Spatial distribution and temporal variation of high fluoride contents in groundwater and prevalence of fluorosis in humans in Yuanmou County, Southwest China

Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure

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.

Identifying the geochemical evolution and controlling factors of the shallow groundwater in a high fluoride area, Feng County, China

Understanding how groundwater is formed and evolves is critical for water resource exploitation and utilization. In this study, hydrochemistry and stable isotope tracing techniques were adopted to determine the key factors influencing groundwater chemical evolution in Feng County. A total of fourteen wells and five surface water samples were investigated in November 2021. The δD and δ¹⁸O compositions show that both surface water and groundwater are recharged from atmospheric precipitation. The dominating order of cations and anions in groundwater appears to be Na⁺ > Mg²⁺ > Ca²⁺ > K⁺ and HCO₃^- > SO₄^2- > Cl^- > NO₃^- > F^-, respectively. The groundwater hydrochemical facies are mainly characterized by HCO₃-Ca-Mg and SO₄-Cl-Na types. The chemical evolution of groundwater is dominated by water-rock interaction and cation exchange reactions. The major ions in groundwater are mainly controlled by various geogenic processes including halite, gypsum, calcite, dolomite, Glauber's salt, feldspar, and fluorite dissolution/precipitation. Furthermore, the abundant fluoride-bearing sediments, together with low Ca²⁺, promote the formation of high F^- groundwater. Approximately 85.7% and 28.6% of groundwater samples exceeded the permissible limit for F^- and NO₃^- respectively. Apart from geogenic F^-, human interventions (i.e., industrial fluoride-containing wastewater discharge and agricultural phosphate fertilizer uses) also regulate the F^- enrichment in the shallow groundwater. Nitrate pollution of the groundwater may be attributed to domestic waste and animal feces. Our findings could provide valuable information for the sustainable exploitation of groundwater in the study area and the development of effective management strategies by the authorities.

Advances in electrospun nanofibrous membrane sensors for ion detection

Harmful metal ions and toxic anions produced in industrial processes cause serious damage to the environment and human health. Chemical sensors are used as an efficient and convenient detection method for harmful ions. Electrospun fiber membranes are widely used in the field of solid-state chemical sensors due to high specific surface area, high porosity, and strong adsorption. This paper reviews the solid-state chemical sensors based on electrospinning technology for the detection of harmful heavy metal ions and toxic anions in water over the past decade. These electrospun fiber sensors have different preparation methods, sensing mechanisms, and sensing properties. The preparation method can be completed by physical doping, chemical modification, copolymerization, surface adsorption and self-assembly combined with electrospinning, and the material can also be combined with organic fluorescent molecules, biological matrix materials and precious metal materials. Sensing performance aspects can also be manifested as changes in color and fluorescence. By comparing the literature, we summarize the advantages and disadvantages of electrospinning technology in the field of ion sensing, and discuss the opportunities and challenges of electrospun fiber sensor research. We hope that this review can provide inspiration for the development of electrospun fiber sensors.

Novel machine learning techniques based hybrid models (LR-KNN-ANN and SVM) in prediction of dental fluorosis in groundwater

Studies have shown that excessive intake of fluoride into human body from drinking water may cause fluorosis adversely affects teeth and bones. Fluoride in water is mostly of geological origin and the amounts depend highly on many factors such as availability and solubility of fluoride minerals as well as hydrogeological and geochemical conditions. Chemical methods usually accomplish fluoride analysis in drinking water. The chemical methods are expensive, labor-intensive and time-consuming in general although accurate and reliable results are obtained. An alternative cost-effective approach based on machine learning (ML) technique is investigated in this study. Furthermore, most effective input parameters are selected via proposed Simulated Annealing (SA) search scheme. Selected subset (SAR, K⁺, NO₃^-, NO₂^-, Mn, Ba and Fe) by SA algorithm exhibited high correlation coefficient values of 0.731 and strong t test scores of 5.248. On the other hand, most frequently selected individual features were identified as NO₃^-, NO₂^-, Fe and SAR by vote map. The results of experiments revealed that selected feature subset improves the prediction performance of the learning models while feature size is reduced substantially. Thus it eventually enabled determination of fluoride in a cheap, fast and feasible way.

Spatial and seasonal variability, control factors and health risk of fluoride in natural water in the Loess Plateau of China

Hundreds of millions of people around the world are currently exposed to excessive amounts of fluoride (F^-) in drinking water. Although the factors controlling the spatiotemporal distribution of F^- contents have been analyzed, their contributions have rarely been quantified. In this study, 510 water samples were collected in the dry and wet seasons in China's Loess Plateau to investigate the spatial and seasonal distribution, controlling factors, and potential health risks of F^- in natural water. High-F^- waters were mainly distributed in valley areas of the Loess Plateau, and more severe fluoride pollution of streamwater and groundwater was found in the wet and dry seasons, respectively. Mineral dissolution, competitive adsorption, adsorption/desorption and cation exchange jointly controlled F^- enrichment. Spatiotemporal distribution of high-F^- levels was mainly determined by climate and streamwater-groundwater connectivity in the dry season, with contribution rates of 41.7% and 37.6%, and by terrain and anthropogenic activities in the wet season, with contribution rates and 49.9-55.6% and 30.7%, respectively. Fluoride in groundwater through oral intake posed the greatest health risks to infants, followed by children, teenagers and adults in the dry and wet seasons. This study provides a scientific basis for the effective management of high-F^- water in arid regions.

The performance of water-soluble fluoride transformation in soil-tea-tea infusion chain system and the potential health risk assessment

BACKGROUND

Water-soluble fluoride (WS-F) can be absorbed directly by tea plants from soil and comprises a major source of dietary F in tea consumers. To reveal the WS-F accumulation in tea leaves and assess WS-F health risks, 70 sets of samples including tea leaves at three maturity stages and corresponding topsoil were collected from Xinyang, China. The WS-F contents in tea samples and pH values in soil samples were determined.

RESULTS

The contents of WS-F in tea leaves exhibited a positive correlation with leaf maturity. The contents of WS-F in tea leaves showed a positive correlation with WS-F contents in the soil as the soil pH value exceeds 5. All the bud with two leaves samples, 84.29% of the third to sixth leaves samples, and 78.57% mature leaves samples in 5-min infusion tend to be no health threat. The leaching characteristics of WS-F from tea leaves were influenced by the leaf maturity and soaking time.

CONCLUSION

Taking measures to control pH and WS-F concentration of plantations soil, as well as drinking tea infusion made from young leaves or reducing soaking time could decrease the WS-F health risk. © 2021 Society of Chemical Industry.

The cholinergic system, intelligence, and dental fluorosis in school-aged children with low-to-moderate fluoride exposure

Disruption of cholinergic neurotransmission can affect cognition, but little is known about whether low-to-moderate fluoride exposure affects cholinergic system and its effect on the prevalence of dental fluorosis (DF) and intelligence quotient (IQ). A cross-sectional study was conducted to explore the associations of moderate fluoride exposure and cholinergic system in relation to children's DF and IQ. We recruited 709 resident children in Tianjin, China. Ion selective electrode method was used to detect fluoride concentrations in water and urine. Cholinergic system was assessed by the detection of choline acetyltransferase (ChAT), acetylcholinesterase (AChE) and acetylcholine (ACh) levels in serum. Compared with children in the first quartile, those in fourth quartile the risk of either developing DF or IQ < 120 increased by 19% and 20% for water and urinary fluoride. The risk of having both increased by 58% and 62% in third and fourth quartile for water fluoride, 52% and 65% for urinary fluoride. Water fluoride concentrations were positively associated with AChE and negatively associated with ChAT and ACh, trends were same for urinary fluoride except for ACh. The risk of either developing DF or having non-high intelligence rose by 22% (95%CI: 1.07%, 1.38%) for the fourth quartile than those in the first quartile of AChE, for having the both, the risk was 1.27 (95%CI: 1.07, 1.50), 1.37 (95%CI: 1.17, 1.62) and 1.44 (95%CI: 1.23, 1.68) in second, third and fourth quartiles. The mediation proportion by AChE between water fluoride and either developing DF or IQ < 120 was 15.7%. For both to exist, the proportion was 6.7% and 7.2% for water and urinary fluoride. Our findings suggest low-to-moderate fluoride exposure was associated with dysfunction of cholinergic system for children. AChE may partly mediate the prevalence of DF and lower probability of having superior and above intelligence.

Hydrogeogenic fluoride in groundwater and dental fluorosis in Thai agrarian communities: a prevalence survey and case-control study

Background

Dental fluorosis can be a disease of social inequity in access to safe drinking water. This dental public health issue becomes prominent in socially disadvantaged agrarian communities in fluoride endemic areas where the standard irrigation system is unavailable and groundwater containing natural fluoride is the major drinking water source. This study aimed to determine the prevalence and severity of dental fluorosis in children and to evaluate its association with fluoride in groundwater in the aforementioned setting in Thailand.

Methods

A cross-sectional survey of 289 children in Nakhon Pathom Province was conducted in 2015. Children with very mild to severe fluorosis were regarded as ‘cases’ while their counterparts were ‘controls’ for a subsequent case–control study. Records of fluoride concentrations in groundwater used for household supply corresponding to resident and number of years by age of each child during 2008–2015 were retrieved. Other exposure variables were measured using a questionnaire. Prevalence ratio (PR), a measure indicating the relative effect of different levels of fluoride on dental fluorosis, was obtained from Poisson regression with robust standard error.

Result

There were 157 children with very mild to moderate dental fluorosis (54.3% prevalence). The univariable analysis revealed that the prevalence of dental fluorosis among children with fluoride concentrations in water sources of 0.7–1.49 (index category 1) and ≥ 1.5 ppm (index category 2) was 1.62 (95% CI; 0.78, 3.34) and 2.75 (95% CI; 1.42, 5.31) times the prevalence among those with fluoride < 0.7 ppm (referent category). After adjusting for all covariates, the adjusted prevalence ratios in both index categories were 1.64 (95% CI; 0.24, 11.24) and 2.85 (95% CI; 0.44, 18.52) which were close to their corresponding crude estimates. Since the magnitude of confounding, measured by (PR_crude–PR_adjusted)/PR_adjusted, were less than 10% for both index categories; this indicated the limited confounding effect of all covariates.

Conclusions

In fluoride endemic areas, groundwater containing natural fluoride utilized for household consumption resulted in high dental fluorosis prevalence, particularly in the groundwater with fluoride concentrations of ≥ 1.5 ppm.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01902-8.

Groundwater fluoride concentrations in the watershed sedimentary basin of Quetta Valley, Pakistan

Litho-geochemical characteristics of low and high fluoride (F^-) groundwater along with hydrological processes were investigated to delineate its genesis and enrichment mechanism in a watershed sedimentary basin. In this study, groundwater F^- concentration ranged from 0 to 20 mg/L with a mean and standard deviation of 2.8 and ± 3.7 mg/L, respectively. Out of N = 87, 63% of samples exceeded the World Health Organization (WHO) limit of 1.5 mg/L. The order of cationic and anionic dominance in groundwater samples with mean was found in decreasing order as Na⁺  > Mg²⁺  > Ca²⁺  > K⁺ and HCO₃^-  > SO₄^2-  > Cl^-  > PO₄^3-  > NO₃^- measured in milligrams per liter. Groundwater chemistry changed from Ca-HCO₃ to Na-HCO₃ type and low to high fluoride as we moved from mountain foot towards the synclinal basin. Low fluoride groundwater reflected weathering, recharge, and reverse ion exchange processes with Ca-HCO₃- and Ca-Mg-Cl-type water while high fluoride groundwater revealed base ion exchange, mixing, and desorption as dominant hydrological processes with Na-HCO₃ and Na-Cl types of water. Gibb's diagram showed rock weathering and mineral dissolution as the major geochemical processes controlling water chemistry with an insignificant role of evaporation in the semi-arid area. Fluoride was undersaturated with mineral fluorite, indicating fluoride in groundwater is released by secondary minerals. However, due to complex geological features, groundwater fluoride enrichment was affected by a broad-scale process across a wide area such as depth, residence time, and most important geomorphological units hosting the aquifer.

A novel ICT-based chemosensor for F- and its application in real samples and bioimaging

A novel colorimetric and fluorescent chemosensor MQS-Si with intramolecular charge transfer character has been designed and synthesized. The chemosensor shows exclusively "off-on" fluorescence response toward F^- at 620 nm in HEPES (pH 7.4): DMSO solution (7:3, v/v), which is attributed to the specific cleavage of Si-O bond. The ultrasensitive detection limit for F^- in the fluorescence measurement is down to 30 nM. Application of the chemosensor has been demonstrated by selective detection of F^- in drinking water, urine and serum samples and fluorescence imaging of F^- in living cells and zebrafish, which proves that MQS-Si has a promising application in vitro and in vivo detection of F^- and may be utilized for the diagnosis of fluorosis and esteofluorosis.

Upregulation of miR-200c-3p induced by NaF promotes endothelial apoptosis by activating Fas pathway

Fluoride has been considered as a risk factor of cardiovascular disease due to its endothelial toxicology. However, the mechanism underlying the endothelial toxicity of fluoride has not been clearly illustrated. MiR-200c-3p was strongly linked with endothelial function and its level is increased in serum of fluorosis patients, but it is unclear the role of miR-200c-3p in the fluoride induced endothelial dysfunction. In this study, we confirmed that fluoride exposure induced the apoptosis of endothelial cells both in established rats model and cultured human umbilical vein endothelial cells (HUVECs). And miR-200c-3p was found to be upregulated in NaF treated HUVECs. Fluoride stimulation increased caspase-dependent apoptosis through miR-200c-3p upregulation, with repressing expression of its target gene Fas-associated phosphatase 1 (Fap-1), which functioned as Fas inhibitor. This resulted in activation of Fas-associated extrinsic apoptosis via interaction with increased Fas, Fadd, Cleaved Caspase-8 and Cleaved Caspase-3. The activation of Fas-associated extrinsic apoptosis was abrogated by miR-200c-3p inhibitor. Furthermore, the antiapoptotic effect of downregulated miR-200c-3p was restored by Fap-1 siRNA. These results suggested a determinant role of the miR-200c-3p/Fap-1 axis in fluoride induced endothelial apoptosis.

Ozone oxidation of wastewater containing trichlorobiphenyl and used transformer oil

Trichlorobiphenyl (TCB) is a persistent toxic organic compound and exerts more hydrophilicity than other polychlorinated biphenyl (PCB) compounds. PCBs have been used on large scale in transformer oil. To observe the strong ozone oxidation effect on the degradation of TCB in aqueous medium, synthetic wastewater was prepared from transformer oil with TCB. Microbubbles ozonation of TCB was done in order to completely oxidize it. A batch treatment system was used for 60 min in glass column with a diffuser at the bottom to convert ozone gas into microbubbles. GCMS analyzed TCB and other toxic compounds before and after the treatment. TCB was reduced to below detection limit during the first 20 min of ozonation. Ethylbenzene and 1-chloroheptacosine were identified after 10 and 20 min, the concentrations of these compounds increased to 1.45 and 3.9 mg/L after 60 min. Alkane with chlorine containing compounds were identified more than any other compounds. The alkanes compounds with chlorine, such as tetradecane 1-chloro, hexadecane 1-chloro, heptadecane 1-chloro, octadecane 1-chloro and nonadecane 1-chloro were found during 60 min of ozonation. Chemical oxygen demand (COD) in the wastewater reduced from 700 to 390 mg/L. Small increase in pH was observed from 7.7 to 8.3. In this study it was concluded that TCB and other pollutants in transformer oil were degraded with ozone dose, 0.05 g/min L in the shortest period of 60 min.

Spatial variation and health risk assessment of fluoride in drinking water in the Chongqing urban areas, China

Fluoride is an essential trace element for humans, and its deficiency or excess in the environment could lead to disease. To investigate the spatial distribution and health risk assessment of fluoride (F^-) in drinking water, 302 tap water samples from Chongqing urban areas, China, were collected to analyze F^- using an ion chromatograph. The results showed that (1) F^- concentration in drinking water ranged from 0.100 to 0.503 mg/L, with an average of 0.238 ± 0.045 mg/L. (2) The spatial autocorrelation analysis showed that high-low clusters were mostly located in Dadukou District and Beibei District, while low-low clusters were mainly in southern Banan District. (3) The fluoride average daily doses of children, teens and adults were 0.030, 0.029 and 0.031 mg/(kg day). (4) Hazard quotients of excessive fluoride (HQ_e) of children, teens and adults were 0.51 ± 09, 0.49 ± 0.09 and 0.52 ± 0.10, respectively (inferior to 1.00), whereas hazard quotients of inadequate fluoride (HQ_i) of those groups were 1.21 ± 0.26, 1.23 ± 0.26 and 1.15 ± 0.25, respectively (superior to 1.00). Therefore, average daily fluoride intake of residents with drinking water was inadequate. This could pose dental caries and osteoporosis threats for residents from Chongqing urban areas.

Spatiotemporal distribution of fluoride in drinking water and associated probabilistic human health risk appraisal in the coastal region, Bangladesh

Spatiotemporal distribution of fluoride in drinking water has been posing serious health concerns worldwide. However, in Bangladesh, to date, there is a very limited study reported the probabilistic health risks from fluoride content in drinking water. Therefore, we investigate the spatiotemporal distribution of fluoride concentration in drinking water and associated health risks in the coastal districts of Bangladesh based on randomly collected 840 groundwater samples (Dry-season = 302 and Wet-season = 538). Probabilistic health risk appraisal from fluoride was performed using the Monte-Carlo simulation and sensitivity analysis. Fluoride concentration in 11.89% (Wet-season) and 24.50% (Dry-season) of the samples exceeded the acceptable level of 1.0 mg/L, while 3.90% (Wet-season) and 7.28% (Dry-season) samples surpassed the maximum permissible limit (fluoride: 1.5 mg/L. The deficiency of fluoride content in groundwater (<0.50 mg/L) in Wet-season (60.41%) and in Dry-season (55.63%) was identified from the study area. The seasonality to the spatial change of fluoride concentration in drinking water has been explored. The mean non-carcinogenic risks e.g., hazard quotient (HQ) from the consumption of high fluoride-containing water for infants and children were mostly exceeded the threshold value 1 (HQ > 1) in both seasons. However, the risk of children and infants at the 95th percentile crossed the safe level (SL: 1) in the wet season and the risk of infants, children, teens and adults at the 95th percentile surpassed 1 in the dry season, indicating the potential adverse health effects. Apart from the high exposure, fluoride deficiency might be a severe problem in this region due to the very low concentration of fluoride (<0.50 mg/L) in drinking water. Sensitivity analyses indicate high fluoride-containing drinking water was the most contributing variables affecting the model outcome. Finally, the case-control study should be performed to examine further the health effects from the ingestion of high/low fluoride-bearing groundwater in the study area.

Fluoride occurrence in the lower East African Rift System, Southern Malawi

Countries located on the East African Rift System (EARS) are vulnerable to fluoride in their groundwater; a vulnerability for the developing country of Malawi at the southern rift periphery that is not well characterised. Groundwater fluoride occurrence in Malawi is documented here to better understand and manage fluoride risks posed. Available literature and Gov't of Malawi archive fluoride data spanning some fifty years have been collated and augmented by our own 2016-18 surveys of groundwater quality in Southern Malawi, targeting deep-sourced springs. In total, fluoride data for 1365 borehole, spring and hot spring samples were assembled. Statistically, 83% of samples were below the 1.5 mg/l WHO limit, concentrations in the 1.5-6 mg/l range between former (pre-1993) and current WHO guidelines at 14%, and those with fluoride above the current Malawi (former WHO) 6 mg/l guideline, at 3%. A lower occurrence than in other zones of the EARS, but indicative of a need for a Malawi Gov't management policy revision and associated management strategies endorsed by several documented incidences of dental fluorosis in proximity to high fluoride groundwater. Increased fluoride is related to increased groundwater temperatures signifying the importance of geothermal groundwater provenance. Temperature data may indeed be used as a proxy indicator of fluoride risk; samples with a temperature >32 °C, contained >6 mg/l fluoride. Structural geological controls appear to allow deep geothermal groundwaters to come to the near surface, as evidenced by increased fluoride in springs and boreholes close to faulted areas. Hydrochemical evaluation shows that fluoride concentrations are influenced by fluorite equilibration and sensitivity to calcium and pH. Recommendations are made to further document the occurrence of fluoride and enhance management of risks due to fluoride in drinking water in Malawi. With fluoride as a key indicator within Sustainable Development Goal number 6, the current Malawi standard and waters with concentration between 1.5 and 6 mg/l will come under increased scrutiny and pose a key challenge to assessment and management efforts.

Immobilization of fluoride in the sediment of mine drainage stream using loess, Northwest China

Fluoride (F) is a necessary trace element in the human body, which would lead to some diseases if human body lacks or accumulates it excessively (1-1.5 mg d^-1). Fluoride contamination in sediments has become more and more serious, which has potential hazards to human body. In this paper, a novel sorbent (loess) was proposed to immobilize trace element F in sediment. The effectiveness of loess on F stabilization was evaluated by decreasing F bioavailability in contaminated sediment. The loess and the sediment were mixed at different proportions for stabilization. About 70 days after the application of loess, the soil column was subject to simulate acid rain leaching test to observe the leaching-migration of F, which can be used to predict the leaching migration of F in the study area. The results showed that when the loess dose was 5 kg, the loess converted highly effective fractions of F (i.e., water-soluble and exchangeable fractions) into a more stable state (i.e., residual state). After 30 days of leaching with HNO₃ solution with pH at 3.0, the lowest concentration of F was found in the leachate of soil column with 2 kg loess application. Correlation analysis showed that the F concentration in soil column profile was affected by CaCO₃, EC, pH, and OM, of which, pH and CaCO₃ have greater influence than other factors.

Fluoride contamination, health problems and remediation methods in Asian groundwater: A comprehensive review

In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.

Assessment of hydrological processes operating in a multi-layered sedimentary aquifer system in Saudi Arabia using integrated chemical and statistical approach

Hydrochemical processes have a great influence on the groundwater quality especially in arid regions where groundwater is the single most important source of water supply. The present study was carried out in the Wadi Ad Dawasir region of Saudi Arabia. The objective of this study was to determine the processes influencing the groundwater composition in the region by integrated hydrochemical and statistical assessment. Hydrochemical data from 140 groundwater samples were interpreted using hydrochemical and statistical techniques. Evaporation, mineral dissolution, reverse ion exchange, and chloride/nitrate contamination from irrigation return flows were the main geogenic and anthropogenic sources influencing the groundwater composition. Principal component analysis was carried out to determine the component showing the maximum variability in the data. Two principal components were extracted. The first principal component representing gypsum dissolution and anthropogenic pollution (chloride and nitrate pollution from agricultural farms) was more pronounced in the western part of the study area whereas the second principal component representing silicate weathering process was more dominant in the eastern part. Total dissolved solid was found to be the single most important hydrochemical parameter showing the maximum variation in the analyzed data set. This study demonstrates that the loadings of the individual hydrochemical parameters in the extracted principal component and the component scores of the individual samples for each extracted principal component can be effectively used for determining the hydrochemical processes influencing the groundwater chemistry in an area.

Investigation on the Gradient Nanomechanical Behavior of Dental Fluorosis Enamel

This study aims to investigate the gradient nanomechanical behavior of dental fluorosis enamel and provide appropriate selection criteria for restorative materials. The nanomechanical properties of the outer, middle, and inner layers of normal tooth enamel, mild dental fluorosis enamel, and severe dental fluorosis enamel were tested by nanoindentation under an applied load of 2000 μN and holding time of 30 s. The nanotribological properties were then evaluated through nanoscratch tests under an applied load of 1000 μN. In addition, the nanotribological property of the outer layer of dental fluorosis enamel was compared with that of four restorative materials, namely, lithium disilicate glass-ceramic (IPS e.max CAD), polymer-infiltrated-ceramic network (PICN), composite resin block (Lava™ ultimate), and conventional composite resin (Fltek™ Z350XT). The nanohardness and elastic modulus of mild dental fluorosis enamel increased from the outer to the middle layers and then decreased from the middle to the inner layers. By contrast, the changed displacement, friction coefficient, and nanoscratch depth and width decreased from the outer to the middle layers and then increased from the middle to the inner layers. In severe dental fluorosis enamel, nanohardness and elastic modulus increased from the outer to the inner layers, but the changed displacement, friction coefficient, and nanoscratch depth and width decreased from the outer to the inner layers. The nanoscratch depth and width of Lava™ ultimate were similar to those of the outer layer of the mild dental fluorosis enamel. The gradient nanomechanical behavior of dental fluorosis enamel significantly differed from that of normal tooth enamel. Dental materials with a wear resistance similar to that of the opposing enamel are a good choice for restoring dental fluorosis (trial registration: WCHSIRB-D-2014-126, registered 25 December 2014).

Effects of Changing pH, Incubation Time, and As(V) Competition, on F- Retention on Soils, Natural Adsorbents, By-Products, and Waste Materials

The purpose of this work was to elucidate the repercussion of changing pH, incubation time and As(V) competition on fluoride (F⁻) sorption on forest and vineyard soil samples, pyritic, and granitic materials, as well as on the by-products pine sawdust, oak wood ash, mussel shell ash, fine and coarse mussel shell, and slate processing waste fines. To reach this end, the methodological approach was based on batch-type experiments. The results indicate that, for most materials, F⁻ sorption was very high at the start, but was clearly diminished when the pH value increased. However, oak wood ash and shell ash showed high F⁻ sorption even at alkaline pH, and pine sawdust showed low F⁻ sorption for any pH value. Specifically, F⁻ sorption was close to 100% for both ashes at pH < 6, and around 70% at pH 10, while for forest soil it was close to 90% at pH < 2, and around 60% at pH values near 8. Regarding the effect of incubation time on F⁻ sorption, it was very low for both soils, pyritic material, granitic material, and both kinds of ashes, as all of them showed very rapid F⁻ sorption from the start, with differences being lesser than 10% between sorption at 30 min and 1 month of incubation. However, sawdust and slate fines sorbed 20% of added F⁻ in 30 min, remaining constant up to 12 h, and doubling after 30 days. And finally, mussel shell sorbed 20% at 30 min, increasing to close to 60% when incubation time was 30 days. This means that some of the materials showed a first sorption phase characterized by rapid F⁻ sorption, and a slower sorption in a second phase. As regards the effect of the presence of As(V) on F⁻ sorption, it was almost negligible, indicating the absence of competition for sorption sites. In view of that all, these results could aid to appropriately manage soils and by-products when focusing on F⁻ removal, in circumstances where pH value changes, contact time vary from hours to days, and potential competition between F⁻ and As(V) could take place.

A review of emerging adsorbents and current demand for defluoridation of water: Bright future in water sustainability

Fluoride contamination of groundwater is a serious problem in several countries of the world because of the intake of excessive fluoride caused by the drinking of the contaminated groundwater. Geological and anthropogenic factors are responsible for the contamination of groundwater with fluoride. Excess amounts of fluoride in potable water may cause irreversible demineralisation of bone and tooth tissues, a condition called fluorosis, and long-term damage to the brain, liver, thyroid, and kidney. There has long been a need for fluoride removal from potable water to make it safe for human use. From among several defluoridation technologies, adsorption is the technology most commonly used due to its cost-effectiveness, ease of operation, and simple physical process. In this paper, the adsorption capacities and fluoride removal efficiencies of different types of adsorbents are compiled from relevant published data available in the literature and represented graphically. The most promising adsorbents tested so far from each category of adsorbents are also highlighted. There is still a need to discover the actual feasibility of usage of adsorbents in the field on a commercial scale and to define the reusability of adsorbents to reduce cost and the waste produced from the adsorption process. The present paper reviews the currently available methods and emerging approaches for defluoridation of water.

Occurrence and mobility of toxic elements in coals from endemic fluorosis areas in the Three Gorges Region, SW China

Fluorine (F) is a topic of great interest in coal-combustion related endemic fluorosis areas. However, little extent research exists regarding the environmental geochemistry of toxic elements that are enriched in coals and coal wastes in traditional endemic fluorosis areas, particularly focusing on their occurrences and mobilities during the weathering-leaching processes of coals and coal wastes in the surface environment. This paper addressed the issue of toxic elements in coals and coal wastes in the Three Gorges Region, Southwest (SW) China, where endemic fluorosis has historically prevailed, and investigated the distribution, occurrence, mobility features, and associated potential health risks. For this purpose, a modified experiment combined with long-term humidity cell test and column leaching trial was applied to elucidate the mobility of toxic elements in coals and coal wastes. In addition, sequential chemical extraction (SCE) was used to ascertain the modes of occurrence of toxic elements. The results demonstrated that the contents of toxic elements in the study area followed the order: stone coals > gangues > coal balls > coals. Furthermore, modes of occurrence of toxic elements were obviously different in coals and coal wastes. For example, cadmium (Cd) was mainly associated with monosulfide fraction in coals, molybdenum (Mo) and arsenic (As) were mainly associated with carbonate and silicate in coal gangues and stone coals, chromium (Cr) mainly existed in silicate and insoluble matter in coal gangues and coal balls, thallium (Tl) mainly occurred in organic matter in stone coals and sulfide in coals, and the occurrence of antimony (Sb) varied with different kinds of samples. Moreover, a large amount of toxic elements released to the leachates during the weathering and leaching process, which might pollute the environment and threaten human health. Based on the geo-accumulation index (I_geo), single factor index (P_i) and Nemerow index (P_N), soils _in the study area were mainly polluted by Cd, which constituted a potential risk to locally planted crops.

Spatial scale and seasonal dependence of land use impacts on riverine water quality in the Huai River basin, China

Land use pattern is an effective reflection of anthropic activities, which are primarily responsible for water quality deterioration. A detailed understanding of relationship between water quality and land use is critical for effective land use management to improve water quality. Linear mixed effects and multiple regression models were applied to water quality data collected from 2003 to 2010 from 36 stations in the Huai River basin together with topography and climate data, to characterize the land use impacts on water quality and their spatial scale and seasonal dependence. The results indicated that the influence of land use categories on specific water quality parameter was multiple and varied with spatial scales and seasons. Land use exhibited strongest association with dissolved oxygen (DO) and ammonia nitrogen (NH₃-N) concentrations at entire watershed scale and with total phosphorus (TP) and fluoride concentrations at finer scales. However, the spatial scale, at which land use exerted strongest influence on instream chemical oxygen demand (COD) and biochemical oxygen demand (BOD) levels, varied with seasons. In addition, land use composition was responsible for the seasonal pattern observed in contaminant concentrations. COD, NH₃-N, and fluoride generally peaked during dry seasons in highly urbanized regions and during rainy seasons in less urbanized regions. High proportion of agricultural and rural areas was associated with high nutrient contamination risk during spring. The results highlight the spatial scale and seasonal dependence of land use impacts on water quality and can provide scientific basis for scale-specific land management and seasonal contamination control.

National and sub-national drinking water fluoride concentrations and prevalence of fluorosis and of decayed, missed, and filled teeth in Iran from 1990 to 2015: a systematic review

Fluoride intake, fluorosis, and dental caries could affect quality of life and disease burden worldwide. As a part of the National and Sub-national Burden of Disease Study (NASBOD) in Iran, we conducted a systematic review to evaluate province-year-specific mean drinking water fluoride concentrations and prevalence of fluorosis and of decayed, missed, and filled teeth (DMFT) in Iran from 1990 to December 2015. We did electronic searches of all English and Persian publications on PubMed, ScienceDirect, Google Scholar, and Iranian databases. Results revealed that the weighted mean drinking water fluoride concentration in Iran from 1990 to 2015 has been about 0.65 ± 0.38 mg/l. However, based on the WHO guideline value (1.50 mg/l) and the maximum permissible Iranian national fluoride standard (1.40 to 2.40 mg/l depending on the region's climate), there have been some regions in Iran with non-optimum fluoride concentrations in their drinking water (up to 7.0 mg/l). Overall, concentrations have been higher in southern parts of Iran and in some areas of Azerbaijan-e-Gharbi Province in the northwest and lower in the rest of the northwest and central parts of Iran. In addition, some hotspots have been found in Bushehr Province, southwest of Iran. The highest prevalence of dental flourosis has been reported in normal index while the lowest prevalence has been expressed in severe index. The lowest DMFT (about 0.1) was in Arsanjan City in Fars Province, and the highest (about 6.7) was for Najaf Abad City in Isfahan Province. Prevalence of fluorosis has been rather high in studied areas of Iran (e.g. 100 % in Maku City in Azarbaijan-e-Gharbi Province), and there was discrepancy for DMFT, but a lack of studies renders the results inconclusive. Further studies, health education and promotion plans, and evidence-based nutrition programs are recommended.

Water fluoridation for the prevention of dental caries

BACKGROUND

Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence.

OBJECTIVES

To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis.

SEARCH METHODS

We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases.

SELECTION CRITERIA

For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water.

DATA COLLECTION AND ANALYSIS

We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation.

MAIN RESULTS

A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation.

AUTHORS' CONCLUSIONS

There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.

The spatial and seasonal variability of the groundwater chemistry and quality in the exploited aquifer in the Daxing District, Beijing, China

The aquifer in the Beijing Plain is intensively used as a primary source to meet the growing needs of the various sectors (drinking, agricultural, and industrial purposes). The analysis of groundwater chemical characteristics provides much important information useful in water resources management. To characterize the groundwater chemistry, reveal its spatial and seasonal variability, and determine its quality suitability for domestic and agricultural uses, a total of 200 groundwater samples were collected in June and October 2012 from 100 exploited wells in Daxing District, Beijing, China. All of the indices (39 items) listed in the Quality Standard for Groundwater of China (QSGC) as well as eight additional common parameters were tested and analyzed for all samples, based on which research target was achieved. The seasonal effect on the groundwater chemistry and quality was very slight, whereas the spatial changes were very obvious. The aquifer is mainly dominated by HCO3-Ca·Mg-type water. Of the 39 quality indices listed in QSGC, 28 indices of all of the samples for the 2 months can be classified into the excellent level, whereas the remaining 11 indices can be classified into different levels with the total hardness, NO3, NO2, and Fe being the worst, mainly distributed in the residential and industrial land. According to the general quality index, the groundwater can be classified from good to a relatively poor level, mainly from southeast to northwest. Furthermore, the relatively poor-level area in the northwest expands to the southeast more than in the past years, to which people should pay attention because this reverse spatial distribution relative to the natural law indicates an obvious, anthropogenic impact on the groundwater. In addition, the groundwater in this area is generally very suitable for irrigation year-round. Nevertheless, we recommend performing agricultural water-saving measures for the sustainable development of water and urbanization, groundwater recovery, and ecological safety.

A Review on Adsorption of Fluoride from Aqueous Solution

Fluoride is one of the anionic contaminants which is found in excess in surface or groundwater because of geochemical reactions or anthropogenic activities such as the disposal of industrial wastewaters. Among various methods used for defluoridation of water such as coagulation, precipitation, membrane processes, electrolytic treatment, ion-exchange, the adsorption process is widely used. It offers satisfactory results and seems to be a more attractive method for the removal of fluoride in terms of cost, simplicity of design and operation. Various conventional and non-conventional adsorbents have been assessed for the removal of fluoride from water. In this review, a list of various adsorbents (oxides and hydroxides, biosorbents, geomaterials, carbonaceous materials and industrial products and by-products) and its modifications from literature are surveyed and their adsorption capacities under various conditions are compared. The effect of other impurities on fluoride removal has also been discussed. This survey showed that various adsorbents, especially binary and trimetal oxides and hydroxides, have good potential for the fluoride removal from aquatic environments.

Geographical distribution patterns of iodine in drinking-water and its associations with geological factors in Shandong Province, China

County-based spatial distribution characteristics and the related geological factors for iodine in drinking-water were studied in Shandong Province (China). Spatial autocorrelation analysis and spatial scan statistic were applied to analyze the spatial characteristics. Generalized linear models (GLMs) and geographically weighted regression (GWR) studies were conducted to explore the relationship between water iodine level and its related geological factors. The spatial distribution of iodine in drinking-water was significantly heterogeneous in Shandong Province (Moran's I = 0.52, Z = 7.4, p < 0.001). Two clusters for high iodine in drinking-water were identified in the south-western and north-western parts of Shandong Province by the purely spatial scan statistic approach. Both GLMs and GWR indicated a significantly global association between iodine in drinking-water and geological factors. Furthermore, GWR showed obviously spatial variability across the study region. Soil type and distance to Yellow River were statistically significant at most areas of Shandong Province, confirming the hypothesis that the Yellow River causes iodine deposits in Shandong Province. Our results suggested that the more effective regional monitoring plan and water improvement strategies should be strengthened targeting at the cluster areas based on the characteristics of geological factors and the spatial variability of local relationships between iodine in drinking-water and geological factors.