Fluoride in drinking water and cancer mortality in Taiwan

Exploring a variance decomposition approach integrated with the Monte Carlo method to evaluate groundwater fluoride exposure on the residents of a typical fluorosis endemic semi-arid tract of India

This study appraised the groundwater fluoride (F^-) endemicity and the exposure levels under the Central Tendency Exposure (CTE) condition and the Reasonable Maximum Exposure (RME) condition on the residents of the semi-arid parts of the Birbhum district of Peninsular India using a Variance Decomposition (Sobol Sensitivity Indices) approach combined with Monte Carlo Simulations. The study finds the national scale drinking water standard limit for F^- (1.5 mg L^-1) is inappropriate for the present survey area where F^- concentration in groundwater varied between 0.26 and 11.82 mg L^-1 and ~54.5% of the samples (N = 400) exceeded this limit. Therefore, estimated the optimum F^- concentration of 0.733 mg L^-1 for the region using the method recommended by the World Health Organization (WHO) to calculate the optimum F^- limit at a regional scale. The average value of F^- concentrations for this region (1.71 mg L^-1) is considerably higher than the estimated optimum concentration or even the maximum permissible limits recommended for the subtropical regions (0.5-0.7 mg L^-1). The exposure analysis revealed the infants and children as potentially vulnerable populations compared to adolescents and adults of the study area for CTE and RME scenarios. The multi-exposure pathways indicated oral intake as the main exposure pathway whereas exposure through dermal contact was insignificant for the residents of all age groups of this region. Based on the first, second and total order Sobol Sensitivity Indices, F^- concentration (C) in groundwater, the groundwater ingestion rate and their combined interaction are the greatest significant parameters for the oral exposure model whereas C and its interaction effects with the proportion of the skin surface area in contact with groundwater as the utmost sensitive variables for the dermal health risks assessment model. The present study insists the inhabitants to intake defluoridated groundwater.

Identifying fluoride endemic areas and exposure pathways for assessment of non-carcinogenic human health risk associated with groundwater fluoride for Gujarat state, India

Analytical data of fluoride concentration in groundwater collected from various geological formations in Gujarat, India, have been studied to assess their spatial distribution characteristics and related potential chronic health risks. Decadal analysis of groundwater was attempted for precise quantification and a realistic ground representation of fluoride concentration in the entire state. This exercise involved collection of 6407 samples over a period of 10 years (2009-2018), from 641 representative locations, distributed evenly throughout the state (6407 = 641 locations × 10 years). The analytical results indicate that 19% of the sample locations have fluoride concentration higher than the permissible limit and 42% of the locations have fluoride concentration much below the desirable limit, thereby exposing children to a higher risk of associated dental morbidities. Monte Carlo simulation integrated with sensitivity and uncertainty analysis was applied for an accurate and realistic assessment of the non-carcinogenic health risk. Model results indicated that groundwater fluoride exposure through consumption is way higher than the exposure due to dermal absorption pathway. It is inferred that 94 locations (15%) have total hazard index greater than the unity value for all population groups, thereby increasing the vulnerability of the local populace to dental and skeletal fluorosis. Total hazard index in 210 locations (36%) and 188 locations (29%) are beyond the permissible limit for the population comprising infants and children. Populaces living in these locations are susceptible to health hazards that stems from high fluoride concentration. Children and infants are at greater risk due to groundwater fluoride toxicity when compared to the adult populace. The order of the geographic stratification of vulnerability is Mainland regions > Saurashtra region > Kachchh region. Ingestion rate and fluoride concentration are the sensitive parameters with high impact and residents of these vulnerable locations should be advised to abstain from direct intake of groundwater and resort to defluoridised groundwater.

Toxic effects of fluoride in intestinal epithelial cells and the mitigating effect of methanol extract of coconut haustorium by enhancing de novo glutathione biosynthesis

Fluoride ions are an important environmental contaminant and pollutant found in a wide variety of environmental conditions. The fluoride in drinking water is evident to induce toxic effects including neurodegeneration, skeletal and dental fluorosis as well as organ damage. Nutraceuticals and functional foods are emerging as possible preventive agents against fluoride toxicity. Hence, the possible use of an emerging functional food-the coconut haustorium is being evaluated against sodium fluoride-induced toxicity in intestinal cells (IEC-6). The cells exposed to fluoride showed significant cell death mediated through the increased lipid peroxidation and glutathione depletion. The glutathione biosynthetic enzymes were inhibited by the exposure to fluoride and the apoptotic genes (caspases 3/7 and apaf-1) were upregulated. The CHE pre-treatment improved the activity of enzymes involved in the de novo biosynthesis of glutathione and subsequently improved the intracellular GSH pool. The improved antioxidant defense was also evident from the reduced expression of apoptotic genes (p < 0.05). Overall, the study concludes that fluoride ions induce oxidative stress-mediated apoptosis in intestinal epithelial cells, via inhibiting glutathione biosynthesis. Methanol extract of coconut haustorium increased glutathione biosynthesis and subsequently prevented fluoride toxicity in IEC-6 cells by virtue of its antioxidant potentials.

Borassus flabellifer Linn haustorium methanol extract mitigates fluoride-induced apoptosis by enhancing Nrf2/Haeme oxygenase 1 -dependent glutathione metabolism in intestinal epithelial cells

Fluoride is the most common cause of drinking water-associated toxicity and is known to induce various metabolic imbalances and dental/skeletal fluorosis. The present study analyzed the protective effect of Borassus flabellifer Linn. haustorium extract (BHE) against fluoride-induced intestinal redox metabolism and apoptosis. The total polyphenols and total flavonoids present in BHE were estimated to be 39.67 ± 5.14 mg gallic acid equivalent/g extract and 8.59 ± 0.74 mg quercetin equivalent. In cultured intestinal epithelial cells (IEC-6), sodium fluoride exposure-induced apoptosis mediated through antioxidant enzyme inhibition and subsequent oxidative damages. Further, there observed an increased expression of caspase-3, caspase-7, and apoptotic protease activating factor-1 (apaf-1) genes, increased cytochrome C release, and caspase 3/7 activity indicating the apoptosis- mediated cell death (p < 0.05). Upon pretreatment with BHE, the cytotoxic effect of fluoride was reduced by decreasing the expression of apoptotic genes and increased the cytochrome release as well as caspase 3/7 activity (p < 0.01). Providing the mechanistic basis, the expression of nuclear factor erythroid 2-related factor-2 (Nrf2)/haeme oxygenase-1 (HO1) gene was increased in the BHE pretreated cells; corroborating to these, there observed increased activity of glutathione biosynthetic enzymes (p < 0.05) and glutathione reductase. Hence, the protective effect of BHE may be mediated through Nrf2-mediated glutathione biosynthesis, the subsequent establishment of redox balance, and inhibition of apoptosis in intestinal epithelial cells.

Rapid Microwave Method for Synthesis of Iron Oxide Particles under Specific Conditions

The advantages of microwave technology over conventionally conducted experiments are numerous. Some of them are reduction in reaction time, a higher degree of process control, repeatability, and work safety. Microwave synthesis routes require a complete description of the experimental details, instrumentation, and design program of a microwave oven used in the experiments. In this work, microwave-assisted hydrothermal synthesis of hematite (α-Fe2O3) particles from 0.1 M FeCl3 solution in highly alkaline media with heating in a microwave oven at continuous microwave emission of 800 W at 150 °C, 200 °C, and 250 °C for 20 min are presented. Also, the influence of the percentage of the addition of a cationic surfactant, cetyltrimethylammonium bromide (CTAB) on the composition, size, and shape of the final product was investigated. The samples precipitated at 150 °C formed a final product consisting of goethite (α-FeOOH) and hematite particles in contrast to the those precipitated at 200 °C and 250 °C where pure hematite phase was obtained. In these synthesis routes, the CTAB caused to slow down the rate of the goethite-to-hematite transformation process at temperatures at 200 °C but did not affect the transformation at 250 °C.

Biopolymer-Based Nanohydroxyapatite Composites for the Removal of Fluoride, Lead, Cadmium, and Arsenic from Water

In this study, hydroxyapatite (HAP) nanocomposites were prepared with chitosan (HAP-CTS), carboxymethyl cellulose (HAP-CMC), alginate (HAP-ALG), and gelatin (HAP-GEL) using a simple wet chemical in situ precipitation method. The synthesized materials were characterized using scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, Brunauer-Emmett-Teller surface area analysis, and thermogravimetric analysis. This revealed the successful synthesis of composites with varied morphologies. The adsorption abilities of the materials toward Pb(II), Cd(II), F-, and As(V) were explored, and HAP-CTS was found to have versatile adsorption properties for all of the ions, across a wide range of concentrations and pH values, and in the presence of common ions found in groundwater. Additionally, X-ray photoelectron spectroscopy and energy-dispersive X-ray spectroscopy confirmed the affinity of HAP-CTS toward multi-ion mixture containing all four ions. HAP-CTS was hence engineered into a more user-friendly form, which can be used to form filters through its combination with cotton and granular activated carbon. A gravity filtration study indicates that the powder form of HAP-CTS is the best sorbent, with the highest breakthrough capacity of 3000, 3000, 2600, and 2000 mL/g for Pb(II), Cd(II), As(V), and F-, respectively. Hence, we propose that HAP-CTS could be a versatile sorbent material for use in water purification.

Hydrogeochemical characterisation and health hazards of fluoride enriched groundwater in diverse aquifer types

High concentration of fluoride (up to 20.9 mg/L) in groundwater with significant variation (p = 5.9E-128) among samples was reported from Birbhum district, an acknowledged fluoride endemic region in India. The groundwater samples (N = 368) were grouped based on their hydrochemical properties and aquifer geology for hydro-geochemical characterization. Friedman's test showed p < 0.0001 confidence level which indicates that fluoride concentration among geological groups and water groups are independent. Bland-Altman plot was used to study the inter-relationships among the groups through bias value (∂) and limit of agreement (LoA). Among the geological groups, laterites and granite-gneiss groups exhibited statistically significantly difference in fluoride geochemistry; whereas the younger and older alluvium groups displayed similar characteristics. The fluoride concentration was found to be in the order Lateritic > Granite-gneiss > Older alluvium ≥ Younger alluvium. Dissolution of minerals (such as fluorite, biotite) in laterite sheeted basalt, and granite-gneiss is the main source of groundwater fluoride in the region. Fluoride concentration is also influenced by depth of water table. Hydrochemical study indicated that fluoride concentration was higher in Na-HCO₃ than in Ca-SO₄ and Ca-HCO₃ type of groundwater. The fluoride concentration were positively correlated with Na⁺ and pH and negatively correlated with the Ca²⁺ and Mg²⁺ signifying linkage with halite dissolution and calcite, dolomite precipitation. Geostatistical mapping of WQI through empirical bayesian kriging (EBK) with respect to regional optimal guideline value (0.73 mg/L) classified that groundwater in some parts of the district are unfit for drinking purpose. Health survey (N = 1767) based on Dean's criteria for dental fluorosis indicated presence of slight to moderate dental hazard. Besides, providing baseline data for management of groundwater quality in the study area, the study demonstrated the applicability of Bland-Altman analysis and empirical bayesian kriging (EBK) in delineation and interpolation of fluoride contaminated region.

Exploring a multi-exposure-pathway approach to assess human health risk associated with groundwater fluoride exposure in the semi-arid region of east India

Human health risks associated with groundwater fluoride have been assessed using USEPA method in few parts of India, but those assessments were conducted based on a single value for each parameter, which may lead to certain inaccuracy and uncertainties in results. In this study, a higher degree of accuracy in health risk assessment was achieved through Monte Carlo simulations, sensitivity analysis and uncertainty analysis. As fluoride hazards to human health are chronic, a total of 4560 water samples (N = 4560) were collected during consecutive four seasons (2 pre-monsoon and 2 post-monsoon seasons; 1140 samples/season) from the entire Birbhum district, covering all the blocks and geological settings to obtain the spatiotemporal variation of fluoride level. The Empirical Bayesian Kriging geostatistical model was employed to determine fluoride endemic areas. Amongst all blocks, Nalhati-1 had exhibited the highest fluoride level (18.25 mg/L). The study revealed that most of the blocks are vulnerable to groundwater fluoride due to its occurrences in excess level. The average and 95th percentile values of total hazard index indicate that the infants and children populations of the district are more susceptible than the adults and teens. The sensitivity analysis revealed that water ingestion rate and fluoride concentration are the most influential parameters for higher risk of fluoride-related health hazards. Health risks were evaluated through ingestion and dermal exposure routes for infants, children, teens, and adult residents. The exposure was much higher through ingestion than dermal contacts. Ingestion of defluoridated water will reduce the health risks associated with groundwater fluoride exposure.

Evaluation of optimal water fluoridation on the incidence and skeletal distribution of naturally arising osteosarcoma in pet dogs

Experimental toxicological studies in laboratory animals and epidemiological human studies have reported a possible association between water fluoridation and osteosarcoma (OSA). To further explore this possibility, a case-control study of individual dogs evaluated by the UC Davis Veterinary Medical Teaching Hospital was conducted using ecologic data on water fluoridation based on the owner's residence. The case group included 161 dogs with OSA diagnosed between 2008-2012. Two cancer control groups included dogs diagnosed with lymphoma (LSA) or hemangiosarcoma (HSA) during the same period (n = 134 and n = 145, respectively). Dogs with OSA were not significantly more likely to live in an area with optimized fluoride in the water than dogs with LSA or HSA. Additional analyses within OSA patients also revealed no significant differences in age, or skeletal distribution of OSA cases relative to fluoride status. Taken together, these analyses do not support the hypothesis that optimal fluoridation of drinking water contributes to naturally occurring OSA in dogs.

TDDFT study on the sensing mechanism of a fluorescent sensor for fluoride anion: Inhibition of the ESPT process

The fluoride-sensing mechanism of a reported salicylaldehyde-based sensor (J. Photochem. Photobiol. B 2014, 138, 75) has been investigated by the TDDFT method. The present theoretical study indicates that there is an excited-state proton transfer (ESPT) process from the phenolic O-H moiety to the neighbor N atom in the sensor. The added fluoride anion could capture the proton in the O-H moiety and the corresponding phenolic anion is formed, which could inhibit the ESPT process. The experimental UV/Vis and fluorescence spectra are well reproduced by the calculated vertical excitation energies. Frontier molecular orbital analysis indicates that the local excited state of phenolic anion is responsible for its enhanced fluorescence. Due to this reason, the sensor can be used to sense fluoride anion by monitoring the fluorescent change.

Differences in age-standardized mortality rates for avoidable deaths based on urbanization levels in Taiwan, 1971-2008

The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result.

Fluoride in drinking water and osteosarcoma incidence rates in the continental United States among children and adolescents

INTRODUCTION

It has been suggested that fluoride in drinking water may increase the risk of osteosarcoma in children and adolescents, although the evidence is inconclusive. We investigated the association between community water fluoridation (CWF) and osteosarcoma in childhood and adolescence in the continental U.S.

METHODS

We used the cumulative osteosarcoma incidence rate data from the CDC Wonder database for 1999-2006, categorized by age group, sex and states. States were categorized as low (≤30%) or high (≥85%) according to the percentage of the population receiving CWF between 1992 and 2006. Confidence intervals for the incidence rates were calculated using the Gamma distribution and the incidence rates were compared between groups using Poisson regression models.

RESULTS

We found no sex-specific statistical differences in the national incidence rates in the younger groups (5-9, 10-14), although 15-19 males were at higher risk to osteosarcoma than females in the same age group (p<0.001). Sex and age group specific incidence rates were similar in both CWF state categories. The higher incidence rates among 15-19 year old males vs females was not associated with the state fluoridation status. We also compared sex and age specific osteosarcoma incidence rates cumulated from 1973 to 2007 from the SEER 9 Cancer Registries for single age groups from 5 to 19. There were no statistical differences between sexes for 5-14 year old children although incidence rates for single age groups for 15-19 year old males were significantly higher than for females.

CONCLUSION

Our ecological analysis suggests that the water fluoridation status in the continental U.S. has no influence on osteosarcoma incidence rates during childhood and adolescence.

Drinking water fluoridation and osteosarcoma incidence on the island of Ireland

The incidence of osteosarcoma in Northern Ireland was compared with that in the Republic of Ireland to establish if differences in incidence between the two regions could be related to their different drinking water fluoridation policies. Data from the Northern Ireland Cancer Registry (NICR) and the National Cancer Registry of Ireland (NCRI) on osteosarcoma incidence in the respective populations were used to estimate the age-standardised and age-specific incidence rates in areas with and without drinking water fluoridation. One hundred and eighty-three osteosarcoma cases were recorded on the island of Ireland between 1994 and 2006. No significant differences were observed between fluoridated and non-fluoridated areas in either age-specific or age-standardised incidence rates of osteosarcoma. The results of this study do not support the hypothesis that osteosarcoma incidence in the island of Ireland is significantly related to public water fluoridation. However, this conclusion must be qualified, in view of the relative rarity of the cancer and the correspondingly wide confidence intervals of the relative risk estimates.

Association of bladder cancer with residential exposure to petrochemical air pollutant emissions in Taiwan

To investigate the relationship between petrochemical air pollution and risk of death due to bladder cancer, studies were conducted using a matched cancer case-control model based upon deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than neoplasms or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into three levels (< or =25th percentile; 25th-50th percentile; >50th percentile). Subjects who lived in the group of municipalities characterized by the high levels of petrochemical air pollution had a significantly higher risk of death attributed to bladder cancer than subjects in the group that lived in municipalities with the lowest petrochemical air pollution levels, after controlling for possible confounders. The findings of this study warrant further investigation of the role of petrochemical air pollution in the etiology of bladder cancer.

Potential exposure and risk of fluoride intakes from tea drinks produced in Taiwan

Tea is the second most commonly consumed drink in the world. Excess fluoride intakes from tea drinks may cause health effects. This work assesses infusible fluoride levels in popular tea sold in Taiwan and evaluates potential exposure factors. Lungjing, pouchong, tienguanyin, oolong, pureh, and black tea specimens were purchased from different counties in Taiwan. Fluoride levels were evaluated in one complete cycle of tea making as well as at different calcium carbonate contents in water, with glass or porcelain teapots, and with/without adding sugar. Oolong tea leaves in each manufacturing step were also analyzed for infusible fluoride. Potential fluoride intakes and risks are estimated based on a national survey. Among six kinds of tea, black tea had the highest fluoride concentrations (8.64+/-2.96 mg/l), whereas pureh (1.97+/-2.70 mg/l) had the lowest levels. Higher percentages of infusible fluoride can be rinsed away from tea leaves curved lengthways compared to those curved end-to-end in the first 2.5 min. The use of glass or porcelain teapots and calcium carbonate content (up to 400 mg/l) in water would not affect infusible fluoride levels, whereas adding sugar increased the infusible fluoride in the first few minutes. In addition, it was found that the critical step during the manufacturing process affecting the percentage of infusible fluoride was ball rolling rather than fermentation. Furthermore, intakes of high amounts (> or =5 l/week) of certain tea may result in excess risks of dental or skeletal fluorosis. Tea lovers could be exposed to excess fluoride and may be at risk of fluorosis.

Increased Risk of Preterm Delivery in Women Residing near Thermal Power Plants in Taiwan

In this article, the researchers studied the prevalence of preterm births for women living near thermal power plants. The prevalence of delivery of preterm birth infants was significantly higher among women living within 3 km of a thermal power plant than among women living within 3-4 km of a plant. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, infant gender, and birth site), the adjusted odds ratio was 1.14 (95% confidence interval, 1.01-1.30) for delivery of preterm infants for women living close to the thermal power plants. These data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy, although a semiecological study cannot confirm a direct causal relationship.

Drinking water chlorination and adverse birth outcomes in Taiwan

Chlorination has been the major strategy for the disinfection of drinking water in Taiwan. The use of chlorinated water has been hypothesized to lead to several adverse birth outcomes, including low birth weight and preterm delivery. We have performed a study to examine the relationship between the use of chlorinated water and adverse birth outcomes in Taiwan. The study areas included 113 "chlorinating municipalities" (CHMs) (which were defined as municipalities in which more than 95% of the municipality population was served by chlorinated water) and 15 "nonchlorinating municipalities" (NCHMs) (defined as municipalities in which less than 5% of the municipality population was served by chlorinated water). The study population comprised 182,796 women residing in the 128 municipalities who had a first parity singleton birth between 1 January 1994 and 31 December 1996, and for which complete information on maternal age, education, gestational age, birth weight, and sex of the baby were available The results of this study suggest that there was an association between the consumption of chlorinated drinking water and the risk of preterm delivery.

Increased risk of preterm delivery among people living near the three oil refineries in Taiwan

The petrochemical and petroleum industries are two of the main sources of industrial air pollution in Taiwan. Data used in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to oil refinery plants. The prevalence of delivery of preterm birth infants was significantly higher in mothers living near the oil refinery plants than in control mothers in Taiwan. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.14 (95% CI=1.01-1.28) for delivery of preterm infants for mothers living near oil refinery plants. These data provide further support for the hypothesis that air pollution can affect the outcome of pregnancies.

Evidence for Increased Risks of Preterm Delivery in a Population Residing near a Freeway in Taiwan

Traffic emissions are a major source of air pollution in urban areas. The results of recent studies have suggested that air pollution may be related to adverse pregnancy outcomes such as low birth weight and preterm delivery. The authors investigated the association between traffic-related air pollution and preterm deliveries. The study group included all first-parity singleton live births that occurred during 1992-1997 to women who lived in a zone along the Zhong-Shan Freeway in Taiwan (N = 6,251). The zone was defined as areas 1,500-m wide on either side of the freeway; it was located in the San-Ming, Nan-Tzu, Chienchen, and Linya wards-all of which are residential areas in East Kaohsiung. The prevalence of deliveries of preterm birth infants was significantly higher among mothers who lived within 500 m of the freeway than among mothers who resided 500-1,500 m from the freeway. In their analysis, the authors controlled for several confounders (e.g., maternal age, season, marital status, maternal education, infant gender). The adjusted odds ratio was 1.30 (95% confidence interval = 1.03, 1.65) for delivery of preterm infants born to mothers who lived within 500 m of the freeway. Such data provide additional support for the hypothesis that air pollution can affect the outcome of pregnancy.

Increased incidence of preterm delivery in mothers residing in an industrialized area in Taiwan

The objective of this study was to determine whether women living in the vicinity of industrial districts where emission levels of air contaminants from multiple sources including petrochemical, petroleum, steel, and shipbuilding industries are highly correlated with increased incidence of preterm births. The prevalence of delivery of preterm-birth infants was significantly higher in mothers living in the industrial study area compared to control regions of Taiwan. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, infant gender, and birthplace), the adjusted odds ratio was 1.11 (95% CI = 1.02-1.21) for delivery of preterm infants in the industrial area. Data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy, although a semiecological study cannot confirm a direct causal relationship.

Fluoride concentrations in three types of commercially packed tea drinks in Taiwan

Tea is a popular drink around the world. It is also one of the major sources of fluoride intake. The objectives of this study were to assess fluoride concentrations in popular non-, semi-, and full-fermented tea drinks sold on the Taiwan market. Concentration differences among three types of commercially available tea drinks (tea leaf, tea bag, and packaged tea beverage) were explored. Several influential factors in intake concentrations were evaluated. The acute threshold intake (ATI) and allowable daily intake (ADI) of those tea drinks were also estimated. For each commercial type, samples from the most popular tea in one particular fermentation degree (non, semi, and full) were randomly purchased and analyzed for fluoride concentrations. Fluoride levels in different rounds of tea, in different containers, and with different ratios of water and tea leaf were also assessed. In total, 132 tea samples were analyzed. The mean fluoride concentrations in leaf tea without the first round, leaf tea with the first round, bagged tea, and packaged tea were 7.04, 7.79, 5.37, and 25.7 mg/l, respectively. Most of the intake concentrations in those samples exceeded 4 mg/l F, the lower bound of fluoride levels reported in the literatures to be associated with a lower IQ in children and a higher risk of bone fracture. Fluoride concentrations in packaged tea were the highest among the three types of commercially available tea. For studied leaf and bagged tea, almost a constant amount of fluoride was infused from the same amount of tea leaf regardless of the water volume. Besides this, making tea with glass or pottery tea makers would not affect fluoride intake concentrations. Acute intoxication is unlikely to occur. However, tea lovers in high fluoride content areas shall consider limit their consumption of tea drinks to avoid potential chronic effects.

Arsenic in drinking water and adverse pregnancy outcome in an arseniasis-endemic area in northeastern Taiwan

The well water in Lanyang Basin, which is located in the northeastern portion of Taiwan island, was found to have high levels of arsenic ranging from undetectable levels (<0.15 ppb) to 3.59 ppm. We performed a study to compare the risk of adverse pregnancy outcomes (preterm delivery and birthweight) between an area with historic high well water arsenic levels (arsenic-exposed area (AE)) and a comparison area with no historic evidence of arsenic water contamination (non-arsenic-exposed area (NAE)). The mean birth weight in the AEs and NAEs were 3132.6 and 3162.6 g, respectively. Babies born in AEs were on average 30 g lighter than those born in NAEs. AEs had a higher rate of preterm delivery than NAEs (3.74% vs 3.43%). The results of this study suggest that, after adjustment for potential confounders, arsenic exposure from drinking well water was associated, although not significantly, with the risk of preterm delivery, with an odds ratio of 1.10 (0.91-1.33). The estimated reduction in birth weight was 29.05 g (95% CI=13.55-44.55). The findings from this investigation provide evidence for a potential role for arsenic exposure through drinking water in increasing the risk of low birthweight.

Association between petrochemical air pollution and adverse pregnancy outcomes in Taiwan

The petrochemical industry is the main source of industrial air pollution in Taiwan. To date, little is known about the possible effects of such pollution on the human fetus. In this study, the authors investigated the relationship between term low birthweight and preterm delivery and residence in a petrochemical industrial municipality (PIM). The study areas included 16 PIMs (which were defined as municipalities in which the number of workers in the petroleum and petrochemical industry made up at least 2% of the municipality's total population) and 16 matched reference municipalities (RFMs). Among 39,750 1st-parity singleton live births, the prevalences of preterm delivery in the PIMs and RFMs were 4.72% and 4.58%, respectively, and the prevalences of term low birthweight were 2.51% and 2.35%, respectively. When PIMs were compared with RFMs, and after controlling for possible confounders (including maternal age, marital status, maternal education, and gender of the baby), the adjusted odds ratios were 1.07 (95% confidence interval [CI] = 0.95, 1.22) for term low birthweight and 1.03 (95% CI = 0.94, 1.13) for preterm delivery, respectively.

Increased risk of preterm delivery in areas with cancer mortality problems from petrochemical complexes

The petrochemical and petroleum industries are the main sources of industrial air pollution in Taiwan. Data in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to petrochemical industrial complexes. The prevalence of delivery of preterm birth infants was significantly higher in mothers living near petrochemical industrial complexes than in control mothers living elsewhere in Taiwan. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.18 (95% CI=1.04-1.34) for delivery of preterm infants in the petrochemically polluted region. The data provide further support for the hypothesis that air pollution can affect the outcome of pregnancy.

Increased risk of preterm delivery in areas with air pollution from a petroleum refinery plant in Taiwan

The petrochemical and petroleum industries are among the main sources of industrial air pollution in Taiwan. Data in this study concern outdoor air pollution and the health of individuals living in communities in close proximity to a petroleum refinery plant. The prevalence of delivery of preterm birth infants was significantly higher in mothers living in a petroleum refinery area compared to controls in Taiwan. After controlling for several possible confounders (including maternal age, season, marital status, maternal education, and infant sex), the adjusted odds ratio was 1.41 (95% CI = 1.08-1.82) for delivery of preterm infants in the polluted region. Data support the view that air pollution can affect the outcome of pregnancy.