Health effects of groundwater fluoride contamination.
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.
Nayak
Bishwajit
B
School of Environmental Studies, Jadavpur University, Kolkata, India.
Roy
Madan Mohan
MM
Das
Bhaskar
B
Pal
Arup
A
Sengupta
Mrinal Kumar
MK
De
Shankar Prasad
SP
Chakraborti
Dipankar
D
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
D014874:Water Pollutants, Chemical; D005459:Fluorides