Xingchen Yu1, Jingwen Chen2, Yonggang Li3, Hongliang Liu4, Changchun Hou4, Qiang Zeng4, Yushan Cui4, Liang Zhao4, Pei Li2, Ziquan Zhou1, Shuo Pang1, Sha Tang2, Kunming Tian2, Qian Zhao2, Lixin Dong2, Chunyan Xu2, Xiao Zhang2, Shun Zhang5, Li Liu6, Aiguo Wang7. 1. 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. 2. Department of Occupational and Environmental Health, 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. 3. Tianjin Baodi District Centers for Disease Control and Prevention, Tianjin, PR China. 4. Tianjin Centers for Disease Control and Prevention, Tianjin, PR China. 5. Department of Occupational and Environmental Health, 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. Electronic address: shunzhang@hust.edu.cn. 6. 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. Electronic address: liul2012@hust.edu.cn. 7. Department of Occupational and Environmental Health, 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. Electronic address: wangaiguo@mails.tjmu.edu.cn.
Abstract
BACKGROUND: Excessive fluoride exposure is associated with adverse health outcomes, but little is known of the effects of moderately chronic fluoride exposure on children's health. OBJECTIVES: We conducted a cross-sectional study to explore the health impact of moderately excessive fluoride in drinking water. METHODS: We recruited 2886 resident children, aged 7 to 13 years, randomly from endemic and non-endemic fluorosis areas in Tianjin, China. The fluoride levels in drinking water and urine were measured using the national standardized ion selective electrode method. We examined the dose-response effects of low-to-moderate fluoride exposure on dental fluorosis (DF) and intelligence quotient (IQ), and evaluated the potential relationships between DF grades and intelligence levels using piecewise linear regression and multiple logistic regression, respectively. RESULTS: The adjusted odds ratios (ORs) of DF were 2.24 (95% confidence interval [CI]: 2.02 to 2.48) for every 0.1 mg/L increment in the water fluoride concentration in the range of 0.80 to 1.50 mg/L, and 2.61 (95% CI: 2.32 to 2.93) for every 0.5 mg/L increment in the urinary fluoride level up to 1.80 mg/L. Every 0.5 mg/L increment in the water fluoride level was associated with a reduction of 4.29 in the IQ score (95% CI: -8.09 to -0.48) in the range of 3.40 to 3.90 mg/L, and a decreased probability of developing excellent intelligence (IQ ≥ 130, OR = 0.60, 95% CI: 0.47 to 0.77) in the range of 0.20-1.40 mg/L, respectively. Every 0.5 mg/L increment in the urinary fluoride level was related to a decrease of 2.67 in the IQ scores (95% CI: -4.67 to -0.68) between 1.60 mg/L to 2.50 mg/L. Excellent intelligence decreased by 51% in children with higher urinary fluoride, and by 30% with each degree increment of DF. CONCLUSIONS: Our study suggests threshold and saturation effects of moderately excessive fluoride exposure on DF and intelligence loss in children, and a potential association between DF and the loss of excellent intelligence.
BACKGROUND: Excessive fluoride exposure is associated with adverse health outcomes, but little is known of the effects of moderately chronic fluoride exposure on children's health. OBJECTIVES: We conducted a cross-sectional study to explore the health impact of moderately excessive fluoride in drinking water. METHODS: We recruited 2886 resident children, aged 7 to 13 years, randomly from endemic and non-endemic fluorosis areas in Tianjin, China. The fluoride levels in drinking water and urine were measured using the national standardized ion selective electrode method. We examined the dose-response effects of low-to-moderate fluoride exposure on dental fluorosis (DF) and intelligence quotient (IQ), and evaluated the potential relationships between DF grades and intelligence levels using piecewise linear regression and multiple logistic regression, respectively. RESULTS: The adjusted odds ratios (ORs) of DF were 2.24 (95% confidence interval [CI]: 2.02 to 2.48) for every 0.1 mg/L increment in the water fluoride concentration in the range of 0.80 to 1.50 mg/L, and 2.61 (95% CI: 2.32 to 2.93) for every 0.5 mg/L increment in the urinary fluoride level up to 1.80 mg/L. Every 0.5 mg/L increment in the water fluoride level was associated with a reduction of 4.29 in the IQ score (95% CI: -8.09 to -0.48) in the range of 3.40 to 3.90 mg/L, and a decreased probability of developing excellent intelligence (IQ ≥ 130, OR = 0.60, 95% CI: 0.47 to 0.77) in the range of 0.20-1.40 mg/L, respectively. Every 0.5 mg/L increment in the urinary fluoride level was related to a decrease of 2.67 in the IQ scores (95% CI: -4.67 to -0.68) between 1.60 mg/L to 2.50 mg/L. Excellent intelligence decreased by 51% in children with higher urinary fluoride, and by 30% with each degree increment of DF. CONCLUSIONS: Our study suggests threshold and saturation effects of moderately excessive fluoride exposure on DF and intelligence loss in children, and a potential association between DF and the loss of excellent intelligence.
Authors: Emily A Adkins; Kimberly Yolton; Jeffrey R Strawn; Frank Lippert; Patrick H Ryan; Kelly J Brunst Journal: Environ Res Date: 2021-10-29 Impact factor: 6.498
Authors: Sabine Guth; Stephanie Hüser; Angelika Roth; Gisela Degen; Patrick Diel; Karolina Edlund; Gerhard Eisenbrand; Karl-Heinz Engel; Bernd Epe; Tilman Grune; Volker Heinz; Thomas Henle; Hans-Ulrich Humpf; Henry Jäger; Hans-Georg Joost; Sabine E Kulling; Alfonso Lampen; Angela Mally; Rosemarie Marchan; Doris Marko; Eva Mühle; Michael A Nitsche; Elke Röhrdanz; Richard Stadler; Christoph van Thriel; Stefan Vieths; Rudi F Vogel; Edmund Wascher; Carsten Watzl; Ute Nöthlings; Jan G Hengstler Journal: Arch Toxicol Date: 2020-05-08 Impact factor: 5.153
Authors: Philippe Grandjean; Howard Hu; Christine Till; Rivka Green; Morteza Bashash; David Flora; Martha Maria Tellez-Rojo; Peter Song; Bruce Lanphear; Esben Budtz-Jørgensen Journal: medRxiv Date: 2020-11-04