Abstract
Highlights
- Fluoride concentrations were 0.55 mg L-1 in 3427 water consumption points in Shanxi Province.
- Health risks were assessed for children consumers regarding fluoride exposure.
- Approximately 10%, 1.3% and 0.06% children are at risk for dental decay, dental and skeletal fluorosis, respectively.
- The fluoride concentrations were being decreased significantly from 2008 to 2017.
- The fluoride endemic areas were marked by GIS mapping system.
Excessive and inadequate intake of fluoride may cause adverse effects in children, such as dental caries and dental fluorosis. This study reports the results of monitoring fluoride concentrations in drinking water from an endemic fluorosis region during the ten-year period (2008 through 2017). The fluoride concentration had a range of 0.03–9.42 mg L-1 (mean = 0.55 ± 0.01 mg L-1). Approximately 10%, 1.3% and 0.06% children are at risk for dental decay, dental fluorosis and skeletal fluorosis, respectively. Probabilistic risks for children were assessed and the fluoride endemic areas were marked by GIS mapping system. On several water consumption points, the hazard quotient (HQ) values for children were higher than 1, indicating potential non-cancer health risks due to fluoride exposure. The results of this study will help governmental agencies to develop better policies for protecting children from exposure to fluoride.
Graphical abstract
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Dental and early-stage skeletal fluorosis in children induced by fluoride in brick-tea
Fluorosis from brick-tea was discovered during the last decade in western and northern parts of China. Dental fluorosis has a high prevalence among children in these brick-tea endemic areas, but skeletal fluorosis does not normally become apparent until adulthood. In July 2002 we examined 132 primary school children, age 8
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The impact of the hyperacid Ijen Crater Lake: risks of excess fluoride to human health.
The Asembagus irrigation area (East Java, Indonesia) receives a high input of fluoride (F) via surface water that partially originates from the hyperacid crater lake of the Ijen volcano. Endemic dental fluorosis among local residents has been ascribed to F in water wells. In this study, the total F intake
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Endemic Fluorosis in the Nellore District of South India.
About the month of April 1936 the district health officer, Nellore, Dr. Lakshminarayana, had his attention drawn by the health inspectors of Podili and Darsi ranges of the Nellore district to a disease characterized by a definite train of symptoms and which was very prevalent in the district. The most
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Occurrence of fluorosis in endemic forms in Hyderabad state.
FIRST PAGE OF PAPER All animal tissues and plants contain fluorine in very small amounts. It is found in soils, rocks and water. No convincing evidence has been as yet produced to show that it performs any useful function in animal nutrition, or that it is essential for animal metabolism. During the
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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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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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Community Fluorosis Index (CFI)
The current Community Fluorosis Index for U.S. adolescents as a whole (from both fluoridated and non-fluoridated areas) is roughly 5 times higher than the CFI health authorities predicted for fluoridated areas when fluoridation first began. It is also higher than the CFI that the NIDR found in fluoridated areas back in the 1980s. It is readily apparent, therefore, that children are ingesting far more fluoride than was the case in the 1950s, and even as recently as the 1980s.
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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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Moderate/Severe Dental Fluorosis
In its "moderate" and severe forms, fluoride causes a marked increase in the porosity of the enamel. After eruption into mouth, the porous enamel of moderate to severe fluorosis readily takes up stain, creating permanent brown and black discolorations of the teeth. In addition to extensive staining, teeth with moderate to severe fluorosis are more prone to attrition and wear - leading to pitting, chipping, and decay.
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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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