Heavy Metal Contamination in Drinking Water and Its Association with Health Risks among Peri-Urban Households in Peshawar

Abstract

Abstract

Background: Heavy metal contamination in drinking water is an under-recognized but serious public health issue in Pakistan. Peri-urban settlements of Peshawar largely depend on shallow tube wells and tanker water, both highly vulnerable to chemical pollutants. Chronic exposure to arsenic, lead, and chromium may lead to anemia, impaired growth, and organ dysfunction.

Methods: A community-based cross-sectional study was conducted among 220 households in two peri-urban settlements of Peshawar (Shaheen Muslim Town and Warsak Road colony) between January and July 2025. Household water samples (n=220) were analyzed for arsenic, lead, and chromium using atomic absorption spectrophotometry. Structured questionnaires and household health records were used to capture information on anemia, growth retardation in children (<12 years), and liver disease in adults. Logistic regression was applied to estimate associations between water contaminants and health outcomes.

Results: Arsenic exceeded WHO limits in 29% of samples, lead in 18%, and chromium in 11%. Children from arsenic-contaminated households had a higher prevalence of stunting compared to those from uncontaminated households (27% vs 14%, p<0.05). Lead contamination was associated with a two-fold increased odds of anemia (AOR=2.0; 95% CI: 1.1–3.6). Adults from households with contaminated water were more likely to have liver morbidity (16% vs 7%, p=0.04).

Conclusion: Heavy metal contamination of drinking water in peri-urban Peshawar is a significant public health threat, linked with stunting, anemia, and liver morbidity. Strengthened water monitoring, safe supply systems, and targeted awareness interventions are urgently needed to protect vulnerable populations.

Keywords: Heavy metals, Water pollution, Stunting, Anemia, Public health, Peshawar