Abstract
Objective: To observe the clinical characteristics of occupational chronic fluorosis cases and follow up patients?condition changes after they have been transferred from fluoride work.
Methods: In January 2020, the clinical data of occupational chronic fluorosis cases diagnosed in our hospital and their corresponding two-year follow-up data were collected and analyzed. These cases happened in an aluminum factory between January 2010 to January 2020.
Results: Nine patients were diagnosed as occupational chronic mild fluorosis because of long bones and joints pain. Skeletal X-ray examination showed a result of skeletal fluorosis and increased urine fluoride. Among the six patients who have been followed up for two years, two of them showed improvements in both symptoms and skeletal X-ray examination results. Three patients?symptoms were alleviated, but their skeletal X-ray examination results showed no significant change. Besides them, the last patient?s symptoms and skeletal X-ray examination results were aggravated, which was considered related to still exposed to hydrogen fluoride in new position.
Conclusion: Changes of skeletal X-ray examination are the characteristics of occupational chronic fluorosis. By leaving the fluoride position, patients?clinical symptoms can be alleviated, and their bone lesions are not aggravated or even show a trend of alleviating in some cases.
*Original abstract online at https://pubmed.ncbi.nlm.nih.gov/34218562/
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Skeletal Fluorosis: An Unusual Manifestation of Computer Cleaner Inhalant Abuse.
Skeletal fluorosis is a metabolic bone disease caused by accumulation of fluoride and is generally associated with chronic exposure to fluoride-contaminated groundwater, a phenomenon endemic to developing countries. Whereas elevated water fluoride concentrations do not constitute a public health issue in the United States, emergence of skeletal fluorosis as a
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Association of Dietary Calcium Intake with Dental, Skeletal and Non-Skeletal Fluorosis among Women in the Ethiopian Rift Valley.
Fluorosis is a major public health problem in the Rift Valley of Ethiopia. Low calcium (Ca) intake may worsen fluorosis symptoms. We assessed the occurrence of fluorosis symptoms among women living in high-fluoride (F) communities in South Ethiopia and their associations with dietary Ca intake. Women (n = 270) from
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[Epidemiology and clinical study of endemic fluorosis in a village that has improved water for 40 years].
Objective: To investigate the control effect of water improvement for endemic fluorosis over a long period of time, the health status of the residents in the disease area and the restoration to health of endemic fluorosis patients. Methods: It was investigated that the water improvement lasting for 40 years and the rate
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Effects of water improvement and defluoridation on fluorosis-endemic areas in China: A meta-analysis.
Highlights The first analysis of the effect of improving water quality and reducing fluoride in China over 40 years. Analysis of the effect of water improvement and fluoride reduction in different provinces of China. We analyzed the effect of water improvement on dental fluorosis, skeletal fluorosis, and fluoride content
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Impact of Community Defluoridation on a Village Endemic for Hydric Fluorosis in Rural Karnataka, India.
Introduction: Excessive intake of fluorides can lead to the development of fluorosis, a serious public health issue in India. The objective of this study was to assess the impact of community defluoridation in preventing fluorosis in Kaiwara village. Methodology: This community interventional trial was conducted in Kaiwara
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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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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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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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