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The presence of excessive iron and manganese in municipal water supply causes:

ADental fluorosis
BReddish-brown staining of laundry and plumbing fixtures
CMethemoglobinemia (blue baby disease)
DGoiter and thyroid disorders

Explanation

Iron (> 0.3 mg/L) and Manganese (> 0.05 mg/L) impart reddish-brown and black stains to clothes and plumbing fixtures.

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