Abstract
A study was made of an area of endemic fluorosis based on the relation between detection rate or incidence, classification and severity of skeletal fluorosis, and sex-age distribution. The results show that Minzhu Town of Longli County is a moderate and typical epidemic area of endemic fluorosis resulting from coal-burning pollution in Guizhou Province, China. Five features characterize skeletal fluorosis of the residents: (1) Osteosclerosis is significantly more prevalent than osteoporosis. (2) No mixed type of skeletal fluorosis and no osteomalacia were found in the subjects examined. (3) No cases with moderate or severe osteoporosis were found. (4) The severity of osteosclerosis in females was significantly milder than in males. (5) The rate of osteoporosis caused by fluoride in females showed no difference from that in males. These observations provide new parameters for assessing collective conditions of epidemic regions of endemic fluorosis resulting from coal-burning pollution.
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Fluorosis with report of an advanced case.
It is quite possible that endemic centres [of skeletal fluorosis] exist but that the cause of the disabling spondylitis or other joint affections has not been determined, and a diagnosis of chronic arthritis has resulted. Few cases in Canada or the United States will be found to be as dramatic
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Skeletal fluorosis due to excessive tea and toothpaste consumption
We describe the case of a 53-year-old woman who presented with a metatarsal fracture and was found to have a bone mineral density (BMD) T-score of +11 in the lumbar spine and +7.6 in the hip. Subsequent investigation revealed very high serum, urine and tissue fluoride levels, associated with excessive
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Intraosseous schwannoma of the cervical spine associated with skeletal fluorosis
Intraosseous Schwannoma of the cervical spine is very rare. Its association with skeletal fluorosis is also extremely rare. A case of successfully treated intraosseous neurofibroma of the cervical spine associated with skeletal fluorosis causing tetraparesis is reported. The clinical features, diagnostic aspects and the management is described and the literature
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Quantification of rib COL1A2 gene expression in healthy and fluorosed Inner Mongolia cashmere goats.
Damage to collagen protein and its gene expression caused by excessive fluoride (F) ingestion plays an important role in the etiology of skeletal fluorosis. Recently we found that industrial F pollution significantly increased the expression level of type II collagen gene (COL2A1) in rib cartilage of Inner Mongolia cashmere goats. With the same goats and
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Relations between environment and endemic fluorosis in Hohhot region, Inner Mongolia
Results are reported of a comprehensive investigation into fluoride levels in drinking water and other environmental characteristics, and their relation to endemic fluorosis, in Hohhot Region, Inner Mongolia.
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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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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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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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Fluoride Magnifies Impact of Repetitive Stress on Joints
Research has repeatedly found that fluoride's effect on the skeleton is most pronounced in the bones and joints that undergo the greatest strain. Indeed, both the symptoms of fluorosis (i.e., joint pain and stiffness) as well as the radiological findings (e.g., exostoses, interosseuous membrane calcification) have been found to occur earliest, and most severely, in the joints
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