Assessment of water contribution on total fluoride intake of various age groups of people in fluoride endemic and non-endemic areas of Dindigul District, Tamil Nadu, South India

The Effect of Prenatal and Neonatal Fluoride Exposure to Morphine-Induced Neuroinflammation

Physical dependence is associated with the formation of neuroadaptive changes in the central nervous system (CNS), both at the molecular and cellular levels. Various studies have demonstrated the immunomodulatory and proinflammatory properties of morphine. The resulting neuroinflammation in drug dependence exacerbates substance abuse-related behaviors and increases morphine tolerance. Studies prove that fluoride exposure may also contribute to the development of neuroinflammation and neurodegenerative changes. Morphine addiction is a major social problem. Neuroinflammation increases tolerance to morphine, and neurodegenerative effects caused by fluoride in structures related to the development of dependence may impair the functioning of neuronal pathways, change the concentration of neurotransmitters, and cause memory and learning disorders, which implies this element influences the development of dependence. Therefore, our study aimed to evaluate the inflammatory state of selected brain structures in morphine-dependent rats pre-exposed to fluoride, including changes in cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) expression as well as microglial and astroglial activity via the evaluation of Iba1 and GFAP expression. We provide evidence that both morphine administration and fluoride exposure have an impact on the inflammatory response by altering the expression of COX-1, COX-2, ionized calcium-binding adapter molecule (Iba1), and glial fibrillary acidic protein (GFAP) in brain structures involved in dependence development, such as the prefrontal cortex, striatum, hippocampus, and cerebellum. We observed that the expression of COX-1 and COX-2 in morphine-dependent rats is influenced by prior fluoride exposure, and these changes vary depending on the specific brain region. Additionally, we observed active astrogliosis, as indicated by increased GFAP expression, in all brain structures of morphine-dependent rats, regardless of fluoride exposure. Furthermore, the effect of morphine on Iba1 expression varied across different brain regions, and fluoride pre-exposure may influence microglial activation. However, it remains unclear whether these changes are a result of the direct or indirect actions of morphine and fluoride on the factors analyzed.

Prevalence of Dental and Skeletal Fluorosis Among School Children in Rural Areas of YSR Kadapa District, Andhra Pradesh, India

Background Andhra Pradesh (AP) is one of the states in India found to have districts with endemic fluoride and YSR Kadapa district is one among them. Fluorosis is a well-known endemic disease affecting the hard tissues of the human body like teeth and bone and soft tissues like the kidneys, gastrointestinal system, nervous system, etc. Dental fluorosis is being proven as a biomarker for exposure to fluoride. This study evaluated the toxicity of fluoride in drinking water on the teeth (dental fluorosis) and on the bones (skeletal fluorosis) in YSR Kadapa district, AP. Material and methods A cross-sectional study was done in schools in the study areas and a total of 488 school children aged between eight to 14 years were screened for fluorosis. Consent from parents or legal representatives was taken. The information regarding personal details, source of drinking water, diet, and socio-demographic characteristics was obtained from children through a questionnaire. Oral examination of teeth was done to assess dental fluorosis by the Deans's fluorosis index and a general physical examination to assess skeletal fluorosis as per guidelines given by the Central Government of India in the National Program for Prevention of Fluorosis in India. Fluoride in drinking water samples and urine samples of school children was assessed by a fluoride ion meter. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 25, (Released 2017; IBM Corp., Armonk, New York, United States). Descriptive statistics were used to assess the percentage distribution and Chi-square test of Independence for comparison between variables. Results The mean fluoride levels in water in the study areas ranged between 1.5mg/l to 4.2mg/l and there was a prevalence of 44.05% dental fluorosis and 0% skeletal fluorosis in the school children. A total of 48.47% of girls and 40.64% of boys were affected with dental fluorosis. A prevalence of 23.06% mild, 22.1% moderate, 5.31% very mild, and 4.55% severe dental fluorosis was observed in the examined children. Conclusion Our study results showed the presence of dental fluorosis with no clinical evidence of skeletal fluorosis among school children in the YSR Kadapa district of Andhra Pradesh. This indicates the fluoride toxicity on teeth in children confirming the exposure to fluoride in the YSR Kadapa district. So, further long-term follow-up surveys are necessary to evaluate skeletal fluorosis in these children though there was no clinical skeletal fluorosis. This highlights that measures need to be enforced by the local governance for the supply of defluorinated water in these areas.

Re-evaluating fluoride intake from food and drinking water: Effect of boiling and fluoride adsorption on food

Although drinking water is the main source of fluoride intake, recent studies reported that fluoride intake from foods could also be high, depending on cooking methods. In this study, we quantified the fluoride accumulation in foods soaked or boiled in fluoride-containing water and assessed the fluoride intake in different age groups from food and drinking water. We observed that, in the case of rice soaked in fluoride-containing water, more fluoride was accumulated in the rice than previously estimated. Fluoride interferes with the iodine staining process of rice, indicating fluoride adsorption. Fluoride accumulation in rice and vegetables increased when the soaking temperature was raised to 100 °C due to the gelatinization of rice grains and softening of vegetables. Ingesting foods boiled in fluoride-containing water increased the fluoride intake per body weight of infants more significantly than that in children and adults due to their low body weight. These results indicate that soaking and boiling foods in fluoride-containing water significantly increases fluoride intake compared to previous estimations. Therefore, it is necessary to re-evaluate the fluoride intake from food and drinking water considering the methods used for cooking food in each country and region.

Industrial Utilization of Capacitive Deionization Technology for the Removal of Fluoride and Toxic Metal Ions (As3+/5+ and Pb2+)

Capacitive deionization (CDI) is an emerging desalination technology, particularly useful for removing ionic and polarizable species from water. In this context, the desalination performance of fluoride and other toxic species (lead and arsenic) present in brackish water at an industrial scale of a few kilo liters using a CDI prototype built by InnoDI Private Limited is demonstrated. The prototype is highly efficient in removing ionic contaminants from water, including toxic and heavy metal ions. It can remove fluoride ions below the World Health Organization (WHO) limit (1.5 ppm) at an initial concentration of 7 ppm in the input feed water. The fluoride removal efficiency of the electrodes (at a feed concentration of 6 ppm) deteriorates by ≈4-6% in the presence of bicarbonate and phosphate ions at concentrations of 100 ppm each. The removal efficiency depends on flow rate, initial total dissolved solids, and other co-ions present in the feed water. Interestingly, toxic species (As^3+/5+ and Pb²⁺) are also removed efficiently (removal efficiency > 90%) by this technology. The electrodes are characterized extensively before and after adsorption to understand the mechanism of adsorption at the electrode.

Spatial analysis and probabilistic risk assessment of exposure to fluoride in drinking water using GIS and Monte Carlo simulation

Prevalence of fluorosis is a worldwide public health problem especially in many states of India. It is necessary to find out the fluoride endemic areas to adopt remedial measures to the people on the risk of fluorosis. The target goals of this research were to assess (a) the exposure of fluoride concentration; (b) probabilistic risk assessment, sensitivity analysis, and uncertainty through intake of groundwater among population of Agra City (infants, children and adults) by Crystal Ball software; and (c) spatial distribution of HQ and fluoride concentration. A total of sixty samples from standing tube wells/hand pumps were gathered from selected and identified fluoride prevalent areas in Agra City. The concentration of fluoride scrutinized was obtained to be ranging from 1.32 to 4.60 mg/L with mean value of 2.36 in Agra City, and more than 91% of samples investigated surpassed the allowable level set for fluoride concentration in potable water 1.5 mg/L, although 9% of the samples were well within the drinking water guidelines (0.5-1.5 mg/L). The hazard quotient (HQ) was obtained to an enormous difference in the exposure dose in infants (1.66-3.91), children (1.87-4.4), and adults (0.92-2.16), correspondingly. The non-carcinogenic HQ values in the group of infants, children, and more than 90% of adults were higher than those of the safety level (i.e., HQ >1). Consequently, the non-carcinogenic risks (HQ level) of fluoride vary from the most to the least: children, infant, and adults, respectively. With 87.41% certainty, the results indicated that the HQ values are between 1 and 3.42. So, infant is the most vulnerable group to fluoride consumption in study area. Uncertainty analysis results indicated that the children group's HQ level was between 1 and 1.90 with 38.48% certainty. To avoid further worsening of the situation as far as health is concerned, remedial actions like alternate sources of water supply and appropriate treatment of water need to be adopted besides required medical attention to affected people.

Assessing contribution of bottled water in nutrient absorption using the bottled water nutritional quality index (BWNQI) in Iran

In this study, the contribution of bottled water in the absorption of nutritional minerals in Iran has been investigated. To calculate the nutritional quality index of bottled water (BWNQI) and evaluate the contribution of bottled water in nutrient absorption; the concentration of nutrient minerals, the standard level of these elements in bottled water, the recommended amount of nutrient mineral and the total consumption of drinking water in different age-sex groups were analyzed. The results showed that the average contribution of bottled water in absorbing the recommended amount of the nutrients of fluoride (F), magnesium (Mg), calcium (Ca), sodium (Na), copper (Cu), zinc (Zn) and manganese (Mn) was 12.16, 4.98, 4.85, 2.12, 0.49, 0.33 and 0.02%, respectively. According to the BWNQI index, the bottled water quality was as follows: 53.5% poor, 36.6% marginal, 7% fair, 2.81% good. Although most of the bottled water studied in this research were mineral water, a significant portion of them had poor nutritional quality, so the addition of minerals needed by the body through bottled water should be given more attention by the bottled water manufacturers and suppliers.

Isolation and identification of high fluoride resistant bacteria from water samples of Dindigul district, Tamil Nadu, South India

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High Fluoride (F⁻) resistant bacteria (200-300 mM) isolated from water samples of Dindigul district, Tamil Nadu, South India.High F⁻ (4.7 and 11 ppm) concentration was detected at Odukampatty and Chellapanaikenpatti villages of Dindigul district. They exhibited β and γ-haemolytic activities on blood agar plates. F⁻ resistant isolates showed their salt tolerances ranged from 4% to 7% NaCl.

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The selected F⁻ resistant bacteria were identified as Enterobacter cloacae strain 3, E. hormaechei strain 14, Enterobacter sp. strain 21, E. hormaechei strain 22, E. coli strain S2-9, Aeromonas caviae strain 31, A. caviae strain 32, A. caviae strain 34.

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F⁻ resistant Aeromonas species are pathogens and exhibited β-haemolytic activity. E. coli S2-9 is a fluoride resistant, non-pathogenic and thermotolerant bacteria.

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The ‘crcB’ involved in bacterial fluoride resistance was amplified from Aeromonas, E. coli, and Enterobacter species.

Fluoride (F⁻) pollution is one of the major issues in India and worldwide. Water samples were collected, and analyse the physicochemical characteristics. From the results, acceptable limit pH ranges, low and high electrical conductivity (EC) values, high-level of TDS (total dissolved solids) and chloride (Cl⁻) values, less than desirable and higher than permissible F⁻ concentrations (4.7 and 11 ppm) were found. At first, ninety-three colonies were screened using rapid hicoliform agar plates. After that, sixty-six F⁻ resistant colonies were picked up from 50  mM NaF (Sodium fluoride) containing LB agar plates. Finally, eight isolates were showing a high degree of F⁻ resistance (200–-300 mM NaF) and selected for further studies. High F⁻ resistance isolates exhibited β and γ-haemolytic activities were determined in blood agar plates. F⁻ resistant isolates showed their salt tolerances ranged from 4% to 7% NaCl and resistant to multiple antibiotics. Biochemical and 16S rRNA sequencing results showed that the F⁻ resistant isolates were identified as Enterobacter cloacae strain 3, E. hormaechei strain 14, Enterobacter sp. strain 21, E. hormaechei strain 22, E. coli strain S2-9, Aeromonas caviae strain 31, A. caviae strain 32, A. caviae strain 34. All strains were submitted in the NCBI database with the accession numbers (MW131637, MW131639; MW131650-655). The F⁻ resistant gene ‘crcB’ gene was successfully amplified from the resistant isolates using gene-specific primers. These results have demonstrated that fluoride resistant bacteria would be useful for bacterial fluoride bioremediation near future.

Removal of Fluoride from Drinking Water by Sorption Using Diatomite Modified with Aluminum Hydroxide

Exposure to fluoride beyond the recommended level for longer duration causes both dental and skeletal fluorosis. Thus, the development of cost-effective, locally available, and environmentally benign adsorbents for fluoride removal from contaminated water sources is absolutely required. In the present study, diatomaceous earth (diatomite) locally available in Ethiopia, modified by treating it with an aluminum hydroxide solution, was used as an adsorbent for fluoride removal from aqueous solutions. Adsorption experiments were carried out by using batch contact method. The adsorbent was characterized using FT-IR spectroscopy. Effects of different parameters affecting efficiency of fluoride removal such as adsorbent dose, contact time, initial fluoride concentration, and pH were investigated and optimized. The optimum adsorbent dose, contact time, initial fluoride concentration, and pH values were 25 g/L, 180 min, 10 mg/L, and 6.7, respectively. The performance of the adsorbent was also tested under optimum conditions using groundwater samples taken from Hawassa and Ziway. Langmuir and Freundlich isotherm models were applied to describe the equilibrium data. Compared to Langmuir isotherm (R ² = 0.888), the Freundlich isotherm (R ² = 0.985) model was better fitted to describe the adsorption characteristics of fluoride on Al-diatomite. The Langmuir maximum adsorption capacity was 1.67 mg/g. The pseudosecond-order model was found to be more suitable than the pseudofirst-order to describe the adsorption kinetics. The low correlation coefficient value of R ² = 0.596 for the intraparticle diffusion model indicates that the intraparticle diffusion model does not apply to the present studied adsorption system. The maximum fluoride removal was observed to be 89.4% under the optimum conditions which indicated that aluminum hydroxide-modified diatomite can be used as efficient, cheap, and ecofriendly adsorbents for the removal of fluoride from contaminated water.

Age-sex specific and sequela-specific disability-adjusted life years (DALYs) due to dental caries preventable through water fluoridation: An assessment at the national and subnational levels in Iran, 2016

We assessed disability-adjusted life years (DALYs) due to dental caries preventable through water fluoridation apportioned by sex, age group, sequela, province, and community type in Iran, 2016. The burden of disease due to dental caries was extracted from the Global Burden of Disease Study 2016 (GBD 2016) and the caries preventive effect of water fluoridation was calculated using a database of fluoride levels in drinking water. All the preventable DALYs were caused by years lived with disability (YLDs) because of the non-fatal character of dental caries. DALYs and DALY rate (per 100,000 people) preventable through water fluoridation at the national level in 2016 were 14,971 (95% uncertainty interval 7348- 24,725) and 18.73 (9.19-30.93), respectively. The national population preventable fraction (PPF) of dental caries by water fluoridation was determined to be as high as 0.176 (0.141-0.189). The share of sequelae in the preventable DALYs at the national level were estimated to be 76.8% for edentulism and severe tooth loss, 21.4% for caries of permanent teeth, and 1.8% for caries of deciduous teeth. The national DALYs and DALY rate preventable through water fluoridation exhibited no difference by sex, but considerably increased by age from 110 (37-223) and 1.5 (0.5-3.1) for the age group 0-4 y to 4331 (2334-6579) and 88.9 (47.9-135.1) for the age group 65 y and older, respectively. Over 80% of the national preventable DALYs occurred in urban areas due to higher population and lower coverage of fluoridated drinking water. The highest provincial DALYs and DALY rate preventable by water fluoridation were observed in Tehran and Gilan to be 3776 (1866-6206) and 37.2 (18.6-60.8), respectively. The results indicated that water fluoridation can play a profound role in the promotion of dental public health and compensate the spatial inequality and increasing temporal trend of health losses from dental caries at the national level.

A Physiologically-Based Pharmacokinetic Modeling Approach Using Biomonitoring Data in Order to Assess the Contribution of Drinking Water for the Achievement of an Optimal Fluoride Dose for Dental Health in Children

Due to an optimal fluoride concentration in drinking water advised for caries prevention purposes, the population is now exposed to multiple sources of fluoride. The availability of population biomonitoring data currently allow us to evaluate the magnitude of this exposure. The objective of this work was, therefore, to use such data in order to estimate whether community water fluoridation still represents a significant contribution toward achieving a suggested daily optimal fluoride (external) intake of 0.05 mg/kg/day. Therefore, a physiologically-based pharmacokinetic model for fluoride published in the literature was used and adapted in Excel for a typical 4-year-old and 8-year-old child. Biomonitoring data from the Canadian Health Measures Survey among people living in provinces with very different drinking water fluoridation coverage (Quebec, 2.5%; Ontario, 70% of the population) were analyzed using this adapted model. Absorbed doses for the 4-year-old and 8-year-old children were, respectively, 0.03 mg/kg/day and 0.02 mg/kg/day in Quebec and of 0.06 mg/kg/day and 0.05 mg/kg/day in Ontario. These results show that community water fluoridation contributes to increased fluoride intake among children, which leads to reaching, and in some cases even exceeding, the suggested optimal absorbed dose of 0.04 mg/kg/day, which corresponds to the suggested optimal fluoride intake mentioned above. In conclusion, this study constitutes an incentive to further explore the multiple sources of fluoride intake and suggests that a new balance between them including drinking water should be examined in accordance with the age-related physiological differences that influence fluoride metabolism.

Does flavoured dentifrice increase fluoride intake compared with regular toothpaste in children? A systematic review and meta-analysis

BACKGROUND

Toothpaste manufacturers encourage through aggressive marketing strategies the overconsumption of fluoridated dentifrices. There are conflicting results regarding fluoride intake from toothpastes in children.

AIM

The aim of this systematic review and meta-analysis was to determine whether dentifrice flavour increases fluoride ingestion by children.

DESIGN

We included clinical trials on children that evaluated the use of flavoured dentifrice - FD vs regular dentifrice - RD to identify the fluoride intake. An electronic search was performed in PubMed, Web of Science, Scopus, The Cochrane Library, LILACS/BBO, and grey literature followed by manual search. The methodological quality of the studies was assessed using the Cochrane Collaboration common scheme for bias and ROBINS-I tool. Data were analysed in subgroups such as low (G1) and ordinary (G2) fluoride concentrations of dentifrices. We carried out heterogeneity and sensitive analyses.

RESULTS

For G1, the fluoride intake from RD was significantly higher than from FD [standardised mean difference = -2.57 (-3.26, -1.89), P < 0.00001]. For G2, the fluoride ingestion from RD was significantly higher than from FD [mean difference = -0.00 (-0.00, -0.00), P = 0.02].

CONCLUSIONS

There is evidence to support the null hypothesis that flavouring from dentifrice does not increase fluoride intake in young children.

Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal Block of Bankura District, W.B., India

There has been growing public concern about intellectual performance of children at high levels of fluoride exposure. A cross-sectional study was conducted in Simlapal Block of Bankura District, West Bengal, to find out the relationship between fluoride (F) exposure as exposure dose (ED) with dental fluorosis (DF), urinary fluoride concentration (UF), intelligence quotient (IQ) and body mass index (BMI). Fifty groundwater samples were collected from the target area. One hundred forty-nine children belonging to age group 6 to 18 years were considered for this study. Experimental results reveal that mean F(-) concentration of that area is 2.11 mg/L (±SD 1.64). On the basis of F concentration in groundwater and water consumption pattern, ED was calculated to explore the impact of F(-) on DF, UF, IQ, and BMI. Paired t test results suggest that exposure rate of F does not show any significant differences (<0.05) among the children of 12 different places. As a result of F exposure, DF cases are mostly found in the order of moderate > severe > mild > very mild > questionable > normal conditions. The highest UF concentration was recorded as 17 mg/L, but the status of DF in the affected children was recorded as moderate. The results also reveal that ED has a positive correlation with DF (r = 0.299, P < 0.01) and UF (r = 0.513, P < 0.01) and a negative correlation with IQ (r = -0.343, P < 0.01) along with BMI (r = 0.083, non-significant). Therefore, from this study, it may be concluded that UF and DF concentration could act as a biomarker of fluoride toxicity.

Rutin potentially attenuates fluoride-induced oxidative stress-mediated cardiotoxicity, blood toxicity and dyslipidemia in rats

This study was undertaken to evaluate cardio protective effect of rutin against sodium fluoride (NaF)-induced oxidative stress-mediated cardiotoxicity and blood toxicity. Cardiac injury was induced by daily administration of NaF 600 ppm in distilled water for four weeks. The animals exposed to NaF exhibited a significant increase in levels of cardiac serum markers, lipid peroxidative markers, serum total cholesterol, LDL, triglycerides and decrease in HDL levels. Decrease in hematological parameters, namely hemoglobin, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin (MCH), MCH count and increase in white blood cells and erythrocyte sedimentation levels were also observed. Marked histopathological lesions and increased DNA fragmentation in cardiac tissues were observed. Activity of antioxidants-catalase, superoxide dismutase and reduced glutathione contents were decreased (p < 0.01), whereas lipid peroxidation product (malondialdehyde) was increased. A significant decrease in body and heart weight was also observed. Treatment with rutin effectively ameliorated the alterations in the studied parameters of rat through its antioxidant nature. There was also significant improvement in hematological parameters. Thus, results of this study clearly demonstrated that treatment with rutin against NaF intoxication has a significant role in protecting F-induced cardiotoxicity, blood toxicity and dyslipidemia in rats.

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.

The effect of non-fluoride factors on risk of dental fluorosis: evidence from rural populations of the Main Ethiopian Rift

Elevated level of fluoride (F(-)) in drinking water is a well-recognized risk factor of dental fluorosis (DF). While considering optimization of region-specific standards for F(-), it is reasonable, however, to consider how local diet, water sourcing practices, and non-F(-) elements in water may be related to health outcomes. In this study, we hypothesized that non-F(-) elements in groundwater and lifestyle and demographic characteristics may be independent predictors or modifiers of the effects of F(-) on teeth. Dental examinations were conducted among 1094 inhabitants from 399 randomly-selected households of 20 rural communities of the Ziway-Shala lake basin of the Main Ethiopian Rift. DF severity was evaluated using the Thylstrup-Fejerskov Index (TFI). Household surveys were performed and water samples were collected from community water sources. To consider interrelations between the teeth within individual (in terms of DF severity) and between F(-) and non-F(-) elements in groundwater, the statistical methods of regression analysis, mixed models, and principal component analysis were used. About 90% of study participants consumed water from wells with F(-) levels above the WHO recommended standard of 1.5mg/l. More than 62% of the study population had DF. F(-) levels were a major factor associated with DF. Age, sex, and milk consumption (both cow's and breastfed) were also statistically significantly (p<0.05) associated with DF severity; these associations appear both independently and as modifiers of those identified between F(-) concentration and DF severity. Among 35 examined elements in groundwater, Ca, Al, Cu, and Rb were found to be significantly correlated with dental health outcomes among the residents exposed to water with excessive F(-) concentrations. Quantitative estimates obtained in our study can be used to explore new water treatment strategies, water safety and quality regulations, and lifestyle recommendations which may be more appropriate for this highly populated region.

Multivariate Statistical Analyses of Fluoride and Other Physicochemical Parameters in Groundwater Samples of Two Megacities in Asia: Lahore and Sialkot

The present study was carried out to evaluate the current status of contaminants and their sources in groundwater samples collected from Lahore and Sialkot. A total of 93 samples were collected from different localities of Lahore and Sialkot and analyzed for the determination of various physicochemical parameters. The results of the study revealed that mean fluoride and chloride contents of water samples from Lahore were higher than the values recommended by Pak-EPA and WHO whereas the mean nitrate and sulphate levels of these samples were well within the limits. The order observed for these physicochemical parameters from Lahore was Cl−> alkalinity >SO4-2>NO3-> F−. All the observed physicochemical parameters for water samples from Sialkot were found to be greater than those of Lahore, due to a more intensive industrial activity in Sialkot. The correlation study revealed the strongest correlation among conductance and alkalinity in samples from both cities. Fluoride and sulphate were found to be positively correlated in samples from Lahore and negatively correlated in samples from Sialkot. Multivariate analysis in terms of principle component analysis and cluster analysis furnished information about the sources of various parameters in groundwater samples.

Fluoride intake from food items in 2- to 6-year-old Brazilian children living in a non-fluoridated area using a semiquantitative food frequency questionnaire

BACKGROUND

Estimating fluoride intake (FI) using the 'duplicate plate' method is difficult and can raise ethical dilemmas.

AIM

To apply a semiquantitative food frequency questionnaire (FFQ) to 2- to 6-year-old Brazilian children in a non-fluoridated area (i) to estimate their FI and (ii) to provide additional validity to the questionnaire by comparing the results obtained with those found previously in a fluoridated municipality.

DESIGN

The FFQ was administered to parents of 398 children residing in a non-fluoridated community. Constituents of the diet were divided into solids, water and other beverages and their fluoride content was analysed with the electrode. Data were analysed using unpaired t-test.

RESULTS

The mean (±SD) FIs from solids, water and other beverages were 0.009 ± 0.004, 0.001 ± 0.001 and 0.007 ± 0.007 mg F/kg body weight/day, respectively, totalling 0.017 ± 0.009 mg F/kg body weight/day. Total FI from food/beverage items ingested in the non-fluoridated area was significantly lower than that observed in a study previously conducted in a fluoridated area (P < 0.0001).

CONCLUSIONS

This result reinforces the use of the FFQ as a promising alternative to duplicate diet in order to estimate FI in children in this age range, with potential application in broad epidemiological surveys.

Mapping of fluoride endemic area and assessment of F(-1) accumulation in soil and vegetation

The prevalence of fluorosis is mainly due to the consumption of more fluoride (F(-1)) through drinking water, vegetables, and crops. The objective of the study was mapping of F(-1) endemic area of Newai Tehsil, Tonk district, Rajasthan, India. For the present study, water, soil (0-45 cm), and vegetation samples were collected from 17 villages. Fluoride concentration in water samples ranged from 0.3 to 9.8 mg/l. Out of 17 villages studied, the amounts of F(-1) content of eight villages were found to exceed the permissible limits. Labile F(-1) content and total F(-1) content in soil samples ranges 11.00-70.05 mg/l and 50.3-179.63 μg g(-1), respectively. F(-1) content in tree species was found in this order Azadirachta indica 47.32-55.76 μg g(-1) > Prosopis juliflora 40.16-49.63 μg g(-1) > Acacia tortilis 34.39-43.60 μg g(-1). While in case of leafy vegetables, F(-1) content order was Chenopodium album 54.23-98.42 μg g(-1) > Spinacea oleracea 30.41-64.09 μg g(-1) > Mentha arvensis 35.48-51.97 μg g(-1). The order of F(-1) content in crops was found as 41.04 μg g(-1) Pennisetum glaucum > 13.61 μg g(-1) Brassica juncea > 7.98 μg g(-1) Triticum sativum in Krishi Vigyan Kendra (KVK) farms. Among vegetation, the leafy vegetables have more F(-1) content. From the results, it is suggested that the people of KVK farms should avoid the use of highly F(-1) containing water for irrigation and drinking purpose. It has been recommended to the government authority to take serious steps to supply drinking water with low F(-1) concentration for the fluorosis affected villages. Further, grow more F(-1) hyperaccumulator plants in F(-1) endemic areas to lower the F(-1) content of the soils.

The pollution control of fluorine and arsenic in roasted corn in "coal-burning" fluorosis area Yunnan, China

Pilot experiments were carried out to reduce the fluorine (F) and arsenic (As) pollution of roasted corn dried by open ovens in "coal-burning" fluorosis area Yunnan, China. The results indicated that the average emission amount of F and As in briquettes in experimental group were 29.20mg/kg and 0.76 mg/kg in Xiaolongdong, and 46.8 mg/kg and 0.54 mg/kg in Mangbu respectively. The results also indicated that the fixing rate of F and As in briquettes in experimental group was more than 4 times and 1.2 times of that in control group respectively. The average concentration of F and As in roasted corn in experimental group were 3.86 mg/kg and 13.23 μg/kg in Xiaolongdong, and 4.77 mg/kg and 122.96 μg/kg in Mangbu respectively, which reduced by more than 65% and 75% respectively compared with that in control group. Adding local natural calcium-based materials in briquettes can reduce the emission of F and As and their pollution on roasted corn largely, and thus will reduce the risk of fluorosis for residents greatly in "coal-burning" fluorosis area of southwestern China.

Groundwater quality and its health impact: An assessment of dental fluorosis in rural inhabitants of the Main Ethiopian Rift

This study aims to assess the link between fluoride content in groundwater and its impact on dental health in rural communities of the Ethiopian Rift. A total of 148 water samples were collected from two drainage basins within the Main Ethiopian Rift (MER). In the Ziway-Shala basin in particular, wells had high fluoride levels (mean: 9.4±10.5mg/L; range: 1.1 to 68 mg/L), with 48 of 50 exceeding the WHO drinking water guideline limit of 1.5mg/L. Total average daily intake of fluoride from drinking groundwater (calculated per weight unit) was also found to be six times higher than the No-Observed-Adverse-Effects-Level (NOAEL) value of 0.06 mg/kg/day. The highest fluoride levels were found in highly-alkaline (pH of 7 to 8.9) groundwater characterized by high salinity; high concentrations of sodium (Na⁺), bicarbonate (HCO₃⁻), and silica (SiO₂); and low concentrations of calcium (Ca²⁺). A progressive Ca²⁺ decrease along the groundwater flow path is associated with an increase of fluoride in the groundwater. The groundwater quality problem is also coupled with the presence of other toxic elements, such as arsenic (As) and uranium (U). The health impact of fluoride was evaluated based on clinical examination of dental fluorosis (DF) among local residents using the Thylstrup and Fejerskov index (TFI). In total, 200 rural inhabitants between the ages of 7 and 40 years old using water from 12 wells of fluoride range of 7.8-18 mg/L were examined. Signs of DF (TF score of ≥ 1) were observed in all individuals. Most of the teeth (52%) recorded TF scores of 5 and 6, followed by TF scores of 3 and 4 (30%), and 8.4% had TF scores of 7 or higher. Sixty percent of the teeth exhibited loss of the outermost enamel. Within the range of fluoride contents, we did not find any correlation between fluoride content and DF. Finally, preliminary data suggest that milk intake has contributed to reducing the severity of DF. The study highlights the apparent positive role of milk on DF, and emphasizes the importance of nutrition in management efforts to mitigate DF in the MER and other parts of the world.

Inflammatory responses induced by fluoride and arsenic at toxic concentration in rabbit aorta

Epidemiological and experimental studies have demonstrated the atherogenic effects of environmental toxicant arsenic and fluoride. Inflammatory mechanism plays an important role in the pathogenesis of atherosclerosis. The aim of the present study is to determine the effect of chronic exposure to arsenic and fluoride alone or combined on inflammatory response in rabbit aorta. We analyzed the expression of genes involved in leukocyte adhesion [P-selectin (P-sel) and vascular cell adhesion molecule-1(VCAM-1)], recruitment and transendothelial migration of leukocyte [interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1)] and those involved in pro-inflammatory cytokines [interleukin-6 (IL-6)]. We found that fluoride and arsenic alone or combined increased the expression of VCAM-1, P-sel, MCP-1, IL-8, and IL-6 at the RNA and protein levels. The gene expressions of inflammatory-related molecules were attenuated when co-exposure to the two toxicants compared with just one of them. We also examined the lipid profile of rabbits exposed to fluoride and (or) arsenic. The results showed that fluoride slightly increased the serum lipids but arsenic decreased serum triglyceride. We showed that inflammatory responses but not lipid metabolic disorder may play a crucial role in the mechanism of the cardiovascular toxicity of arsenic and fluoride.