Analysis of Fluoride Concentration in Toothpastes in the United Arab Emirates: Closing the Gap between Local Regulation and Practice

Development and Validation of an Instrument to Appraise the Tolerability, Safety of Use, and Pleasantness of a Cosmetic Product

Background: Acceptability tests are designed to demonstrate that there is no chance that cosmetics would irritate or distress users in day-to-day situations. Objectives: to develop and validate a tool or scale that dermatologists, general practitioners, and other healthcare professionals can employ to assess a cosmetic product’s tolerability, safety of usage, and pleasantness. Methods: A three-step modified Delphi technique was used in the consensus process. Two rounds of online surveys and a final face-to-face meeting were performed. Fifty experts for the Delphi panel were chosen to reflect a holistic array of expertise and perspectives in pharmacovigilance, dermatology, and cosmetic safety assessments. In round 1, 80 statements and 115 statements related to skin tolerance and cosmetic safety/efficacy, respectively, were distributed to all members of the expert panel. The expert panel was asked to rate the extent to which they agreed with each statement in the questionnaire using a 5-point Likert scale and given a chance to include a remark beside each item. A statement had to receive 80% of the panel’s approval to be accepted. Results: A total of 50 professional experts were recruited in the Delphi questionnaire rounds (response rate = 63%). The expert panel reached a consensus on 30 statements to evaluate skin tolerability and 34 statements to evaluate cosmetic safety and efficacy (agreement rate level ≥ 80%). The experts also proposed a generic, systematic approach that would allow patients to report both functional and physical symptoms in addition to those discovered during an examination (clinical signs). The confrontation of these symptoms determines whether the investigated cosmetic product is ultimately cutaneously acceptable. Conclusion: The tool that was proposed during this study offered good content validity. Future studies are recommended to test the developed tools in practice to evaluate the good skin compatibility and the safety and quality of cosmetics in the UAE and other nations.

Development and validation of a novel cosmetics safety assessment scale (CSAS): Factual understanding of cosmetic safety and fostering international awareness

Background

Falsified cosmetics are increasingly common especially online through social media networks and mobile applications.

Objectives

This study developed and validated a novel tool to evaluate the safety of cosmetics and personal care products in the United Araba Emirates (UAE).

Method

This is methodological validation study and the data were derived from a cross-sectional study conducted on students and staff at Ajman University (AU) in the UAE. The study sample was selected via simple random sampling. The link to the survey was sent to potential respondents via email, and the responses were analysed using SPSS version 26. Content validity, factor analysis, and known group validity were employed to construct and validate an instrument that will enable the identification of cosmetics safety. The instrument’s reliability was evaluated using test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs).

Results

The study sample included 978 participants. The content validity index for the final 24-item scale was 0.84. The Kaiser-Meyer-Olkin value was 0.959 with a statistically significant Bartlett’s test of sphericity (p <0.001). Factor analysis presented a three-component model. PCFA analysis found good fit values with 0.960 for the normed fit index, 0.977 for the comparative fit index, and 0.987 for the Tucker Lewis Index. All values were in excess of 0.95, and the root mean square error of approximation was below 0.06 (0.03); thus, the model had a good fit. Cronbach’s alpha also showed good consistency of the overall instrument (0.963), and all factors had a Cronbach’s alpha above 0.70. Each item on the instrument met the IIC correlation standard of ≥ 0.40, and there were good overall ICC statistics of 0.963 (0.959–0.966) for the instrument as a whole with statistical significance (p < 0.001). The instrument’s test-retest reliability was assessed by correlating the respondents’ identification scores at two time points with a four-week gap revealing a correlation coefficient of 0.870 (p-value <0.01). Participants holding a bachelor’s degree were more likely to be able to identify safe and authentic cosmetics than those with a high-school educational level (p = 0.015).

Conclusions

This study developed a novel validated instrument to determine the safety of cosmetics. The final questionnaire uses 24 items on three dimensions (13 items on hazard information, eight items on product identity, and three items on product handling and storage). The tool is concise and easy to complete, and it is suitable for use among the general population. The use of this instrument can promote greater collaboration between the consumer health regulatory authorities and inspection authorities thus increasing consumer satisfaction and public participation.

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15−25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean’s Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.