Skeletal fluorosis

From Wikipedia, the free encyclopedia

**Skeletal fluorosis**
*Classification & external resources*
ICD-10	M85.1
ICD-9	733.9

Skeletal fluorosis is a bone disease exclusively caused by excessive consumption of fluoride. In India, the most common cause of fluorosis is fluoride-laden water derived from borewells dug deep into the earth.

While fluorosis is most severe and widespread in the two largest 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."

Common causes of fluorosis include inhalation of fluoride dusts/fumes by workers in industry, use of coal as an indoor fuel source (a common practice in China), consumption of fluoride from drinking water, and consumption of fluoride from the drinking of tea, particularly brick tea.[1]

In China, the World Health Organization recently estimated that 2.7 million people have the crippling form of skeletal fluorosis, while in India, 17 of its 32 states have been identified as "endemic" areas, with an estimated 66 million people at risk and 6 million people seriously afflicted.

According to scientific surveys, skeletal fluorosis in India and China occurs when the fluoride concentration in water exceeds 1 part per million (ppm), and has been found to occur in communities with only 0.7 part per million (SOURCE: Singh 1961; Singh 1963; Jolly 1970; Siddiqui 1970; Susheela 1993; Choubisa 1997; Xu 1997; Bo 2003).

The Chinese government now considers any water supply containing over 1 ppm fluoride a risk for skeletal fluorosis (SOURCE: Bo 2003).

In the United States, an average of 1 ppm of fluoride is intentionally added to water supplies for water fluoridation, while the Maximum Contaminant Level (as established by the US Environmental Protection Agency) is 4 ppm.

[edit] 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 radiographically-detectable increases in bone mass
Clinical Phase I	6,000 to 7,000	Sporadic pain; stiffness of joints; osteosclerosis of pelvis and vertebral spine
Clinical Phase II	7,500 to 9,000	Chronic joint pain; arthritic symptoms; slight calcification of ligaments' increased osteosclerosis and cancellous bones; with/without osteoporosis of long bones
Phase III: Crippling Fluorosis	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

[edit] Source

U.S.P.H.S. "Review of Fluoride, Benefits and Risks", 1991 - adapted from: Smith & Hodge, 1979; Franke et al., 1975; Schlegal, 1974 Comment about the EPA level being bumped up: http://rense.com/health/fluoride1.htm