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Jin T, Huang T, Zhang T, Li Q, Yan C, Wang Q, Chen X, Zhou J, Sun Y, Bo W, Luo Z, Li H, An Y. A Bayesian benchmark concentration analysis for urinary fluoride and intelligence in adults in Guizhou, China. Sci Total Environ 2024; 925:171326. [PMID: 38460703 DOI: 10.1016/j.scitotenv.2024.171326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
Environmental fluoride exposure has been linked to numerous cases of fluorosis worldwide. Previous studies have indicated that long-term exposure to fluoride can result in intellectual damage among children. However, a comprehensive health risk assessment of fluorosis-induced intellectual damage is still pending. In this research, we utilized the Bayesian Benchmark Dose Analysis System (BBMD) to investigate the dose-response relationship between urinary fluoride (U-F) concentration and Raven scores in adults from Nayong, Guizhou, China. Our research findings indecate a dose-response relationship between the concentration of U-F and intelligence scores in adults. As the benchmark response (BMR) increased, both the benchmark concentration (BMCs) and the lower bound of the credible interval (BMCLs) increased. Specifically, BMCs for the association between U-F and IQ score were determined to be 0.18 mg/L (BMCL1 = 0.08 mg/L), 0.91 mg/L (BMCL5 = 0.40 mg/L), 1.83 mg/L (BMCL10 = 0.83 mg/L) when using BMRs of 1 %, 5 %, and 10 %. These results indicate that U-F can serve as an effective biomarker for monitoring the loss of IQ in population. We propose three interim targets for public policy in preventing interllectual harm from fluoride exposure.
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Affiliation(s)
- Tingxu Jin
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China; School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
| | - Tongtong Huang
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China
| | - Tianxue Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Quan Li
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Cheng Yan
- School of Environmental Studies, China University of Geosciences, Wuhan 430074, China; Hubei Key Laboratory of Environmental Water Science in the Yangtze River Basin, China University of Geosciences, Wuhan 430074, China
| | - Qian Wang
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Xiufang Chen
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Jing Zhou
- Center for Disease Control and Prevention, Nayong County, 553300 Bijie City, Guizhou Province, China
| | - Yitong Sun
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Wenqing Bo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Ziqi Luo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Haodong Li
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - Yan An
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu, China.
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Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X, Jensen N, Terrell R, Hemmerich A, Krewski D. Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol 2024; 54:2-34. [PMID: 38318766 DOI: 10.1080/10408444.2023.2295338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns have been raised about several other potential health risks of fluoride. OBJECTIVE To conduct a robust synthesis of evidence regarding human health risks due to exposure to fluoride in drinking water, and to develop a point of departure (POD) for setting a health-based value (HBV) for fluoride in drinking water. METHODS A systematic review of evidence published since recent reviews of human, animal, and in vitro data was carried out. Bradford Hill considerations were used to weigh the evidence for causality. Several key studies were considered for deriving PODs. RESULTS The current review identified 89 human studies, 199 animal studies, and 10 major in vitro reviews. The weight of evidence on 39 health endpoints was presented. In addition to dental fluorosis, evidence was considered strong for reduction in IQ scores in children, moderate for thyroid dysfunction, weak for kidney dysfunction, and limited for sex hormone disruptions. CONCLUSION The current review identified moderate dental fluorosis and reduction in IQ scores in children as the most relevant endpoints for establishing an HBV for fluoride in drinking water. PODs were derived for these two endpoints, although there is still some uncertainty in the causal weight of evidence for causality for reducing IQ scores in children and considerable uncertainty in the derivation of its POD. Given our evaluation of the overall weight of evidence, moderate dental fluorosis is suggested as the key endpoint until more evidence is accumulated on possible reduction of IQ scores effects. A POD of 1.56 mg fluoride/L for moderate dental fluorosis may be preferred as a starting point for setting an HBV for fluoride in drinking water to protect against moderate and severe dental fluorosis. Although outside the scope of the current review, precautionary concerns for potential neurodevelopmental cognitive effects may warrant special consideration in the derivation of the HBV for fluoride in drinking water.
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Affiliation(s)
- Mohamed Kadry Taher
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Jennifer Go
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Shintaro Hagiwara
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Siva Ramoju
- Risk Sciences International, Ottawa, ON, Canada
| | - Xuefeng Hu
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, ON, Canada
| | - Natalie Jensen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Rowan Terrell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
| | - Alex Hemmerich
- Risk Sciences International, Ottawa, ON, Canada
- Faculty of Education, Queen's University, Kingston, ON, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Mathematics and Statistics, Carleton University, Ottawa, ON, Canada
- Risk Sciences International, Ottawa, ON, Canada
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Nelima D, Wambu EW, Kituyi JL. Fluoride distribution in selected foodstuffs from Nakuru County, Kenya, and the risk factors for its human overexposure. Sci Rep 2023; 13:15295. [PMID: 37714918 PMCID: PMC10504336 DOI: 10.1038/s41598-023-41601-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
Critical data on the impacts of fluoride (F) in food systems along the Eastern Africa Rift Valley System (EARS) is needed for public health risk assessment and for the development of strategies for ameliorating its deleterious effects among the affected communities. Long-term F overexposure causes dental and skeletal fluorosis, and leads to neurotoxicity, which impacts several important body functions. Investigating F exposure pathways is of essence to inform and safeguard public health of the affected communities. The current study assessed the F levels in potatoes (Solanum tuberosum L.), beans (Phaseolus vulgaris L.) and garden peas (Possum sativa) from Nakuru County, Kenya, by potentiometric analysis using F ion-selective electrodes. It then evaluated the risk factors for excessive human exposure to F through contaminated foodstuffs. The mean F levels in the potatoes (8.50 ± 4.70 mg/kg), beans (8.02 ± 4.12 mg/kg) and peas (4.99 ± 1.25 mg/kg) exceeded recommended dietary allowances (RDA) level of 4 mg/kg endorsed by US Institute of Medicine for the different categories of people. The F distribution trends in beans and potatoes reflected the environmental patterns of F contamination of the study area but the spatial extent Fin the peas indicated existence of partial resistance of the pea plants to environmental F uptake. The results indicated that both the beans and the potatoes were more liable to accumulating greater amounts of F from the environment than garden peas and that all the three foodstuffs contained high F levels that posed greater risk of F overexposure and its deleterious impacts among the young children, male populations, and in people of greater body weight and high physical activity levels.
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Affiliation(s)
- Delphine Nelima
- Department of Chemistry, School of Science, University of Eldoret, P.O. BOX, Eldoret, 1125-30100, Kenya
| | - Enos W Wambu
- Department of Chemistry, School of Science, University of Eldoret, P.O. BOX, Eldoret, 1125-30100, Kenya.
| | - John L Kituyi
- Department of Chemistry, School of Science, University of Eldoret, P.O. BOX, Eldoret, 1125-30100, Kenya
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Wang F, Li Y, Tang D, Yang B, Tian T, Tian M, Meng N, Xie W, Zhang C, He Z, Zhu X, Ming D, Liu Y. Exploration of the SIRT1-mediated BDNF-TrkB signaling pathway in the mechanism of brain damage and learning and memory effects of fluorosis. Front Public Health 2023; 11:1247294. [PMID: 37711250 PMCID: PMC10499441 DOI: 10.3389/fpubh.2023.1247294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/16/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Fluoride is considered an environmental pollutant that seriously affects organisms and ecosystems, and its harmfulness is a perpetual public health concern. The toxic effects of fluoride include organelle damage, oxidative stress, cell cycle destruction, inflammatory factor secretion, apoptosis induction, and synaptic nerve transmission destruction. To reveal the mechanism of fluorosis-induced brain damage, we analyzed the molecular mechanism and learning and memory function of the SIRT1-mediated BDNF-TrkB signaling pathway cascade reaction in fluorosis-induced brain damage through in vivo experiments. Methods This study constructed rat models of drinking water fluorosis using 50 mg/L, 100 mg/L, and 150 mg/L fluoride, and observed the occurrence of dental fluorosis in the rats. Subsequently, we measured the fluoride content in rat blood, urine, and bones, and measured the rat learning and memory abilities. Furthermore, oxidative stress products, inflammatory factor levels, and acetylcholinesterase (AchE) and choline acetyltransferase (ChAT) activity were detected. The pathological structural changes to the rat bones and brain tissue were observed. The SIRT1, BDNF, TrkB, and apoptotic protein levels were determined using western blotting. Results All rats in the fluoride exposure groups exhibited dental fluorosis; decreased learning and memory abilities; and higher urinary fluoride, bone fluoride, blood fluoride, oxidative stress product, and inflammatory factor levels compared to the control group. The fluoride-exposed rat brain tissue had abnormal AchE and ChAT activity, sparsely arranged hippocampal neurons, blurred cell boundaries, significantly fewer astrocytes, and swollen cells. Furthermore, the nucleoli were absent from the fluoride-exposed rat brain tissue, which also contained folded neuron membranes, deformed mitochondria, absent cristae, vacuole formation, and pyknotic and hyperchromatic chromatin. The fluoride exposure groups had lower SIRT1, BDNF, and TrkB protein levels and higher apoptotic protein levels than the control group, which were closely related to the fluoride dose. The findings demonstrated that excessive fluoride caused brain damage and affected learning and memory abilities. Discussion Currently, there is no effective treatment method for the tissue damage caused by fluorosis. Therefore, the effective method for preventing and treating fluorosis damage is to control fluoride intake.
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Affiliation(s)
- Feiqing Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Yanju Li
- Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Dongxin Tang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Bo Yang
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Tingting Tian
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Mengxian Tian
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Na Meng
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Wei Xie
- Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Chike Zhang
- Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Zhixu He
- National & Guizhou Joint Engineering Laboratory for Cell Engineering and Biomedicine Technique, Guiyang, Guizhou Province, China
| | - Xiaodong Zhu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Yang Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- National & Guizhou Joint Engineering Laboratory for Cell Engineering and Biomedicine Technique, Guiyang, Guizhou Province, China
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Lin YY, Hsu WY, Yen CE, Hu SW. Association of Dental Fluorosis and Urinary Fluoride with Intelligence among Schoolchildren. Children (Basel) 2023; 10:987. [PMID: 37371219 DOI: 10.3390/children10060987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Fluoride is present naturally in water and has been used worldwide for the prevention of caries. Several studies conducted in high water fluoride or endemic fluorosis areas reported that fluoride adversely affected children's cognitive function, but some studies had negative findings. This study aimed to assess the relationship between urinary fluoride, dental fluorosis, and intelligence among schoolchildren living in communities with non-fluoridated drinking water. This cross-sectional study was conducted on 562 children aged 6-12 years in Taichung, Taiwan. Each child's urinary fluoride level was determined by a fluoride-ion-selective electrode, and the dental fluorosis condition was evaluated according to the criteria of Dean's Index. The Raven's Colored Progressive Matrices-Parallel and Standard Progressive Matrices-Parallel were used to assess children's intelligence. The results showed that the mean (±standard deviation) urinary fluoride concentrations were 0.40 ± 0.27 mg/L (0.43 ± 0.23 mg/g creatinine) among participants. The prevalence of dental fluorosis was 23.67%. After extensive evaluation of potential confounders, dental fluorosis and urinary fluoride were not associated with intelligence quotient (IQ) scores or grades in the regression models. In conclusion, dental fluorosis and urinary fluoride levels were not significantly related to the IQ of schoolchildren living in areas with low drinking water fluoride.
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Affiliation(s)
- Yuh-Yih Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Wen-Yu Hsu
- Department of Psychology, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chin-En Yen
- Department of Early Childhood Development and Education, Chaoyang University of Technology, Taichung 41349, Taiwan
| | - Suh-Woan Hu
- Institute of Oral Sciences, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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Bibi S, Habib R, Shafiq S, Abbas SS, Khan S, Eqani SAMAS, Nepovimova E, Khan MS, Kuca K, Nurulain SM. Influence of the chronic groundwater fluoride consumption on cholinergic enzymes, ACHE and BCHE gene SNPs and pro-inflammatory cytokines: A study with Pakistani population groups. Sci Total Environ 2023; 880:163359. [PMID: 37030382 DOI: 10.1016/j.scitotenv.2023.163359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023]
Abstract
Fluoride is one of the abundant elements found in the Earth's crust and is a global environmental issue. The present work aimed to find the impact of chronic consumption of fluoride contained groundwater on human subjects. Five hundred and twelve volunteers from different areas of Pakistan were recruited. Cholinergic status, acetylcholinesterase and butyrylcholinesterase gene SNPs and pro-inflammatory cytokines were examined. Association analysis, regression and other standard statistical analyses were performed. Physical examination of the fluoride endemic areas' participants revealed the symptoms of dental and skeletal fluorosis. Cholinergic enzymes (AChE and BChE) were significantly increased among different exposure groups. ACHE gene 3'-UTR variant and BCHE K-variant showed a significant association with risk of fluorosis. Pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) were found to be increased and have a significant correlation in response to fluoride exposure and cholinergic enzymes. The study concludes that chronic consumption of high fluoride-contained water is a risk factor for developing low-grade systemic inflammation through the cholinergic pathway and the studied cholinergic gene SNPs were identified to be associated with the risk of flurosis.
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Affiliation(s)
- Sara Bibi
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | - Rabia Habib
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | - Sania Shafiq
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | - Syed Sayyam Abbas
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | - Shaiza Khan
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | | | - Eugenie Nepovimova
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Mansoor Shaukat Khan
- Department of Mathematics, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic; Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, 18071 Granada, Spain; Biomedical Research Centre, University Hospital in Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic.
| | - Syed Muhammad Nurulain
- Department of Biosciences, COMSATS University Islamabad, Park Road Tarlai, Islamabad 45550, Pakistan
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Zhou J, Sun D, Wei W. Necessity to Pay Attention to the Effects of Low Fluoride on Human Health: an Overview of Skeletal and Non-skeletal Damages in Epidemiologic Investigations and Laboratory Studies. Biol Trace Elem Res 2023; 201:1627-1638. [PMID: 35661326 DOI: 10.1007/s12011-022-03302-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/26/2022] [Indexed: 12/15/2022]
Abstract
Due to the implementation of water improvement and fluoride reduction plans supported by central and local governments in recent years, areas with high fluoride exposure are being gradually decreased. Therefore, it is of practical importance to study the effect of low fluoride on human health. Epidemiologic investigations and in vivo and in vitro studies based on low fluoride have also confirmed that fluoride not only causes skeletal damage, such as dental fluorosis, but also causes non-skeletal damage involving the cardiovascular system, nervous system, hepatic and renal function, reproductive system, thyroid function, blood glucose homeostasis, and the immune system. This article summarizes the effects of low fluoride on human and animal skeletal and non-skeletal systems. A preliminary exploration of corresponding mechanisms that will help to fully understand the harm of low fluoride on human health was undertaken to provide the basis for establishing new water fluoride standards and help to implement individual guidance.
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Affiliation(s)
- Jing Zhou
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China
| | - Wei Wei
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
- National Health Commission, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, Heilongjiang Province, China.
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, 150081, Harbin, Heilongjiang Province, China.
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Veneri F, Vinceti M, Generali L, Giannone ME, Mazzoleni E, Birnbaum LS, Consolo U, Filippini T. Fluoride exposure and cognitive neurodevelopment: Systematic review and dose-response meta-analysis. Environ Res 2023; 221:115239. [PMID: 36639015 DOI: 10.1016/j.envres.2023.115239] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Many uncertainties still surround the possible harmful effect of fluoride exposure on cognitive neurodevelopment in children. The aim of this systematic review and meta-analysis was to characterize this relation through a dose-response approach, by comparing the intelligence quotient (IQ) scores in the highest versus the lowest fluoride exposure category with a random-effects model, within a one-stage dose-response meta-analysis based on a cubic spline random-effects model. Out of 1996 potentially relevant literature records, 33 studies were eligible for this review, 30 of which were also suitable for meta-analysis. The summary mean difference of IQ score, comparing highest versus lowest fluoride categories and considering all types of exposure, was -4.68 (95% confidence interval-CI -6.45; -2.92), with a value of -5.60 (95% CI -7.76; -3.44) for drinking water fluoride and -3.84 (95% CI -7.93; 0.24) for urinary fluoride. Dose-response analysis showed a substantially linear IQ decrease for increasing water fluoride above 1 mg/L, with -3.05 (95% CI -4.06; -2.04) IQ points per 1 mg/L up to 2 mg/L, becoming steeper above such level. A weaker and substantially linear decrease of -2.15 (95% CI -4.48; 0.18) IQ points with increasing urinary fluoride emerged above 0.28 mg/L (approximately reflecting a water fluoride content of 0.7 mg/L). The inverse association between fluoride exposure and IQ was particularly strong in the studies at high risk of bias, while no adverse effect emerged in the only study judged at low risk of bias. Overall, most studies suggested an adverse effect of fluoride exposure on children's IQ, starting at low levels of exposure. However, a major role of residual confounding could not be ruled out, thus indicating the need of additional prospective studies at low risk of bias to conclusively assess the relation between fluoride exposure and cognitive neurodevelopment.
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Affiliation(s)
- Federica Veneri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), Unit of Dentistry & Oral-Maxillo-Facial Surgery - University of Modena and Reggio Emilia, Modena, Italy; PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences - University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, Medical School - University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), Unit of Dentistry & Oral-Maxillo-Facial Surgery - University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Edvige Giannone
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, Medical School - University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Mazzoleni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, Medical School - University of Modena and Reggio Emilia, Modena, Italy
| | - Linda S Birnbaum
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), Unit of Dentistry & Oral-Maxillo-Facial Surgery - University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, Medical School - University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
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Tang H, Wang M, Li G, Wang M, Luo C, Zhou G, Zhao Q, Dong L, Liu H, Cui Y, Liu L, Zhang S, Wang A. Association between dental fluorosis prevalence and inflammation levels in school-aged children with low-to-moderate fluoride exposure. Environ Pollut 2023; 320:120995. [PMID: 36603756 DOI: 10.1016/j.envpol.2022.120995] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/24/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Inflammation mediates the neurological deficits caused by fluoride. Thus, whether inflammation is the underlying mechanism of dental fluorosis (DF) in school-aged children is worth exploring. A cross-sectional study was conducted to investigate the association between inflammation and the prevalence and severity of DF with low-to-moderate fluoride exposure. Fasting morning urine and venous blood samples were collected from 593 children aged 7-14 years. The fluoride content in the water and urine samples was measured using a fluoride ion-selective electrode assay. The levels of interleukin-1β (IL-1β) and C-reactive protein (CRP) were detected using an enzyme-linked immunosorbent assay. The Dean's index was used when performing dental examinations. Regression, stratified, and mediation analyses were performed to analyze the association between fluoride exposure, inflammation, and DF prevalence. In the adjusted regression models, the prevalence of mild DF was 1.723-fold (95% confidence interval [CI]:1.612, 1.841) and 1.594-fold (1.479, 1.717) greater than that of normal DF for each 1 mg/L increase in water and urinary fluoride content, respectively. The prevalence of mild DF increased by 3.3% for each 1 pg/mL increase in the IL-1β level and by 26.0% for each 1 mg/L increase in the CRP level. Stratified analysis indicated a weaker association between fluoride concentration and DF prevalence in boys than in girls, and susceptibility in the boys was reflected by the association of IL-1β with very mild and moderate DF prevalence. For every 1 mg/L increase in water and urinary fluoride levels, the proportion of IL-1β-mediated effects on the prevalence of mild DF was 10.0% (6.1%, 15.8%) and 8.7% (4.8%, 15.2%), respectively, and the proportion of CRP-mediated effects was 9.2% (5.5%, 14.9%) and 6.1% (3.3%, 11.0%), respectively. This study indicates that the DF prevalence may be sex-specific. Inflammatory factors may partially mediate the increased prevalence of mild DF in school-aged children with low-to-moderate fluoride exposure.
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Affiliation(s)
- Huayang Tang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengru Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Henan Center for Disease Control and Prevention, Zhengzhou, Henan, PR China
| | - Gaochun Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Mengwei Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chen Luo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Guoyu Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Qian Zhao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lixin Dong
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Hongliang Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Yushan Cui
- Tianjin Center for Disease Control and Prevention, Tianjin, PR China
| | - Li Liu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shun Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Aiguo Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health(incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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10
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Liu J, Zhan Y, Qiu B, Lin Z, Guo L. Portable Smartphone Platform Based on Aggregation-Induced Enhanced Emission Carbon Dots for Ratiometric Quantitative Sensing of Fluoride Ions. ACS Sens 2023; 8:884-892. [PMID: 36657970 DOI: 10.1021/acssensors.2c02589] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The development of an instrument-free, on-site, real-time, sensitive, and visualized fluoride-ion (F-) content rapid detection strategy is crucial to ensuring the health of the population. Smart microdevices that are portable, directly read, and easy to operate have recently attracted much attention. Herein, a ratiometric fluorescent probe (AA-CDs@[Ru(bpy)3]2+)-based smartphone sensing platform was developed for the detection of F-. The red fluorescent ruthenium bipyridine [Ru(bpy)3]2+ molecule was chosen as the reference signal, and the carbon dots (AA-CDs) with Al3+ aggregation-induced enhanced emission (AIE) were designed as the response signal. The ratiometric probe fluorescence changed continuously from red to cyan in response to different concentrations of F-, and the red-green-blue (RGB) channel values of the fluorescence image were extracted through the smartphone color recognition application (APP). There was a linear relationship between the blue-red (B/R) ratio and the F- concentration, with a limit of detection (LOD) of 1.53 μM, far below the allowable content of F- in drinking water prescribed by the World Health Organization. The F- content was rapidly detected on-site with satisfactory repeatability and relative standard deviation using several water and toothpaste samples as the real sample. The platform features low cost, portability, easy operation, and good stability, selectivity, and repeatability, which provides a powerful tool for the visual quantitative detection of smartphone-based microsensing platforms possibly in the fields of environmental protection, diagnosis, and food safety assessment.
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Affiliation(s)
- Jingjing Liu
- Fujian Universities and Colleges Engineering Research Center of Soft Plastic Packaging Technology for Food, Fujian Polytechnic Normal University, Fuqing, Fujian Province 350300, P. R. China
| | - Yuanjin Zhan
- Department of Chemistry, State Key Laboratory of Molecular Engineering of Polymers and Chem, Fudan University, Shanghai 200433, P. R. China
| | - Bin Qiu
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350116, PR China
| | - Zhenyu Lin
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350116, PR China
| | - Longhua Guo
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350116, PR China.,Jiaxing Key Laboratory of Molecular Recognition and Sensing, College of Biological, Chemical Sciences and Engineering, Jiaxing University, Jiaxing 314001, PR China
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11
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Balasubramanian S, Perumal E. A systematic review on fluoride-induced epigenetic toxicity in mammals. Crit Rev Toxicol 2022; 52:449-468. [PMID: 36422650 DOI: 10.1080/10408444.2022.2122771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fluoride, one of the global groundwater contaminants, is ubiquitous in our day-to-day life from various natural and anthropogenic sources. Numerous in vitro, in vivo, and epidemiological studies are conducted to understand the effect of fluoride on biological systems. A low concentration of fluoride is reported to increase oral health, whereas chronic exposure to higher concentrations causes fluoride toxicity (fluorosis). It includes dental fluorosis, skeletal fluorosis, and fluoride toxicity in soft tissues. The mechanism of fluoride toxicity has been reviewed extensively. However, epigenetic regulation in fluoride toxicity has not been reviewed. This systematic review summarizes the current knowledge regarding fluoride-induced epigenetic toxicity in the in vitro, in vivo, and epidemiological studies in mammalian systems. We examined four databases for the association between epigenetics and fluoride exposure. Out of 932 articles (as of 31 March 2022), 39 met our inclusion criteria. Most of the studies focused on different genes, and overall, preliminary evidence for epigenetic regulation of fluoride toxicity was identified. We further highlight the need for epigenome studies rather than candidate genes and provide recommendations for future research. Our results indicate a correlation between fluoride exposure and epigenetic processes. Further studies are warranted to elucidate and confirm the mechanism of epigenetic alterations mediated fluoride toxicity.
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Affiliation(s)
| | - Ekambaram Perumal
- Molecular Toxicology Laboratory, Department of Biotechnology, Bharathiar University, Coimbatore, India
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