Status of radiation in South African water: a review

South Africa's water resources are increasingly impacted by mining, industrial activity, and natural geology, raising concerns about radionuclide contamination. This review synthesizes peer-reviewed studies assessing radionuclide concentrations, regulatory compliance, and health risks in South African water systems. There has been a report on the increased activity of 238U,235U,232Th, 40K, and 226Ra; some of them exceed the maximum levels allowed according to the European Union and World Health Organization regulations. The highest concentration recorded was 73.8 Bq/L of 235U in Mafikeng, North West Province. The Witwatersrand Basin showed uranium up to 387.7 μg/L near gold mines, while acidic mine void water in the Western Rand Basin contained 0.16 Bq/L of 238U, enhancing radionuclide mobility. Although some municipal treatment plants reduced activities to safe levels, untreated or poorly managed sources frequently surpassed guidelines, with gross alpha/beta activities up to 12 times above limits. Health risk assessments indicate heightened lifetime cancer morbidity and mortality, particularly in women. Continuous monitoring, advanced treatment technologies, stricter enforcement of environmental regulations, and provision of safer water sources are urgently required to safeguard public health and ensure sustainable water management in South Africa.