Abstract
A case-controlled study has compared urinary, blood plasma, and serum fluoride (F) levels of people living in endemic areas of the Thar Desert, Sindh, Pakistan, consuming groundwater with F concentrations as high as 4.00–10.00 mg/L with those consuming groundwater with low F levels of 0.30 mg/L. A total of 121 individuals from Samme Jo Tar Village of the Chachro Sub-District, Tharparker, and 121 controls from Gadap Town, Karachi, Pakistan, were selected for this study. Results indicated highly significant differences were present between the mean urinary F (12.90 versus 2.30 mg/L, p<0.001), plasma F (0.61 versus 0.25 mg/L, p<0.001) and serum F levels (0.75 versus 0. 29 mg/L, p<0.001) of cases and controls. There was a strong positive correlation between plasma and serum F levels (r = 0.884), while moderate correlations were found between urine plus plasma and between urine plus serum (r = 0.576 an d 0.621) F levels of cases, respectively.
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… The accompanying fluorosis problem can be observed at various intensity levels in the study area ranging from dental fluorosis to debilitating skeletal fluorosis, along with nonskeletal manifestations and premature aging…
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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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Impact of Community Defluoridation on a Village Endemic for Hydric Fluorosis in Rural Karnataka, India.
Introduction: Excessive intake of fluorides can lead to the development of fluorosis, a serious public health issue in India. The objective of this study was to assess the impact of community defluoridation in preventing fluorosis in Kaiwara village. Methodology: This community interventional trial was conducted in Kaiwara
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Endemic Fluorosis. (An Epidemiológical, Biochemical and Clinical Study in the Bhatinda District of Punjab).
Earlier observations and a review on endemic fluorosis in the Bhatinda District of Punjab were published in 1961 [this Bulletin, 1962, v. 37, 243] and the object of the present paper "is to summarize our epidemiological work done over three years and to emphasize the importance of this work from
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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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Skeletal fluorosis from brewed tea
BACKGROUND: High fluoride ion (F(-)) levels are found in many surface and well waters. Drinking F(-)-contaminated water typically explains endemic skeletal fluorosis (SF). In some regions of Asia, however, poor quality "brick tea" also causes this disorder. The plant source of brick, black, green, orange pekoe, and oolong tea, Camellia
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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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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.
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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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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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Fluoride & Osteomalacia
One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been
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