Fluoride concentration in bottled water: a systematic review

Abstract

This study aimed to summarize major methodological features and main findings described in the studies on fluoride concentration monitoring in bottled water, published in specialized journals between 2008 and 2012, highlighting their implications for public health surveillance. A systematic review was conducted searching scientific articles in the databases: Lilacs, PubMed and Scopus. Twenty-two articles from the world's main continents were included: 68.2% informed both the number of samples and brands collected; 81.8% examined products collected in only a city or metropolitan area; 77.3% assessed the outcomes using a sound criterion; 45.5% compared the values of fluoride measured in the sample and those informed in the label, being noted significant discrepancies. In conclusion, the discrepancy between the found amount and the informed concentration in the label was quite common reinforcing the warnings raised by several researchers. The parameters that define hazard to health and instruct the content of labelling should be revised. There is an important room for improvement of the methodological procedures in further studies. Keywords: fluoride; fluoridation; surveillance; bottled water. ResumoO objetivo foi sumarizar as principais características metodológicas e os principais achados descritos em estudos sobre monitoramento da concentração de fluoreto em água engarrafada publicados em revistas científicas especializadas entre 2008 e 2012, examinando suas implicações para a vigilância em saúde pública. Uma revisão sistemática foi realizada buscando artigos nas bases de dados: Lilacs, PubMed e Scopus. Vinte e dois artigos dos principais continentes do mundo foram incluídos: 68,2% informaram tanto o número de amostras como de marcas recolhidas; 81,8% examinaram produtos coletados em somente uma cidade ou área metropolitana; 77,3% avaliaram os achados usando critério lícito; 45,5% compararam os valores observados na amostra com aqueles informados no rótulo, sendo notadas discrepâncias significativas. A discrepância entre o valor observado e o divulgado no rótulo do produto foi bastante comum, reforçando as advertências reclamadas por vários pesquisadores. Os parâmetros que definem risco para saúde e instruem o conteúdo da rotulagem deveriam ser revisados. Observou-se importante espaço para melhorar os procedimentos metodológicos em futuros estudos. Palavras-chave: fluoreto; fluoretação; vigilância; água engarrafada.

Fluoride in Bottled Waters Consumed in Northeastern Brazil

“…Differences between the fluoride concentration analyzed in bottled waters and reported on the label were already observed in the literature [5,[7][8][9]. Our study reinforces the need for periodic analysis of fluoride concentration to confirm compliance with the legislation and provide reliable and safe water for consumers.…”

“…Studies showed that several brands contain different fluoride concentrations than reported on the label or higher than recommended, possibly influencing the incidence of dental fluorosis [5,6]. The literature also highlights the importance of determining the fluoride concentration of bottled waters, verifying the acceptable levels to prevent dental fluorosis, and providing reliable data on fluoride exposure [7]. Thus, this study aimed to assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil.…”

Global Bottled Water Industry: A Review of Impacts and Trends

“…It has been demonstrated across countries and bottled water brands that the claim "bottled water is a safer and healthier alternative to tap water" must be critically evaluated (Cha and Lee 2020, Cohen et al 2022, Diduch et al 2013, Valavanidis 2020, Venturini and Frazão 2015, Williams et al 2015. However, hard evidence for and against claims of purity and safety is limited or scattered Globally, over 2 billion people rely on groundwater as their primary water source (Alley et al 2002).…”

Bottled water quality and associated health outcomes: a systematic review and meta-analysis of 20 years of published data from China

“…Williams et al [12] conducted a relatively comprehensive review focused on fecal contamination in packaged and bottled water in LMICs; however, as the authors noted in their review, they did not include results from China due to the language barrier. The other systematic review focused only on fluoride concentrations in bottled water [13], but likewise did not review Chinese-language results. In addition, in a recently published non-systematic review [14] focused on emerging contaminants (including microplastics), as well as contamination attributed to the types of plastic used for water bottles, the authors did not appear to include results from Chinese-language publications.…”