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Heidi Johansen. Fluorosis in the Arusha region, TZ. Bones & teeth Long term exposure Arthritis, osteoporosis. Dental and skeletal fluorosis. Arusha region Rift valley, ground water WHO recommends <1.5 mg/L 1.5 – 24.9 mg/L, mean 8 mg/L 3-6 mg/L associated with skeletal fluorosis
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Heidi Johansen Fluorosis in the Arusha region, TZ
Bones & teeth Long term exposure Arthritis, osteoporosis Dental and skeletal fluorosis
Arusha region Rift valley, ground water WHO recommends <1.5 mg/L 1.5 – 24.9 mg/L, mean 8 mg/L 3-6 mg/L associated with skeletal fluorosis 1 mg/L associated with mild dental fluorosis Background
Mechanism Absorption in GIT Storage in bones & teeth Excretion in urine and sweat • Bones – Calcium replacement • Thyroid – Iodine replacement
Functional & structural change in bone – severity proportionate to fluoride concentration Symptoms of stage 1 & 2 fluorosis as arthritis – diagnostic difficulties Osteoporosis, osteomalacia secondary hyperparathyroidism, thyroid hypofunction Characteristics
Treatment & prevention Domestic, simple techniques Bone ash, clay Nalgonda method No cure – limit fluoride exposure Advanced, large scale techniques Precipitation – Al and Ca salts Reverse osmosis
Benefit Freedom of choice Fluoridation of public drinking water
http://wedc.lboro.ac.uk/resources/conference/22/dahi.pdf Dhar V, Bhatnagar M. Physiology and toxicity of fluoride. Indian J Dent Res 2009;20:350-5 http://fluoridation.com/bones.htm http://www.who.int/water_sanitation_health/dwq/chemicals/fluoride.pdf http://www.sciencedirect.com/science/article/pii/S0011916409006407 http://www.docstoc.com/docs/92445321/Fluorosis-and-Thyroid-by-Dr-Sarma-handout Sources