Groundwater nitrate (NO) contamination is a global concern. The distribution patterns, enrichment mechanisms, and human health risks of NO contaminated groundwater were investigated using 144 groundwater samples collected from domestic and irrigation wells in the piedmonts of the North China Plain (Beijing and Shijiazhuang areas). The results showed that the groundwater was neutral to weakly alkaline, and 47% of the groundwater samples had NO concentrations exceeding 50 mg/L, a threshold proposed by world health organization to threaten infants up to 3 months. Groundwater NO concentrations were generally higher in the Beijing piedmont than in the Shijiazhuang piedmont and decreased with depth in both piedmonts. High-NO (> 50 mg/L) groundwater was distributed sporadically spatially and mainly was of Ca-Mg-HCO hydrochemical facies. Stable isotopes (D and O) compositions and NO/Cl ratios indicated that NO accumulation in groundwater was primarily due to use of N-fertilizers under agricultural practices, and was associated with groundwater recharge sources such as septic tank leakage and re-infiltration of reclaimed irrigation water. Water quality evaluation showed that groundwater quality was highly dependent on NO concentration, with entropy-weighted water quality index values increasing linearly with increasing NO concentrations. The potential health risk of high-NO groundwater was the most serious for infants in both the piedmonts. Therefore, reducing NO input from sources and drinking water intake is recommended to minimize the human health risk.
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