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Severe magnitude of dental and skeletal fluorosis and its impact on society and environment in a part of Manbhum-Singhbhum Plateau, India.
Abstract
Background
Numerous approaches have been adopted to evaluate limited freshwater resources and the associated health hazards due to excessive amounts of fluoride in drinking water. The study aims to assess the degree and severity of dental and skeletal fluorosis and examine the broader effects of fluorosis on human health and society in the Manbhum-Singhbhum Plateau region, India.
Methods
The Community Fluorosis Index (CFI) and Dean’s Index have been used to measure the magnitude and severity of dental and skeletal fluorosis. Questionnaire surveys, Focus Group Discussions (FGDs), and appropriate statistical methods have been applied to identify the social impacts. Risk-prone zones have been identified through overlay analysis using geoinformatics.
Results
About 54.60% of people in 67 villages of this part of the Manbhum-Singhbhum Plateau are affected in varying degrees of fluorosis ranging from very mild to mild, moderate, and severe dental fluorosis. Among these 67 villages, Janra (Manbazar I) and Hijla (Barabazar) have the most severely affected people. School dropout (n?=?426), social isolation (n?=?149), remarriage (n?=?21), and physically disabled (n?=?75) have also been reported. The study shows that about 414.29 km2 of the Manbhum-Singhbhum Plateau comes under the high-risk-prone category.
Conclusions
The societal and environmental awareness of the fluorosis-affected individuals is almost absent in this region. Economic hardships, lack of education, inadequate health care facilities, water scarcity, and lack of awareness increase the magnitude of health hazards and societal vulnerability of the people in this region, who are largely dependent on natural resources.
Full text study online at https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19446-1
Excerpts:
… However, most of the regions of this section of the Manbhum-Singbhum Plateau have moderate to low risk in terms of fluorosis or fluoride hazards. In addition, moderate to low-risk areas cover 1584.24 km2 whereas high to very high areas are 4543.09 km2. Among them, 414.29 km2 comes under high risk prone for fluorosis (Fig. 5).
Fluoride risk zones (high to low) of Purulia district, a part of Manbhum-Singhbhum Plateau- Full size image
Conclusion
This study gives an outline of the detrimental effects of high fluoride levels that affect human health and society in the part of Manbhum-Singhbhum Plateau region. People living in highly contaminated villages are vulnerable to dental and skeletal fluorosis. In most of the villages in this semi-arid fluoride endemic hotspot region, the Community Fluorosis Index is greater than the prescribed value (0.6) as recognized in the Dean’s Index. Some blocks in this tribal-dominated hard rock terrain come within the very risk-prone zone category and suffer from fluorosis-induced hazards. School dropout, social isolation and remarriage are some of the remarkable social consequences which are directly related to the problem of fluoride in this terrain region. However, the present study suggests that awareness through improved education is much needed to fight against the negative impacts of fluoride on the human body and society. Some alternative sources of drinking water are now available in some localities but a wider and large-scale pipe water scheme should be in place to supply water regularly to the high fluoride-contaminated villages. It is also essential to initiate water crisis management in this semi-arid region. This situationis common in Asian countries, particularly in China and India. Therefore, this study will be helpful for better management not only in this part of the Indian subcontinent but also around the different parts of the semi-arid fluoride-contaminated regions of the world.