Public perceptions and scientific evidence for perceived harms/risks of community water fluoridation: An examination of online comments pertaining to fluoridation cessation in Calgary in 2011

Fluoride contamination in groundwater and associated health risks in Karbi Anglong District, Assam, Northeast India

Health hazards due to excess intake of fluoride via groundwater contamination are a major concern worldwide. This study provides a comprehensive report on the human health risks associated with the consumption of groundwater contaminated by fluoride. Several groundwater samples were collected across 8 blocks of Karbi Anglong district of Assam, India. The concentration of fluoride was observed in the range of 0.15-17.13 mg/L. In 4 out of 8 studied blocks, the mean fluoride level exceeded the permissible limit (1.5 mg/L) as prescribed by the World Health Organization. Elevated fluoride levels in some parts of the district may be attributed mainly to dissolution from fluoride-containing minerals in the granitic rocks and regional geological settings. The health risk of fluoride was assessed in terms of hazard quotient (HQ). The HQ was observed in the ranges of 0.06-10.7 (adult) and 0.2-35 (children). Mean HQ values exceeded the safe level (HQ > 1) for children in all blocks, except B-6 and B-8. For adult population, the HQ value was above the safe limits in 13-40% of the sampled locations in different blocks and HQ values were within safe limits in B-6 and B-8. These findings suggest that some sites in the district need serious attention in order to ensure the health safety of local residents.

Medical Geological assessment of fluoride contaminated groundwater in parts of Indo-Gangetic Alluvial plains

As drinking water is considered as a major pathway of exposure to fluoride in the human body, an endeavor has been made for the assessment of the non-carcinogenic health risk by using hazard quotient (HQ) of fluoride for males, females, and children separately in fluoride affected ground water areas of Indo-Gangetic Alluvial Plains. The study suggests that children groups are more prone to the non-carcinogenic risk of fluoride in the area as HQ for fluoride is more than unitary in 44% (Pre-monsoon) and 38% (Post-monsoon) samples respectively. Field survey conducted in fluoride-affected villagers of the study area portrays cases of mottling of teeth and bone deformities depending on the duration and dosage of fluoride consumption. Petrographic observations of host rocks coupled with molar ratios of chemical species studies exemplify that weathered material developed over the granite-gneiss, mica-schist, amphibolite, granitic intrusive and pegmatite veins due to weathering and extensive water-rock interaction resulting higher concentration of fluoride in groundwater. Likewise, the base exchange index (r1) and meteoric genesis index (r2) advocates that most of the samples belong to Na⁺-HCO₃⁻ type and meteoric origin respectively, and substantiate longer residence time of water along with solute acquisition processes are responsible for elevated fluoride in groundwater. It is, therefore, solar energy-driven electrolytic de-fluoridation technology ought to be provided on a priority basis to the affected inhabitants besides the implementation of rainwater harvesting schemes for mitigation/ dilution of elevated fluoride concentration.

Calix[4]arene urea derivatives: The pathway from fundamental studies to the selective removal of fluorides and phosphates from water

Wet processes of phosphoric acids produce untreated wastewater containing large amounts of fluoride leading to serious environmental problems. This paper reports fundamental studies on two lower rim functionalised calix[4]arene based receptors namely 5, 11, 17, 23 tetra-tert-butyl, 25, 27 bis [diethylphenylurea]ethoxy, 26, 28 dihydroxycalix[4]arene, 1 and 25, 27 bis[diethylphenylurea]ethoxy, 26, 28 dihydroxycalix[4]arene, 2 and their ionic interactions. It is shown that these receptors only interact with fluoride and phosphate in acetonitrile. Their receptive properties are higher for phosphate (2:1 anion:receptor complex) relative to fluoride (1:1 complex). However, thermodynamics shows that these receptors are more selective for fluoride relative to phosphate in the formation of the 1:1 complex. The pathway from fundamental studies to the use of these receptors for removing these anions from water has been tested. The receptive properties of 1 for phosphate are held when the extraction involves aqueous solutions containing individual ions. However, in mixtures containing both anions, the kinetics of the process and the selectivity of 1 for fluoride predominate and as a result, fluoride is better extracted than phosphate. The counter-ion effect on the removal process is assessed from Molecular Simulation studies. The removal of fluoride from phosphate is discussed taking into account existing technologies.

Fluoride exposure and reported learning disability diagnosis among Canadian children: Implications for community water fluoridation

OBJECTIVES

Recent studies have connected increased fluoride exposure with increased risk of neurodevelopmental-related outcomes, such as ADHD (attention deficit hyperactivity disorder) and lower IQ in children. Our primary objective was to examine the association between fluoride exposure and reported diagnosis of a learning disability among a population-based sample of Canadian children aged 3-12 years.

METHODS

We analyzed data from Cycles 2 and 3 of the Canadian Health Measures Survey. Four measures of fluoride exposure were available: 1) urinary fluoride (μmol/L), 2) creatinine-adjusted urinary fluoride (μmol/mmol), 3) specific gravity-adjusted urinary fluoride (μmol/L), and 4) fluoride concentration of tap water (mg/L) (Cycle 3 only). Diagnosis of a learning disability (yes/no) was based on parental- or self-report. Associations were examined using logistic regression (where possible), unadjusted and adjusted for covariates.

RESULTS

When Cycles 2 and 3 were examined separately, reported learning disability diagnosis was not significantly associated with any measure of fluoride exposure in unadjusted or adjusted models. When Cycles 2 and 3 were combined, a small but statistically significant effect was observed such that children with higher urinary fluoride had higher odds of having a reported learning disability in the adjusted model (p = 0.03). However, the association was not observed in models that used creatinine-adjusted urinary fluoride and specific gravity-adjusted urinary fluoride, which are believed to be more accurate measures due to their correction for urinary dilution.

CONCLUSION

Overall, there did not appear to be a robust association between fluoride exposure and parental- or self-reported diagnosis of a learning disability among Canadian children.

Fluoride exposure and indicators of thyroid functioning in the Canadian population: implications for community water fluoridation

Background

There are concerns that altered thyroid functioning could be the result of ingesting too much fluoride. Community water fluoridation (CWF) is an important source of fluoride exposure. Our objectives were to examine the association between fluoride exposure and (1) diagnosis of a thyroid condition and (2) indicators of thyroid functioning among a national population-based sample of Canadians.

Methods

We analysed data from Cycles 2 and 3 of the Canadian Health Measures Survey (CHMS). Logistic regression was used to assess associations between fluoride from urine and tap water samples and the diagnosis of a thyroid condition. Multinomial logistic regression was used to examine the relationship between fluoride exposure and thyroid-stimulating hormone (TSH) level (low/normal/high). Other available variables permitted additional exploratory analyses among the subset of participants for whom we could discern some fluoride exposure from drinking water and/or dental products.

Results

There was no evidence of a relationship between fluoride exposure (from urine and tap water) and the diagnosis of a thyroid condition. There was no statistically significant association between fluoride exposure and abnormal (low or high) TSH levels relative to normal TSH levels. Rerunning the models with the sample constrained to the subset of participants for whom we could discern some source(s) of fluoride exposure from drinking water and/or dental products revealed no significant associations.

Conclusion

These analyses suggest that, at the population level, fluoride exposure is not associated with impaired thyroid functioning in a time and place where multiple sources of fluoride exposure, including CWF, exist.

Risk assessment of fluoride exposure in drinking water of Tunisia

The presence of fluoride in drinking water is known to reduce dental cavities among consumers, but an excessive intake of this anion might leads to dental and skeletal fluorosis. This study reports a complete survey of the fluoridated tap water taken from 100 water consumption points in Tunisia. The fluoride concentrations in tap water were between 0 and 2.4 mg L^-1. Risk assessment of Fluoride exposure was assessed depending on the age of consumers using a four-step method: hazard identification, toxicity reference values selection (TRVs), daily exposure assessment, and risk characterization. Our findings suggest that approximately 75% of the Tunisian population is at risk for dental decay, 25% have a potential dental fluorosis risk, and 20% might have a skeletal fluorosis risk according to the limits of fluoride in drinking water recommended by WHO. More investigations are recommended to assess the exposure risk of fluoride in other sources of drinking water such as bottled water.