Abstract
In preventive medicine and occupational health, decision-makers face uncertainty, divergent opinions, and varying needs. In the Swiss aluminum industry, screening for industrial fluorosis illustrates how decision analysis and cost-effectiveness analysis can provide rational and explicit models of decision-making in such contexts. Data on fluoride-exposed potroom workers are used to compare the cost-effectiveness of two strategies: mass screening of fluorosis versus individual detection of the disease on the basis of the worker’s symptoms. A decision-analysis and a sensitivity analysis are performed to assess the impact of the screening program for different levels of expected prevalence of the disease. The optimal decision, in economic terms, is the one that minimizes the pension and screening-related costs and maximizes the number of years of full working capacity. Swiss data suggest that a diagnosis of clinical fluorosis is unlikely before 10 years of exposure to fluoride. Between 10 and 30 years of exposure to fluoride, mass screening may be more cost-effective than individual detection of the disease, even when the expected prevalence of the disease in a given industrial setting is less than 10%.
-
-
Alert on long-term lumbago and skelalgia not responsive to anti-rheumatic pharmacotherapy
In our work we have often dealt with patients who were diagnosed with “rheumatic or rheumatoid arthritis” in rural basic medical units or certain hospitals. A minority of those patients did have rheumatoid arthritis, but most of them did not improve with anti-rheumatic pharmacotherapy for multiple years; instead, their conditions
-
Enduring fluoride health hazard for the Vesuvius area population: the case of AD 79 Herculaneum
BACKGROUND: The study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological
-
Bone mineral structure after six years fluoride treatment investigated by backscattered electron imaging (BSEI) and small angle x-ray scattering (SAXS): a case report
NaF, a bone formation stimulating agent, is used for the treatment of osteoporosis. Controversy exists concerning the quality of the newly formed bone and the antifracture effectiveness. We report about a 70 years old woman, who had received 50 mg NaF/d for about 6 years. Calcium or Vit D supplements
-
X-ray changes in the forearm and crus of residents of areas in Jilin Province with varying drinking water fluoride concentrations
GOAL: To understand the characteristics of forearm and crus X-rays of residents from areas with varying concentrations of fluoride in their drinking water, providing evidence for diagnosis of osteofluorosis. METHOD: Using quantificational epidemiological methods, a total of 15 villages from Qianan and Nonan Counties of Jilin Province were selected as the
-
Paleopathology of skeletal fluorosis
Skeletal fluorosis is one of a range of conditions causing excessive ossification and joint ankylosis in skeletons. It is rarely considered, however, in differential diagnoses of palaeopathological lesions. This paper considers the identification of skeletal fluorosis in a skeletal sample from the island of Bahrain, Arabian Gulf, dating to ca.
Related Studies :
-
-
-
Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
-
"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
-
Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
-
Fluoride & Osteopetrosis
One of the most common radiological findings in skeletal fluorosis is osteosclerosis - a hardening of bones with a blurring of the trabecular structure. In advanced cases, the osteosclerotic form of fluorosis may closely resemble the appearance of osteopetrosis, a "marble bone" disease in which the bones are dense, but fragile and prone to fracture.
-
Fluoride & Arthritis
The doses that American adults now routinely ingest overlap the doses that may cause chronic joint pain.
Related FAN Content :
-