Abstract

Fluoride  is  widely  distributed  in  nature  and  a  direct  source  of  adverse  health  effects  in  human  populations.  Fluoride poisoning  attributed  by  long-term  exposure  to  high  levels  of  fluoride  [is] called  fluorosis.  The  present  study was  carried  out among  9-14  years  old  school  children  of Dausa  district,  Rajasthan  India.  The  subjects were  selected  from  high  fluoride region  (>2.0  ppm)  and  age matched were  selected  from  Jaipur  district where  fluoride  content was  (<1.5  ppm). A  [questionnaire] was used to collect information from the children’s personal character, clinical health outcome, residential record, educational achievements and  family socioeconomic status. Fluoride  in serum, urine and drinking water were estimated  in both subjects and controls along with serum vitamin (A, C, D and E) and acetylcholinesterase (AChE). The Raven’s Standard Progressive  Matrices  was  used  to  measurement  of  children’s  intelligence.  IQ  scores  and  serum  F  levels  was  directly correlated with the concentration of serum F level. Reduced concentration of vitamin (C, D and E) and AChE activity is the potent markers of  neuro-degeneration.  The  conclusion  of  the  study  is  that  the  excessive  fluoride  delineates  the  neuronal impairment which were evident by reduce IQ score and serum AChE activity.   Moreover, the altered vitamin concentrations which may further lead to brain and bone damage.

EXCERPTS:

Material and Methods
In the present study, 73 school children (male, age- 9 to 14  years) were selected from the high fluoride region of the eastern regions (Rural area of Dausa district) in Rajasthan India where fluoride content in water is more than 2.0 ppm. The affected children were investigated clinically. The subjects were similar in living conditions, parental literacy, socioeconomic status, and health history. Moreover, age and sex matched controls were selected from the rural area of Jaipur district where fluoride content in water was less than 1.5 ppm. The proposed study was approved by the Institutional ethical committee.

Results and Discussion
The demographic distribution in term of age and BMI was insignificant (p>0.05) change in control and subjects in table-1. The concentration of fluoride in drinking water, urine and serum of control and subject groups presented in table-2. Significant (p<0.001) difference were observed in subjects serum fluoride levels and fluoride in their drinking water. The fluoride concentration serum and urine was directly proportional to the concentration of fluoride in drinking water. The IQ scores of the subjects were comparatively reduced as compared to controls. However, subjects exhibited lower IQ. The maximum subjects exhibited the range 80-90 (35%) followed by 90-109 (29%) and 70-79 (22%), while, the maximum controls were exhibited 90-109 (47%) followed by 80-89 (30%) and 70-79 (10%). The cardiac physiology was observed in subject and control in figure-1. The systolic blood pressure were found to be significantly (p=0.05) in subject as compared with controls. While, heart rate and systolic blood pressure was insignificantly (p>0.05) change in subjects as compared to controls. The concentration of hemoglobin was found to be significantly (p<0.05) reduced in subject when compared with age matched controls. The concentration of vitamin A, C, D and E were found to be changes in subjects as compared to controls depicted in figure -2. The concentration of vitamin C, E and D was found to be significantly (p<0.05) reduced in subject when compared with the age matched controls while the concentration of vitamin A was insignificant (p>0.05) changed as compared to controls. The activity of AChE was found to be markedly (p<0.05) reduced in subjects in fluoride exposed subjects when compared with the age matched healthy subjects in figure-3.

Conclusion
The results of the present study may conclude that fluoride exposure promote oxidative stress and alteration in trace metal analysis. These alterations may induce pathophysiological activities due to lack of proper drinking water source. High fluoride content in the drinking water (bore well water) and associated fluoride induced health problem among the children, our team would like to advised the administration to provide an alternative water sources and to provide some specific antioxidant source for preventation of fluoride toxicity in children and other population of Rajasthan who are suffering from fluoride toxicity. However, further in depth studies is required for the understanding of pathophysiology of fluorosis.

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