Comparison of hydrofluorosilicic acid and pharmaceutical sodium fluoride as fluoridating agents—A cost–benefit analysis

Hirzy, J. William; Carton, Robert J.; Bonanni, Christina D.; Montanero, Carly M.; Nagle, Michael

doi:10.1016/j.envsci.2013.01.007

Cited by 9 publications

(6 citation statements)

References 7 publications

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“…64 In addition, fluoridation chemicals often contain other regulated contaminants. 5 – 8 Hirzy et al 65 estimated that the typical concentration of arsenic in the major fluoridation chemical (HFSA) could be responsible for several excess lung and bladder cancers per year in the U.S. and the consequent costs of treatment.…”

Section: Costsmentioning

confidence: 99%

A critique of recent economic evaluations of community water fluoridation

Lee

Thiessen

2014

International Journal of Occupational and Environmental Health

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Background:Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.Objective:To examine the reported cost-effectiveness of CWF.Methods:Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.Results:Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.Conclusions: Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.

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Section: Costsmentioning

confidence: 99%

A critique of recent economic evaluations of community water fluoridation

Lee

Thiessen

2014

International Journal of Occupational and Environmental Health

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“…Recent research has demonstrated significant cost saving from using sodium fluoride in place of fluorosilicic acid (Hirzy et al 2013). However, the prior cost-benefit analysis did not consider costs associated with diabetes, which represents a major and growing disease burden.…”

Section: Discussionmentioning

confidence: 99%

Community water fluoridation predicts increase in age-adjusted incidence and prevalence of diabetes in 22 states from 2005 and 2010

Fluegge

2016

Journal of Water and Health

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Community water fluoridation is considered a significant public health achievement of the 20th century. In this paper, the hypothesis that added water fluoridation has contributed to diabetes incidence and prevalence in the United States was investigated. Panel data from publicly available sources were used with population-averaged models to test the associations of added and natural fluoride on the outcomes at the county level in 22 states for the years 2005 and 2010. The findings suggest that a 1 mg increase in the county mean added fluoride significantly positively predicts a 0.23 per 1,000 person increase in age-adjusted diabetes incidence (P < 0.001), and a 0.17% increase in age-adjusted diabetes prevalence percent (P < 0.001), while natural fluoride concentration is significantly protective. For counties using fluorosilicic acid as the chemical additive, both outcomes were lower: by 0.45 per 1,000 persons (P < 0.001) and 0.33% (P < 0.001), respectively. These findings are adjusted for county-level and time-varying changes in per capita tap water consumption, poverty, year, population density, age-adjusted obesity and physical inactivity, and mean number of years since water fluoridation started. Sensitivity analyses revealed robust effects for both types of fluoride. Community water fluoridation is associated with epidemiological outcomes for diabetes.

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“…Lead is associated with various endocrine disturbances causing testicular atrophy and reduced sperm quality and quantity (Moreira and Moreira, 2004) and causing a significant increase in the rate of abortion, stillbirth, prematurity, decreased postnatal growth and increase the rate of malformations (Peres et al 2001). Contamination with lead caused by corrosion in water pipes has been studied under various fluoridation conditions (Masters et al 2000;Coplan et al 2007;Maas et al 2007;Hirzy et al 2014) and…”

Section: Evaluation Of T3 and T4 Parameters And Total Antioxidant Capmentioning

confidence: 99%

Evaluation of the Effects of Fluoride and Associated With Lead in Animal Model and Physical-Chemical Analysis of Public Supply Water and of the Sinos River in the South of Brazil

Krützmann

Machado

Constante

et al. 2020

Int J Innov Educ Res

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Fluoride related to caries prevention is at the center of a scientific controversy. Studies show that fluoride causes damage to health and the environment, as well as reducing IQ in children. The fluoridation of drinking water, mandatory in Brazil, has repercussions over the whole society. One of our objectives was to know the concentrations of fluoride (F) and toxic metals of Sinos River, treated water and final consumers of the cities of Campo Bom (CB), Novo Hamburgo (NH) and São Leopoldo (SL), as well as the groundwater from Ivoti, located in southern Brazil. We also evaluated in rats the effects of F and, in association with lead (Pb), on thyroid hormones and the Total Antioxidant Capacity (TAC). Three groups of rats were exposed to different waters: G1-Control with distilled water (DW); G2-DW with 25ppm (F); G3-DW with 25ppm (F) + 30 ppm (Pb). The Sinos River has an average concentration of 0.0735 mg.L-1 of F. But the F of both the water treated by the ETA of SL as well as in the final consumers of SL had concentrations above 0.9 mg.L-1 (State Ordinance No. 10/1999). In addition, we verified the presence of Pb and Cr (VI) in all types of water. The results with the animals showed a significant difference in T3 (p=0.032) and in T4 (p=0.043) from G3 to G1. In TAC, the difference was significant from G2 to G1 and G3 (p=0.007), showing that F and F with Pb interfere with the endocrine and antioxidant functions of rats. In addition, the fact that there are water fluoridation failures shows that the population is exposed to health risks. We confirm that drinking water fluoridation needs to be demystified and reconsidered as a public health intervention.

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Comparison of hydrofluorosilicic acid and pharmaceutical sodium fluoride as fluoridating agents—A cost–benefit analysis

Cited by 9 publications

References 7 publications

A critique of recent economic evaluations of community water fluoridation

A critique of recent economic evaluations of community water fluoridation

Community water fluoridation predicts increase in age-adjusted incidence and prevalence of diabetes in 22 states from 2005 and 2010

Evaluation of the Effects of Fluoride and Associated With Lead in Animal Model and Physical-Chemical Analysis of Public Supply Water and of the Sinos River in the South of Brazil

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