Abstract
Long-term natural geochemical processes result in wide occurrence of fluoride contamination in underground water and fluoride exposure via drinking water for over 500 million people globally. The control of fluoride pollution and fluorosis is one of the most important issues for drinking water safety. In the past several decades, many initiatives failed in defluoridation of water. Better understanding of fluoride occurrence mechanisms in underground water chemistry and the prediction of high-risk areas by geographic information and remote sensing are of crucial importance to minimize fluorosis occurrence. The use of alternative source water or blending should be considered as priority option. Much efforts should be devoted to the fundamental studies on defluoridation reagents and innovative materials, and to the development of highly-efficient, economic, easy-to-handle and stable technologies and integrated instruments. Furthermore, the design, construction, operation, and supervision of defluoridation facilities should be carefully evaluated and strengthened to achieve stable benefits as much as possible.
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The relationship between water-borne fluoride, dental fluorosis and skeletal development in 11-15 year old Tanzanian girls
Dental fluorosis was evaluated by a classification system, previously shown to be sensitive, and skeletal changes evaluated by bone maturity and structure. Dental fluorosis was more severe in posterior than in anterior teeth in both jaws irrespective of fluoride concentration of the drinking water. There appeared to be no dependence between fluoride content
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Age-sex specific disability-adjusted life years (DALYs) attributable to elevated levels of fluoride in drinking water: A national and subnational study in Iran, 2017.
Highlights DALYs attributable to elevated water fluoride levels in Statistical Center of Iran, 2017 were estimated. The attributable DALYs and DALY rate in Statistical Center of Iran, 2017 were respectively 3443 and 4.31. About 94% of the attributable DALYs were concentrated in 4 out of 31 provinces. Over 66%
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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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Distribution of fluoride contamination in drinking water resources and health risk assessment using geographic information system, northwest Iran.
Highlights Fluorosis is a considerable health problem worldwide. High concentrations fluoride above 3 mg l?1 may cause dental and skeletal fluorosis. HQ indicated health risk assessment in relation to F- concentration for children and adults were significant. The fluoride contamination must be reduced in this study area to decrease endemic
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Clinical aspects of fluorosis in horses
Horses grazing in areas where cattle and sheep had developed severe fluorosis were examined clinically. Of those examined, 12 horses of different ages and with various degrees of fluorosis were selected for necropsy. Selected tissues were examined grossly, histologically, and radiographically. Major fluorotic lesions occurred only when the horses ingested
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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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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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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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Fluoride & DISH (Diffuse Idiopathic Skeletal Hyperostosis)
Among individuals with skeletal fluorosis, the fluoride-induced changes to the spine, and the accompanying symptoms, can bear a close resemblance to DISH (Forestier's Disease). Some authors report that skeletal fluorosis can so closely resemble that DISH that the only way to distinguish the two would be to conduct an invasive bone biopsy. No studies have ever been conducted to determine what role, if any, fluoride plays in the development of DISH.
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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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