Abstract

Clinical and radiological investigations were performed for 2,258 aluminum workers exposed to fluoride for an average of 17.6 yr (standard deviation = 7.6). Changes in bone and joints were presented in detail in three groups: (1) exposed up to 5 yr (135 cases), (2) exposed from 6-32 yr (1,463 cases), and (3) retired workers (660 cases). A semiquantitative assessment of early fluorosis was introduced. A 20.2% incidence of fluorosis was found, but, according to Roholm, only 1.05% was in stage I. The disease was mainly in the pre-stages of O and OI. A close relationship between the occurrence of fluorosis and the time and degree of fluoride exposure was found. The difficulties in diagnosing skeletal fluorosis result from the questionable sensitivity of the x-ray techniques and from the nonspecificity of the associated symptoms. A quantitative method to assess osteosclerosis and bone structure alteration is needed.

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    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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