Fluoride Journal
HEALTH/BIOLOGICAL EFFECTS IN HUMANS
FLUORIDE IN DRINKING WATER: A REVIEW ON THE STATUS AND STESS EFFECTS
According to latest estimates, around 200 million people residing in 25 nations are exposed to toxic levels of fluoride in their drinking water. China and India, the two most populous countries in the world, are the worst affected. India in particular has numerous water quality problems caused by prolific fluoride contamination of geological origin. Weathering of primary rocks and leaching of fluoride minerals in soils produce fluoride-rich groundwater generally associated with low levels of calcium and bicarbonate ions. Unfettered tapping of
groundwater exacerbates the failure of drinking water sources and accelerates the entry of fluoride into groundwater. Despite claims of anticaries benefits, average fluoride concentrations as low as 0.5 and 0.7 ppm have been found in India to cause dental and skeletal fluorosis, respectively, with crippling effects often seen at higher concentrations. Nearly 37,000 habitations in India are known to be affected, and the numbers continue to increase. A close association between poverty and fluorosis occurs with malnutrition playing an aggressive
role in its severity. The review cites 311 references and has 13 tables and five maps, including the occurrence of endemic fluorosis globally, in India, and in several other countries.
Authors: Ayoob S, Gupta AK.
Correspondence: AK Gupta, Environmental Engineering Division, Department of Civil
Engineering, Indian Institute of Technology, Karagpur, India. E-mail: akgupta@iitkgp.ac.in
Keywords: Crippling skeletal fluorosis; Dental caries; Dental fluorosis; Drinking water fluoride;
Endemic fluorosis; Fluoride water; Fluorosis worldwide; Skeletal fluorosis.
Source: Crit Rev Environ Sci Technol 2006;36:433-87.
DOSE-EFFECT RELATIONSHIP BETWEEN DRINKING WATER FLUORIDE LEVELS AND DAMAGE TO
LIVER AND KIDNEY FUNCTIONS IN CHILDREN
Although a dose-effect relationship between water fluoride levels and damage to liver and kidney functions has been reported in animals, it apparently has not been clearly demonstrated in humans. To evaluate the effects of drinking water fluoride levels on the liver and kidney functions in children with and without dental fluorosis, we identified 210 children who were divided into seven groups with 30 each based on different drinking water fluoride levels in the same residential area. We found that the fluoride levels in serum and urine of these children increased as the levels of drinking water fluoride increased. There were no significant differences in the levels of total protein (TP), albumin (ALB), aspartate transamine (AST), and alanine transamine (ALT) in serum among these groups. However, the activities of serum lactic dehydrogenase (LDH), urine N-acetyl-beta-glucosaminidase (NAG), and urine gammaglutamyltranspeptidase (gamma-GT) in children with dental fluorosis and having water fluoride of 2.15–2.96 mg/L and in children having water fluoride of 3.15–5.69 mg/L, regardless of dental fluorosis, were significantly higher than in children exposed to water
fluoride of 0.61–0.87 mg/L in a dose-response manner. In contrast to children with dental fluorosis and having water fluoride of 2.15–2.96 and 3.10–5.69 mg/L, the serum LDH activity of children without dental fluorosis but exposed to the same levels of water fluoride as those with dental fluorosis was also markedly lower, but the activities of NAG and gamma-GT in their urine were not. Therefore, our results suggest that drinking water fluoride levels above 2.0 mg/L can cause damage to liver and kidney functions in children and that dental fluorosis was independent of damage to the liver but not the kidney. Further studies on the mechanisms
and significance underlying damage to the liver without dental fluorosis in the exposed children are warranted.
Authors: Xiong X, Liu J, He W, Xia T, He P, Chen X, Yang K, Wang A.
Correspondence: Department of Respiratory Disease, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, 430030 Hubei, People's Republic of
China.
Keywords: Children; Dental fluorosis; Drinking water; Fluoride; Kidney function; Liver function;
Serum enzymes; Urine enzymes.
Source: Environ Res 2007 Jan;103(1):112-6.
Copyright © 2007 International Society for Fluoride Research.
www.fluorideresearch.org www.fluorideresearch.com www.fluorideresearch.net
Editorial Office: 727 Brighton Road, Ocean View, Dunedin 9035, New Zealand.
FLUORIDE IN DRINKING WATER: A REVIEW ON THE STATUS AND STESS EFFECTS
According to latest estimates, around 200 million people residing in 25 nations are exposed to toxic levels of fluoride in their drinking water. China and India, the two most populous countries in the world, are the worst affected. India in particular has numerous water quality problems caused by prolific fluoride contamination of geological origin. Weathering of primary rocks and leaching of fluoride minerals in soils produce fluoride-rich groundwater generally associated with low levels of calcium and bicarbonate ions. Unfettered tapping of
groundwater exacerbates the failure of drinking water sources and accelerates the entry of fluoride into groundwater. Despite claims of anticaries benefits, average fluoride concentrations as low as 0.5 and 0.7 ppm have been found in India to cause dental and skeletal fluorosis, respectively, with crippling effects often seen at higher concentrations. Nearly 37,000 habitations in India are known to be affected, and the numbers continue to increase. A close association between poverty and fluorosis occurs with malnutrition playing an aggressive
role in its severity. The review cites 311 references and has 13 tables and five maps, including the occurrence of endemic fluorosis globally, in India, and in several other countries.
Authors: Ayoob S, Gupta AK.
Correspondence: AK Gupta, Environmental Engineering Division, Department of Civil
Engineering, Indian Institute of Technology, Karagpur, India. E-mail: akgupta@iitkgp.ac.in
Keywords: Crippling skeletal fluorosis; Dental caries; Dental fluorosis; Drinking water fluoride;
Endemic fluorosis; Fluoride water; Fluorosis worldwide; Skeletal fluorosis.
Source: Crit Rev Environ Sci Technol 2006;36:433-87.
DOSE-EFFECT RELATIONSHIP BETWEEN DRINKING WATER FLUORIDE LEVELS AND DAMAGE TO
LIVER AND KIDNEY FUNCTIONS IN CHILDREN
Although a dose-effect relationship between water fluoride levels and damage to liver and kidney functions has been reported in animals, it apparently has not been clearly demonstrated in humans. To evaluate the effects of drinking water fluoride levels on the liver and kidney functions in children with and without dental fluorosis, we identified 210 children who were divided into seven groups with 30 each based on different drinking water fluoride levels in the same residential area. We found that the fluoride levels in serum and urine of these children increased as the levels of drinking water fluoride increased. There were no significant differences in the levels of total protein (TP), albumin (ALB), aspartate transamine (AST), and alanine transamine (ALT) in serum among these groups. However, the activities of serum lactic dehydrogenase (LDH), urine N-acetyl-beta-glucosaminidase (NAG), and urine gammaglutamyltranspeptidase (gamma-GT) in children with dental fluorosis and having water fluoride of 2.15–2.96 mg/L and in children having water fluoride of 3.15–5.69 mg/L, regardless of dental fluorosis, were significantly higher than in children exposed to water
fluoride of 0.61–0.87 mg/L in a dose-response manner. In contrast to children with dental fluorosis and having water fluoride of 2.15–2.96 and 3.10–5.69 mg/L, the serum LDH activity of children without dental fluorosis but exposed to the same levels of water fluoride as those with dental fluorosis was also markedly lower, but the activities of NAG and gamma-GT in their urine were not. Therefore, our results suggest that drinking water fluoride levels above 2.0 mg/L can cause damage to liver and kidney functions in children and that dental fluorosis was independent of damage to the liver but not the kidney. Further studies on the mechanisms
and significance underlying damage to the liver without dental fluorosis in the exposed children are warranted.
Authors: Xiong X, Liu J, He W, Xia T, He P, Chen X, Yang K, Wang A.
Correspondence: Department of Respiratory Disease, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, 430030 Hubei, People's Republic of
China.
Keywords: Children; Dental fluorosis; Drinking water; Fluoride; Kidney function; Liver function;
Serum enzymes; Urine enzymes.
Source: Environ Res 2007 Jan;103(1):112-6.
Copyright © 2007 International Society for Fluoride Research.
www.fluorideresearch.org www.fluorideresearch.com www.fluorideresearch.net
Editorial Office: 727 Brighton Road, Ocean View, Dunedin 9035, New Zealand.
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