Bone Diseases ; chemically induced ; epidemiology ; China ; epidemiology ; Chronic Disease ; Fluoride Poisoning ; epidemiology ; etiology ; genetics ; Fluorosis, Dental ; epidemiology ; etiology ; Humans ; Prevalence

Objective: To investigate the spatial distribution characteristics and correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in coal-fired fluorosis areas. Methods: Based on the survey data on the prevalence of dental fluorosis at CDC in Guizhou Province in 2022, 274 original surface drinking water sources were collected in typical coal-fired fluorosis areas, and fluoride (F), calcium (Ca), magnesium (Mg), aluminum (Al), titanium (Ti), chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), barium (Ba), lead (Pb) 17 elements; apply Moran's I index, Getis-Ord Gi* hotspot analysis of the global spatial autocorrelation of chemical elements in drinking water and the degree of aggregation of each element on the local area, and correlation analysis with the prevalence of dental fluorosis in the region. Results: Except for Cu, Zn, and Cd, global spatial autocorrelation Moran's I was negative, and all other elements were positive. F, Ca, Al, Ti, As, Mo, Cd, and Cu elements showed high values of aggregation in the southeastern low-altitude area; Mg, Ba, Pb, Cr, Mn, and Fe elements were mainly aggregated in the central altitude terrain transition area, Zn and Se elements in water sources are significantly positively correlated with the prevalence of dental fluorosis (P<0.05). In contrast, F, Mg, Al, Ti, As, Mo, Cd, Ba, and Pb elements negatively correlate (P<0.05). Elements in the central region were high-high aggregation, as a hot spot aggregation area with high disease incidence, while F, Al, Mn, Mo, Cd, and Ba elements in the western region were low-low aggregation, as a cold spot aggregation area with a low incidence of fluorosis. Conclusions: The risk of population fluoride exposure in surface drinking water sources is shallow. However, the chemical element content of drinking water sources in coal-fired polluted endemic fluorosis areas has prominent spatial geographical distribution characteristics. There is a significant spatial aggregation effect with the prevalence of dental fluorosis, which may play a synergistic or antagonistic effect on the occurrence and prevalence of dental fluorosis.
Humans ; Drinking Water ; Prevalence ; Coal ; Fluorides/adverse effects* ; Cadmium ; Fluorosis, Dental/epidemiology* ; Lead ; Selenium ; Arsenic

OBJECTIVETo explore the psychosocial effect of fluorosis on patients in fluorosis epidemic areas.

METHODSMultistage, stratified, clustered and random sampling method was used in this survey. Totally 416 inhabitants of 12, 15 and 35-44 years of age from rural fluorosis epidemic areas in Hebei province were selected. Dental fluorosis was classified by Dean's index (DI). A total of 178 patients with different types of fluorosis were involved in a psychosocial questionnaire investigation which included six five-point subscales, including attitude to teeth, subjective well-being, life satisfaction, interpersonal or social anxiety, effect of self-esteem, impact on behavior.

RESULTSFluorosis prevalence in fluorosis epidemic areas of Xingtai in Hebei province was 71.20%, and significant difference existed among three age groups (Pearson Chi-square value = 167.51, P < 0.01). With the increase of DI score, the average value of subscale "attitude to teeth" rising, ranging from 2.58 to 3.51, and value of "subjective well-being" was also increasing, ranging from 2.35 to 2.9. Statistical difference of subscale average value was found only in these two subscales ("attitude to teeth": F = 4.787, P < 0.01; "subjective well-being": F = 2.538, P < 0.05). "Attitude to teeth" was significantly different between control group and moderate group (F = 0.52, P < 0.01) and between control group and severe group (F = 0.72, P < 0.01). While significant difference of "subjective well-being" could only be found between control group and severe group (F = 0.56, P < 0.01). According to the bivariate correlation analysis, strong correlation could be found between the degree of fluorosis and the average value of sub-scales.

CONCLUSIONSThe psychosocial impact of fluorosis on patients in fluorosis epidemic areas mainly appeared in two aspects, i.e. attitude to teeth and the perception of well-being, especially in severe group.

Adolescent ; Adult ; Child ; China ; epidemiology ; Female ; Fluorosis, Dental ; epidemiology ; psychology ; Humans ; Male ; Mental Health ; Rural Population ; Surveys and Questionnaires

OBJECTIVETo assess changes in prevalence and degree of dental fluorosis in individuals born before and after the introduction of water with 1.2 mg/L fluoride instead of water with 2.0-10.0 mg/L fluoride previously used in Da Li County in China.

METHODSThe students (n = 291) were divided into 2 groups. The dental fluorosis was scored according to Dean's classification. The statistical analysis was performed by t-test and chi(2) tests.

RESULTSThe prevalence of dental fluorosis was significantly lower in the group of the students drinking water from the new well (group 1) as compared to the group of the students drinking the old water (group 2), i.e. 48.8% versus 87.2% (P < 0.01). The percentage of moderate to very severe fluorosis was 13.9% and 0 in group 1 as compared to 32.0% and 8.8% in group 2. The fluorosis community index (FCI), defined by Dean, in group 1 and 2 was medium (1.01) and marked (2.12) respectively.

CONCLUSIONSThe results showed that: (1) The prevalence of dental fluorosis was significantly lowered by the new source of drinking water. (2) Drinking water, even with 1.2 mg/L fluoride, may cause dental fluorosis during the period of tooth mineralization.

Adolescent ; Child ; China ; epidemiology ; Female ; Fluorides ; analysis ; Fluorosis, Dental ; epidemiology ; Humans ; Male ; Prevalence ; Sex Factors ; Water Supply ; analysis

OBJECTIVETo discuss the relations of dental fluorosis and the social economic status in fluorosis-stricken villages where drying the corn by burning coal was prevail.

METHODSA total of 6 fluorosis-endemic villages and one non-endemic village were involved in the study. The general fluorine intake and the concentrations of fluorine in corn, in the pupils' were tested. Dental fluorosis among the pupils was also examen. A individual interview or household questionnaire survey was conducted to probe the economic condition and staple food structure in 600 adults.

RESULTSThe fluorosis prevalence was lower in the villages of transportation convenience, higher income, less coal-dried corn intake. There was a declining trend of dental fluorosis in the corresponding age groups (r: 0.912, 0.916; P < 0.05); There was no significant changes in age-specified dental fluorosis in the low income villages. The correlation (r) of corn fluorine concentration and student's age-specified dental fluorosis prevalence and disparity was 0.755 - 0.980 (P < 0.05) and 0.302 - 0.811; The urine fluorine concentrations were 0.811 and 0.915 (P < 0.05). It was assumed that there was a negative correlation between family cash income and the dental fluorosis.

CONCLUSIONSThe corn fluorine concentration is closely related to age-specified dental fluorosis. With the economic improvement, taking less coal-burned corn is the one of major factors in reducing the of dental fluorosis in these areas.

China ; Coal ; Factor Analysis, Statistical ; Feeding Behavior ; Fluorine ; analysis ; urine ; Fluorosis, Dental ; economics ; epidemiology ; Humans ; Rural Population ; Zea mays

OBJECTIVEBy using Benchmark Dose (BMD) approach to explore the relations among drinking water fluoride, urine fluoride, serum fluoride and dental fluorosis; and to evaluate the significance of urine fluoride and serum fluoride in control and prevention of endemic fluorosis.

METHODS512 children (290 in Xinhuai Village, 222 in Wamiao Village) aged 8-13 years were recruited in the study. Epidemiological methods were used to investigate the prevalence of dental fluorosis, and the levels of urine fluoride, serum fluoride, and drinking water fluoride in superficial well. The children were divided into six subgroups by the concentration of fluoride in drinking water: < 0.5 mg/L, 0.5-mg/L, 1.0-mg/L, 2.0-mg/L, 3.0-mg/L and > or = 4.0 mg/L.

RESULTSThere was significant dose-response relationship between the drinking water fluoride and the prevalence of dental fluorosis or the prevalence of defect dental fluorosis. The BMDLs (Benchmark Dose Lower Bound) were 1.01 and 1.30 mg/L, respectively. Urine fluoride and serum fluoride also had significant dose-response relationship to the prevalence of dental fluorosis or defect dental fluorosis. The correlation coefficient between drinking water fluoride and urine fluoride was 0.717, and it was 0.855 between drinking water fluoride and serum fluoride, and 0.617 between urine fluoride and serum fluoride.

CONCLUSIONSThe currently national standard of fluoride in drinking water in China is safe and reasonable. As a biological monitoring index, the levels of fluoride in serum may be more useful than that in urine in the control and prevention of endemic fluorosis.

Adolescent ; Child ; China ; epidemiology ; Environmental Monitoring ; Epidemiological Monitoring ; Female ; Fluorides ; analysis ; blood ; urine ; Fluorosis, Dental ; epidemiology ; Humans ; Male ; Prevalence ; Water Supply ; analysis ; standards

BACKGROUNDHigh fluoride exposure can result in dental fluorosis. Fluoride and iodine are coexistent in the drinking water of areas in China and may affect the prevalence of dental fluorosis and osteogenesis. The aim of this study was to investigate the relationship between serum calciotropic hormone level, and dental fluorisis in children exposed to different concentrations of fluoride and iodine in drinking water.

METHODSA pilot study was conducted in three villages located in the Kaifeng and Tongxu counties of Henan Province, China in 2006. Children aged 8 to 12 years, born and raised in the three villages were recruited. The fluoride levels in the samples of urine from these children were detected by fluoride ion selective electrode. Calcitonin and osteocalcin levels in the serum, and serum calcium were measured by radioimmunassay and flame atomic absorption spectrometry, respectively.

RESULTSFluoride levels in urine were significantly lower in children from control area (CA) as compared with those from the high fluoride & iodine areas (HFIA) and the high fluoride area (HFA) (P < 0.05 respectively), and no statistically significant difference was found between the children from HFIA and HFA. Additionally, calcitonin levels in the serum were significantly lower in children from CA and HFA as compared with that from HFIA (P < 0.05 respectively), and osteocalcin levels in the serum was lower in children from CA than those from HFIA (P < 0.05). No statistically significant difference in serum osteocalcin concentrations was found between children from HFA and HFIA.

CONCLUSIONThis study provides an evidence that iodine exposure may modify the serum calciotropic hormone levels related to fluorine exposure.

Calcitonin ; blood ; Child ; Female ; Fluorides ; administration & dosage ; Fluorosis, Dental ; epidemiology ; Humans ; Iodine ; administration & dosage ; Male ; Osteocalcin ; blood ; Pilot Projects ; Prevalence ; Water Supply ; analysis