Original Paper

Cancer Causes & Control

, Volume 17, Issue 4, pp 421-428

First online:

Age-specific Fluoride Exposure in Drinking Water and Osteosarcoma (United States)

  • Elise B. BassinAffiliated withDepartment of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine
  • , David WypijAffiliated withDepartment of Pediatrics, Harvard Medical SchoolClinical Research Program, Children’s HospitalDepartment of Biostatistics, Harvard School of Public Health
  • , Roger B. DavisAffiliated withDepartment of Biostatistics, Harvard School of Public HealthDivision of General Medicine and Primary Care, Beth Israel Deaconess Medical Center
  • , Murray A. MittlemanAffiliated withDepartment of Epidemiology, Harvard School of Public HealthCardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center

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Abstract

Objective

We explored age-specific and gender-specific effects of fluoride level in drinking water and the incidence of osteosarcoma.

Methods

We used data from a matched case–control study conducted through 11 hospitals in the United States that included a complete residential history for each patient and type of drinking water (public, private well, bottled) used at each address. Our analysis was limited to cases less than 20 years old. We standardized fluoride exposure estimates based on CDC-recommended target levels that take climate into account. We categorized exposure into three groups (<30%, 30–99%, >99% of target) and used conditional logistic regression to estimate odds ratios.

Results

Analysis is based on 103 cases under the age of 20 and 215 matched controls. For males, the unadjusted odds ratios for higher exposures were greater than 1.0 at each exposure age, reaching a peak of 4.07 (95% CI 1.43, 11.56) at age 7 years for the highest exposure. Adjusting for potential confounders produced similar results with an adjusted odds ratio for males of 5.46 (95% CI 1.50, 19.90) at age 7 years. This association was not apparent among females.

Conclusions

Our exploratory analysis found an association between fluoride exposure in drinking water during childhood and the incidence of osteosarcoma among males but not consistently among females. Further research is required to confirm or refute this observation.

Keywords

Osteosarcoma Fluoride Fluoridation Case–control