Abstract
This is a review of findings on workers in an aluminum plant with industrial fluorosis. Early signs of the disease are nocturnal back pains and restriction of the rotation of the trunk. Stage I of the disease usually occurs after 10 years, stage II after 15 years and stage III after 20 years. The diagnosis was established at an early stage through biopsies of the iliac crest by histological and microanalytical determinations of fluoride. A fluoride level exceeding 4000 ppm in the iliac crest ash was found to be associated with typical signs of fluorosis. The early histological changes including the microradiographic findings and typical foci of calcification in the corticalis are demonstrated.
Three necropsies in patie.nts with fluorosis at different stages are reviewed. On. e of them showed a lesion in the cells of the anterior horn of the spinal cord which was believed to be related to fluorine. Cristallographic studies revealed that crystals of fluorotic bone mineral had become more slender. Increase in gastric acidity was associated with greater sensitivity toward fluoride. Prophylaxis and treatment of industrial fluorosis are discussed.
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Non-Endemic Skeletal Fluorosis: Causes And Associated Secondary Hyperparathyroidism (Case Report and Literature Review).
Highlights Fluorocarbon “huffing” is an under-appreciated cause of skeletal fluorosis (SF) We present a SF case with hyperparathyroidism, osteosclerosis, and osteomalacia SF may go undetected due to variation in symptoms, radiology, and biochemistry Dietary calcium, prior bone health, and skeletal F exposure influence SF features SF is common in
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The effect of fluoride on bone
Conclusions Although it is well known that the ingestion of high levels of fluoride can give rise to severe lesions in the skeletal tissues, such effects have never been found radiographically in persons using a water supply, containing less than 4 p.p.m fluorlde throughout life. A histological study of thirty ribs taken
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Renal osteodystrophy in patients on long-term hemodialysis with fluoridated water
Serum and bone fluoride concentrations of ten patients maintained on long-term hemodialysis with fluoridated water (1 ppm, i.e., 50uM) were correlated with duration of treatment and the occurrence of clinical, radiological, and histological manifestations of bone disease. Two patients had symptomatic renal osteodystrophy when accepted on the program, whereas six
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Value of the bone biopsy in the diagnosis of industrial fluorosis
Iliac crest biopsies taken from 43 men with industrial fluorosis were compared with control bone samples. The bone fluoride content was determined, histological examinations were made on stained sections and microradiographs, and morphometric analysis performed on the microradiographs alone. In the subjects with fluorosis, the bone fluoride content (5617 +/- 2143
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Fluoridation of public water supplies and its relation to musculoskeletal diseases
The fluoride content in parts per 1,000,000 of ash was estimated in 18 various bone samples from 14 patients with different forms of arthritis and from 1 patient who did not have arthritis, all of whom had ingested fluoridated water for a period ranging from three years and five months
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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.
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Kidney Patients Are at Increased Risk of Fluoride Poisoning
It is well established that individuals with kidney disease are susceptible to suffering bone damage and other ill effects from low levels of fluoride exposure. Kidney patients are at elevated risk because when kidneys are damaged they are unable to efficiently excrete fluoride from the body. As a result, kidney patients
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Mayo Clinic: Fluoridation & Bone Disease in Renal Patients
The available evidence suggests that some patients wtih long-term renal failure are being affected by drinking water with as little as 2 ppm fluoride. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers and if fluoride is indeed the cause. It would seem prudent, therefore, to monitor the fluoride intake of patients with renal failure living in high fluoride areas.
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"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.
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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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