Skeletal fluorosis

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Skeletal fluorosis
Fluorosis patient in the industrial city of Raigarh, India
SpecialtyRheumatology Edit this on Wikidata

Skeletal fluorosis is a

joints
.

Symptoms

Symptoms are mainly promoted in the bone structure. Due to a high fluoride concentration in the body, the bone is

ossified.[2] Most patients with skeletal fluorosis show side effects from the high fluoride dose such as ruptures of the stomach lining and nausea.[3]
Fluoride can also damage the
higher calcium concentration in the blood. As a result, bone flexibility decreases making the bone more susceptible to fractures.[4]

The clinical symptoms of fluoride toxicity in the bones are indistinguishable from arthritis. Even low level exposure to fluoride can cause or worsen the symptoms in consumers with vulnerable genotypes. [5] [6] [7]

Causes

Common causes of fluorosis include inhalation of fluoride dusts or fumes by workers in industry and consumption of fluoride from drinking water (levels of fluoride in excess of levels that are considered safe.[8])

In

deep-bore wells. Over half of groundwater sources in India have fluoride above recommended levels.[9]

Fluorosis can also occur as a result of volcanic activity. The 1783 eruption of the

killed about 22% of the Icelandic population, and 60% of livestock, as a result of fluorosis and sulfur dioxide gases.[10] The 1693 eruption of Hekla also led to fatalities of livestock under similar conditions.[11]

Skeletal fluorosis phases

Osteosclerotic phase Ash concentration (mgF/kg) Symptoms and signs
Normal Bone 500 to 1,000 Normal
Preclinical Phase 3,500 to 5,500 Asymptomatic; slight
bone mass
Clinical Phase I 6,000 to 7,000 Sporadic
pelvis and vertebral column
Clinical Phase II 7,500 to 9,000 Chronic joint pain;
cancellous bones; with/without osteoporosis
of long bones
Clinical Phase III 8,400 Limitation of joint movement; calcification of ligaments of neck vertebral column; crippling deformities of the spine and major joints;
muscle wasting
; neurological defects/compression of spinal cord

Treatment

As of now, there are no established treatments for skeletal fluorosis patients.[12] However, it is reversible in some cases, depending on the progression of the disease. If fluorine intake is stopped, the amount in bone will decrease and be excreted via urine. However, it is a very slow process to eliminate the fluorine from the body completely. Minimal results are seen in patients. Treatment of side effects is also very difficult. For example, a patient with a bone fracture cannot be treated according to standard procedures, because the bone is very brittle. In this case, recovery will take a very long time and a pristine healing cannot be guaranteed.[13] However, further fluorosis can be prevented by drinking defluoridated water. It is recently suggested that drinking of defluoridated water from the "calcium amended-hydroxyapatite" defluoridation method may help in the fluorosis reversal.[14] Defluoridated water from this suggested method provides calcium-enriched alkaline drinking water as generally fluoride contaminated water has a low amount of calcium mineral and drinking alkaline water helps in eliminating the toxic fluoride from the body.[14]

Epidemiology

In some areas, skeletal fluorosis is endemic. While fluorosis is most severe and widespread in the world's two most populous countries – India and China – UNICEF estimates that "fluorosis is endemic in at least 25 countries across the globe. The total number of people affected is not known, but a conservative estimate would number in the tens of millions."[15]

In India, 20 states have been identified as endemic areas, with an estimated 60 million people at risk and 6 million people disabled; about 600,000 might develop a neurological disorder as a consequence.[9]

Effects on animals

knobby hoofed leg
Moroccan cow with fluorosis

The histological changes which are induced through fluorine on rats resemble those of humans.[16]

See also

References

  1. S2CID 21763028
    .
  2. ^ Kalia LV, Lee L, Kalia SK, Pirouzmand F, Rapoport MJ, Aviv RI, Mozeg D, Symons SP. Thoracic myelopathy from coincident fluorosis and epidural lipomatosis. Canadian Journal of Neurological Sciences. 2010 March; 37(2):276–278.
  3. ^ Gönnewicht, Daniela (2005). "Untersuchung eines Zusammenhanges von Fluoridkonzentrationen in privaten Trinkwasserversorgungsanlagen und Kariesentwicklung im Raum Ascheberg (Südliches Münsterland/Westfalen)" (PDF). Dissertation. Universität Münster, Fachbereich Medizinische Fakultät.
  4. PMID 4692708
    .
  5. S2CID 262013882
    .
  6. S2CID 237724628
    .
  7. PMID 28152004
    .
  8. ^ "CDC – National Research Council (NRC) Report – Safety – Community Water Fluoridation – Oral Health". Cdc.gov. Retrieved 2013-09-04.
  9. ^
    PMID 19305069
    .
  10. doi:10.1029/2001JD002042
    .
  11. ^ Eruption History
  12. PMID 15639213
    .
  13. PMID 6626475
    .
  14. ^
    S2CID 173993086
    .
  15. ^ "UNICEF – Water, environment and sanitation – Common water and sanitation-related diseases". Retrieved 2007-09-17.
  16. S2CID 75961170
    .

Further reading

External links

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