Abstract
Serum fluoride in relation to the prevalence of skeletal fluorosis was investigated in two villages in Jiangsu Province, China. In the high-fluoride village of Wamiao, 132 adults (average age 52.36 years; water fluoride 2.18±0.86mg/L; range 0.85–4.50mg/L) were surveyed. In the low-fluoride village of Xinhuai, 35 adults (average age 48.11 years; water fluoride 0.37±0.09 mg/L; range 0.21–0.55mg/L) were surveyed. Subjects were recruited by sampling according to the fluoride content of the drinking water in their household wells. When the subjects were divided into five subgroups according to their serum fluoride concentration, higher serum fluoride concentration was strongly associated with a higher prevalence of skeletal fluorosis in the form of a significant positive dose-response relationship (regression equation: Y = –27.29+890.42X–223.20X2). In Wamiao village a significant difference was also found between serum fluoride concentrations in 41 subjects with X-ray detectable skeletal fluorosis and in 91 subjects without X-ray detectable skeletal fluorosis. Gender related differences in serum fluoride concentration, household well water fluoride, and the prevalence of skeletal fluorosis were not found in the subjects in Wamiao village. These findings indicate that serum fluoride concentrations have a significant positive dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water.
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[Cervical myelopathy revealing bone fluorosis].
Bone fluorosis is a rare metabolic disease characterized by massive bone fixation of fluorine. It is seen endemically around phosphate mines in North Africa. Neurologic complications, such as medullar compression may rarely reveal the disease. We report a case of cervical myelopathy due to bone fluorosis causing tetraparesis. Medullar compression was caused by posterior
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Studies on fluorosis in Mehsana District of North Gujarat.
A survey was conducted in eighteen fluoride endemic villages in Mehsana District of North Gujarat (India). The individuals afflicted with fluorosis were examined for apparent mottled teeth and skeletal complications. Samples of urine and blood of these individuals along with drinking water were collected and compared with samples obtained from
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Experimental fluorosis in rats: NaF induced changes of bone and bone marrow
The results of our experiments suggest that increased doses of NaF cause more extensive osteosclerosis due to the decrease in number and/or activity of osteoclasts. Therefore oateosclerosis is caused primarily, not by increased bone formation but, by the inhibition of bone resorption. This view is supported by the fact that
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Investigations of soft tissue funtions in fluorotic Individuals of north Gujarat
The present study was undertaken to investigate the various health problems caused by water-borne fluoride in endemic villages of Mehsana and Banaskantha districts of Gujarat. The study revealed high levels of fluoride in serum samples of the villagers. Mottling of teeth and skeletal complications were common. Intake of fluoride caused
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Endemic fluorosis in southern Rajasthan, India
Chronic fluoride intoxication in the form of osteo-dental fluorosis was investigated in 21 villages of Banswara, Dungarpur, and Udaipur districts of southern Rajasthan, where fluoride (F) concentrations in drinking waters range from 1.5 to 4.0 ppm. Interestingly, a variable prevalence of fluorosis was observed in villages having almost the same
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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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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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X-Ray Diagnosis of Skeletal Fluorosis
In 1937, Kaj Roholm published his seminal study Fluorine Intoxication in which he described three phases of bone changes that occur in skeletal fluorosis. (See below). These three phases, which are detectable by x-ray, have been widely used as a diagnostic guide for detecting the disease. They describe an osteosclerotic bone disease that develops first in the axial skeleton (the spine, pelvis, and ribs), and ultimately results in extensive calcification of ligaments and cartilage, as well as bony outgrowths such as osteophytes and exostoses. Subsequent research has found, however, that x-rays provide a very crude measure for diagnosing fluorosis since the disease can cause symptoms and effects (e.g., osteoarthritis) before, and in the absence of, radiologicaly detectable osteosclerosis in the spine.
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Fluoride & Osteopetrosis
One of the most common radiological findings in skeletal fluorosis is osteosclerosis - a hardening of bones with a blurring of the trabecular structure. In advanced cases, the osteosclerotic form of fluorosis may closely resemble the appearance of osteopetrosis, a "marble bone" disease in which the bones are dense, but fragile and prone to fracture.
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