An Integrated Health Risk Assessment Approach to the Study of Carbonated Water Spring from Tuzla Area, Bosnia and Herzegovina

This study investigates the quality and potential health risks associated with natural carbonated spring water taken in 2023 in Tuzla, Bosnia and Herzegovina. Employing a multidisciplinary approach, we conducted extensive physicochemical analyses to characterize the water, assessing mineral and ionic content, organoleptic properties, and potential contaminants of geological and anthropogenic origins. Subsequently, a deterministic human health risk assessment was undertaken for the ingestion of individual contaminants, while an integrated approach was used to assess the overall health risk from the consumption of this water by the local population. Surprisingly, despite its natural origin, the water exhibited elevated levels of fluoride (F−), cadmium (Cd), lead (Pb), and iron (Fe), exceeding recommended health standards. Although, the presence of F− in concentration of 1.65 ± 0.29 mg/L, Cd 0.07 ± 0.01 mg/L, Pb 0.176 ± 0.02 mg/L, and Fe 0.69 ± 0.24 mg/L resulted in an acceptable individual health risk, the integrated approach revealed an increased risk associated with the consumption of the water (HQ = 2.28). This underscores the importance of adopting the integrated approach in health risk assessment, considering the additive effect of various contaminants. The study emphasizes the necessity for ongoing monitoring, regulatory measures, and public awareness to mitigate the identified health risks, ensuring the safe consumption of natural carbonated spring water from Tuzla.