Çevresel bir hastalık olarak florozis ve insan sağlığı üzerine etkisi

Flor; toprak, su, kaya, hava, bitki ve hayvansal dokularda değişik miktarlarda bulunan bir halojendir. Normal şartlar altında insanlar günlük olarak zararlı olmayacak miktarlarda florlu bileşikleri alırlar ve bu durum daha az diş çürüğü ve daha kuvvetli kemiklerin oluşmasına sebep olur. Ancak uzun süre günlük olarak alınan flor miktarı güvenlik eşiğini aşacak olursa florozis olarak bilinen kronik flor zehirlenmesi ortaya çıkar. Florozis sonucu dişlerde, iskelet sisteminde, karaciğer, böbrek, kalp, gastrointestinal sistem ve endokrin sistemde patolojik değişiklikler oluşmaktadır.

Fluorosis as an environmental disease and its effect on human health

Fluoride is a halogene found in earth, water, rocks, air, plants and animal tissue in various amounts. In normal conditions, people daily take fluoride compounds in amounts without any harmful effects this cause fewer dental caries and the formation of stronger bones. However, if the amount of fluoride taken daily exceeds the safety threshold, chronic fluoride intoxication, known as fluorosis, arises. As a result of fluorosis, pathological changes appear in tooths, skeletal system, liver, kidney, heart, gastrointestinal system and endocrin system.

PDF

___

1. Atabey E. Tıbbi Jeoloji. Ankara. Jeoloji Mühendisleri Odası Yayınları, 2005, s. 216.
2. Küçükeşmen Ç, Sönmez H. Diş Hekimliğinde Florun, İnsan Vücudu ve Dişler Üzerindeki Etkilerinin Değerlendirilmesi. S.D.Ü. Tıp Fak. Derg. 2008; 15(3): 43-53.
3. Varol S, Davraz A, Varol E. Yeraltı suyu Kimyası ve Sağlığa Etkisinin Tıbbi Jeoloji Açısından Değerlendirilmesi. TAF Prev Med Bull. 2008; 7(4): 351-356.
4. Oruc N. Occurrence and Problems of High Fluoride Waters in Turkey: an Overview. Environ Geochem Health. 2008;30(4):315-23.
5. Kaminsky L, Mahony M, Leach J, Melius J, Miller MJ. Fluoride: Benefits and risks of exposure. Crit Rev Oral Biol Med. 1990; 1:261–281.
6. Ergun HS, Rüssel–Sinn HA, Bayşu N, Dündar Y. Studies on the Fluoride Contents in Water and Soil, Urine, Bone, and Theeth of Sheep and Urine of Human from Eastern and Western Parts of Turkey. Dtsch Tierarztl Wschr. 1987; 94: 416– 420.
7. World Health Organization. Guidelines for Drinking-Water Quality. Third Edition. Geneva. 2006, p. 221-459.
8. Edmunds WM, Smedley PL. Fluoride in Natural Waters. In: Selinus O (ed). Essentials of Medical Geology. Burlington MA. Elsevier Academic Press, 2005, p. 301–329.
9. Whitford GM. The physiological and Toxicological Characteristics of Fluoride. J Dent Res. 1990; 69: 539-44.
10. Chachra D, Turner CH, Dunipace AJ, Grynpas MD. The Effect of Fluoride Treatment on Bone Mineral in Rabbits. Calcif Tissue Int. 1999; 64: 345–351.
11. Tamer MN, Kale Köroğlu B, Arslan C, Akdoğan M, Köroğlu M, Cam H, Yildiz M. Osteosclerosis Due to Endemic Fluorosis. Sci Total Environ. 2007; 373(1): 43-8.
12. Doull J, Boekelheide K, Farishian BG, Isaacson RL, Klotz JB, Kumar JV et al. Fluoride in Drinking Water: a Scientific Review of EPA’s Standards. Committee on Fluoride in Drinking Water, Board on Environmental Studies and Toxicology, Division on Earth and Life Sciences, National Research Council of the National Academies. Washington DC. National Academies Press, 2006, p. 530.
13. Gupta SK, Khan TI, Gupta RC. Compensatory hyperparathyroidism Following High Fluorine Ingestions - a Clinico-Biochemical Correlation. Indian Pediatr. 2001; 38: 139–146.
14. Jooste PL, Weight MJ, Kriek JA, Louw AJ. Endemic Goiter in the Absence of Iodine Deficiency in Schoolchildren of the Northern Cape Province of South Africa. Eur J Clin Nutr. 1999; 53: 8–12.
15. Desai VK, Solanki DM, Bansalm RK. Epidemiological Study on Goitre in Endemic Fluorosis District of Gujarat. Fluoride. 1993; 26(3): 187–190.
16. Teotia SP, Teotia M, Singh RK, Taves DR, Heels. Endocrine Aspects of Endemic Skeletal Fluorosis. J Assoc Physicians India. 1978; 26(11): 995– 1000.
17. Srivastava RN, Gill DS, Moudgil A, Menon RK, Thomas M, Dandona P. Normal Ionized Calcium, Parathyroid Hypersecretion, and Elevated Osteocalcin in a Family With Fluorosis. Metabolism. 1989; 38(2): 120-4.
18. Trivedi N, Mithal A, Gupta SK, Godbole MM. Reversible Impairment of Glucose Tolerance in Patients With Endemic Fluorosis. Diabetologia. 1993; 36 (9): 826-8.
19. Eliud A. Garcia-Montalvo, Hugo Reyes-Perez, Luz M. Del Razo Fluoride Exposure Impairs Glucose Tolerance Via Decreased Insulin Expression and Oxidative Stres. Toxicology. 2009; 263: 75–83.
20. Hoffman R, Mann J, Calderone J, Trumbull J, Burkhart M. Acute Fluoride Poisoning in a New Mexico Elementary School. Pediatrics. 1980; 65: 897–900.
21. Spak C-J, Sjöstedt S, Eleborg L, Veress B, Perbeck L, Ekstrand J. Tissue Response of Gastric Mucosa After Ingestion of Fluoride. Brit Med J. 1989; 298:1686–1687.
22. Susheela AK, Kumar A, Bhatnagar M, Bahadur R. Prevalence of Endemic Fluorosis With Gastrointestinal Manifestations in People Living in some North-Indian Villages. Fluoride. 1993; 26(2): 97–104.
23. Dasarathy S, Das TK, Gupta IP, Susheela AK, Tandon RK. Gastroduodenal Manifestations in Patients With Skeletal Fluorosis. J Gastroenterol. 1996; 31(3): 333–337.
24. Xiu An Zhan, Min Wang, Zi Rong Xu, Wei Fen Li, Jian Xin Li. Evaluation of caspase-dependent apoptosis during fluoride-induced liver lesion in pigs. Arch Toxicol. 2006; 80:74–80.
25. Lantz O, Jouvin MH, DeVernejoul MC, Druet P. Fluoride-Induced Chronic Renal Failure. Am J Kidney Dis. 1987; 10: 136–139.
26. Kessabi M, Hamliri A, Braun JP, Rico AG. Experimental Acute Sodium Fluoride Poisoning in SHEEp: Renal, Hepatic, and Metabolic Effects. Fundam Appl Toxicol. 1985; 5:1025–1033.
27. Greenberg SR. Response of the Renal Supporting Tissues to Chronic Fluoride Exposure as Revealed by a Special Technique. Urol Int. 1986; 41: 91–94.
28. Singh PP, Barjatiya MK, Dhing S, Bhatnagar R, Kothari S, Dhar V. Evidence Suggesting that High Intake of Fluoride Provokes Nephrolithiasis in Tribal Populations. Urol Res. 2001; 29(4): 238– 244.
29. Eichler HG, Lenz K, Fuhrmann M, Hruby K. Accidental ingestion of NaF tablets by children. Int J Clin Pharmacol Ther Toxicol. 1982; 20: 334– 338.
30. Tang QQ, Du J, Ma HH, Jiang SJ, Zhou XJ. Fluoride and Children's Intelligence: a Metaanalysis. Biol Trace Elem Res. 2008; 126(1-3): 115-20.
31. Eren E, Ozturk M, Mumcu EF, Canatan D. Fluorosis and Its Hematological Effects. Toxicol Ind Health. 2005; 21: 255-8.
32. Karadeniz A, Altintas L. Effects of Panax Ginseng on Fluoride-İnduced Haematological Pattern Changes in Mice. Fluoride. 2008; 41(1): 67–71.
33. Kant V, Verma PK, Pankaj NK, Kumar J, Kusum, Raina R, Srivastava AK. Haematological Profile of Subacute Oral Toxicity of Fluoride and Ameliorative Efficacy of Aluminium Sulphate in Goats. Toxicology International. 2009; 16(1): 31- 35.
34. Choubisa SL. Prevalence of Fluorosis in Some Villages of Dungarpur District of Rajasthan. Indian J Env Health. 1996; 38: 119-26.
35. Olgar S, Kuybulu AE, Karademir S, Sipahi T, Ormeci AR, Kösker M. Effects of Chronic Fluorosis on Cardiovascular System in Children. Cairns, Australia. 5th World Congress of Pediatric Cardiology and Cardiac Surgery, 2009, p. 21-26.
36. Purohit SD, Gupta RC, Mathur AK, Gupta N, Jeswani ID, Choudhary VK et al. Experimental Pulmonary Fluorosis. Indian J Chest Dis Allied Sci. 1999; 41: 27–34.
37. Baltazar RF, Mower MM, Funk M. Acute Fluoride Poisoning Leading to Fatal Hyperkalemia. Chest. 1980; 78: 660–663.
38. Çiçek E, Aydın G, Akdoğan M, Okutan H. Effects of Chronic Ingestion of Sodium Fluoride on Myocardium in a Second Generation of Rats. Hum Exp Tox. 2005; 24: 79–87.
39. Okushi I. Experimental Studies on the Effects of Sodium Fluoride upon the Heart Muscle of Rabbits. Fluoride. 1971; 4: 199–203.
40. Shashi A, Thapar SP. Histopathology of Myocardial Damage in Experimental Fluorosis in Rabbits. Fluoride. 2001; 34: 43–50.
41. Donmez N, Cinar A. Effects of Chronic Fluorosis on Electrocardiogram in Sheep. Biol Trace Elem Res. 2003; 92: 115-22.
42 Kilicalp D, Cinar A, Belge F. Effects of Chronic Fluorosis on Electrocardiogram in Dogs. Fluoride. 2004; 37(2): 96-101.
43. Kant V, Srivastava AK, Verma PK, Raina R, Pankaj NK. Alterations in Electrocardiographic Parameters after Subacute Exposure of Fluoride and Ameliorative Action of Aluminium Sulphate in Goats. Biol Trace Elem Res. 2009; 4(Epub ahead of print)
44. Xu RY, Xu RQ. Electrocardiogram Analysis of Patients With Skeletal Fluorosis. Fluoride. 1997; 30(1): 16-18.
45. Varol E, Akcay S, Ersoy IH, Ozaydin M, Koroglu BK, Varol S. Aortic Elasticity is Impaired in Patients With Endemic Fluorosis. Biol Trace Elem Res. 2009 (in press).
46. Freni SC. Exposure to High Fluoride Concentrations in Drinking Water is Associated With Decreased Birth Rates. J Toxicol Environ Health. 1994; 42: 109–121.
47. Al-Hiyassat AS, Elbetieha AM, Darmani H. Reproductive Toxic Effects of Ingestion of Sodium Fluoride in Female Rats. Fluoride. 2000; 33: 79–84.
48. Guney M, Oral B, Take G, Giray SG, Mungan T. Effect of Fluoride Intoxication on Endometrial Apoptosis and Lipid Peroxidation in Rats: Role of Vitamins E and C. Toxicology. 2007, 231(2-3): 215-23.
49. Sharma A, Chinoy NJ. Role of Free Radicals in Fluoride İnduced Toxicity in Liver and Kidney of Mice and its Reversal. Fluoride. 1998; 31: 26–32.
50. Shanthakumari D, Srinivasalu S, Subramanian S. Effect of Fluoride Intoxication on Lipid Peroxidation and Antioxidant Status in Experimental Rats. Toxicology. 2004; 204: 219– 228.
51. Shivarajashankara YM, Shivashankara A, Hanumanth RS, Gopalakrishna BP. Oxidative Stress in Children With Endemic Skeletal Fluorosis. Fluoride. 2001; 34, 103–107.
52. Shivarajashankara YM, Shivashankara AR, Gopalakrishna PB, Hanumanth RS. Effect of Fuoride Intoxication on Lipid Peroxidation and Antioxidant Systems in Rats. Fluoride. 2001; 34 (2): 108–113.
53. David L. Ozsvath. Fluoride and Environmental Health: A Review. Rev Environ Sci Biotechnol. 2009; 8: 59–79.