Environmental Monitoring and Assessment

, Volume 162, Issue 1–4, pp 1–14

Fluoride and health hazards: community perception in a fluorotic area of central Rajasthan (India): an arid environment

Article

Abstract

India is among the 23 nations around the globe where health problems occur due to excess ingestion of fluoride (>1.5 mg/l) by drinking water. In Rajasthan, 18 out of 32 districts are fluorotic and 11 million of the populations are at risk. An exploratory qualitative survey was conducted to describe perception of the community regarding fluoride and related health problems in Central Rajasthan. A study on distribution and health hazards by fluoride contaminate in groundwater was performed in 1,030 villages of Bhilwara district of Central Rajasthan. One thousand thirty water samples were collected and analyzed for fluoride concentration. Fluoride concentration in these villages varies from 0.2 to 13.0 mg/l. Seven hundred fifty-six (73.4%) villages have fluoride concentration above 1.0 mg/l. Sixty (5.83%) villages have fluoride concentration above 5.0 mg/l with maximum numbers (24, 19.5%) from Shahpura tehsil. A detailed fluorosis study was carried out in 41 villages out of 60 villages having fluoride above 5.0 mg/l in the study age, sex, and occupation data were also collected. Four thousand, two hundred fifty-two individuals above 5 years age were examined for the evidence of dental fluorosis, while 1998 individuals above 21 years were examined for the evidence of skeletal fluorosis. The overall prevalence of dental and skeletal fluorosis was found to be 3,270/4,252 (76.9%) and 949/1,998 (47.5%), respectively. Maximum of 23.9% (1,016) individuals have mild grade of Dean’s classification. Three hundred seventy-four (8.8%) individuals have severe type of dental fluorosis. The Dean’s Community Fluorosis Index for the studied area in total is 1.62. Maximum CFI 3.0 was recorded from Surajpura of Banera Tehsil. Five hundred sixty-six (28.3%) individuals have Grade I type of skeletal fluorosis while only 0.6% (12) individuals have Grade III skeletal fluorosis. In conclusion, the prevalence and severity of fluorosis increased with increasing fluoride concentration. It was interesting to note that in some villages, the prevalence and severity of fluorosis were highest in subjects belonging to the economically poor community. Similarly, male laborers showed highest prevalence of fluorosis. Prevalence and severity of fluorosis were observed higher in subjects using tobacco, bettle nuts, and alcoholic drinks. In contrast, subjects using citrus fruits and having good nutritional status showed low prevalence.

Keywords

Ground water Fluoride Dental fluorosis Skeletal fluorosis CFI Central Rajasthan India 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. APHA (1991). Standard methods for the examination of water and wastewater (17th ed.). Washington, DC: American Public Health Association.Google Scholar
  2. Ayoob, S., & Gupta, A. K. (2006). Fluoride in drinking water: A review on the status and stress effects. Critical Reviews in Environmental Science and Technology, 36, 433–487. doi:10.1080/10643380600678112.CrossRefGoogle Scholar
  3. Azar, H. A., Nucho, C. K., Bayyuk, S. I., & Bayyuk, W. B. (1961). Skeletal fluorosis due to chronic fluoride intoxication. Cases from an endemic area of fluorosis in the region of the Persian Gulf. Annals of Internal Medicine, 55(2), 193–200.Google Scholar
  4. Bilbeissi, M. W., Fraysee, C., Mitre, D., Kerebel, M., & Kerebel, B. (1988). Dental fluorosis in relation to tea drinking in Jordan. Fluoride, 21(3), 121–126.Google Scholar
  5. Brouwer, I. D., De Bruin, A., Dirks, O. A., & Hautvast, J. (1988). Unsuitability of WHO guidelines for fluoride concentration in drinking water in Senegal. Lancet, I, 223–225. doi:10.1016/S0140-6736(88)91073-2.CrossRefGoogle Scholar
  6. Brown, E., Skougstad, M. W., & Fishman, M. J. (1974). Method for collection and analysis of water sample for dissolved minerals for dissolved minerals and gases (Book No. 5). Washington, DC: US Department of Interior.Google Scholar
  7. Bureau of Indian Standard (BIS) (1991). Indian standard specification for drinking water (pp. 2–4). Delhi: BIS, IS 10500.Google Scholar
  8. Census (2001). District Bhilwara, Rajasthan, Government of Rajasthan.Google Scholar
  9. Choubisa, S. L., & Sompura, K. (1996). Dental fluorosis in tribal villages of Dungarpur district (Rajasthan). Pollution Research, 15(1), 45–47.Google Scholar
  10. Cuifeng, L., Wyborny, L. E., & Chan, J. T. (1995). Fluoride content of dairy milk from supermarket. A possible contributing factor to dental fluorosis. Fluoride, 28(1), 10–16.Google Scholar
  11. Dean, H. T. (1942). The investigation of physiological effects by the epidemiological method. American Association for the Advancement of Science, 19, 23–31.Google Scholar
  12. Desai, V. R., Saxena, D. K., Bhavasar, B. S., & Kantharia, S. L. (1988). Epidemiological study of dental fluorosis in tribal residing near fluorspar mines. Fluoride, 21(2), 137–141.Google Scholar
  13. Godfrey, S., Wate, S., Kumar, P., Swami, A., Rayalu, S., & Rooney, R. (2006). Health-based risk targets for fluorosis in tribal children of rural Madhya Pradesh. In India 32nd WEDC international conference. Colombo, Sri Lanka, 2006.Google Scholar
  14. Guanglu, B. (2007). Screening high-fluoride and high-arsenic drinking waters and surveying endemic fluorosis and arsenism in Shaanxi province in western China. Water Research, 41(5), 1168. doi:10.1016/j.watres.2006.11.002.CrossRefGoogle Scholar
  15. Han, Y. Z., Zhang, J. Q., Lie, Z. Y., Zhang, L. Z., Yu, X. H., & Dai, J. A. (1995). High fluoride content of food and endemic fluorosis. Fluoride, 28(4), 201–202.Google Scholar
  16. Hussain, J. (2001). Studies on the impact of industrial and domestic waste on groundwater quality. Ph.D. Thesis, MDS University Ajmer Rajasthan, India.Google Scholar
  17. Hussain, I., Hussain, J., Sharma, K. C., & Ojha, K. G. (2002). Fluoride in drinking water and health hazardous: Some observations on fluoride distribution Rajasthan. In Environmental Scenario of 21st Century (pp. 355–374). New Delhi: APH.Google Scholar
  18. Hussain, J., Shrama, K. C., Arif, M., & Hussain, I. (2007). Fluoride distribution and modeling using best subset procedure in Nagour District of Central Rajasthan, India. In The XXVIITH conference of the international society for fluoride research (ISFR XXVII), 9–12 October, 2007. Beijing, China.Google Scholar
  19. Hussain, J., Sharma, K. C., & Hussain, I. (2003). Fluoride distribution in groundwater of Raipur Tehsil in Bhilwara District. International Journal of Bioscience Reports, 1(3), 580–587.Google Scholar
  20. Hussain, J., Sharma, K. C., & Hussain, I. (2004a). Fluoride in drinking water and its ill affect on Human Health: A review. Journal of Tissue Research, 4(2), 263–273.Google Scholar
  21. Hussain, J., Sharma, K. C., & Hussain, I. (2004b). Fluoride in drinking water and health hazards: Some observations of fluoride distribution in Sahara Tehsil of Bhilwara District, Rajasthan. Bioscience and Biotechnology Research Asia, 2(2), 107–116.Google Scholar
  22. Hussain, J., Sharma, K. C., & Hussain, I. (2005a). Fluoride distribution in groundwater of Banera Tehsil in Bhilwara District, Rajasthan. Asian Journal of Chemistry, 17(1), 457–461.Google Scholar
  23. Hussain, J., Sharma, K. C., & Hussain, I. (2005b). Fluoride contamination in groundwater sources of Hurda Tehsil of Bhilwara, Rajasthan. Pollution Research, 24(2), 431–434.Google Scholar
  24. Hussain, J., Sharma, K. C., Ojha, K. G., & Hussain, I. (2000). Fluoride distribution in ground waters of Sirohi district in Rajasthan. Indian Journal of Environment and Eco-planning, 3(3), 661–664.Google Scholar
  25. Jacks, G., Rajagopalan, K., Alveteg, T., & Jonsson, M. (1993). Genesis of high-F groundwaters, southern India. Applied Geochemistry, 2, 241–244.CrossRefGoogle Scholar
  26. Jolly, S. S., Prasad, S., & Sharma, R. (1970). Endemic fluorosis in India. The Journal of the Association of Physicians of India, 18, 459–471.Google Scholar
  27. Khaiwal, R., & Garg, V. K. (2007). Hydro-chemical survey of groundwater of Hisar City and assessment of defluoridation methods used in India. Environmental Monitoring and Assessment, 132(1–3), 33–43. doi:10.1007/s10661-006-9500-6.Google Scholar
  28. Li, Y., Liang, C. K., Katz, B. P., Niu, S., Cao, S., & Stookey, G. K. (1996). Effect of fluoride exposure and nutrition on skeletal fluorosis. Journal of Dental Research, 75, 2699.Google Scholar
  29. Opinya, G. N., Bwibo, N., Valderhaug, J., Birkeland, J. M., & Lokken, P. (1991). Intake of fluoride through food and beverages by children in high fluoride (9 ppm) area in Kenya. Discovery and Innovation, 3(4), 71–76.Google Scholar
  30. Raina, A. K., & Kant, S. (1995). Dental fluorosis. A case study in three villages of district Rajauri (J&K). Proceedings of the Academy of Environmental Biology, 4(2), 143–146.Google Scholar
  31. Sharma, K. C., Arif, M., Hussain, I., & Hussain, J. (2007). Observation on fluoride contamination in groundwater of district Bhilwara, Rajasthan and a proposal for a low cost defluoridation technique. In The XXVIITH conference of the international society for fluoride research (ISFR XXVII), 9–12 October, 2007. Beijing, China.Google Scholar
  32. Singh, A., Jolly, S. S., Bansal, B. C., & Mathur, O. C. (1963). Endemic fluorosis. Medicine, 42, 229–246. doi:10.1097/00005792-196305000-00003.CrossRefGoogle Scholar
  33. Susheela, A. K. (1993). Prevention and control of fluorosis in India. Health Aspect (Vol. I). New Delhi: Rajeev Gandhi National Drinking Water Mission, Ministry of Rural Development.Google Scholar
  34. Teotia, S. P. S., Teotia, M., & Singh, D. P. (1985). Bone static and dynamic histomorphometry in endemic fluorosis. Fluoride research. Studies in environmental sciences, (Vol. 27, pp. 347–355). Amsterdam: Elsevier.Google Scholar
  35. UNICEF (1999). States of the art report on the extent of fluoride in drinking water and the resulting endemicity in India. Report by fluorosis and rural development foundation for UNICEF. New Delhi: UNICEF.Google Scholar
  36. USPHS (United States Public Health Service) (1962). Drinking water standards. USPHS, Publications 956. Washington DC: USGPO.Google Scholar
  37. Whitford, G. M. (1997). Determinants and mechanisms of enamel fluorosis. Ciba Foundation Symposium, 205, 226–241.Google Scholar
  38. Whitford, G. M., Pashley, D. H., & Stringer, G. I. (1976). Fluoride renal clearance: A 334 pH-dependent event. The American Journal of Physiology, 230, 527–532.Google Scholar
  39. WHO (World Health Organization) (1984). Fluorine and fluoride (Vol. 36). Geneva: Environmental Health Criteria.Google Scholar
  40. WHO (World Health Organization) (1996). Guideline for drinking water quality. Geneva: World Health Organization.Google Scholar
  41. WHO (World Health Organization) (2006). Fluoride in drinking water (p. 144). London, UK: IWA Publishing.Google Scholar
  42. Zheng, B. S., Dingm, Z. H., Huang, R. G., Zhu, J. M., Yu, X. Y., Wang, A. M., et al. (1999). Issues of health and disease relating to coal use in southwestern China. International Journal of Coal Geology, 40(2–3), 119–132. doi:10.1016/S0166-5162(98)00064-0.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  1. 1.National River Water Quality LaboratoryCentral Water CommissionNew DelhiIndia
  2. 2.Public Health Engineering Department (PHED) LaboratoryRajasthanIndia
  3. 3.Department of Environmental StudiesM.D.S. UniversityRajasthanIndia

Personalised recommendations