Evaluation of drinking water quality and health risk assessment in rural primary schools along the Thai Myanmar border

Abstract

Safe drinking water in schools is important for students' health. Despite the presence of water treatment systems in rural schools, systematic monitoring and evaluation of drinking water quality are often insufficiently integrated into risk assessment frameworks, potentially compromising student health. In this study, a cross-sectional survey was conducted using drinking water samples from rural primary schools along the Thai-Myanmar border in Kanchanaburi, Thailand, aiming to evaluate the quality of drinking water in terms of physicochemical and bacteriological parameters and assess the health risks to students. A total of 52 drinking water samples were collected for water quality analysis. Among these, approximately 42% (n = 22) of these collected samples did not comply with Thailand's recommended limits of drinking water quality. Among the noncompliant samples, total coliform bacteria were detected in 59% (n = 13), fluoride concentrations exceeded the permissible limit of 0.70 mg/L in 18% (n = 4), and arsenic levels surpassed the recommended limit of 10 µg/L in 9% (n = 2). These contaminants may pose a potential health risk to students. Health risk assessments indicated that, although the majority of hazard index (HI) and cancer risk (CR) values were within acceptable limits (HI < 1; CR between 1 × 10⁻6 and 1 × 10⁻4), the 95th percentile values exceeded these thresholds, suggesting potential health risks for students consuming the contaminated water. To mitigate health risks associated with contaminated drinking water in rural primary schools, the implementation of effective water treatment systems, coupled with routine monitoring of drinking water quality and proper maintenance, is recommended. However, this study has some limitations, including a restricted geographic coverage and reliance on generalized exposure parameters, which constrain causal inferences between contaminant exposure and health outcomes. Future research should expand the study area and incorporate region-specific behavioral data to more comprehensively assess chronic exposure risks and the effectiveness of intervention strategies.