title: Effect of copper-based fungicide (bordeaux mixture) spray on the total copper content of areca nut: Implications in increasing prevalence of oral submucous fibrosis.
abstract: BACKGROUND
  Potentially malignant disorders like oral submucous fibrosis (OSMF) often precede oral squamous cell carcinoma (OSCC). The rate of transformation of OSMF to OSCC ranges from 3 to 19%. OSMF is etiologically related to chewing of areca nut (betel nut), and the high copper content in areca nut plays an important role in the pathogenesis of the disorder. Even though many studies estimated and confirmed increased copper levels in areca nuts, studies tracing the source of the increased copper content are scarce. Interestingly, on review of agricultural literature, it was found that most of the areca nut plantations in South India commonly use a copper-based fungicide, bordeaux mixture (BM).
  
  
  OBJECTIVE
  The aim of the study was to estimate and compare the copper content in areca nuts from plantations with and without copper-based fungicide usage.
  
  
  METHODS
  Four areca nut plantations from Dakshina Kannada district, Karnataka (group A) and four plantations from Ernakulam district, Kerala (group B) were selected for the study. The plantations from Karnataka used copper-based fungicide regularly, whereas the latter were devoid of it. Areca nut samples of three different maturities (unripe, ripe, and exfoliated) obtained from all plantations were dehusked, ground, and subjected to atomic absorption spectrometry (AAS) for copper analysis.
  
  
  RESULTS
  There was statistically significant difference in the copper content of areca nuts from both groups. The areca nuts from plantations treated with copper-based fungicide showed significantly higher copper levels in all maturity levels compared to their counterparts in the other group (P < 0.05).
  
  
  CONCLUSIONS
  The high copper content in areca nut may be related to the copper-based fungicide treatment on the palms. These areca nuts with high copper content used in quid or commercial products may be responsible for the increasing prevalence of OSMF.
authors: Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India.
authors: Philips
authors: P
authors: Mathew
authors: Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India.
authors: Ravi David
authors: RD
authors: Austin
authors: Department of Oral Pathology and Microbiology, Mar Baselious Dental College and Hospital, Ernakulam, Kerala, India.
authors: Soma Susan
authors: SS
authors: Varghese
authors: Department of Prosthodontics, KVG Dental College and Hospital, Sullia, Karnataka, India.
authors: A D
authors: AD
authors: Manojkumar
keywords: Areca nut; bordeaux mixture; copper; fungicide; oral submucous fibrosis