Biomarkers of chronic fluoride exposure in groundwater in a highly exposed population

Rango, Tewodros; Vengosh, Avner; Jeuland, Marc; Whitford, Gary M.; Tekle-Haimanot, Redda

doi:10.1016/j.scitotenv.2017.04.021

Cited by 58 publications

(29 citation statements)

References 57 publications

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“…However, overall the evidence from this study shows that As contamination is not likely to be a widespread issue across this region and is more likely associated with particular geological settings, for example F and As hot-spots in the Rift Valley (e.g. Rango et al 2017).…”

Section: Discussionmentioning

confidence: 74%

Drinking water quality from rural handpump-boreholes in Africa

Lapworth

MacDonald

Kebede

et al. 2020

Environ. Res. Lett.

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Groundwater provides a vital source of drinking water for rural communities in many parts of Africa, particularly in the dry season when there are few safe alternative sources. This paper summarises results from a study (n = 428) assessing dry season water quality, both microbiological and inorganic chemistry, in handpump equipped boreholes (HPBs) across the Ethiopia Highlands (n = 142), Malawi (n = 162) and Uganda (n = 124) using a stratified, randomised sampling design. This study seeks to examine general water quality by randomly sampling rural groundwater supplies across larger areas with different geology and climate. The majority, 72%, of HPBs surveyed provide good quality dry season drinking water as defined by WHO drinking water quality criteria. Within this overall picture, the most notable constraints were from thermotolerant coliforms (TTCs), which exceeded the WHO drinking water guideline of zero colony forming units (cfu/100 ml) in 21% of sites (range 0-626 cfu/100 ml). TTC contamination was found to have a significant and positive correlation with annual average rainfall (ρ = 0.2, p = 0.00003). Across all three countries, WHO health based chemical drinking water quality values were exceeded at 9% of sites and were found for manganese (4%), fluoride (2.6%) and nitrate (2.5%); arsenic concentrations were below the guideline value of 10 µg l −1 (range < 0.5-7 µg l −1 ). The high percentage of Mn exceedances (14% ± 5.2% >400 µg l −1 ) found in drinking water sources in Uganda challenges the decision by WHO not to formalise a health-based guideline for Mn. While the overall level of microbiological contamination from HPBs is low, results from this study strongly suggest that at a national and regional level, microbiological contamination rather than chemical contamination will provide a greater barrier to achieving targets set for improved drinking water quality under the UN-SDG 6. Efforts should be made to ensure that boreholes are properly sited and constructed effectively to reduce pathogen contamination.

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Section: Discussionmentioning

confidence: 74%

Drinking water quality from rural handpump-boreholes in Africa

Lapworth

MacDonald

Kebede

et al. 2020

Environ. Res. Lett.

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“…The highest fluoride concentration reported 2,800 mg/l in Lake Nakuru in Kenya (4). Like other African countries crossed by Rift Valley, fluoride is also a major health problem for communities using ground water sources in the Ethiopian Rift valley area (3,(10)(11)(12). Nearly 8 million people in the Ethiopian Rift Valley are drinking from high fluoride water sources (7).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies in African countries, including Tanzania, Sudan, Nigeria and Kenya have found a high prevalence of dental fluorosis among populations that consume drinking water with high fluoride content (4,13,15). High fluoride concentration in ground water resulted high prevalence of dental fluorosis in the Ethiopian Rift Valley (7,11,12) which have lifelong health impacts ranged from loss of teeth to debilitating pain (7,16). About 13 million people also thought to be at risk of developing fluorosis in this region (3).…”

Section: Introductionmentioning

confidence: 99%

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Enyew

Beyene

Abebe

et al. 2019

Preprint

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Background High fluoride concentrations in ground water is a serious health, social and economic problem in developing countries. The Ethiopian Rift Valley is associated with high fluoride levels in ground water where deep wells are the major source of drinking water supply. Many epidemiological studies on fluoride concentration and its adverse effects have been carried out. However, the result is scattered in different studies which needs systematically summarized for utilization.Objective The aim of this research is to estimate the pooled level of fluoride concentration in ground water and the prevalence of dental fluorosis in Ethiopian rift valley.Methods MEDLINE/PubMed, Cochrane library and Google scholar databases were systematically searched for studies reporting the mean concentration of fluoride in ground water and prevalence of dental fluorosis in Ethiopian Rift valley. We identified search terms by extracting key terms from reviews and selected relevant papers and review medical subject headings for relevant and appropriate terms.Results The mean concentration of fluoride in ground water and the prevalence of dental fluorosis were pooled from eleven and nine primary studies conducted in Ethiopian Rift Valley respectively. The pooled mean concentration of fluoride in ground water therefore was 6.03 mg/l (95% CI; 4.72–7.72, p < 0.001) and the pooled prevalence of dental fluorosis among residents in Ethiopian rift valley was 32% (95% CI: 25, 39%, p<0.001), 29% (95% CI: 22, 36%, p<0.001) and 24% (95% CI: 17, 32%, p<0.001 for mild, moderate and sever fluorosis respectively. The overall prevalence of dental fluorosis is 28% (95% CI: 24, 32%, p<0.001).Conclusions The mean concentration of fluoride in ground water in Ethiopian rift valley is nearly four times greater than the WHO guideline (1.5mg/l). Relatively high-level pooled prevalence of dental fluorosis was also seen in Ethiopian rift valley. Therefore, further studies covering the temperature, exposure time and other intake path ways including diet with large sample size is recommended. Interventional projects should conduct to decrease the concentration of fluoride in the ground drinking water source.

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“…The highest fluoride concentration reported 2,800 mg/l in Lake Nakuru in Kenya (4). Like other African countries situated in Rift Valley, fluoride is also a major health problem for communities using ground water sources in the Ethiopian Rift valley area (3,(10)(11)(12). Nearly 8 million people in the Ethiopian Rift Valley are drinking from high fluoride water sources (7).…”

mentioning

confidence: 99%

“…Several studies in African countries, including Tanzania, Sudan, Nigeria and Kenya have found a high prevalence of dental fluorosis among populations that consume drinking water with high fluoride content (4,13,15). High fluoride concentration in ground water resulted high prevalence of dental fluorosis in the Ethiopian Rift Valley (7,11,12) which has lifelong health impacts ranged from loss of teeth to debilitating pain (7,16).…”

mentioning

confidence: 99%

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Enyew

Beyene

Abebe

et al. 2019

Preprint

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Background: The concentration of fluoride in ground drinking water greater than the world health organization standard value imposes a serious health, social and economic problem in developing countries. In the Ethiopian Rift Valley where deep wells are the major source of drinking water, high fluoride level is expected. Though many epidemiological studies on fluoride concentration and its adverse effects have been conducted in the region, the result is highly scattered and needs systematically summarized for better utilization. Objective: This research is aimed at estimating the pooled level of fluoride concentration in ground drinking water and the prevalence of dental fluorosis among Ethiopian rift valley residences. Methods: Cochrane library, MEDLINE/PubMed and Google scholar databases were searched for studies reporting the mean concentration of fluoride in ground water and prevalence of dental fluorosis in Ethiopian Rift valley. Search terms were identified by extracting key terms from reviews and selected relevant papers and review medical subject headings for relevant terms. Results: The mean fluoride level in ground water and the prevalence of dental fluorosis were pooled from eleven and nine primary studies conducted in Ethiopian Rift Valley respectively. The pooled mean level of fluoride in ground water therefore was 6.03 mg/l (95% CI; 4.72–7.72, p < 0.001) and the pooled prevalence of dental fluorosis among residents in Ethiopian rift valley was 32% (95% CI: 25, 39%, p<0.001), 29% (95% CI: 22, 36%, p<0.001) and 24% (95% CI: 17, 32%, p<0.001 for mild, moderate and sever dental fluorosis respectively. The overall prevalence of dental fluorosis is 28% (95% CI: 24, 32%, p<0.001). Conclusions: Though, the concentration level varies across different part of the rift valley region, still the level of fluoride in ground drinking water is greater than the WHO standard value (1.5mg/l). Relatively high-level pooled prevalence of dental fluorosis was also seen in Ethiopian rift valley. Therefore, further studies covering the temperature, exposure time and other intake path ways with large sample size is recommended. Interventional projects should be implemented to decrease the concentration of fluoride in the ground drinking water source. Key words: Dental fluorosis, Fluoride, Concentration, Rift Valley, Ethiopia

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Biomarkers of chronic fluoride exposure in groundwater in a highly exposed population

Abstract: Graphical abstract

Cited by 58 publications

References 57 publications

Drinking water quality from rural handpump-boreholes in Africa

Drinking water quality from rural handpump-boreholes in Africa

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

Fluoride Concentration in Ground Water and Prevalence of Dental Fluorosis in Ethiopian Rift Valley: Systematic Review and Meta-Analysis

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