Numerous reports on epidemiological surveys of skeletal and dental fluorosis exist, but information is quite limited on non-skeletal manifestations of fluoride toxicity. The present study was conducted to assess the prevalence and severity of non-skeletal manifestations, especially gastrointestinal disturbances, in an area o skeletal and dental fluorosis.
The subjects, numbering 1958 inhabitants belonging to 489 families residing in four endemic villages of Faridabad District of Haryana State, were interviewed on health complaints. The information was recorded in a precoded questionnaire. Every drinking water source was analyzed for fluoride content. This led to the identification of “safe” (fluoride 1 ppm or less) and “contaminated” (fluoride above 1 ppm) sources of water.
Results revealed that among the subjects were people affected with: 1) Dental fluorosis (58%), 2) Skeletal fluorosis (27%), 3) Non-skeletal manifestations (41%) and 4) Gastrointestinal complaints (26%). Those affected were consuming water contaminated with fluoride ranging from 0.25-8.00 ppm. Among the total of 78 sources of water, 20 were “safe” while the remaining 58 were more contaminated with fluoride from natural sources.
It is concluded that in an endemic zone, where the inhabitants are consuming water of high fluoride content, the occurrence of gastrointestinal complaints – viz., loss of appetite, nausea, abdominal pain, flatulence, constipation and intermittent diarrhoea – is one of the early warning signs of fluoride toxicity and fluorosis. When water with negligible amounts of fluoride (safe water) is provided, the complaints disappear within a fortnight.