Abstract
Environmental contamination with cadmium (Cd) and fluorine (F) and the associated health impacts on humans have raised significant concerns in the literature, but the additional health risks created by Cd have not been investigated in areas with endemic fluorine intoxication (fluorosis). Here, we report for the first time that naturally occurring Cd in areas where endemicfluorosis is related to coal combustion is a serious hidden toxin. The high Cd levels in rocks and soils of these areas may increase health risks to epidemiological level, irrespective of fluorine levels. We implemented a pilot study in a fluorosis-affected rural area within China’s Three Gorges region, and revealed enrichment of Cd in local bedrock (4.48-187 mgkg(-1)), coal (11.5-53.4 mgkg(-1)), and arable soils (1.01-59.7 mgkg(-1)). Cadmium was also observed to concentrate in local food crops (0.58-14.9 mgkg(-1)) and in the urine of local residents (1.7-13.4 microgL(-1)). A routine epidemiological investigation revealed that the two major Cd exposure pathways were through crop consumption and inhalation of emissions from coal combustion. Therefore, the naturally occurring Cd in areas with endemic fluorosis related to coal combustion represents a previously unrecognized toxin that must be addressed as part of efforts to control the endemic problem. The biogeochemical processes of Cd and the associated environmental effects will require additional in-depth study.
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Fluorine and Fluorosis [June 1944].
Excerpt The first account of mottled enamel in human beings was given in 1902 by Eager of the United States Public Health Service who noticed its frequency among Italian emigrants from Naples. Black and McKay (1916) found it occurring in various parts of the U.S.A. and described it more fully in
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Skeletal radiographic appearances of high aluminum fluorosis caused by domestic coal fuel (analysis of 39 cases)
PURPOSE: To find out the skeletal radiologic appearances of high aluminum fluorosis caused by burning coal as domestic fuel. MATERIALS AND METHODS: Thirty-nine cases of high aluminum fluorosis caused by eating corns baked by coal and china clay were studied. The authors also investigated the environmental conditions, clinical appearances and other laboratory test
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Industrial Fluorosis [Carnow et al.]
SUMMARY: In 1242 apparently healthy and actively employed workers of a Canadian aluminum facility, the history of musculoskeletal symptoms, of the incidence of fractures, of neck and back surgery, as well as the x-ray findings were reviewed. A highly significant relationship of exposure to fluoride was established with the frequency
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Effects of smoking, use of aluminum utensils, and tamarind consumption on fluorosis in a fluorotic village of Andhra Pradesh, India
A field study was undertaken to determine effects of tamarind, the use of aluminium (Al) cooking utensils, and smoking on dental and skeletal fluorosis in the randomly selected fluoride (F) endemic village of Buttlapally in the Nalgonda District, Andhra Pradesh, India, where the F level in the drinking water is
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Fluoride Sources, Toxicity and Fluorosis Management Techniques - A Brief Review.
Highlights Overexposure to fluoride via drinking water causes several health effects including fluorosis Endemic fluorosis is still persisted in several countries even with advancement in research Most of fluorosis management techniques suggested in the past have come with their own drawbacks Defluoridation techniques based on aluminium materials pose serious
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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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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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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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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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Skeletal Fluorosis Causes Bones to be Brittle & Prone to Fracture
It has been known since as the early as the 1930s that patients with skeletal fluorosis have bone that is more brittle and prone to fracture. More recently, however, researchers have found that fluoride can reduce bone strength before the onset of skeletal fluorosis. Included below are some of the
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