Acid mine drainage (AMD), characterized by its acidity and high content of heavy metals, is a significant global environmental problem that harms human health through its impact on rivers. Therefore, this study aims to identify heavy metals in both surface and underground AMD-polluted karst rivers, focusing on the Zhijin River area which is severely affected by AMD, and assess their health risks to residents. Through the collection of 30 surface water samples and 16 groundwater samples from both wet and dry seasons, the study examines the concentration, sources of pollution, and health implications of six heavy metals (Fe, Mn, Cr, Cd, As, and Hg). The results showed that Fe and Mn levels in surface water were highly polluted during both seasons, especially during the wet season, with Fe levels reaching 20.0 mg/L and Mn levels reaching 1.9 mg/L. Further correlation and principal component analyses revealed that mining activities are the primary contributors to the contamination in this region. Health risk assessments and Monte Carlo simulation, including both deterministic and probabilistic, showed that the noncarcinogenic health risk indices for surface water and groundwater were within acceptable limits for both seasons. However, groundwater poses a higher carcinogenic risk to children, with As levels during the wet season and Cr levels during the dry season warranting close monitoring. Factors such as body weight and intake rate played a crucial role in health risk evaluations. This study underscores the need for further attention to groundwater risk, temporal heterogeneity in the Zhijin River.

酸性矿山排水 （AMD） 的特点是酸性和高重金属含量，是一个重大的全球性环境问题，其对河流的影响会危害人类健康。因此，本研究旨在识别 AMD 污染的地表和地下喀斯特河流中的重金属，重点关注受 AMD 严重影响的知津江地区，并评估其对居民的健康风险。通过收集 30 个地表水样本和 16 个雨季和旱季地下水样本，该研究检查了六种重金属（铁、锰、铬、镉、砷和汞）的浓度、污染来源和健康影响。结果表明，地表水中的铁和锰含量在两个季节都受到高度污染，尤其是在雨季，铁含量达到 20.0 mg/L，锰含量达到 1.9 mg/L。进一步的相关性和主成分分析表明，采矿活动是该地区污染的主要因素。健康风险评估和蒙特卡洛模拟，包括确定性和概率性模拟，表明地表水和地下水的非致癌健康风险指数在两个季节都在可接受的范围内。然而，地下水对儿童构成更高的致癌风险，雨季的 As 水平和旱季的 Cr 水平需要密切监测。体重和摄入率等因素在健康风险评估中起着至关重要的作用。这项研究强调了进一步关注地下水风险的必要性，即志津河的时间异质性。