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Pan F, Zhu S, Shang L, Wang P, Liu L, Liu J. Assessment of drinking water quality and health risk using water quality index and multiple computational models: a case study of Yangtze River in suburban areas of Wuhan, central China, from 2016 to 2021. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:22736-22758. [PMID: 38413522 DOI: 10.1007/s11356-024-32187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/21/2024] [Indexed: 02/29/2024]
Abstract
Water quality, increasingly recognized for its significant impact on health, is garnering heightened attention. Previous studies were limited by the number of water quality indicators and the duration of analysis. This study assessed the drinking water quality and its associated health risk in suburban areas of Wuhan, a city in central China, from 2016 to 2021. We collected 368 finished water samples and 1090 tap water samples and tested these for 37 different indicators. The water quality was evaluated using the water quality index, with trends over time analyzed via the Mann-Kendall test. Furthermore, an artificial neural network model was employed for future water quality prediction. Our findings indicated that the water quality in rural Wuhan was generally good and had an improvement from 2016 to 2021. The qualification and excellent rates were 98.91% and 86.81% for finished water, and 97.89% and 78.07% for tap water, respectively. The drinking water quality was predicted to maintain satisfactory in 2022 and 2023. Additionally, principal component analysis revealed that the primary sanitary issues in the water were poor sensory properties, elevated metal contents, high levels of dissolved solids, and microbial contamination. These issues were likely attributable to domestic and industrial waste discharge and aging water pipelines. The health risks associated with the long-term consumption of this water have been steadily decreasing over the years, underscoring the effectiveness of Wuhan's ongoing water management efforts.
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Affiliation(s)
- Feng Pan
- Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, 430024, People's Republic of China
| | - Sijia Zhu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Lv Shang
- Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, 430024, People's Republic of China
| | - Pei Wang
- Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, 430024, People's Republic of China
| | - Li Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Junling Liu
- Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, 430024, People's Republic of China.
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India Aldana S, Colicino E, Cantoral Preciado A, Tolentino M, Baccarelli AA, Wright RO, Téllez Rojo MM, Valvi D. Longitudinal associations between early-life fluoride exposures and cardiometabolic outcomes in school-aged children. ENVIRONMENT INTERNATIONAL 2024; 183:108375. [PMID: 38128386 PMCID: PMC10842303 DOI: 10.1016/j.envint.2023.108375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/06/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND/AIM Fluoride is a natural mineral present in food, water, and dental products, constituting ubiquitous long-term exposure in early childhood and across the lifespan. Experimental evidence shows fluoride-induced lipid disturbances with potential implications for cardiometabolic health. However, epidemiological studies are scarce. For the first time, we evaluated associations between repeated fluoride measures and cardiometabolic outcomes in children. METHODS We studied ∼ 500 Mexican children from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort with measurements on urinary fluoride at age 4, and dietary fluoride at ages 4, 6, and 8 years approximately. We used covariate-adjusted linear mixed-effects and linear regression models to assess fluoride associations with multiple cardiometabolic outcomes (ages 4-8): lipids (total cholesterol, HDL, LDL, and triglycerides), glucose, HbA1c, adipokines (leptin and adiponectin), body fat, and age- and sex-specific z-scores of body mass index (zBMI), waist circumference, and blood pressure. RESULTS Dietary fluoride intake at age 4 was associated with annual increases in triglycerides [β per-fluoride-doubling = 2.02 (95 % CI: 0.37, 3.69)], cholesterol [β = 1.46 (95 % CI: 0.52, 2.39)], HDL [β = 0.39 (95 % CI: 0.02, 0.76)], LDL [β = 0.87 (95 % CI: 0.02, 1.71)], and HbA1c [β = 0.76 (95 % CI: 0.28, 1.24)], and decreased leptin [β = -3.58 (95 % CI: -6.34, -0.75)] between the ages 4 and 8. In cross-sectional analyses at age 8, higher tertiles of fluoride exposure were associated with increases in zBMI, triglycerides, glucose, and leptin (p-tertile trend < 0.05). Stronger associations were observed in boys at year 8 and in girls prior to year 8 (p-sex interaction < 0.05). Fewer but consistent associations were observed for urinary fluoride at age 4, indicating increased annual changes in HDL and HbA1c with higher fluoride levels. CONCLUSION Dietary fluoride exposures in early- and mid-childhood were associated with adverse cardiometabolic outcomes in school-aged children. Further research is needed to elucidate whether these associations persist at later ages.
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Affiliation(s)
- Sandra India Aldana
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Maricruz Tolentino
- Department of Nutrition, National Institute of Perinatology, Mexico City, Mexico
| | - Andrea A Baccarelli
- Departments of Environmental Health Sciences and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Ahamad A, Janardhana Raju N, Madhav S, Ram P. Fluoride in groundwater of industrial town of Sonbhadra district, Uttar Pradesh, India: probable release mechanism and potential health risk assessment. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:7957-7977. [PMID: 37515726 DOI: 10.1007/s10653-023-01692-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 07/31/2023]
Abstract
In the selected study region of Sonbhadra district, coal burning and mining activities are dominant. Previous studies reported F contamination in very few groundwater samples of this region. A detailed study is required to estimate the fluoride in groundwater of this area. Hence, a total of 128 groundwater samples were collected during post- and pre-monsoon seasons in the year 2017 to estimate the F-, its geochemistry, and health risk assessment from Renukoot and Anpara industrial clusters of Sonbhadra district, Uttar Pradesh, India. The pH of groundwater samples varied from slightly acidic to alkaline during both seasons. Almost all the major cations (Ca2+, Mg2+, Na+, and K+) and major anions (HCO3-, Cl-, SO42-, and F-) values in groundwater samples of both clusters were found within the permissible limit of World Health Organization (WHO) and Beauro of Indian standards except F- in both seasons. The scatter plots of F- with Ca2+, Na+, HCO3-, and pH are used to explain the release mechanism of fluoride in groundwater. Saturation indices (SI) calcite versus SI fluorite and SI dolomite versus SI fluorite plots of both clusters used to check the involvement of these minerals in fluoride enrichment of aquifers. F- contamination in groundwater due to coal burning in coal mining and thermal power plant dominated region is discussed globally and locally both. The non-carcinogenic health risk due to consumption of fluoride-contaminated water is estimated by using target hazard quotient (THQ). THQ values of F- showed that children are at high risk than adults in both clusters of the study area during both seasons. Pictorial representation is used to show the dental fluorosis cases in children of the study region.
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Affiliation(s)
- Arif Ahamad
- Department of Environmental Science, Jamia Millia Islamia (Central University), New Delhi, 110025, India
| | - N Janardhana Raju
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.
| | - Sughosh Madhav
- Department of Civil Engineering, Jamia Millia Islamia (Central University), New Delhi, 110025, India
| | - Prahlad Ram
- DST-SERB, Technology Bhawan, New Mehrauli Road, New Delhi, 110030, India
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Hung M, Mohajeri A, Vu T, Moparthi H, Lipsky MS. Association between fluoride exposure and blood pressure. J Public Health Res 2023; 12:22799036231204323. [PMID: 37822995 PMCID: PMC10563487 DOI: 10.1177/22799036231204323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/22/2023] [Indexed: 10/13/2023] Open
Abstract
Objectives This study investigated whether fluoride was associated with an increased prevalence of high blood pressure (BP) among adolescents in the United States. Methods The study sample consisted of 2015-2016 National Health and Nutrition Examination Survey participants aged 13-17 years. Independent-samples t-tests, Chi-square tests, and regression models were used to analyze the data. Results A total of 814 participants met the study criteria. The findings showed that the proportion of patients with high levels of water or plasma fluoride in the high BP group was higher than that in the normal BP group. However, after adjusting for sociodemographic covariates, neither water nor plasma fluoride levels were significantly associated with a high BP. Conclusions This study did not find an association between either water or plasma fluoride levels and high BP. Further study is needed to exclude a dose dependent effect at higher levels of fluoride.
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Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
- Division of Public Health, University of Utah, Salt Lake City, UT, USA
- Veteran Affairs Salt Lake City Health Care, Salt Lake City, UT, USA
| | - Amir Mohajeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Teresa Vu
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Hyma Moparthi
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Martin S Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
- Institute on Aging, Portland State University, Portland, OR, USA
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Zhou J, Sun D, Wei W. Necessity to Pay Attention to the Effects of Low Fluoride on Human Health: an Overview of Skeletal and Non-skeletal Damages in Epidemiologic Investigations and Laboratory Studies. Biol Trace Elem Res 2023; 201:1627-1638. [PMID: 35661326 DOI: 10.1007/s12011-022-03302-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/26/2022] [Indexed: 12/15/2022]
Abstract
Due to the implementation of water improvement and fluoride reduction plans supported by central and local governments in recent years, areas with high fluoride exposure are being gradually decreased. Therefore, it is of practical importance to study the effect of low fluoride on human health. Epidemiologic investigations and in vivo and in vitro studies based on low fluoride have also confirmed that fluoride not only causes skeletal damage, such as dental fluorosis, but also causes non-skeletal damage involving the cardiovascular system, nervous system, hepatic and renal function, reproductive system, thyroid function, blood glucose homeostasis, and the immune system. This article summarizes the effects of low fluoride on human and animal skeletal and non-skeletal systems. A preliminary exploration of corresponding mechanisms that will help to fully understand the harm of low fluoride on human health was undertaken to provide the basis for establishing new water fluoride standards and help to implement individual guidance.
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Affiliation(s)
- Jing Zhou
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China
| | - Wei Wei
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China.
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China.
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Tang H, Wang M, Li G, Wang M, Luo C, Zhou G, Zhao Q, Dong L, Liu H, Cui Y, Liu L, Zhang S, Wang A. Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 320:120995. [PMID: 36603756 DOI: 10.1016/j.envpol.2022.120995] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/24/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Inflammation mediates the neurological deficits caused by fluoride. Thus, whether inflammation is the underlying mechanism of dental fluorosis (DF) in school-aged children is worth exploring. A cross-sectional study was conducted to investigate the association between inflammation and the prevalence and severity of DF with low-to-moderate fluoride exposure. Fasting morning urine and venous blood samples were collected from 593 children aged 7-14 years. The fluoride content in the water and urine samples was measured using a fluoride ion-selective electrode assay. The levels of interleukin-1β (IL-1β) and C-reactive protein (CRP) were detected using an enzyme-linked immunosorbent assay. The Dean's index was used when performing dental examinations. Regression, stratified, and mediation analyses were performed to analyze the association between fluoride exposure, inflammation, and DF prevalence. In the adjusted regression models, the prevalence of mild DF was 1.723-fold (95% confidence interval [CI]:1.612, 1.841) and 1.594-fold (1.479, 1.717) greater than that of normal DF for each 1 mg/L increase in water and urinary fluoride content, respectively. The prevalence of mild DF increased by 3.3% for each 1 pg/mL increase in the IL-1β level and by 26.0% for each 1 mg/L increase in the CRP level. Stratified analysis indicated a weaker association between fluoride concentration and DF prevalence in boys than in girls, and susceptibility in the boys was reflected by the association of IL-1β with very mild and moderate DF prevalence. For every 1 mg/L increase in water and urinary fluoride levels, the proportion of IL-1β-mediated effects on the prevalence of mild DF was 10.0% (6.1%, 15.8%) and 8.7% (4.8%, 15.2%), respectively, and the proportion of CRP-mediated effects was 9.2% (5.5%, 14.9%) and 6.1% (3.3%, 11.0%), respectively. This study indicates that the DF prevalence may be sex-specific. Inflammatory factors may partially mediate the increased prevalence of mild DF in school-aged children with low-to-moderate fluoride exposure.
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Affiliation(s)
- Huayang Tang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengru Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Henan Center for Disease Control and Prevention, Zhengzhou, Henan, PR China
| | - Gaochun Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengwei Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chen Luo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Guoyu Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Qian Zhao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lixin Dong
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Hongliang Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Yushan Cui
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Li Liu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shun Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Aiguo Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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Li F, Liao S, Zhao Y, Li X, Wang Z, Liao C, Sun D, Zhang Q, Lu Q. Soil exposure is the major fluoride exposure pathways for residents from the high-fluoride karst region in Southwest China. CHEMOSPHERE 2023; 310:136831. [PMID: 36241100 DOI: 10.1016/j.chemosphere.2022.136831] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
In the karst areas of southwest China, soil fluoride levels are higher than in China (478 mg kg-1) and world (200 mg kg-1). High levels of F in the environment might pose a health risk to humans. The comprehensive exposure risk must be studied in this area. Herein, samples of crops and soil were collected from Bijie City, a typical karst area in southwest China, to investigate the pollution level and evaluate the comprehensive F exposure risk. The single-factor index (PFw) and the geological accumulation index (Igeo) were used. The hazard index (HI) was applied to assess exposure risk from multiple exposure routes. The results revealed that there is considerable F contamination in soil and crops in the study area. Average soil total fluorine (Ft) was 1139.13 mg kg-1, and soil water soluble F (Fw) was 3.792 mg kg-1. In corn, rice, wheat, and potatoes, F contents were 1.167-9.585, 1.222-6.698, 1.587-9.976, and 1.797-9.143 mg kg-1, respectively. The mean values of HI were 4.45 and 2.42 for children and adults, respectively, > 1, showing potential health risk exists. Youngsters are at a greater exposure risk than adults. From the results of contribution ratios of different exposure routes for health risk, the major exposure risk was determined to be from soil exposure. Based on this, we suggest that risk managers mainly strive to control the soil fluoride level and implement the risk education and communication.
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Affiliation(s)
- Fumin Li
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Shengmei Liao
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Yifang Zhao
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Xiangxiang Li
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Zelan Wang
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Chaoxuan Liao
- Guizhou Academy of Testing and Analysis, Guizhou, Guiyang, 550014, China
| | - Dali Sun
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Qinghai Zhang
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Qinhui Lu
- School of Public Health, The Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
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Shi Y, Zhong H, Pang L. Maternal micronutrient disturbance as risks of offspring metabolic syndrome. J Trace Elem Med Biol 2023; 75:127097. [PMID: 36272194 DOI: 10.1016/j.jtemb.2022.127097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Metabolic syndrome (MetS) is defined as a constellation of individual metabolic disturbances, including central obesity, hypertension, dyslipidemia, and insulin resistance. The established pathogenesis of MetS varies extensively with gender, age, ethnic background, and nutritional status. In terms of nutritional status, micronutrients are more likely to be discounted as essential components of required nutrition than macronutrients due to the small amount required. Numerous observational studies have shown that pregnant women frequently experience malnutrition, especially in developing and low-income countries, resulting in chronic MetS in the offspring due to the urgent and increasing demands for micronutrients during gestation and lactation. Over the past few decades, scientific developments have revolutionized our understanding of the association between balanced maternal micronutrients and MetS in the offspring. Examples of successful individual, dual, or multiple maternal micronutrient interventions on the offspring include iron for hypertension, selenium for type 2 diabetes, and a combination of folate and vitamin D for adiposity. In this review, we aim to elucidate the effects of maternal micronutrient intake on offspring metabolic homeostasis and discuss potential perspectives and challenges in the field of maternal micronutrient interventions.
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Affiliation(s)
- Yujie Shi
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
| | - Hong Zhong
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Lingxia Pang
- Department of Child Healthcare, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
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The association between fluoride in water and blood pressure in children and adolescents. Pediatr Res 2022; 92:1767-1772. [PMID: 35190682 DOI: 10.1038/s41390-022-01982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/10/2022] [Accepted: 01/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The objective of this study was to determine the association between water and plasma fluoride and blood pressure (BP) among children and adolescents. METHODS Our study population was individuals of 8-18 years in the 2013-2016 National Health and Nutrition Examination Survey. We performed a multivariable linear and logistic regression analysis to examine the relationship between fluoride and BP. RESULTS In a linear regression analysis for systolic BP (SBP) (mm Hg) adjusting for age, sex, race, and poverty, fluoride in water (mg/L) was significant with a coefficient of -0.44 (p = 0.046) among adolescents (12-18 years). Additional adjustments for race, poverty, serum levels of cotinine, and BMI remained significant. While an inverse relationship was found in children (8-11 years), none were significant. Fluoride in plasma was not significant across all ages. The odds ratio of high BP for an increase in water fluoride also was not significant. CONCLUSIONS Higher concentrations of fluoride in water were associated with low SBP only among adolescents. Fluoride alone cannot be responsible for BP as several biological metabolic processes may influence its physiological effects. Fluoride consumption should be considered in conjunction with these processes. IMPACT The high fluoride in drinking water was statistically significantly associated with low systolic BP in children and adolescents. The odds ratio of high BP for an increase in fluoride in drinking water was not significant. Our study contributes to the existing literature by providing individualized data and results on an individual level.
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Ortíz-García SG, Torres-Sánchez LE, Muñoz-Rocha TV, Mercado-García A, Peterson KE, Hu H, Osorio-Yáñez C, Téllez-Rojo MM. Maternal urinary fluoride during pregnancy and birth weight and length: Results from ELEMENT cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156459. [PMID: 35660617 DOI: 10.1016/j.scitotenv.2022.156459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Epidemiological studies assessing prenatal fluoride exposure and anthropometry at birth are scarce, inconsistent and with methodological limitations. The aim of this study was to evaluate associations between maternal urinary fluoride (MUF) at each trimester of pregnancy and birth weight and length in 536 mother-child pairs in the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort study. MUF (mg/L) was measured using microdiffusion/fluoride-specific electrode from at least one trimester of pregnancy. Non-linear associations were assessed through segmented regression models (MUF and birth weight Z-score) and we used linear regression models for MUF and birth length Z-score. Models were adjusted for potential confounders including urinary creatinine concentrations as a covariate. Non-creatinine adjusted MUF levels at each trimester of pregnancy were 0.81, 0.86, and 0.82 mg/L, mean concentrations for first, second and third trimester, respectively. For birth weight, we identified a MUF breakpoint at 0.99, 0.68 and 0.58 mg/L, for first, second and third trimester of pregnancy, respectively. In the first trimester, an increase of 1 mg/L in MUF concentrations ≥0.99 mg/L was associated with an increase in weight Z-score at birth (β = 0.79; 95% CI: 0.10, 1.48; p = 0.02). Second trimester MUF (≥0.68 mg/L) was marginally associated with birth weight decrease (β = -0.25; 95% CI: -0.55, 0.04; p = 0.09) and third trimester MUF (≥0.58 mg/L) was significantly associated with birth weight decrease (β = -0.33; 95% CI: -0.63, -0.03; p = 0.03). We observed a linear and significant association between MUF and Z-score of length at birth only for the first trimester of pregnancy (β = 0.55; 95% CI: 0.07, 1.04; p < 0.02). Prenatal fluoride exposure was associated with birthweight z-score with different susceptibility windows. Our findings reinforce the hypothesis that maternal fluoride exposure may affect birth anthropometry.
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Affiliation(s)
| | | | | | | | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Howard Hu
- University of Washington, School of Public Health, Seattle, WA, USA
| | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INCICH, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de Mexico, Mexico.
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11
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Avila-Rojas SH, Aparicio-Trejo OE, Sanchez-Guerra MA, Barbier OC. Effects of fluoride exposure on mitochondrial function: Energy metabolism, dynamics, biogenesis and mitophagy. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 94:103916. [PMID: 35738460 DOI: 10.1016/j.etap.2022.103916] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/09/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
Fluoride is ubiquitous in the environment. Furthermore, drinking water represents the main source of exposure to fluoride for humans. Interestingly, low fluoride concentrations have beneficial effects on bone and teeth development; however, chronic fluoride exposure has harmful effects on human health. Besides, preclinical studies associate fluoride toxicity with oxidative stress, inflammation, and apoptosis. On the other hand, it is well-known that mitochondria play a key role in reactive oxygen species production. By contrast, fluoride's effect on processes such as mitochondrial dynamics, biogenesis and mitophagy are little known. These processes modulate the size, content, and distribution of mitochondria and their depuration help to counter the reactive oxygen species production and cytochrome c release, thereby allowing cell survival. However, a maladaptive response could enhance fluoride-induced toxicity. The present review gives a brief account of fluoride-induced mitochondrial alterations on soft and hard tissues, including liver, reproductive organs, heart, brain, lung, kidney, bone, and tooth.
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Affiliation(s)
- Sabino Hazael Avila-Rojas
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional. Departamento de Toxicología (CINVESTAV-IPN), Av. IPN No. 2508 Col., San Pedro Zacatenco, México CP 07360, Mexico.
| | | | - Marco Antonio Sanchez-Guerra
- Department of Developmental Neurobiology, National Institute of Perinatology, Montes Urales 800, Lomas Virreyes, Mexico 1100, Mexico.
| | - Olivier Christophe Barbier
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional. Departamento de Toxicología (CINVESTAV-IPN), Av. IPN No. 2508 Col., San Pedro Zacatenco, México CP 07360, Mexico.
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12
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Wang H, Yang L, Gao P, Deng P, Yue Y, Tian L, Xie J, Chen M, Luo Y, Liang Y, Qing W, Zhou Z, Pi H, Yu Z. Fluoride exposure induces lysosomal dysfunction unveiled by an integrated transcriptomic and metabolomic study in bone marrow mesenchymal stem cells. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 239:113672. [PMID: 35617906 DOI: 10.1016/j.ecoenv.2022.113672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
Fluoride has received much attention for its predominant bone toxicity in the human body. However, the toxic mechanism of bone injury caused by fluoride exposure remains largely unclear. Bone marrow mesenchymal stem cells (BMSCs) are widely used as model cells for evaluating bone toxicity after environmental toxicant exposure. In this study, BMSCs were exposed to fluoride at 1, 2, and 4 mM for 24 h, and fluoride significantly inhibited cell viability at 2 and 4 mM. A multiomics analysis combining transcriptomics with metabolomics was employed to detect alterations in genes and metabolites in BMSCs treated with 2 mM fluoride. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of transcriptomics profiles identified "lysosomes" as the top enriched pathway, which was severely damaged by fluoride exposure. Lysosomal damage was indicated by decreases in the expression of lysosomal associated membrane protein 2 (LAMP 2) and cathepsin B (CTSB) as well as an increase in pH. Upregulation of the lysosome-related genes Atp6v0b and Gla was observed, which may be attributed to a compensatory lysosomal biogenesis transcriptional response. Interestingly, inhibition of glutathione metabolism was observed in fluoride-treated BMSCs at the metabolomic level. Moreover, an integrative analysis between altered genes, metabolites and lysosome signaling pathways was conducted. Palmitic acid, prostaglandin C2, and prostaglandin B2 metabolites were positively associated with Atp6v0b, a lysosome-related gene. Overall, our results provide novel insights into the mechanism responsible for fluoride-induced bone toxicity.
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Affiliation(s)
- Hui Wang
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Lu Yang
- Hunan Province Prevention and Treatment Hospital for Occupational Diseases, Hunan, China
| | - Peng Gao
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Ping Deng
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Yang Yue
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Li Tian
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Jia Xie
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Mengyan Chen
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Yan Luo
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China
| | - Yidan Liang
- School of Medicine, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Weijia Qing
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China; The 63710th Military Hospital of PLA, Xinzhou, Shanxi, China
| | - Zhou Zhou
- Department of Environmental Medicine, School of Public Health, and Department of Emergency Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Huifeng Pi
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China.
| | - Zhengping Yu
- Department of Occupational Health (Key Laboratory of Electromagnetic Radiation Protection, Ministry of Education), Third Military Medical University, Chongqing, China.
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Ballantyne JA, Coyle G, Sarwar S, Kühn T. Fluoride Status and Cardiometabolic Health: Findings from a Representative Survey among Children and Adolescents. Nutrients 2022; 14:nu14071459. [PMID: 35406071 PMCID: PMC9003371 DOI: 10.3390/nu14071459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 02/06/2023] Open
Abstract
There is preliminary evidence to suggest a positive association between fluoride exposure and higher blood pressure among children, but population-based biomarker studies are lacking. Thus, data from the 2013/2014 and 2015/2016 cycles of the US-based National Health and Nutrition Examination Survey (NHANES) were analysed to evaluate the association between plasma fluoride concentrations and blood pressure among children and adolescents aged 8 to 19 years. Secondary analyses were carried out on fluoride status in relation to further markers of cardio-metabolic health, i.e., anthropometric indices, biomarkers of lipid and sugar metabolism, and C-reactive protein levels. There was a positive correlation between water fluoride content and plasma fluoride concentrations (Spearman’s r = 0.41, p < 0.01). However, multivariable linear regression models did not show significant differences in adjusted mean values of systolic and diastolic blood pressure across increasing quartiles of fluoride concentrations. Further markers of cardio-metabolic health were not associated with fluoride status, with the exception of a weak inverse association between plasma fluoride and HbA1c levels. Higher plasma fluoride may not be a risk factor for increased blood pressure or impaired cardio-metabolic health among children in the USA, a non-fluoride endemic country, with wide-spread water fluoridation.
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Affiliation(s)
- Jessica A. Ballantyne
- Institute for Global Food Security (IGFS), School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK; (J.A.B.); (G.C.)
| | - Gemma Coyle
- Institute for Global Food Security (IGFS), School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK; (J.A.B.); (G.C.)
| | - Sneha Sarwar
- Institute of Nutrition and Food Sciences, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Tilman Kühn
- Institute for Global Food Security (IGFS), School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK; (J.A.B.); (G.C.)
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +44-28-9097-1387
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14
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Wang A, Ma Q, Gong B, Sun L, Afrim FK, Sun R, He T, Huang H, Zhu J, Zhou G, Ba Y. DNA methylation and fluoride exposure in school-age children: Epigenome-wide screening and population-based validation. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 223:112612. [PMID: 34371455 DOI: 10.1016/j.ecoenv.2021.112612] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Excessive fluoride exposure and epigenetic change can induce numerous adverse health outcomes, but the role of epigenetics underneath the harmful health effects induced by fluoride exposure is unclear. In such gap, we evaluated the associations between fluoride exposure and genome-wide DNA methylation, and identified that novel candidate genes associated with fluoride exposure. A total of 931 school-age children (8-12 years) in Tongxu County of Henan Province (China) were recruited in 2017. Urinary fluoride (UF) concentrations were measured using the national standardized ion selective electrode method. Participants were divided into a high fluoride-exposure group (HFG) and control group (CG) according to the UF concentrations. Candidate differentially methylated regions (DMRs) were screened by Infinium-Methylation EPIC BeadChip of DNA samples collected from 16 participants (eight each from each group). Differentially methylated genes (DMGs) containing DMRs associated with skeletal and neuronal development influenced by fluoride exposure were confirmed using MethylTarget™ technology from 100 participants (fifty each from each group). DMGs were verified by quantitative methylation specific PCR from 815 participants. Serum levels of hormones were measured by auto biochemical analyzer. The mediation analysis of methylation in the effect of fluoride exposure on hormone levels was also performed. A total of 237 differentially methylated sites (DMSs) and 212 DMRs were found in different fluoride-exposure groups in the epigenome-wide phase. Methylation of the target sequences of neuronatin (NNAT), calcitonin-related polypeptide alpha (CALCA) and methylenetetrahydrofolate dehydrogenase 1 showed significant difference between the HFG and CG. Each 0.06% (95% CI: -0.11%, -0.01%) decreased in NNAT methylation status correlated with each increase of 1.0 mg/L in UF concentration in 815 school-age children using QMSP. Also, each 1.88% (95% CI: 0.04%, 3.72%) increase in CALCA methylation status correlated with each increase of 1.0 mg/L in UF concentration. The mediating effect of NNAT methylation was found in alterations of ACTH levels influenced by fluoride exposure, with a β value of 11.7% (95% CI: 3.4%, 33.4%). In conclusion, long-term fluoride exposure affected the methylation pattern of genomic DNA. NNAT and CALCA as DMGs might be susceptible to fluoride exposure in school-age children.
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Affiliation(s)
- Anqi Wang
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Qiang Ma
- Teaching and Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, PR China
| | - Biao Gong
- Department of Endemic Disease, Kaifeng Center for Disease Prevention and Control, Kaifeng, Henan 475004, PR China
| | - Long Sun
- Department of Endemic Disease, Kaifeng Center for Disease Prevention and Control, Kaifeng, Henan 475004, PR China
| | - Francis-Kojo Afrim
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Renjie Sun
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Tongkun He
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Hui Huang
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Jingyuan Zhu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Guoyu Zhou
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China
| | - Yue Ba
- Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China; Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China.
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15
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Li Y, Bi Y, Mi W, Xie S, Ji L. Land-use change caused by anthropogenic activities increase fluoride and arsenic pollution in groundwater and human health risk. JOURNAL OF HAZARDOUS MATERIALS 2021; 406:124337. [PMID: 33144018 DOI: 10.1016/j.jhazmat.2020.124337] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/01/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
Groundwater pollution is becoming a more serious issue because of various anthropogenic activities. A large proportion of the population living in the urbanized and industrialized world is exposed daily to hazardous materials. However, despite the knowledge that protecting groundwater is necessary, little is known about the role of land-use change for human health risks. In this study, we analyzed the temporal and spatial variation of groundwater fluoride (F) and arsenic (As) during 2010-2018 in Shanxi Province of Northern China. Distribution areas of high F and As increased from 2010 to 2018 and spread over time. We assessed human health risk by calculating carcinogenic risk and non-carcinogenic risk. The results showed that F exposure, frequency of high concentration, and risk from 2016 to 2018 were higher than that in 2010-2015, and similar results were obtained for As exposure. Further, land-use change caused by anthropogenic activities increased F and As pollution in groundwater and placed humans at a higher health risk. Our study sheds light on anthropogenic activities that could increase human health risks caused by groundwater F and As via changing land-use. The study provides supports and suggestions for policy-makers to reduce groundwater pollution and prevent adverse health risks to residents.
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Affiliation(s)
- Yuan Li
- School of Environment and Safety, Taiyuan University of Science and Technology, Taiyuan 030024, China; State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Taiyuan Monitoring Station of National Urban Water Quality Monitoring Network, Taiyuan, Shanxi 030009, China.
| | - Yonghong Bi
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China.
| | - Wujuan Mi
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Shulian Xie
- School of Life Science, Shanxi University, Taiyuan 030006, China
| | - Li Ji
- School of Environment and Safety, Taiyuan University of Science and Technology, Taiyuan 030024, China
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16
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Li M, Zhao Y, Tian X, Liu P, Xie J, Dong N, Feng J, Gao Y, Fan Y, Qiu Y, Tian F, Yan X. Fluoride Exposure and Blood Pressure: a Systematic Review and Meta-Analysis. Biol Trace Elem Res 2021; 199:925-934. [PMID: 32602052 DOI: 10.1007/s12011-020-02232-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/31/2020] [Indexed: 12/07/2022]
Abstract
Fluoride exposure may cause changes in blood pressure, but this conclusion is controversial. Therefore, this meta-analysis aims to investigate the potential relationship between fluoride exposure and blood pressure or hypertension. PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), WANFANG MED ONLINE, and Chinese Scientific Journals Full-Text Databases (VIP) were searched; in addition, two related studies were added manually. In total, 7 observational studies were identified, the pooled odds ratios (ORs) for hypertension between high and reference fluoride exposure groups were calculated, and the pooled standardized weighted mean difference (SMD) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was estimated using an inverse-variance weighted random-effects model; next, sensitivity analysis and subgroup analysis were used to assess potential sources of heterogeneity; furthermore, publication bias was assessed using the Begg and Egger test. In brief, there were no statistical differences between exposure groups and control groups in terms of blood pressure or hypertension when all included studies considered. However, subgroup analysis indicated that blood pressure will rise with the increase of fluoride exposure concentrations in endemic fluorosis areas. The corresponding pooled SMD estimates were 0.31 (95% CI 0.11, 0.51) and 0.27 (95% CI 0.11, 0.43) for SBP and DBP. Funnel plots suggested no asymmetry. Our findings support the possibility of a positive correlation between fluoride exposure and blood pressure in endemic fluorosis areas. Additional evidence is needed to assess the dose-response relationship between fluoride exposure and blood pressure.
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Affiliation(s)
- Meng Li
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yannan Zhao
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiaolin Tian
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
- Shanxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, 030801, Shanxi, China
| | - Penghui Liu
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jiaxin Xie
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Nisha Dong
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jing Feng
- Shanxi Key Laboratory of Experimental Animal and Human Disease Animal Models, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yi Gao
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Ye Fan
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yulan Qiu
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Fengjie Tian
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiaoyan Yan
- School of Public Health, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.
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