Skeletal fluorosis

About: Skeletal fluorosis is a research topic. Over the lifetime, 653 publications have been published within this topic receiving 14089 citations.

Fluoride in Drinking-Water

Abstract: Fluoride is known to occur at elevated concentrations in a number of parts of the world where it can be a significant cause of disease. The primary focus of Fluoride in Drinking Water is the prevention of adverse health effects from excessive levels of fluoride in drinking water. The book fills the urgent need, identified for updating the WHO Guidelines for Drinking-water Quality, for information on the occurrence of fluoride, its health effects, ways of reducing excess levels and methods for analysis of fluoride in water. The draft document, produced by a working group of experts convened to consider protection from fluoride and its control, was issued for extensive review and consultation. The resultant book, which incorporates the comments received, was further peer review by experts in developed and developing countries. It is aimed at a wide range of individuals, including health workers and sanitary engineers who may require a broad introduction to the subject with more detailed guidance in some specific areas. Fluoride in Drinking-water will be an invaluable reference source for all those concerned with the management of drinking-water containing fluoride and the health effects arising from its consumption, including water sector managers and practitioners as well as health sector staff at policy and implementation levels. It will also be of interest to researchers, students, and development workers and consultants. Contents Introduction Environmental occurrence, geochemistry and exposure Human health effects Guidelines and standards Removal of excessive fluoride Analytical methods Country data on dental and skeletal fluorosis associated with exposure to fluoride through drinking water Appendix: Indices of severity of dental fluorosis

Fluoride and environmental health: a review

Abstract: The relationship between environmental fluoride and human health has been studied for over 100 years by researchers from a wide variety of disciplines. Most scientists believe that small amounts of fluoride in the diet can help prevent dental caries and strengthen bones, but there are a number of adverse affects that chronic ingestion at high doses can have on human health, including dental fluorosis, skeletal fluorosis, increased rates of bone fractures, decreased birth rates, increased rates of urolithiasis (kidney stones), impaired thyroid function, and lower intelligence in children. Chronic occupational exposure to fluoride dust and gas is associated with higher rates of bladder cancer and variety of respiratory ailments. Acute fluoride toxicity and even death from the ingestion of sodium fluoride pesticides and dental products have also been reported. The distribution of fluoride in the natural environment is very uneven, largely a result of the geochemical behavior of this element. Fluorine is preferentially enriched in highly evolved magmas and hydrothermal solutions, which explains why high concentrations are often found in syenites, granitoid plutonic rocks, alkaline volcanic, and hydrothermal deposits. Fluoride can also occur in sedimentary formations that contain fluoride-bearing minerals derived from the parent rock, fluoride-rich clays, or fluorapatite. Dissolved fluoride levels are usually controlled by the solubility of fluorite (CaF2); thus, high concentrations are often associated with soft, alkaline, and calcium-deficient waters. Although much is known about the occurrence and health effects of fluoride, problems persist in Third World countries, where populations have little choice in the source of their drinking water and food. However, even in developed nations, fluoride ingestion can exceed the recommended dose when sources other than drinking water are ignored.

Fluoride in Natural Waters

Abstract: The element fluorine has long been recognised to have benefits for dental health: low-fluoride intake has been linked to development of dental caries and the use of fluoride toothpastes and mouthwashes is widely advocated in mitigating dental health problems. Fluoridation of water supplies to augment naturally low fluoride concentrations is also undertaken in some countries. However, despite the benefits , optimal doses of fluoride appear to fall within a narrow range. The detrimental effects of ingestion of excessive doses of fluoride are also well documented. Chronic ingestion of high doses has been linked to the development of dental fluorosis, and in extreme cases, skeletal fluorosis. High doses have also been linked to cancer (Marshall 1990), although the association is not well-established (Hamilton 1992).

Geochemistry, genesis, and health implications of fluoriferous groundwaters in the upper regions of Ghana

Abstract: The most appropriate and widely used source of drinking water for the populations of the upper regions of Ghana is groundwater. In general, groundwater quality is acceptable except for some parts of the Bolgatanga and Bongo Districts, where there are occurrences of elevated levels of natural groundwater fluoride. Concentrations of groundwater fluoride in excess of the World Health Organization (WHO) maximum guideline value (1.5 mg/l) in the Bongo area have been known since 1978. However, the effect of fluoride on people ingesting the water did not receive public and medical attention until October 1993, when health personnel were asked to investigate the cause of stained teeth in school children. The investigation established that 62% of the total population of school children in the Bongo area had dental fluorosis. Against this background, a study was initiated to understand the geochemistry, genesis, and distribution of fluoride in relation to the geology of the area. Groundwater fluoride in the upper regions ranges from 0.11 to 4.60 ppm, with the highest concentrations associated with the fluorine-enriched Bongo coarse-grained hornblende granite and syenite suite. The source of groundwater fluoride within the Bongo granitoids is dissolution of the mineral fluorite and dissolution of and anion exchange with micaceous minerals and their clay products. Applying the WHO recommended guideline values for fluoride in drinking water reveals that 49% of wells in the area deliver water below the optimum level of 0.5 mg/l F–; these populations are thus prone to dental caries. Twenty-eight percent of the wells fall within the optimum interval for good dental health (0.5–1.5 mg/l F–). Twenty-three percent of the wells have concentrations above the recommended maximum guideline limit of 1.5 mg/l F–; this population is susceptible to dental and possibly skeletal fluorosis. Climatic conditions of the area suggest that the individual water consumption is in the order of 3 to 4 l which is higher than the WHO estimate of 2 l/adult/day. In addition, dietary intake for the upper region population is probably higher than WHO baseline values (0.2–0.5 mg/day). This implies that a much higher population is susceptible to developing dental and skeletal fluorosis than originally suspected. Geochemical symbol plot maps help geochemists understand factors controlling the distribution and uptake of fluoride in the upper regions, but they are of minimal value to health officials responsible for planning epidemiological studies and dental health education programs in the region. By casting fluoride data into contoured 'geochemical health-risk maps' using intake interval guidelines more closely aligned to regional climatic and dietary conditions, health officals can better judge the impacts (regional and population based) of fluoride on segments of the population, such as various sex and age groups.