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Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X, Jensen N, Terrell R, Hemmerich A, Krewski D. Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol 2024; 54:2-34. [PMID: 38318766 DOI: 10.1080/10408444.2023.2295338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns have been raised about several other potential health risks of fluoride. OBJECTIVE To conduct a robust synthesis of evidence regarding human health risks due to exposure to fluoride in drinking water, and to develop a point of departure (POD) for setting a health-based value (HBV) for fluoride in drinking water. METHODS A systematic review of evidence published since recent reviews of human, animal, and in vitro data was carried out. Bradford Hill considerations were used to weigh the evidence for causality. Several key studies were considered for deriving PODs. RESULTS The current review identified 89 human studies, 199 animal studies, and 10 major in vitro reviews. The weight of evidence on 39 health endpoints was presented. In addition to dental fluorosis, evidence was considered strong for reduction in IQ scores in children, moderate for thyroid dysfunction, weak for kidney dysfunction, and limited for sex hormone disruptions. CONCLUSION The current review identified moderate dental fluorosis and reduction in IQ scores in children as the most relevant endpoints for establishing an HBV for fluoride in drinking water. PODs were derived for these two endpoints, although there is still some uncertainty in the causal weight of evidence for causality for reducing IQ scores in children and considerable uncertainty in the derivation of its POD. Given our evaluation of the overall weight of evidence, moderate dental fluorosis is suggested as the key endpoint until more evidence is accumulated on possible reduction of IQ scores effects. A POD of 1.56 mg fluoride/L for moderate dental fluorosis may be preferred as a starting point for setting an HBV for fluoride in drinking water to protect against moderate and severe dental fluorosis. Although outside the scope of the current review, precautionary concerns for potential neurodevelopmental cognitive effects may warrant special consideration in the derivation of the HBV for fluoride in drinking water.
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Affiliation(s)
- Mohamed Kadry Taher
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Jennifer Go
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Shintaro Hagiwara
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Siva Ramoju
- Risk Sciences International, Ottawa, ON, Canada
| | - Xuefeng Hu
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Natalie Jensen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Rowan Terrell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Alex Hemmerich
- Risk Sciences International, Ottawa, ON, Canada
- Faculty of Education, Queen's University, Kingston, ON, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
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Pang T, Aye Chan TS, Jande YAC, Shen J. Removal of fluoride from water using activated carbon fibres modified with zirconium by a drop-coating method. CHEMOSPHERE 2020; 255:126950. [PMID: 32380266 DOI: 10.1016/j.chemosphere.2020.126950] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
Metal-modified carbon materials have been widely used for fluoride removal, but the traditional impregnation by soaking method suffers from low loading of metals and substantial use of chemicals. This study proposed a new approach to prepare zirconium modified activated carbon fibres (Zr-ACF) by a drop-coating method. Using the same amount of chemicals, the drop-coating method yielded a 5.5 times higher fluoride adsorption capacity than the soaking method due to more effective loading of Zr(IV) onto ACF. The effects of various preparation conditions, including the addition of a complexing agent (oxalic acid) and Zr/ACF mass ratio (0.2-1), were investigated. Zr-ACF prepared by drop-coating was characterised by SEM and BET, and the functional groups involved in the anchoring of Zr(IV) on ACF and the adsorption of fluoride onto Zr-ACF were identified by FTIR and XPS. Adsorption experiments at pH between 3 and 11 revealed that ion exchange and electrostatic attraction were the main adsorption mechanisms at different pH levels. Co-existing anions such as CO32-, HCO3- and Cl- had an insignificant negative impact (<5%) on fluoride adsorption capacity while SO42- decreased fluoride adsorption capacity by 11.5%. The adsorption kinetics followed the pseudo-second-order model. The adsorption isotherms followed the Langmuir isotherm model with a maximum fluoride adsorption capacity of 28.50 mg/L at 25 °C, which was higher than other carbon-based materials in the literature. The remarkable improvement of adsorption capacity and reduced chemical consumption demonstrate that Zr-ACF prepared by drop-coating is a promising adsorbent for fluoride removal.
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Affiliation(s)
- Tianting Pang
- Department of Chemical Engineering, University of Bath, Bath, BA2 7AY, UK
| | - Thet Su Aye Chan
- Department of Chemical Engineering, University of Bath, Bath, BA2 7AY, UK
| | - Yusufu Abeid Chande Jande
- Water Infrastructure and Sustainable Energy Futures (WISE-Futures) Center, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania; Department of Materials and Energy Science and Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Junjie Shen
- Department of Chemical Engineering, University of Bath, Bath, BA2 7AY, UK; Centre for Advanced Separations Engineering (CASE), University of Bath, Bath, BA2 7AY, UK; Water Innovation and Research Centre (WIRC), University of Bath, Bath, BA2 7AY, UK.
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