A new perspective on metals and other contaminants in fluoridation chemicals

Urinary fluoride levels and metal co-exposures among pregnant women in Los Angeles, California

BACKGROUND

Fluoride is ubiquitous in the United States (US); however, data on biomarkers and patterns of fluoride exposure among US pregnant women are scarce. We examined specific gravity adjusted maternal urinary fluoride (MUFsg) in relation to sociodemographic variables and metal co-exposures among pregnant women in Los Angeles, California.

METHODS

Participants were from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. There were 293 and 490 women with MUFsg measured during first and third trimesters, respectively. An intra-class correlation coefficient examined consistency of MUFsg between trimesters. Kruskal-Wallis and Mann-Whitney U tests examined associations of MUFsg with sociodemographic variables. Covariate adjusted linear regression examined associations of MUFsg with blood metals and specific gravity adjusted urine metals among a subsample of participants within and between trimesters. A False Discovery Rate (FDR) correction accounted for multiple comparisons.

RESULTS

Median (IQR) MUFsg was 0.65 (0.5) mg/L and 0.8 (0.59) mg/L, during trimesters one and three respectively. During both trimesters, MUFsg was higher among older participants, those with higher income, and White, non-Hispanic participants than Hispanic participants. MUFsg was also higher for White, non-Hispanic participants than for Black, non-Hispanic participants in trimester three, and for those with graduate training in trimester one. MUFsg was negatively associated with blood mercury in trimester one and positively associated with blood lead in trimester three. MUFsg was positively associated with various urinary metals, including antimony, barium, cadmium, cobalt, copper, lead, nickel, tin, and zinc in trimesters one and/or three.

CONCLUSIONS

MUFsg levels observed were comparable to those found in pregnant women in Mexico and Canada that have been associated with poorer neurodevelopmental outcomes. Lower urinary fluoride levels among Hispanic and non-Hispanic Black participants in MADRES compared to non-Hispanic White participants may reflect lower tap water consumption or lower fluoride exposure from other sources. Additional research is needed to examine whether MUFsg levels observed among pregnant women in the US are associated with neurodevelopmental outcomes.

Effects of soil fluoride pollution on wheat growth and biomass production, leaf injury index, powdery mildew infestation and trace metal uptake

Fluoride (F) is an emerging pollutant that originates from multiple sources and adversely affects plant growth and nutrient bioavailability in soil. This greenhouse study investigated the effects of soil F (0, 10, 20, 50, 100, 200 mg kg^-1) on morpho-physiological growth characteristics of wheat, soil F contents, and bioavailability and uptake of F, phosphorus (P), sulphur (S), potassium (K), calcium (Ca), magnesium (Mg), aluminium (Al), iron (Fe), manganese (Mn), silicon (Si) and zinc (Zn) by wheat. Higher F significantly reduced plant height and number of leaves particularly at early growth stages and increased visible leaf injury index. Powdery mildew infestation coincided with leafy injury and was higher in elevated soil F treatments. Fluoride treatments (>50 mg kg^-1) significantly increased water (H₂O)- and calcium chloride (CaCl₂)-extractable F contents in soil. Water-extractable soil F contents from soil in all concentration were higher than CaCl₂-extractable F. This increased F bioavailability resulted in significantly higher F uptake and accumulation in live leaves, dead leaves and grains of wheat which followed order: live leaves > dead leaves > grains. Leaf injury index and number of dead leaves correlated significantly positively with soil H₂O- and CaCl₂-extractable F contents. Patterns of nutrient (P, K, S) and trace metals (Al, Ca, Mg, Fe, Mn, Si, Zn) varied significantly with F concentrations and between live and dead leaves, and grains except for Zn. Dead leaves generally had higher nutrients and trace metals than live leaves and grains. Fluoride contents in live leaves, dead leaves and grains showed positive correlations with nutrient elements but negative with trace metals. Number of dead leaves correlated negatively with Al, Ca, Fe, Mg, S and Si but positively with P and Zn contents in dead leaves whereas leaf injury index showed positive correlation with Fe, K, P, Si, Zn, S but negative with Al, Ca and Mg contents. These observations provided evidence of higher F uptake and associated impairment in nutrient and trace metal accumulation which caused leaf injury accompanied by powdery mildew infestation in wheat. However, further research in the region is required to confirm the relationship between F pollution, leaf injury and trace metal accumulation in crops under field conditions.

Early childhood fluoride exposure and preadolescent kidney function

BACKGROUND

Early-life renal maturation is susceptible to nephrotoxic environmental chemicals. Given the widespread consumption of fluoride and the global obesity epidemic, our main aim was to determine whether childhood fluoride exposure adversely affects kidney function in preadolescence, and if adiposity status modifies this association.

METHODS

Our study included 438 children from the PROGRESS cohort. Urinary fluoride (uF) was assessed at age 4 by diffusion analysis; outcomes studied included estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), selected kidney proteins and blood pressure measured at age 8-12 years. We modeled the relationship between uF and outcomes, and adjusted for body mass index (BMI), age, sex, and socioeconomic status.

RESULTS

The median uF concentration was 0.67 μg/mL. We observed null associations between 4-year uF and preadolescent eGFR, although effect estimates were in the expected inverse direction. A single unit increase in ln-transformed uF was associated with a 2.2 mL/min decrease in cystatin C-based eGFR (95% CI: 5.8, 1.4; p = 0.23). We observed no evidence of sex-specific effects or effect modification by BMI status. Although uF was not associated with BMI, among children with obesity, we observed an inverse association (β: 4.8; 95% CI: 10.2, 0.6; p = 0.08) between uF and eGFR.

CONCLUSIONS

Low-level fluoride exposure in early childhood was not associated with renal function in preadolescence. However, given the adverse outcomes of chronic fluoride consumption it is possible that the preadolescent age was too young to observe any effects. Longitudinal follow-up in this cohort and others is an important next step.

Efficient Fluoride Removal from Aqueous Solution Using Zirconium-Based Composite Nanofiber Membranes

Herein, composite nanofiber membranes (CNMs) derived from UiO-66 and UiO-66-NH2 Zr-metal-organic frameworks (MOFs) were successfully prepared, and they exhibited high performance in adsorptive fluoride removal from aqueous media. The resultant CNMs were confirmed using different techniques, such as X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), and Brunauer-Emmett-Teller (BET) in addition to Fourier-transform infrared spectroscopy (FTIR). The parameters that govern the fluoride adsorption were evaluated, including adsorbent dose, contact time, and pH value, in addition to initial concentration. The crystalline structures of CNMs exhibited high hydrothermal stability and remained intact after fluoride adsorption. It could also be observed that the adsorbent dose has a significant effect on fluoride removal at high alkaline values. The results show that UiO-66-NH2 CNM exhibited high fluoride removal due to electrostatic interactions that strongly existed between F- and metal sites in MOF in addition to hydrogen bonds formed with MOF amino groups. The fluoride removal efficiency reached 95% under optimal conditions of 20 mg L-1, pH of 8, and 40% adsorbent dose at 60 min. The results revealed that UiO-66-NH2 CNM possesses a high maximum adsorption capacity (95 mg L-1) over UiO-66 CNM (75 mg L-1), which exhibited better fitting with the pseudo-second-order model. Moreover, when the initial fluoride concentration increased from 20 to 100 mg/L, fluoride adsorption decreased by 57% (UiO-66 CNM) and 30% (UiO-66-NH2 CNM) after 60 min. After three cycles, CNM revealed the regeneration ability, demonstrating that UiO-66-NH2 CNMs are auspicious adsorbents for fluoride from an aqueous medium.

Principles of fluoride toxicity and the cellular response: a review

Fluoride is ubiquitously present throughout the world. It is released from minerals, magmatic gas, and industrial processing, and travels in the atmosphere and water. Exposure to low concentrations of fluoride increases overall oral health. Consequently, many countries add fluoride to their public water supply at 0.7-1.5 ppm. Exposure to high concentrations of fluoride, such as in a laboratory setting often exceeding 100 ppm, results in a wide array of toxicity phenotypes. This includes oxidative stress, organelle damage, and apoptosis in single cells, and skeletal and soft tissue damage in multicellular organisms. The mechanism of fluoride toxicity can be broadly attributed to four mechanisms: inhibition of proteins, organelle disruption, altered pH, and electrolyte imbalance. Recently, there has been renewed concern in the public sector as to whether fluoride is safe at the current exposure levels. In this review, we will focus on the impact of fluoride at the chemical, cellular, and multisystem level, as well as how organisms defend against fluoride. We also address public concerns about fluoride toxicity, including whether fluoride has a significant effect on neurodegeneration, diabetes, and the endocrine system.

A critique of recent economic evaluations of community water fluoridation

BACKGROUND

Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.

OBJECTIVE

To examine the reported cost-effectiveness of CWF.

METHODS

Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.

RESULTS

Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.

CONCLUSIONS

Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.