These [fluorotic] changes first appear at sites of greatest metabolic activity and stress within a given bone and in bones that are under the greatest stress from weight bearing and locomotion.
In "Indian basket weavers exposed to fluoride, it was observed that the much used left arm and wrist were particularly susceptible to fluorotic exostosis... [T]he areas suffering repeated or constant stress or trauma, and as a result requiring ongoing repair, may be areas of increased circulation and metabolism and, as a consequence, increased deposition of fluorides.
It is concluded that fluoride, ingested in excessive amounts, increases the solubility and degradation of collagen and reduces the collagen biosynthesis and cross-links. Therefore, the matured tissue collagen fibers would be abnormal due to inadequate cross-linking.
NaF [sodium fluoride] produces abnormal collagen fibres which provide an abnormal environment for calcification. The formation of defective collagen fibres during fluoride poisoning may explain the development of neobone in fluorosis. NaF is suggested to interfere with maturation of collegen fibres by exerting an adverse effect on cross-link precursors.
In 1934 there was a report from the United States (Phillips and others) of chronic fluorosis in cattle resulting from the use of rock phosphate. In Great Britain fluorsis arising from atmospheric pollution was reported by Blackmore and others in 1948 and Burns and Allcroft in 1964. Most of the references in the literature reported cases occurring as a result of industrial contamination of herbage, drinking water with a high fluorine content, or experimentally fed sources of fluorine (usually sod
