title: Health effects of groundwater fluoride contamination.
abstract: BACKGROUND
  The people in Berhait block, Sahibganj district, Jharkhand state, India, have been exposed chronically to fluoridecontaminated groundwater. Hereby, we report the clinical effects of chronic exposure to fluoride.
  
  
  METHODS
  The study population was a convenience sample of 342 adults and 258 children living in the affected area. All volunteers filled out questionnaires and were examined. Well water from the six affected villages and urine samples were analyzed for fluoride using an ion-sensitive electrode.
  
  
  RESULTS
  Twenty nine percent of 89 well water samples had fluoride concentrations above the Indian permissible limit of fluoride in drinking water. Eighty-five children and 72 adults had clinical fluorosis. Urine fluoride concentrations in children were 0.758-2.88 mg/L whereas in adults they were 0.331-10.36 mg/L.
  
  
  CONCLUSIONS
  Clinical effects of fluoride included abnormal tooth enamel in children; adults had joint pain and deformity of the limbs and spine, along with ligamentous calcifications and exostosis formations in seven patients. Elevated urine fluoride concentrations supported the clinical diagnosis of fluorosis. Owing to insufficient fluoride-safe wells and lack of awareness of the danger of fluoride toxicity, villagers often drink fluoride-contaminated water.
  
  
  CONCLUSIONS
  Villagers of Berhait block, including children, are at risk from chronic fluoride toxicity. To combat the situation, villagers need fluoride-safe water, education, and awareness of the danger about fluoride toxicity.
authors.affiliation: School of Environmental Studies, Jadavpur University, Kolkata, India.
authors.forename: Bishwajit
authors.initials: B
authors.lastname: Nayak
authors.forename: Madan Mohan
authors.initials: MM
authors.lastname: Roy
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Das
authors.forename: Arup
authors.initials: A
authors.lastname: Pal
authors.forename: Mrinal Kumar
authors.initials: MK
authors.lastname: Sengupta
authors.forename: Shankar Prasad
authors.initials: SP
authors.lastname: De
authors.forename: Dipankar
authors.initials: D
authors.lastname: Chakraborti
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects; D004784:Environmental Monitoring / Q000379:methods; D062665:Epidemiological Monitoring; D005260:Female; D005458:Fluoride Poisoning / Q000453:epidemiology* / Q000503:physiopathology; D005459:Fluorides / Q000032:analysis* / Q000633:toxicity / Q000652:urine; D009050:Fluorosis, Dental / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013997:Time Factors; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000633:toxicity / Q000652:urine; D014881:Water Supply / Q000032:analysis / Q000592:standards; D055815:Young Adult
chemical_list: D014874:Water Pollutants, Chemical; D005459:Fluorides