A cross-sectional study was undertaken to determine the level of urinary fluoride and dental fluorosis in brick kiln workers (n=100) and a control group (n=20) in Balochistan, Pakistan. The fluoride level was also assessed in groundwater samples(n=30). The results showed the urinary fluoride level was significantly greater (p<0.05)in the brick kiln workers (0.17–0.30 mg/L) than in the control individuals (0.003 mg/L). Dental fluorosis was prevalent in both the brick kiln workers and the control group and the Community Fluoride Index (CFI) values were less than 0.42. The range of the groundwater fluoride levels was 0.87 to 1.59 mg/L with the upper part of the range being above upper limit recommended by the WHO (1.5 mg/L). Significant positive correlations (r=0.98, 0.90, 0.96) were determined between groundwater fluoride, urinary fluoride, and dental fluorosis. Consequently, it is assumed that the level of urinary fluoride and dental fluorosis could increase due to fluoride emissions from brick kilns and groundwater fluoride. The results of the current study suggest urinary fluoride and dental fluorosis are effective biomarkers for the monitoring of short-term and prolonged exposure to fluoride, although dental fluorosis is an indicator of fluoride exposure only while the teeth are developing up until the age of approximately 8 years. In order to avoid the long-term health-related consequences of fluoride exposure, regular monitoring of fluoride levels in the vicinity of brick kilns is recommended.
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