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. 2024 Nov 21;196(12):1230.
doi: 10.1007/s10661-024-13330-6.

Health risk modeling and risk factors of fluorosis in the fluoride endemic village of Maharashtra: A cross-sectional study

Neha Rawat  1   2 , Amit Bafana  3   4
Affiliations

Health risk modeling and risk factors of fluorosis in the fluoride endemic village of Maharashtra: A cross-sectional study

Neha Rawat et al. Environ Monit Assess. .

Abstract

Fluorosis, a debilitating disease, causes dental mottling and bone deformities among other adverse health effects. The current epidemiological study focused on the prevalence and risk factors of fluorosis in the fluoride endemic village, Dongargaon, Maharashtra, India. The clinical diagnosis of subjects showed 96.49% prevalence of dental fluorosis, and 63.16% prevalence of skeletal fluorosis. Duration of exposure, age of subjects and physiological symptoms like chronic joint pain were found to be significantly correlated with skeletal fluorosis (p < 0.05). Fluoride in drinking water showed seasonal variation with highest level in winter (6.54 mg/L) and lowest level in monsoon (0.54 mg/L). Consequently, the mean urinary fluoride concentration was also highest in winter (9.37 mg/L) and lowest in monsoon (3.88 mg/L). Multilogit regression analysis demonstrated that subjects excreting urinary fluoride above 4 mg/L had 7.25 times higher odds of developing skeletal fluorosis (p < 0.05). Health risk assessment showed a high value of hazard quotient, indicating a high probability of adverse health effects. The estimated daily ingestion of 8.80 mg F and a predicted bone uptake of 0.19 mg/kg/day raised significant health concerns for the studied population. Exposure and bone F uptake modeling suggested that the predicted mean fluoride concentrations of 4018.77 ± 1762.45 mg/kg bone ash in asymptomatic, and 5535.12 ± 1526.30 mg/kg bone ash in symptomatic subjects were significantly different (p < 0.05). The comprehensive risk evaluation in the study clearly brings out the high risk of fluoride exposure and adverse effects in Dongargaon village for the first time. Further, urinary fluoride was shown to have significant association with the risk of skeletal fluorosis. The study warrants implementation of immediate control measures at the study site.

Keywords: Dental fluorosis; Health risk assessment; Modeling; Skeletal fluorosis; Urinary fluoride.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Institute (Ref.No.Eth.Com./003/IEC/06/2022). Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests. Ethical responsibilities of authors: All authors have read, understood, and have complied as applicable with the statement on "Ethical responsibilities of Authors" as found in the Instructions for Authors.

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