A Brief Review of Ideal Bio-Indicators, Bio-Markers and Determinants of Endemic of Fluoride and Fluorosis

Fluorosis in man and animals is the resultant of chronic exposure of Fluoride (F) for prolonged period through F contaminated drinking water and foods and industrial F pollution. However, fluoridated water and industrial F emissions are the major sources of F exposure for humans and domestic animals. Chronic F exposure not only deteriorate the health of human beings and animals but also causes diverse adverse toxic effects on hard (teeth and bones) and soft (organs) tissues. Various F induced pathological changes in teeth and bones are known as dental and skeletal fluorosis, respectively. However, skeletal fluorosis is more dangerous and highly significant since it diminishes the mobility at a very early age and develops crippling or lameness bone deformity. Thousands of people and domestic animals are suffering with fluorosis worldwide. Dental fluorosis is rampant and the commonest form of chronic F toxicosis and appears in subjects of almost all age groups. However, children and bovine calves are relatively more sensitive and highly susceptible to F toxicosis and revealed the earliest clinical sign of chronic F poisoning in the form of dental fluorosis. Hence, these are ideal bio-indicators for chronic F intoxication or fluorosis. Nevertheless, the magnitude or severity of fluorosis is much more depending on the density and rate of bio-accumulation of F. Biological samples, milk, urine, blood serum, teeth, nails, etc. are better bio-markers for F intoxication. However, urine F concentration is the best bio-marker for endemic of F and fluorosis. In this communication, ideal bio-indicators and bio-markers for endemic of F and fluorosis and diverse potential determinants influencing the severity of F toxicity (fluorosis) are considered and briefly and critically reviewed. Findings of this review are useful in making and implementation of health policy and the commencement of mitigation and control of fluorosis programme in F endemic areas where it is problematic for human and animal health.

Fluoride Contamination in Groundwater, Around Bhopalpatnam Area, District-Bijapur, Chhattisgarh: Adverse Effect on Human Health

In India many cases of fluorosis (dental and skeletal) have been reported in Archaean and Proterozoic granitic and gneissic t errain from Andhra Pradesh, Rajasthan, Madhya Pradesh, and Chhattisgarh. The origin of hazardous fluoride is attributed to geological reasons. A systematic study is required to understand the behavior of fluoride in drinking water particularly in terms of hydrogeological settings, climatic conditions etc. The present study is an effort to assess hydrogeological study of groundwater in parts of Bhopalpatnam area, District-Bijapur, Chhattisgarh. The study is conducted to understand the fluoride contamination in groundwater and to infer the chemical parameters responsible for distribution of fluoride. The study area is underlain partly by crystalline basement and partly by Proterozoic sedimentary rocks (sandstone, shale and limestone). A total 57 water samples have been taken from dug cum bored wells from the study area in June 2015. The results of chemical analysis showed fluoride concentration from 0.12mg/l to 3.58mg/l. The fluoride bearing minerals in host rock interacted with groundwater and through chemical decomposition, dissociation, reactions dissolution fluoride concentration increased in groundwater. Chemical weathering with relatively high alkalinity favors high concentration of fluoride in Groundwater. Villagers have no option to drink high fluoride groundwater as a result they were badly suffered from dental and skeletal fluorosis.

Utilization of Community-Level Fluoride-Filtered Water and its Associated Factors in Dugda Woreda of East Shewa Zone, Oromia Region, Ethiopia

Background: Long-term consumption of water containing an excessive amount of fluoride causes dental and skeletal fluorosis. De-fluoridation options differ in terms of scale, efficacy, long-term viability, and user acceptance. Therefore, this study aimed to identify the challenges of using fluoride-filtered water and its associated factors among households. Methods: A cross-sectional study was conducted from April to May, 2018 among 405 randomly selected households in Dugda Woreda of Ethiopia Rift Valley East Shewa Zone, Oromia Region. A structured interviewer-administered questionnaire was used to collect the data. SPSS version 20 was used to enter and analyze the collected data. Logistic regression analysis was used to identify association between dependent and independent factors and explained by odds ratio with 95%CI. Results: A total of 228 (56.3%) households were found to utilize fluoride filtered water from community water supply schemes for drinking and cooking purposes. No family history of fluorosis (AOR = 44.4, 95%CI: 18.8, 104.74), monthly income of less than 1000 ETB (AOR = 0.03, 95%CI: 0.004, 0.23), good knowledge of community fluoride filter schemes (AOR = 5.93, 95%CI: 1.30, 26.9), and not afford to pay bill of ⩾0.50 ETB [AOR = 0.4, 95%CI: 0.20, 0.91] were factors significantly associated with utilization of community-level fluoride-filtered water. Conclusion: In this study, more than half of the households used fluoride filtered water. Family monthly income, affordability, presence of family members with the history of fluoride exposure, and knowledge about community fluoride filter schemes were factors significantly associated with utilization of community-level fluoride-filtered water.

Equine dental and skeletal fluorosis induced by well water consumption

Two horses that consumed well water with high fluoride content exhibited clinical signs of chronic dental and skeletal fluoride toxicosis and were later euthanized and autopsied. Both horses had degenerative disease of multiple joints and multiple dental defects. Elevated fluoride concentrations were found in bone and tooth samples of both horses, well water, and feed. Microscopically, abnormalities were noted in bone and tooth samples, and consisted mostly of foci of cement necrosis and hypercementosis. Horses exhibiting bilateral, highly symmetrical dental and/or skeletal lesions, with chronic lameness, should be evaluated for the possible presence of fluoride toxicosis.

Development of a low cost household bone-char defluoridation filter

Regular intake of drinking water containing fluoride above permissible levels (>1.5 mgl-1) is responsible for dental and skeletal fluorosis. The objective of this study was to develop a low cost and efficient water defluoridation filter using local materials. The filter frame was made from Polyvinyl chloride pipe of 125 mm diameter and 1 m height, with a useful filtration volume of 9.55 l. The filtration layer consisted of a sequence of three strata: gravel, bone-char and sand, giving a total weight of 15 kg. Based on the concentration of fluoride in drinking water in parts of northern Cameroon, three different fluoride ion concentrations (10 mgl-1, 20 mgl-1 and 30 mgl-1) were prepared in the laboratory using distilled water and allowed to flow through the filter at the rate of 3.33 lh-1. High fluoride uptake capacity was observed (94.8% to 99.1%), depicting the suitability of the filter in defluoridation. The constructed filter costed about 17 US$. Based on these results, the filter can be recommended as an appropriate technology to mitigate fluoride health hazards problems in low income families. Although the estimated replacement frequency of biochar was three months, further research is required to optimize the point of use system performances.Keywords: Bone-char, water filter, fluoride.

Adsorption of Fluorides in Drinking Water by Palm Residues

Fluorides represent a significant problem in low- and middle-income countries (LMICs). In fact, this ion is essential for human health but, if taken in excess, it can cause dental and skeletal fluorosis. In LMICs, the pollution of groundwater from fluorides is of natural origin. Therefore, if providing alternative sources for drinking water (DW) supply is not possible, the use of specific processes for the removal of fluorides becomes essential. The adsorption on alternative materials, such as agro-food residues, can be a valid treatment for the removal of fluorides in the LMIC considering: (i) their optimal removal yields, (ii) the high availability, and (iii) the low cost. In recent years, the interest on the use of palm residues (PRs) becomes significant. Optimal pH, temperature, adsorbent dosage, and possible combination with metals to increase adsorption performances were deeply investigated. The activated PRs also present two other advantages: (i) very high surface area, and (ii) very low reduction in uptake capacity when regenerated. However, all tests were conducted with synthetic waters in laboratory-scale reactors while application on real-scale are absent. This makes other studies on this type of alternative adsorbent material still necessary.

Drinking water quality assessment for geochemical and microbial parameters in Nowshera District, Khyber Pakhtunkhwa, Pakistan; In an aspect of Geo-ethical Consideration

<p><strong>Abstract</strong></p><p>This study investigated the physicochemical and microbial contamination in the drinking water of fifteen villages in the Nowshera District. For this purpose, water samples (n=165) were collected and analyzed for pH, alkalinity, total dissolved solids, anions: carbonate (CO<sub>3</sub>), bicarbonate (HCO<sub>3</sub>), chloride (Cl), fluoride (F), nitrate (NO<sub>3</sub>) and sulphate (SO<sub>4</sub>), cations: sodium (Na), potassium (K), calcium (Ca), magnesium (Mg) and arsenic (As) and microbial parameters (total coliform, fecal coliform and E coliform). Results revealed higher F, NO<sub>3</sub> and Fecal coliform contaminations in drinking water of the study area that have surpassed 28%, 5% and 30% of sampling respectively.  Higher level of these contaminants in drinking water could cause health hazards such as dental and skeletal fluorosis, joint pain, dysentery, diarrhea and various other water borne diseases among the inhabitants of the study area. Fluoride contamination in water could be attributed to the F containing carbonates rocks of Peshawar Basin. Higher NO<sub>3</sub> and Fecal coliform contaminations in water could be attributed to surface ongoing agriculture activities and animals wastes that have affected dominantly the shallow aquifers in the study area. The study, therefore, strongly recommends deep well boring and defluoridation of the drinking water in the study area.    </p>