Objective The characteristics, sources and potential health risks of groundwater heavy metal pollution in eastern Henan Province were identified in order to provide scientific support for the rational utilization and pollution control of groundwater in this agricultural area. Methods Using 119 representative sampling sites in eastern Henan Province, this study selected 10 heavy metals (Zn, Pb, Cr, As, Cu, Fe, Mn, Al, Hg, and Ni). By integrating single-factor pollution indices, the Nemerow composite index, absolute factor analysis-multivariate linear regression (APCS-MLR), and health risk assessment models, this study examined groundwater heavy metal content characteristics, spatial distribution, and pollution status to identify pollution sources and evaluate health risks. Results ① The average concentrations of groundwater heavy metals in eastern Henan Province, ranked from highest to lowest, were Mn > Zn > Al > Fe > Cu > As > Ni > Pb > Cr > Hg. The average Mn concentration exceeded the class Ⅲ standard limit specified in the “Groundwater Quality Standard (GB/T14848-2017)”. ② Regarding single-factor pollution levels for each heavy metal in eastern Henan Province, Mn exhibited severe pollution while all others remained clean. The proportions of sampling points showing mild and severe pollution were 36.13% and 31.09%, respectively. Mn was identified as the dominant factor in groundwater heavy metal pollution. ③ The average contribution rates of industrial sources, unknown sources, agricultural sources, natural sources, and traffic sources decreased in that order, accounting for 41.44%, 20.81%, 18.72%, 12.57%, and 6.46%, respectively. However, the contributions of different sources to various heavy metals exhibited significant variability. ④ Under drinking water intake and dermal contact pathways, the health risks posed by non-carcinogenic and carcinogenic elements to both adults and children remained within acceptable limits. Conclusion Groundwater in eastern Henan Province exhibits significant spatial heterogeneity in terms of heavy metal content, with Mn being the primary contaminant. However, the health risks posed by various elements are still within an acceptable range. It is necessary to adopt targeted measures based on the pollution characteristics and sources of each element, and to strengthen the utilization and control of groundwater heavy metals according to local conditions, while dynamically monitoring their health risk status.
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