Shuya Li, Huan Shuai, Hong Yu, Yongqian Liu, Yingli Jing, Yizhi Kong, Yaqian Liu, Di Wu
Groundwater, a critical resource for regional water security and public health, faces escalating threats from heavy metal contamination—a pressing environmental challenge worldwide. This study focuses on the central-south Hunan region of China, a mineral-rich, densely populated area characterized predominantly by non-point-source pollution, aiming to systematically unravel the spatial patterns, source contributions, and associated health risks of heavy metals in local groundwater. Based on 717 spring and well water samples collected in 2024, we determined pH and seven heavy metals (As, Cd, Pb, Zn, Fe, Mn, and Tl). By integrating hydrogeological zoning, lithology, topography, and river networks, the study area was divided into 11 assessment units, clearly revealing the spatial heterogeneity of heavy metals. The results demonstrate that exceedances of Cd, Pb, and Zn were sporadic and point-source-influenced, whereas As, Fe, Mn, and Tl showed regional exceedance patterns (e.g., Mn exceeded the standard in 9.76% of samples), identifying them as priority control elements. The spatial distribution of heavy metals was governed the synergistic effects of lithology, water–rock interactions, and hydrological structure, showing a distinct “acidic in the northeast, alkaline in the southwest” pH gradient. Combined application of the APCS-MLR and PMF models resolved five principal pollution sources: an acid-reducing-environment-driven release source (contributing 76.1% of Fe and 58.3% of Pb); a geogenic–anthropogenic composite source (contributing 81.0% of Tl and 62.4% of Cd); a human-perturbation-triggered natural Mn release source (contributing 94.8% of Mn); an agricultural-activity-related input source (contributing 60.1% of Zn); and a primary geological source (contributing 89.9% of As). Monte Carlo simulation-based health risk assessment indicated that the average hazard index (HI) and total carcinogenic risk (TCR) for all heavy metals were below acceptable thresholds, suggesting generally manageable risk. However, As was the dominant contributor to both non-carcinogenic and carcinogenic risks, with its carcinogenic risk exceeding the threshold in up to 3.84% of the simulated adult exposures under extreme scenarios. Sensitivity analysis identified exposure duration (ED) as the most influential parameter governing risk outcomes. In conclusion, we recommend implementing spatially differentiated management strategies: prioritizing As control in red-bed and granite–metamorphic zones; enhancing Tl monitoring in the northern and northeastern granite-rich areas, particularly downstream of the Mishui River; and regulating land use in brick-factory-dense riparian zones to mitigate disturbance-induced Mn release—for instance, through the enforcement of setback requirements and targeted groundwater monitoring programs. This study provides a scientific foundation for the sustainable management and safety assurance of groundwater resources in regions with similar geological and anthropogenic settings.