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      Skeletal fluorosis in relation to drinking water in rural areas of West Azerbaijan, Iran

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          Abstract

          Skeletal fluorosis resulting from high fluoride level in drinking water is a major public health problem. The present study evaluated the association between exposures to drinking water fluoride and skeletal fluorosis in 5 villages of Poldasht County, Iran. All the data and information on the prevalence of bone diseases were obtained from the Health Record Department, Poldasht Health Centre. To obtain the odds ratio of bone disease problem in different risk factors, when considering the cluster effect of rural area, logistic regression in a multilevel model was used. Results showed that skeletal fluorosis of people who live in areas with high fluoride concentration is 18.1% higher than that of individuals who live in areas with low fluoride concentration. Skeletal fluorosis (54.5%) was observed in the age group of 71 years and above, and was more commonly found in females than males. According to Unadjusted, individuals who consume ≤3 unit milk and dairy products per week have almost the same level of bone diseases as compared to those that consume more than 3 units. This study indicated that, skeletal fluorosis is a general health problem in these rural areas because the results revealed that high percentage of the studied population had symptoms of skeletal fluorosis.

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          Most cited references29

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          Fluoride concentration level in rural area in Poldasht city and daily fluoride intake based on drinking water consumption with temperature

          Long-term exposure to high level of fluoride can caused several adverse effects on human health including dental and skeletal fluorosis. We investigated all the drinking water source located in rural areas of Poldasht city, west Azerbaijan Province, North West Iran between 2014 and 2015. Fluoride concentration of water samples was measured by SPADNS method. We found that in the villages of Poldasht the average of fluoride concentration in drinking water sources (well, and the river) was in the range mg/l 0.28–10.23. The average daily received per 2 l of drinking water is in the range mg/l 0.7–16.6 per day per person. Drinking water demands cause fluorosis in the villages around the area residents and based on the findings of this study writers are announced suggestions below in order to take care of the health of area residents.
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            Temporal and spatial variation of chemical parameter concentration in drinking water resources of Bandar-e Gaz City using Geographic Information System

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              Assessment of relationship on excess fluoride intake from drinking water and carotid atherosclerosis development in adults in fluoride endemic areas, China.

              Cross-sectional analysis was conducted to access the relationships between developing carotid artery atherosclerosis through consuming high fluoride in drinking water and its possible mechanism, using the baseline data collected from 585 study subjects. In the cross sectional analysis, subjects were divided into four groups based on the concentrations of fluoride in their drinking water. The range of fluoride concentrations was: normal group (less than 1.20 mg/L), mild group (1.21-2.00 mg/L), moderate group (2.01-3.00 mg/L), and high concentration group (more than 3.01 mg/L). The prevalence rate of carotid artery atherosclerosis in the subjects in each group was found to be 16.13%, 27.22%, 27.10%, and 29.69%, respectively. Significant difference between the prevalence of carotid artery atherosclerosis in the mild, moderate and high fluoride exposure group and in the normal group was observed (P<0.05). In addition, it was found that elevated intercellular cell adhesion molecule-1 (ICAM-1) and reduced glutathione peroxidases (GPx) was associated with carotid artery atherosclerosis in fluoride endemic areas. The findings of the research study revealed a significant positive relationship between excess fluoride exposure from drinking water and prevalence of carotid artery atherosclerosis in adults living in fluoride endemic areas. The possible mechanism was the excess fluoride induced the decreasing level of GPx causing the systemic inflammation and endothelial activation by oxidative stress.
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                Author and article information

                Contributors
                ahmahvi@yahoo.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                11 December 2017
                11 December 2017
                2017
                : 7
                : 17300
                Affiliations
                [1 ]GRID grid.449246.9, Department of Environmental Health Engineering, , Neyshabur University of Medical Sciences, ; Neyshabur, Iran
                [2 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Department of Environmental Health Engineering, School of Public Health, , Tehran University of Medical Sciences, ; Tehran, Iran
                [3 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Department of Epidemiology and Biostatistics, School of Public Health, , Tehran University of Medical Sciences, ; Tehran, Iran
                [4 ]ISNI 0000 0004 0442 8645, GRID grid.412763.5, Department of Epidemiology, , Urmia University of Medical Sciences, ; Urmia, Iran
                [5 ]ISNI 0000 0001 0166 0922, GRID grid.411705.6, Center for Solid Waste Research, Institute for Environmental Research, , Tehran University of Medical Sciences, ; Tehran, Iran
                Article
                17328
                10.1038/s41598-017-17328-8
                5725489
                29229915
                48314d6f-18d5-49ec-bcab-d15978964899
                © The Author(s) 2017

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 6 July 2017
                : 17 November 2017
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