile base nitrogen, and trimethylamine values in contrast to carp fish. Nevertheless, sardine and eel fish obtained the highest values of thiobarbituric acid, free fatty acid, and acid number versus red porgy. Surprisingly, the concentrations of lead in grass carp fish, mercury in all examined samples, as well as arsenic in common carp fish, were lower than the detectable limits. Despite the target hazard quotient and hazard index of all examined heavy metals being below 1 in all fish samples, it could not be confirmed that eating such fish causes acceptable non-carcinogenic health risks due to exposure from fish consumption does not account for the total daily exposure to the heavy metal from all dietary sources. Moreover, the carcinogenic risk of all examined heavy metals in fish samples was higher than 10-6 indicating a high risk of carcinogenicity which needs great efforts to be reduced to the safe limits. In conclusion, the current study provides beneficial data to Egyptian society for choosing seafood with high nutritional value, good quality, and affordable prices.

Evaluation of groundwater quality and health risk assessment in Dawen River Basin, North China

Evaluation of groundwater quality and health risk assessment in Dawen River Basin, North China

CYP2C19 Genetic Variants and Major Depressive Disorder: A Systematic Review

Major depressive disorder (MDD) affects over 300 million people globally and has a multifactorial etiology. The CYP2C19 enzyme, involved in metabolizing certain antidepressants, can influence treatment response. Following the PRISMA protocol and PECOS strategy, this systematic review assessed the variation in common CYP2C19 gene variants’ frequencies across populations with MDD, evaluating their impact on clinical characteristics and treatment response. We comprehensively searched five databases, identifying 240 articles, of which only nine within the last decade met our inclusion criteria. Except for one study that achieved 74.28% of STROPS items, the rest met at least 75% of GRIPS and STROPS guidelines for quality and bias risk assessment. The CYP2C19’s *1 allele, the *1/*1 genotype, and the NM phenotype, considered as references, were generally more frequent. Other CYP2C19 polymorphism frequencies exhibit significant variability across different populations. Some studies associated variants with MDD development, a more extended history of depression, prolonged depressive episodes, and symptom severity, while others reported no such association. Some studies confirmed variants’ effects on escitalopram and citalopram metabolism but not that of other drugs, such as sertraline, venlafaxine, and bupropion. Treatment tolerability and symptom improvement also varied between studies. Despite some common findings, inconsistencies highlight the need for further research to clarify the role of these polymorphisms in MDD and optimize treatment strategies.

An Innovative GIS-Based Policy Approach to Stream Water Quality and Ecological Risk Assessment in Mediterranean Regions: The Case of Crete, Greece

Due to the multiple pressures from human activities, many freshwater ecosystems are facing degradation. To address this issue, a new approach for assessing stream water quality and ecological (WQE) risk using a multi-criteria analysis through a GIS-based policy tool has been developed. The suggested methodology integrates eight different factors along the contaminant pathway from source to streams, including: (a) rainfall variability, (b) soil texture, (c) soil erodibility, (d) slope, (e) river buffer zone, (f) point source contamination buffer zone, (g) non-point source contamination of NO3, and (h) non-point source contamination of PO4. Utilizing fuzzy GIS tools, the above factors and their related maps were spatially overlaid (raster-based suitability for raster reclassification) to obtain the final stream WQE risk map. The final map depicts the spatial distribution of streams concerning their water quality risk and is represented by two classes of WQE risk. The first class is characterized as “appropriate”, in which there is no need for any further actions, while the other one is characterized as “non-appropriate”, indicating that actions should be taken to ensure the sustainability of streams’ water quality. The proposed approach was implemented for the island of Crete, which is located in the Southeast Mediterranean region. The developed methodology was validated using the Hellenic evaluation system (HESY2), an especially established and adapted to the Mediterranean river systems ecological quality metric method, obtained by in situ measurements that were conducted during different monitoring programs (1989–2015). Moreover, this study summarizes appropriate measures and practices that ensure the sustainable management of Mediterranean river basins. These practices can be adopted by local authorities, owners of polluting units, and farmers/breeders to improve the resiliency of streams’ water quality issues in the Mediterranean region.

Water Quality Analysis and Risk Assessment of Potential Toxic Elements in Selected Surface Water Around Mining Sites in Abuakwa South Municipal, Ghana

ABSTRACTSurface water quality at Abuakwa South Municipal has received threats from surrounding mining communities, which are becoming a major concern to the public. As a result, this study aimed to assess water quality by examining the concentration of lead (Pb), cadmium (Cd), and zinc (Zn) pollution in surface water. Fifteen samples were obtained from surface water using a 1.5 L plastic bottle. The mean concentrations of Pb and Cd were above WHO guidelines of 0.01 and 0.003 mg/l, respectively, except for Zn which was below the stipulated limit of 3.0 mg/l. The geochemical process model shows that Cd, Pb, and Zn are adsorbing (released from the drainage to the surrounding environment) in sites 1 and 3 whereas Pb is desorbing (added to the drainage) in site 2. A hazard quotient greater than 1 was recorded for Cd in adults through the ingestion route of exposure at all the sites. Cancer risk also shows that the inhabitants are at risk through the ingestion route of exposure. The findings of this study suggest intake of water draining within the vicinity is unsafe and poses severe health risks.

A holistic water quality risk assessment and key parameter identification approach coupling comparative water quality index (WQI) models: a six-year monitoring study in Danjiangkou Reservoir, China

A holistic water quality risk assessment and key parameter identification approach coupling comparative water quality index (WQI) models: a six-year monitoring study in Danjiangkou Reservoir, China

Groundwater Quality and Potential Health Risk Assessment for Potable Use

The Ramganga River basin, comprising three rivers, the Dhela, Dhandi, and Ramganga, plays a vital role in groundwater recharge, sustaining numerous industries, urban areas, and rural communities reliant on these rivers for daily activities. The study’s primary purpose was to analyze the groundwater quality in the context of potability, irrigation, and health risks to the local inhabitants of the Ramganga River basin. In 2021–2022, 52 samples (26 × 2) were collected from 13 locations in two different seasons, i.e., pre-monsoon and post-monsoon, and 20 physico-chemical and heavy metal and metalloids were analyzed using the standard protocols. The result shows that heavy metal and metalloids and metalloid concentrations of Zn (0.309–1.787 and 0.613–1.633); Fe (0.290–0.965 and 0.253–1.720), Cd (0.001–0.002 and 0.001–0.002); As (0.001–0.002 and 0.001–0.002), Cr (0.009–0.027 and 0.011–0.029), and Pb (−0.001–0.010 and 0.00–0.010) values in mg/L are present in both seasons. The groundwater quality index (GWQI), heavy metal pollution Index (HPI), and heavy metal evaluation index (HEI) were used to assess the water quality and metal pollution in the basin area. As per GWQI values, water quality lies from excellent water quality (41.639 and 43.091) to good water quality (56.326 and 53.902); as per HPI values, it shows good (29.51 and 30.03) to poor quality (60.26 and 59.75) and HEI values show the low-level contamination (1.03–2.57 and 1.13–3.37) of heavy metal and metalloids in both seasons. According to the potential health risk assessment, infants show low risk in pre-monsoon and low risk to medium post-monsoon, while children and adults show low risk to high risk in both seasons. From the health risk perspective, it shows that children and adults have more concerns about non-carcinogenic effects, so adequate remedial measures and treatment are required to avoid the groundwater quality of the Ramganga River basin.

Impact of Landfill Leachate on Groundwater Quality and Health Risk Assessment in Mohammedia Prefecture, Morocco

Several studies have been conducted to identify the potential impact of landfills on groundwater resources. This study evaluates the impact of landfills on groundwater resources in Mohammedia prefecture, Morocco. The groundwater was analysed from 2015 to 2022. The groundwater quality was evaluated based on electrical conductivity, pH, biological oxygen demand, chemical oxygen demand, total Kjeldahl nitrogen, phosphate, suspended solids, dissolved oxygen, ammonia, and total hydrocarbon, aluminium, iron, cadmium, chromium, copper, iron-nickel, zing, and mercury. The assessment was based on the water quality index, leachate pollution index, non-carcinogenic risk assessment, and carcinogenic risk assessment. A leachate pollution index <5 indicates that it poses a severe risk to groundwater resources. The non-carcinogenic risk HQ was determined to be <1, which infers no potential risk. The carcinogenic risk index value of 10-4 indicated that it is within the threshold of acceptable limit. The current study concludes that leachate from the analysed landfills does not infiltrate the groundwater resources of Mohammedia prefecture. However, the leachate pollution, even though it varies, is increasing over time. This is validated by the fact that the landfill is protected with a membrane covering the ground, which inhibits any possible infiltration of soil or water resources. Hence, this study calls for continuous monitoring of groundwater resources in the region. Future studies are required to investigate the groundwater in Mohammedia prefecture in terms of emerging pollutants to identify any potential risk.

Purification Resistance Index: A new water quality assessment method toward drinking water production

Water quality assessment plays a significant role in ensuring the availability of clean and safe water. The Water Quality Index (WQI) model method has been developed to provide a basis for assessing water quality by integrating various water quality parameters. However, existing WQIs do not “actively” consider the difficulty of water treatment from raw water to specific water use scenarios. This study proposes a novel model framework, named as Purification Resistance Index (PRI), quantitatively evaluating not only the exceedance of pollutants but also how difficult they can be removed in the water treatment process. The framework is built based on the conventional drinking water treatment processes, with sub-indices for coagulation-sedimentation (rc), filtration (rf), disinfection (rd), and advanced treatment (ra). The model considers appropriate weights assigned to each sub-index to calculate the purification resistance, resulting in a comprehensive index for water quality evaluation. Case studies on nationwide and citywide water source reservoirs demonstrated the applicability of PRI approach. PRI breakthrough the traditional water quality risk assessment paradigm and extents to engineering region and provide useful tools for water source supervision, drinking water treatment plant planning and updating, operation control, and other purposes. Water authority, water utility and municipal design institute will all benefit. It is open for more localized practices validation and discussion.

Groundwater quality prediction and risk assessment in Kerala, India: A machine-learning approach

Despite its critical importance for health, agriculture, and the economy, and its key role in supporting climate change adaptation, groundwater quality remains vulnerable to contamination and is often neglected until significant deterioration. The groundwater resources of Kerala, one of the southernmost states of India, are under escalating stress and scarcity, despite a high well density with 62% of the population relying on groundwater from approximately 6.5 million open wells. This study investigates the detailed hydrogeochemistry and predicts groundwater quality zones of the state using machine-learning techniques viz, extreme gradient boosting (XGBoost), support vector regression (SVR), artificial neural network (ANN) and random forest (RF) regression. The hydrogeochemical analysis reveals varying groundwater quality across the state. Among the different machine learning models, RF shows higher goodness of fit (R2: 0.922) with minimal prediction error (root mean square error: 6.29 and mean absolute error: 3.12). The predicted groundwater quality was validated using the spatially distributed stiff diagrams, visually representing water composition trends of each well. The very good, good, moderate and poor groundwater quality zones occupy 31.7%, 40.4%, 20.4%, and 7.4% of the state aligning accurately with the groundwater quality scenario of the state. Additionally, groundwater drinking risk assessment was conducted, considering that 7.4% of the state experiences poor-quality groundwater. Integrating groundwater quality maps with population data, the study assessed potential health risks due to consuming untreated water. Nearly 0.59 million people across 252 local self-government bodies (LSGs) are susceptible to consuming poor quality groundwater, which may pose potential health risks. This observation provides valuable insights for sustainable groundwater management and public health safeguarding and the findings of the present study are useful for achieving sustainable development goal (SGD) 6 (clean water and sanitation) and long-term groundwater management in Kerala.

Hydrochemical insights, water quality, and human health risk assessment of groundwater in a coastal area of southeastern China.

Groundwater is a vital water supply worldwide, but its quality has gradually deteriorated with the development of society. In this study, a total of 40 groundwater samples were collected during the pre- and post-monsoon to analyze the hydrochemical process and assess the groundwater quality and human health risks in a coastal area of southeastern China. The results showed that the concentrations of major ions were in the order of Ca2+> Mg2+ > Na+ > K+ and HCO3- > SO42- > Cl- > NO3- > F- during the pre- and post-monsoon periods. A slight increase was observed during the post-monsoon period. The Piper diagram suggested that the hydrochemical type of groundwater was predominantly HCO3-Ca. Principal component analysis (PCA), ionic ratios, and saturation index (SI) determined that the water-rock interactions involving silicate and carbonate minerals played a significant role in the hydrochemical process. The results of the entropy-weighted water quality index (EWQI) and irrigation water quality index (IWQI) evaluations revealed that the general qualities of groundwater were suitable for both drinking and irrigation purposes. However, the excesses of NO3- and SO42- were observed locally. Human health risk assessment concluded that groundwater posed a low risk to human health, and infants faced higher risk compared with adults. The study would provide valuable information for groundwater environmental protection.

Wind speed super-resolution and validation: from ERA5 to CERRA via diffusion models

AbstractThe Copernicus Regional Reanalysis for Europe, CERRA, is a high-resolution regional reanalysis dataset for the European domain. In recent years, it has shown significant utility across various climate-related tasks, ranging from forecasting and climate change research to renewable energy prediction, resource management, air quality risk assessment, and the forecasting of rare events, among others. Unfortunately, the availability of CERRA is lagging 2 years behind the current date, due to constraints in acquiring the requisite external data and the intensive computational demands inherent in its generation. As a solution, this paper introduces a novel method using diffusion models to approximate CERRA downscaling in a data-driven manner, without additional informations. By leveraging the lower resolution ERA5 dataset, which provides boundary conditions for CERRA, we approach this as a super-resolution task. Focusing on wind speed around Italy, our model, trained on existing CERRA data, shows promising results, closely mirroring the original CERRA. Validation with in-situ observations further confirms the model’s accuracy in approximating ground measurements.

Assessment of groundwater quality, irrigation suitability, and health risks from radon and heavy metals near Ilokun dumpsite, Ado-Ekiti, Nigeria

ABSTRACT Concentrations of 222Rn and other toxic metals (Ni, Cu, Fe, Cd, Zn, Pb, Cr, and Mn) were measured by alpha spectrometry using Rad7 and atomic absorption spectrophotometry, respectively, in the water samples from the Ilokun dumpsite, Ado-Ekiti, Nigeria. The physicochemical parameters of the groundwater were also assayed to determine its suitability for drinking and irrigation purposes. While the physicochemical parameters met the World Health Organization (WHO)-safety standards, Cu, Fe, Cd, Pb, Cr, and Mn exceeded permissible limits. Hazard index (HI) values for adults (8.40) and children (39.23) indicated heightened susceptibility to non-carcinogenic health risks among both age group populations. The 222Rn concentrations present in the studied samples range from 5.4 to 23.1 Bq l−1 with an average of 13.9 Bq l−1. Approximately 60% of the samples have radon concentrations above the US Environmental Protection Agency (EPA)-maximum contaminant level of 11.1 Bq l−1. The evaluated radiation doses to the stomach and respiratory tract due to radon content in the water are well below the WHO-specified individual dose criterion of 0.1 mSv year−1. This study suggests a need for groundwater resource management strategies and measures to protect human health from radiological and toxicological risks associated with groundwater consumption around the Ilokun dumpsite.

Emergency airway management in the post anesthesia care unit.

Airway management is one of the most challenging aspects in the field of anesthesia. This is also the case when an emergency airway situation arises in the postoperative patient. These airway procedures are often classified as advanced with high complexity. This article aims to address emergency airway management in the post anesthesia care unit. The way in which care and supervision are organized in the post anesthesia care unit (PACU) varies between hospitals. Airway management in the PACU has typical challenges related to the team, the location itself, and assembling the necessary equipment for airway rescue. Crew resource management is an important aspect of care in these situations. This article focuses on emergency airway management in the post anesthesia-care unit. A questionnaire for risk assessment and improvement of quality of care is presented. Different types of emergencies are discussed, i.e., due to medication, medical conditions (e.g., obstructive sleep apnea, pulmonary problems, stridor), procedural related emergencies (e.g., neurosurgery, head and neck surgery) and cardiac arrest. Each specific cause of emergency needs a different approach. A PACU airway rescue flowchart is presented.

Assessment of groundwater quality and health risks in Ketama region (intrarif), Morocco

For many reasons, water from wells and natural springs is still widely used in Morocco. 90 groundwater samples were analyzed to assess the health risks associated with its quality in the Ketama region, including physicochemical analyses such as pH, electrical conductivity, total dissolved solids, bicarbonates, and nitrates using standardized methods, as well as bacteriological analyses covering total coliforms, fecal coliforms, Escherichia coli and fecal streptococci utilizing the membrane filtration method. Assessment of groundwater physicochemical quality showed that 13.41% of samples had nitrate concentrations exceeding the maximum value set by the World Health Organization (45 mg/ L). In comparison, 12.16% of samples were slightly acidic (pH < 6.5). Bacteriological analyses of the groundwater showed that the water points studied are contaminated with total coliforms, faecal coliforms, Escherichia coli, and faecal streptococci at rates of 80%, 50%, 35%, and 36%, respectively. In conclusion, groundwater in the Ketama region presented potential risks for users, particularly regarding waterborne diseases.

Gaseous air quality and health risk assessment of high school kitchens in the Kumasi Metropolis

Cooking is a major factor that affects the quality of indoor air especially in kitchens. It is a daily activity essential for supplying the requisite energy and nutrients for living through food consumption. Exposure to air pollutants from cooking with solid fuels in domestic and commercial kitchens is a leading health risk in developing nations like Ghana. Real-time monitoring of gaseous pollutants (CO, SO2, NO2) was done during eight hours of occupational cooking in different cookstove kitchens of 14 Senior High Schools in the Kumasi Metropolis, Ghana. The traditional and improved cookstove kitchens were fueled by firewood whereas the briquette cookstove kitchens were fueled by palm kernel shell briquette. The observed median concentrations in the kitchens were 0.43–39.44 mg m−3 for CO, 0.07–0.36 mg m−3 for NO2, and 0.19–0.61 mg m−3 for SO2. The concentrations in the traditional and briquette cookstove kitchens exceeded the respective World Health Organization (WHO) thresholds of 4 mg m−3 for CO, 0.025 mg m−3 for NO2, and 0.04 mg m−3 for SO2 mg m−3. The air quality index of traditional cookstove kitchens was classified as hazardous for human occupancy. Hazard indices > 1 revealed the likelihood of significant non-carcinogenic health risks for cooks’ occupational exposure to gaseous pollutants in all the cookstove kitchens. This study is essential as it informs on gaseous air quality during large-scale cooking within institutional kitchens with different cookstove types in a developing country. The study fills a gap in literature by providing real-time concentrations of gaseous air pollutants to which cooks in high school kitchens of a developing country are occupationally exposed. The study recommends the urgent transition of large-scale kitchens in developing countries to cleaner energies and cookstove types, alongside regular monitoring and enforcement of air quality guidelines, to safeguard occupational health.

Correction to: Risk assessment of river water quality using long-memory processes subject to divergence or Wasserstein uncertainty

Correction to: Risk assessment of river water quality using long-memory processes subject to divergence or Wasserstein uncertainty

Hydrogeochemical appraisal, sources, quality and potential health risk assessment in Holocene and Pleistocene aquifers in Bangladesh.

This study integrated hydrochemical analysis, isotopic analysis, the integrated water quality index (IWQI), and the health risk assessment model to analyze hydrochemical characteristics, quality, and nitrate health risks in a typical agricultural and industrial (i.e., Holocene and Pleistocene) simultaneously affected byanthropogenic activities, as well as to explore the recharge mechanisms of the groundwater. The shallow groundwater is mainly Ca-HCO3- and deep groundwater is mainly Na-HCO3- types. In shallow and intermediate aquifers (Holocene), rainfall recharge is seen, but in deep aquifers (Holocene) and the Madhupur tract (Pleistocene), there is no evidence of recent recharge from the stable isotopic (δ2H‰ and δ18O‰) composition of groundwater. Anthropogenic sources significantly impacted the groundwater chemistry of shallow and intermediate aquifers more than geogenic sources. Most metalloids, and metals (As, and Cr, Fe, Ni, Pb, and Mn) and NO3- exceed the WHO-2011 and BD acceptable limit from shallow and intermediate groundwater. PCA analysis revealed the contamination of shallow and intermediate aquifers by metalloids, metals and from various anthropogenic activities. Based on the IWQI, HPI, HEI, and DC, groundwater samples from shallow and intermediate aquifers are unsuitable for oral consumption. The NPI shows that the metalloids, and metals are responsible for groundwater pollution in a descending order of As > Fe > Pb > Ni > Cr > Mn. Health risk assessment indicates oral and dermal consumption of contaminated water from shallow and intermediate aquifers can pose carcinogenic and non-carcinogenic health risks for both the adults and the children. The HQ and HI values of shallow and intermediate groundwater indicates higher non-carcinogenic risk. Carcinogenic risk through oral and dermal consumption follows an order of As > Ni > Cr > Pb and Ni > Cr > As > Pb, respectively. Compared to adults, children are more susceptible to both carcinogenic and non-carcinogenic risks. Potential threats to the health of people living in the study region need immediate attention from the public, government, and the scientific community.