Report Chemistry Heavy Metal Analysis sonali

Assessment of Water Quality Around IIE Pharmacity, Selaqui, Dehradun Submitted To: Dr. Rajeev Kumar Submitted By: Sonali Sharma

C​ ontents 1. Overview 2. Heavy metals 3. Impact of heavy metals 4. Selaqui, Dehradun 5. IIE Pharmacity 6. List of pharmaceuticals industries at IIE Pharmacity 7. Joint Inspection Report 2017 of the Pharma Units in Selaqui 8. Study conducted to assess the heavy metals in effluent discharge from Pharma Units in Selaqui 8.1 S​ tudy 1 (Ramola and Singh, J Environ Anal Toxicol 2013) 8.2 Study 2 (Rana, Kandari, Singh, Gupta, Analytical Chemistry Letters 2014) 9. Groundwater quality characteristics handpump, Selaqui, Industrial Area 1 (July-2020) 10.Groundwater quality characteristics handpump, Selaqui, Industrial Area 2 (July-2020) 11.Brief analysis from reports and studies 12.Impact on local population consuming groundwater 13.Survey questionnaire for heavy metal impact analysis on health of local people in Selaqui

Overview Dehradun, the capital of Uttrakhand has seen rapid industrial development since it became the capital of the state. The Selaqui region of Dehradun especially has seen mushrooming of pharmaceutical industries in the past few years. Many effluents from these industries are not treated properly and are discharged as such into the water bodies of Selaqui. This has depleted the water quality in the region. Heavy metals have mutagenic and carcinogenic properties and they tend to impact the vital organs of the body. Long-term exposure to heavy metals in the form of drinking water can even lead to death.

Heavy Metals \"Heavy metals'' ​are chemical elements with a specific gravity at least 5 times that of water. The specific gravity of water is 1 at 4°C (39°F). Specific gravity is a measure of density of a given amount of a solid substance when it is compared to an equal amount of water. Some well known toxic metals with a specific gravity 5 or more times those of water are ​arsenic (5.7), cadmium (8.65), iron (7.9), lead (11.34), and mercury (13.546).​ When water is contaminated with these heavy metals then that water becomes toxic and dangerous for our biological system. There are ​35 metals​ that concern us because of occupational or residential exposure; 23 of these are the heavy elements or \"heavy metals\": antimony, arsenic, bismuth, cadmium, cerium, chromium, cobalt, copper, gallium, gold, iron, lead, manganese, mercury, nickel, platinum, silver, tellurium, thallium, tin, uranium, vanadium, and zinc. Impact of Heavy Metals Heavy metal toxicity can result in damaged or reduced mental and central nervous function, lower energy levels, and damage to blood composition, lungs, kidneys, liver and other vital organs. Long-term exposure may result in slowly progressing physical, muscular, and neurological degenerative processes that mimic Alzheimer's disease, Parkinson's disease, muscular dystrophy, and multiple sclerosis. Allergies are not uncommon, and repeated long-term contact with some metals (or their compounds) may cause cancer.

Selaqui, Dehradun Selaqui is located west of the main township of Dehradun along the Chakrata road and it is about 19 km from the Clock tower. The area is situated between latitude 30°21’40”N ​and longitude 7​ 7°50’44.8”E a​ t an altitude of​ 635 m. Selaqui is a very crowded area and located on the outskirts of Dehradun. The temperature of this region is comparatively high as compared to the other city areas like Vasant Vihar, Jhakhan, Raipur, Rajpur, etc. because it is an industrial area. The​ ​pharmaceutical estate, IIE Pharmacity​ ​forms a major portion of the industrial area in Selaqui. Source: Google My Maps

Source: Google My Maps

Source: Google My Maps

Source: Google My Maps

IIE Pharmacity Name of industrial estate Integrated Industrial Estate, IIE Pharma City, Selaqui Total area Total allotable area 50 acres Industrial Institutional 50 acres Commercial Residential 35.3 acres Total area vacant Connectivity 1.04 acres 1.17 acres Nil Nil AIRPORT:​ Nearest Airport is JollyGrant Airport(At a distance of 50 kms) RAILHEAD​: Nearest Railhead is Dehradun(At a distance of 25 kms) ROAD​: Distance from Delhi 291 kms(via NH 44) Infrastructure availability High Class Road: 30m wide and above Electricity & LED Street lights Water Supply DataCom Services Fire & Police Stations Source: State Infrastructure and Industrial DevelopmentCorporation of Uttarakhand Ltd. (SIIDCUL)

List of Pharmaceutical Industries at IIE Pharmacity Sr. No. Name of Company Plot No. Area at The Time 1 Translumina Therapeutics 12 1890 2 Avantor Performance 37 2128 Materials India Ltd 3 Biological E. Ltd 31,32 8700 4 CORAL Laboratories Ltd 27 4100 5 CORAL Laboratories Ltd 28 4100 6 East African India Overseas 1 3600 7 East African India Overseas 8 2839 8 East African India Overseas 8A 1118 9 ESIC (Hospital) ESIC A 2000 10 HAB Pharmaceuticals & 10 2427 research Ltd 11 Hema Laboratories Pvt Ltd 29 4100 12 Himalaya Meditek Pvt Ltd 35,36 4144 13 India Glycols Ltd 3 3600 14 India Glycols Ltd 2 3600 15 India Glycols Ltd 4 3600 16 India Glycols Ltd 5 3600 17 ISH Medicos Pvt Ltd 9 2606 18 Karnani Pharmaceuticals Pvt 38 2128 Ltd

19 M.G. Shahani & Co. Delhi 30 4100 Ltd 11 2290 20 Mancare Laboratories Pvt Ltd 16 4226 21 Mepromax Lifesciences Pvt 24, 24A 7408 Ltd 18A 3450 22 Modhike Pvt Ltd 19 8640 33 2128 23 NATCO PHARMA LIMITED 34 2128 24 Natco Pharma Ltd 14 3879 17, 20 13020 25 Premier Nutraceuticals Pvt Ltd 6 3600 23 3895 26 Premier Nutraceuticals Pvt 40 2128 Ltd 25, 26 8200 21 4226 27 Sann-dee Madicare 22 4052 15A 1960 28 SIDMAK Laboratories India Pvt 7 3600 29 Suncare Formulation Pvt Ltd 30 Sunhill Pharma Pvt Ltd 31 Supermax Laboratories 32 Unimedico Lab 33 Unimedico Lab 34 Unimedico Lab 35 Verve Human Care Laboratories 36 Wheezal Homoeo Pharma

37 Wheezal Homoeo Pharma 18 4643 38 Windlas Biotech Limited 39 2128 Source: State Infrastructure and Industrial Development Corporation of Uttarakhand Ltd. (SIIDCUL)

Joint Inspection Report 2017 of The Pharma Units in Selaqui Name and Wastewater Wastewater Ultimate BOD COD TSS pH Generation (mg/L) (mg/L) (mg/L) address of the Treatment Disposal of 6.78 unit Facility Treated BDL 6.99 Water 11 6.92 11 7.17 Floor Domestic Domestic Industrial 20 washing and 6.92 equipment BDL (Industrial) East African 20 KLD 10 KLD Septic ETP Reuses in BDL 10 (India) gardening Tank/Soak Pit Overseas, Plot No. 1, Pharmacity, Selaqui, Dehradun India Glycols Nil 3.2 KLD ETP cum STP ETP cum Reuses in 6 25 STP Ltd. (Herbal cooling Extraction tower Unit), Plot No. makeup 2 and 5, Selaqui water Dehradun Hab 5.0 KLD 5.0 KLD Septic ETP Gardening 29 120 Pharmaceuticals Tank/Soak Pit and and Research flushing Limited, Plot No. 10, Selaqui Dehradun Mancare 5.0 KLD 0.70 KLD Septic ETP Gardening 22 138 Laboratories Tank/Soak Pit and Private Ltd. flushing 11-Pharmacity, Selaqui, Pharmacity, Sidcul, Tal VKS, Selaqui, Dehradun Mepromax 7.0 KLD 6.00 KLD ETP cum STP ETP cum Gardening 29 120 STP Lifesciences and Private Limited, flushing 16, Pharmacity, Selaqui Industrial Area Tal-VKS,

Selaqui, Dehradun Natco Pharma 2.10 KLD 3.00 KLD ETP cum STP ETP cum Gardening 22 97 15 7.72 STP 87 11 7.03 Limited and 193 15 7.23 19-Pharmacity, 3.50 KLD ETP cum STP ETP cum flushing 108 BDL 7.38 Sidcul, Selaqui STP 107 21 6.86 BDL 23 6.57 Tal-VKS 90 10 8.34 Sidmak 35.20 KLD Gardening 23 Laboratories and India Pvt. Ltd. flushing Plot No. 20, Pharmacity, Selaqui, Dehradun Uni Medico 20.00 KLD 15.00 ETP cum STP ETP cum Gardening 27 KLD STP Labs Plot no. and 21-22, flushing Pharmacity, Selaqui, Dehradun 248001 Kalindi 4.50 KLD 5.00 KLD ETP cum STP ETP cum Gardening 26 Medicure Pvt. STP and Ltd. 25, flushing 5.20 KLD ETP cum STP ETP cum 26-Pharmacity, STP Selaqui Dehradun Coral 3.20 KLD Gardening 23 Laboratories and Ltd. Plot No. flushing 27-28, Pharmacity, Sidcul, Selaqui, Dehradun Hema 6.5 KLD 3.00 KLD Septic ETP Gardening BDL Laboratories and Tank/Soak Pit Pvt. Ltd. Plot flushing No. 29, Pharmacity, Industrial Area, Dehradun M.G. Shahani 8.00 KLD 6.00 KLD ETP cum STP ETP cum Gardening 20 STP & Co. Delhi and Ltd. Plot No. flushing 30, Pharmacity, Selaqui Industrial Area, Dehradun

Biological 10.00 KLD 3.00 KLD ETP cum STP ETP cum Gardening 13 60 BDL 7.46 STP 83 E.Ltd. 31 & 32, and 100 Pharmacity, flushing 132 Selaqui, Dehradun Himalaya 5. 50 KLD 4.00 KLD Septic ETP Gardening 14 13 6.95 Meditek Pvt. and Tank/Soak Pit Ltd. Plot No. 35 flushing & 36 Pharmacity, Selaqui Karnani 5.00 KLD 2.50 KLD Septic ETP Gardening 21 13 6.9 Pharmaceuticals and Tank/Soak Pit Ltd. 38, flushing Pharmacity, Sidcul, Selaqui, Dehradun Supermax 1.00 2.00 KLD Septic ETP Gardening 28 18 6.88 Laboratories. and Tank/Soak Pit 40, Pharmacity, flushing Selaqui Industrial Area, Dehradun Innova Life Not in Sciences. 39, operation Pharmacity, since 2011 Selaqui Industrial Area, Dehradun Premier Unit is Nutriceuticals sealed by 33, Pharmacity, UEPPCB Selaqui, and not Dehradun operational Source: Uttarakhand Pollution Control Board

Studies Conducted to Assess The Heavy Metals in Effluent Discharge From Pharma Units in Selaqui Study 1 (Ramola and Singh, J Environ Anal Toxicol 2013) Overview Most pharmaceutical effluents are known to contain varying concentrations of organic compounds and total solids including heavy metals. Heavy metals such as Lead, Mercury, Cadmium, Nickel, Chromium and other toxic organic chemicals or phenolic compounds discharged from pharmaceutical industries are known to affect the surface and ground waters. Each industry should treat their effluents, in accordance with the legal requirements, before discharging these into the streams otherwise the ‘Polluter Pays Principle’ should be implemented. Sampling Sampling was done as per standard way to ensure representation of industrial effluent. Samples were collected from various industrial units (A, B, C, D & E) situated in the industrial area i.e. Selaqui region. These industrial units synthesize cough syrups, medicinal tablets and cosmetics. Effluent samples were mostly collected from drains coming out of the industrial site. Plastic cans of 2 litre capacity were used for sampling of effluent. The samples were taken in the 3 batches i.e. during different seasons of the year. The first set of samples was collected during summer time, the second sample during the rainy (monsoon), and third during winter season. Analysis of samples was done by flame atomic absorption spectroscopy at ICFAI University, Dehradun.

Outcomes Metals were determined at selective wavelengths, which are given below as Cr (λ) = 357.87 nm, Cu (λ) = 324.75 nm, Co (λ) = 240.73 nm, Fe (λ) = 248.33 nm Cd (λ) = 228.8 nm, Zn (λ) = 213.86 nm and Pb (λ) = 283.31 nm Cr, Cu, Co, Fe, Ni & Zn-Analyzed using Hollow Cathode Lamp (HCL), in a Flame atomizer AAS. Cd and Pb-Analyzed using Electrode Less Discharge Lamp (EDL), in the Flame atomizer AAS. The highest concentration was detected for Iron i.e. 10.80 mg/l or ppm, it varied from 8.5 to 10.8 ppm while in ground water it was found to be about 8 ppm. Though Iron is not considered to be hazardous to health, we experience red, brown or yellow staining of laundry, glassware and dishes. This water has metallic taste and an offensive odor. Water system piping and fixtures can also become restricted or clogged, if water has more than 10 ppm of iron content. Chromium varied from 0.12 to 0.31 ppm in all effluent samples except one pharma company sample. Chromium in drinking water may lead to allergic dermatitis. Lead was found to be in the range of 0.158 to 0.262 ppm which is above the limit of Pb (0.01 ppm as per WHO standards). Pb is very toxic metal and it interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestine, kidneys, reproductive and nervous systems. Nickel was observed in the range from 0.05 to 0.12 ppm, which appears to be higher than the WHO prescribed limit of 0.02 ppm. Ni was not detected in 2 effluent samples including groundwater samples. Cadmium content is in the range of 0.16 to 0.56 ppm while not detected in ground water samples. Its permissible limit as per WHO is 0.01 ppm, in this way we conclude that cadmium is higher in all effluent samples except one pharma company effluent (C). Acute exposure to Cd fumes may cause flu like symptoms including chills, fever and muscle ache. More severe exposure can cause trachea-bronchitis, pneumonitis and pulmonary edema. Cd dust inhalation causes respiratory tract and kidney problems which can be fatal. Ingestion of Cd causes immediate poisoning and damage to the liver and kidney.

Copper was found in the range of 0.08 to 0.38 ppm in the effluent samples while it could not be detected in hand pump water. Cu was found lower than the prescribed limit (2 ppm). Excess copper intake causes stomach upset, nausea, and diarrhea and can lead to tissue injury and disease. Excess copper intake also induces toxicity indirectly by interacting with other nutrients. Excess copper intake produces anemia by interfering with iron transport and/or metabolism. Zinc was observed in the range of 1 to 1.3 ppm which is in the permissible range. Although Zinc is essential for human health, too much Zinc can cause health problems, like stomach cramps, skin irritation, vomiting, nausea and anemia. It is clear that four heavy metals i.e​ Cr, Pb, Cd and Ni ​were observed to be in the higher range in most of the pharma industrial effluent samples. International Standards for Drinking Water Trace Metals WHO Limit (mg/l) 0.01 Cd 2 0.005 Cu 0.05 0.3 Co 0.5 0.02 Cr 0.01 3.0 Fe 0.05 0.1 Mn 0.001 Ni Pb Zn As Al Hg Source: WHO

Conclusion By this study it can be concluded that heavy metals like​ Chromium, Lead, Cadmium and Nickel were found to be above the permissible limit recommended by WHO standards while ​Copper, Zinc and Iron were found almost within the permissible limit. Almost all groundwater samples taken from ​hand pump​ situated in the industrial area were found to contain most of the heavy metals within the permissible range but if the effluents containing above mentioned heavy metals are drained regularly in huge quantity without proper treatment, then after some years the groundwater will be polluted with such toxic heavy metals and will not be suitable for drinking purpose. Study 2 (Rana, Kandari, Singh, Gupta, Analytical Chemistry Letters 2014) In this study, five different sites, located in Pharma City, Selaqui, Dehradun, Uttrakhand, India, were selected, for heavy metal analysis. Heavy metals such as: aluminium, arsenic, cadmium, hexavalent chromium, copper, iron, lead, mercury and zinc were selected for wastewater assessment. Twelve months sampling (January 2012 to December 2012) were done every month for heavy metals study. Heavy metals analysis was done by atomic absorption spectrophotometer (AAS). All parameters were compared with the general standards for discharge of industrial effluents into inland surface water, provided by CPCB and Bureau of Indian standards (BIS). The range of concentrations of all mentioned heavy metals for five different sampling sites were found in the following range 0.001-4.525 mg/l for aluminium, 0-0.056 mg/l for arsenic, 0.0004- 0.0096 mg/l for cadmium, 0-0.125 mg/l for hexavalent chromium, 0.002-0.1112 mg/l for copper, 0.0012-8.62 mg/l for iron, 0-0.027 mg/l for lead, 0.001-1.24 mg/l for manganese and 0.007-2.01 mg/l for zinc. Further, this study was subjected to statistical analysis using Box and Whisker Vertical Plots, Pearson's Correlation and Anova. It was concluded that average value for all selected parameters were f​ ound within the standards limits

provided by CPCB and BIS​. This study further helps us to design an appropriate treatment plan for pharmaceutical industries wastewater containing other pollutants. Groundwater Quality Characteristics Handpump, Selaqui, Industrial Area 1 (July-2020) Parameter Value Desirable-Permissible 7.58 Limit pH 6.5-8.5 BOD (mg/L) 17 200-600 COD (mg/L) 73 250-1000 Temp. (℃) 17 75-200 46 30-100 DO (mg/L) 36 300-600 Alkalinity as CaCO​3 82 500-2000 Chlorides as Cl (mg/L) 82 Calcium as Ca (mg/L) 1-10 <2 Magnesium as Mg 125 (mg/L) Hardness as CaCO​3 Total Dissolved Solids (mg/L) Faecal Coliform (MPN/100 mL) Total Coliform (MPN/100 mL) Conductivity (µΩ/cm)

Groundwater Quality Characteristics Handpump, Selaqui, Industrial Area 2 (July-2020) Parameter Value Desirable-Permissible Limit pH 7.56 6.5-8.5 BOD (mg/L) COD (mg/L) Temp. (℃) 18 DO (mg/L) Alkalinity as CaCO​3 84 200-600 Chlorides as Cl (mg/L) 14 250-1000 Calcium as Ca (mg/L) 56 75-200 Magnesium as Mg 41 30-100 (mg/L) Hardness as CaCO​3 97 300-600 Total Dissolved Solids 136 500-2000 (mg/L) Faecal Coliform (MPN/100 mL) Total Coliform <2 1-10 (MPN/100 mL) Conductivity (µΩ/cm) 210 Source: Uttarakhand Pollution Control Board Brief Analysis From Reports and Studies - The two studies (Ramola and Singh, J Environ Anal Toxicol 2013) and (Rana, Kandari, Singh, Gupta, Analytical Chemistry Letters 2014) have shown that the effluent discharge from the pharma units at IIE Pharmacity

contain heavy metals. While some heavy metals were found to be within the permissible limits, the others were above the prescribed limit. - The groundwater quality characteristics have been found to be within the prescribed limits. - The Joint Inspection Report 2017 of pharma units at IIE Phamacity has shown that the pharma units are effectively treating their discharged effluents. But there remains a ​possibility​ that over a period of time some effluents containing heavy metals which are discharged have/or can accumulate in the groundwater because the studies were done years back. Impact on Local Population Consuming The Groundwater The local population in Selaqui region obtains the water for its daily water use purposes from the groundwater. Now, this groundwater has been found to be in contact with the effluents discharged from the operating pharma units at IIE Pharmacity. This can have a huge impact on the health of the locals and make them susceptible to various traumatic diseases, both short and long-term.

Picture-Based Evidence of The Conducted Survey























Survey Questionnaire for Heavy Metal Impact Analysis on Health of Local People in Selaqui/​सेलाकु ई म थानीय लोग के वा य पर भार धातु के भाव के व लेषण हेतु सव ण नावल Name​/नाम: __________________________ Age/​आय:ु ____________________________ Occupation/​ यवसाय:____​ _______________ Contact No./स​ ंपक:__​__________________

Income/​आय:_​ ________________________ No. of Family Members/​प रवार के सद य क सं या:_________________________________ 1. Do you think water quality has depleted in the Selaqui region over the years?/​ या आपको लगता है क सेलाकु ई े म पछले कु छ वष से पानी क गुणव ा म कमी आई है ? Yes/​हाँ No/​न Can’t Say/​कह नह ं सकते 2. On a scale of 1 to 5, how would you rate the water quality in Selaqui?/​ 1 से 5 के पमै ाने पर, आप कस कार सेलाकु ई म पानी क गणु व ा का मू यांकन करगे ? 12345 3. Do you agree with the rapid industrialization rate in the township of Selaqui?​ / या आप सेलाकु ई म तजे ी से बढ़ते औ यो गक करण के दर स सहमत ह ? Yes​/हाँ No​/न ​ ​ Can’t Say/​कह नह ं सकते 4. Are the fast-developing pharmaceutical industries in Selaqui degrading the groundwater quality of this region?/​ ​ या सेलाकु ई म तजे ी से वक सत हो रहे फामा यु टकल उ योग इस े के भजू ल क गणु व ा को कम कर रहे ह? Yes/​हाँ No​/न Can’t Say/​ कह नह ं सकते 5. Have you witnessed at any point in time any open drains around these pharmaceutical industries in Selaqui?/​ या आपने सेलाकु ई म इन दवा उ योग के आसपास कसी भी खलु नाल को देखा है? Yes​/हाँ No/​ न 6. Is the increased heavy metal discharge into the groundwater or surface water bodies, a direct outcome of poor effluent treatment methods adopted by pharmaceutical industries?/​ या भजू ल या सतह के जल नकाय म भार धातु नवहन,

फामा यु टकल उ योग वारा अपनाई गई खराब अप श ट उपचार व धय का य प रणाम है? Yes/​हाँ No​/न Can’t Say/​कह नह ं सकते 7. Around what % of water supply in Selaqui comes from groundwater?/​ स​ ेलाकु ई म लगभग कतने % पानी क आपू त भजू ल से होती है? >90% 85% 80% 8. From where do you obtain water for your daily household purposes?(Provide location also, if possible)​/​आप अपने दै नक घरेलू उ दे य के लए पानी कहाँ से ा त करते ह? (य द संभव हो तो थान का नाम लख) _______________________________________________________________________ 9. Do you have a 24X7 water supply in your house?/​ ​ या आपके घर म 24X7 पानी क आपू त है? Yes/​हाँ No/​न 10. How does the drinking water of your area taste?/​ आ​ पके े के पेयजल का वाद कै सा है Salty/न​ मक न Metallic/​धाि वक ​ Neutral/​कोई वाद नह ं Sweet/म​ ीठा 11.Is there any kind of offensive odour coming out from your water supply area/storage area?/​ या आपके जल आपू त े / भडं ारण े से कसी कार क अ य गंध नकलती है ? Yes/​हाँ No/​न 12. Do you practice any water purification technique at your house? If yes, then please mention.​/​ या आप अपने घर पर कसी जल शोधन तकनीक का अ यास करते ह? य द हा,ँ तो कृ पया उ लेख कर। Yes/​हाँ No/​न ________________________________________________________________________ 13.Have you seen any specific stains of red, brown, or yellow colour on your laundry? If yes, how often do you see them?/​ या आपने अपने धलु े हुए कपड़ पर

लाल, भरू े या पीले रंग के कोई व श ट दाग देख है? य द हा,ँ तो आप उ ह लगभग कतनी बार देख चकु े ह ? Yes/​हाँ No/​न ________________________________________________________________________ 14.How many women and children do you have in your house?/आ​ पके घर म कतनी म हलाएं और ब चे ह ? Women/​ म हलाएं___________ Children/​ ब चे __​__​__________ 15. Do women and children in your house suffer from anaemia?/​ ​ या आपके घर म म हलाएं और ब चे एनी मया से पी ड़त ह? Yes/​हाँ No/​न 16.Have you undergone any recent health checkup?/​ ​ या आप हाल ह म कसी वा य पर ण से गज़ु रे ह? Yes/​हाँ No/​न 17. Has anybody in your family suffered/suffering from a chronic disease? If yes, please mention the illness?/​ ​ या आपके प रवार म कसी को ल बे समय से कोई बीमार है? य द हा,ँ तो बीमार का उ लेख कर। Yes/​हाँ No/​न _______________________________________________________________________ 18.Have you experienced any kind of dizziness/headache/anxiety/depression/physical disorder? If yes, please mention the problem?/​ ​ या आपने कसी तरह के च कर / सरदद / चतं ा / अवसाद / शार रक वकार का अनभु व कया है? य द हा,ँ तो कृ पया सम या का उ लेख कर? Yes/​हाँ No/ ​न ________________________________________________________________________ 19. Are you a part of any Government Health Scheme?​/​ या आप कसी सरकार वा य योजना का ह सा ह? Yes/​हाँ No/​न

20. On a scale of 1 to 10 what is the probability of people suffering from kidney problems, if they consume Cadmium contaminated drinking water?/1​ से 10 के पमै ाने पर, कडनी क सम या से जझू रहे लोग क सभं ावना या है, अगर वे कै ड मयम से दू षत पेयजल का सेवन करते ह? 1 2 3 4 5 6 7 8 9 10