Chronic Alcohol Consumption and the Development of Skeletal Fluorosis in a Fluoride Endemic Area of the Ethiopian Rift Valley

Abstract

This study compared the occurrence of skeletal fluorosis in chronic consumers of locally brewed alcoholic beverages and their matched controls in the Ethiopian Rift Valley. The study revealed that chronic alcohol consumers developed severe forms of crippling skeletal fluorosis quite early in life. The controls were either symptom-free or exhibited mild forms of the fluorosis. The study showed that crippling skeletal fluorosis was directly associated with the large volumes of the locally brewed beer and honey-mead consumption on a daily basis. Chemical analysis of the alcoholic beverages showed that high concentration of fluoride which was much higher than the fluoride in the water was used for the brewing process. From this study one would conclude that in communities residing in high fluoride areas, there should be awareness creation campaigns to point out the relationship of excessive consumption of locally brewed alcoholic drinks and skeletal fluorosis. Regulations should also be put in place to require producers of local alcoholic beverages to use low fluoride water for brewing.

Fluoride Content in Alcoholic Drinks

“…A significant part of this ingested fluoride is contained in beverages, including alcoholic drinks, a quantitatively significant component of the diet of many people and the primary source of exogenous ethyl alcohol [ 3 ]. Because of their prevalence and volume of consumption, they should be considered a potential source of other xenobiotics and taken into account in preparing a balanced diet [ 4 ]. Due to the continuing controversy over the use of fluorine compounds in the prevention of tooth decay and the possible adverse effects (fluorosis), it seems prudent to examine the presence of fluoride in common food products, including alcoholic beverages [ 5 ].…”

Fluoride exposure from groundwater as reflected by urinary fluoride and children's dental fluorosis in the Main Ethiopian Rift Valley

“…Systematic water testing in the Ziway-Shala basin of the MER has shown that F − concentrations can reach up to 68 mg/L (mean: 9.4 ± 10.5 mg/L), and that F − levels in 94% of the tested wells exceeded the World Health Organization (WHO) standard of 1.5 mg/L (Rango et al, 2012). In this region, an estimated 8.5 million people, mostly from rural communities, are highly dependent on groundwater resources for drinking and domestic purposes and are thus at risk of fluorosis (Tekle-Haimanot et al, 1987;Tekle-Haimanot, 2005;Tekle-Haimanot and Haile, 2014).…”

Geochemical Evolution of Fluoride and Implication for F− Enrichment in Groundwater: Example from the Bilate River Basin of Southern Main Ethiopian Rift

“…Strong dynamic flow in highland areas flush away weathered chemical components (e.g., F − ). Thus, surficial weathering is not a major controlling factor for high concentrations of Fluoride in deep groundwater but the combination of silicate hydrolysis and ion exchange mainly control fluoride enrichment in stagnant flow environments.In past decades, researchers have studied the geographical distribution of fluoride concentration [6-8] and its relationship with dental caries, dental fluorosis and skeletal fluorosis [9][10][11] in the Ethiopian rift valley. Water quality and fluoride sources were investigated in the central Ethiopian rift [12].…”

“…In past decades, researchers have studied the geographical distribution of fluoride concentration [6-8] and its relationship with dental caries, dental fluorosis and skeletal fluorosis [9][10][11] in the Ethiopian rift valley. Water quality and fluoride sources were investigated in the central Ethiopian rift [12].…”