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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Elevated fluoride levels and periostitis in pediatric hematopoietic stem cell transplant recipients receiving long-term voriconazole
Azole therapy is widely utilized in hematopoietic stem cell transplant (HCT) recipients for the treatment of aspergillus. Complications of voriconazole treatment related to its elevated fluoride content have been described in adults, including reports of symptomatic skeletal fluorosis. We review fluoride levels, clinical, and laboratory data in five pediatric HCT recipients
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Fluoride in synovial fluid, bone marrow, and cartilage in patients with osteoarthritis.
The aim of this study was to comp are the concentrations of fluoride (F) in cartilage, bone marrow, and synovial fluid taken from patients with osteoarthritis (OA). We also determined the correlation between OA risk factors, including age, sex, obesity, and hypertension, and F concentrations in the studied materials. The
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Exposure to fluoride in smelter workers in a primary aluminum industry in India
BACKGROUND: Fluoride is used increasingly in a variety of industries in India. Emission of fluoride dust and fumes from the smelters of primary aluminum producing industries is dissipated in the work environment and poses occupational health hazards. OBJECTIVE: To study the prevalence of health complaints and its association with fluoride level
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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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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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Skeletal Fluorosis & Individual Variability
One of the common fallacies in the research on skeletal fluorosis is the notion that there is a uniform level of fluoride that is safe for everyone in the population. These "safety thresholds" have been expressed in terms of (a) bone fluoride content, (b) daily dose, (c) water fluoride level, (d) urinary fluoride level, and (e) blood fluoride level. The central fallacy with each of these alleged safety thresholds, however, is that they ignore the wide range of individual susceptibility in how people respond to toxic substances, including fluoride.
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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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"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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Factors which increase the risk for skeletal fluorosis
The risk for developing skeletal fluorosis, and the course the disease will take, is not solely dependent on the dose of fluoride ingested. Indeed, people exposed to similar doses of fluoride may experience markedly different effects. While the wide range in individual response to fluoride is not yet fully understood, the following are some of the factors that are believed to play a role.
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