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LETTER TO EDITOR
Year : 2017  |  Volume : 61  |  Issue : 1  |  Page : 60  

A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet Taluk, Kolar


1 Senior Research Officer, Department of Anatomy, All Institute of Medical Sciences, New Delhi, India
2 Professor, Department of Anatomy, All Institute of Medical Sciences, New Delhi, India

Date of Web Publication16-Feb-2017

Correspondence Address:
Javed Ahsan Quadri
Department of Anatomy, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.200258

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How to cite this article:
Quadri JA, Shariff A. A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet Taluk, Kolar. Indian J Public Health 2017;61:60

How to cite this URL:
Quadri JA, Shariff A. A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet Taluk, Kolar. Indian J Public Health [serial online] 2017 [cited 2017 May 23];61:60. Available from: http://www.ijph.in/text.asp?2017/61/1/60/200258

Sir,

I have gone through a very interesting research article entitled, “A Comparative Study of Skeletal Fluorosis among Adults in Two Study Areas of Bangarpet Taluk, Kolar.” The research work was done and published by eminent scientists. The article is very informative and highlights the threat of skeletal fluorosis in the elderly.

On the basis of clinical observations, huge numbers of research reports, and after discussion and deliberations, the “Bureau of Indian Standards” has recommended upper permissive level of fluoride in drinking water up to 1 mg/L, with a caution note “The lesser is better.” Many research reports have also been suggested that fluoride in drinking water is a major cause of endemic fluorosis where the large number of persons have skeletal fluorosis as compared to nonendemic areas.

The present research article states that the prevalence of skeletal fluorosis (5.0%) is almost same in the population exposed to high fluoride (fluoride concentration in drinking water: Thimmasandra village – 4.13 mg/L and Batavarahalli village – 2.59 mg/L) and the population exposed to normal levels of fluoride through drinking water (0.61 mg/L in village Maddinayakanahalli). In population exposed to high fluoride, the fluoride concentration is significantly higher than the recommended permissive level of fluoride in drinking water. In the present report, it is also mentioned that no significant differences were observed in daily water intake between high fluoride (3.52 ± 0.51 L/person/day) and low fluoride (3.6 ± 0.53 L/person/day) groups.[1] As per the finding, approximately 5% prevalence of skeletal fluorosis in both high- and low-fluoride areas indicates that not fluoride rather some other factor[s] is/are responsible for the symptoms of skeletal fluorosis. Because all the villages selected for the study (i.e., villages with high fluoride in drinking water and normal fluoride-containing-water villages) are culturally not different and their food and other habits are almost similar, same percentage of prevalence of skeletal fluorosis in two groups with significant differences in fluoride intake through drinking water seems to be unlikely.

Therefore, the authors are requested to give a possible or probable justification for the findings.

The present study also analyzed and compared various epidemiological factors which most likely influence the severity of fluoride toxicity and fluorosis. It is reported in this article that majority (78.8%) of skeletal fluorosis patients belonged to poor class and a significant (P < 0.05) difference was observed among the people belonging to different socioeconomic strata.[1] In contrast to this finding, it is reported that there was no association observed with gender, occupation, caste, and educational status with prevalence of skeletal fluorosis. In addition, it is also mentioned that the prevalence of skeletal fluorosis in both the groups is independent of the risk factors such as quantity of water consumed per day, use of fluoride-added dental products, fluoride-containing medications, tobacco/areca nut, and nutritional status. Contrary to the findings, in discussion, it is mentioned that these risk factors add threat of skeletal fluorosis. According to the “National Committee on Vital and Health Statistics,” USA, education, occupation, and income are main indicators of socioeconomic classification.

Therefore, it is also requested to explain the findings that income affects the prevalence of skeletal fluorosis but not nutritional status, while nutritional status is widely affected/influenced by socioeconomic status.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Shruthi MN, Santhuram AN, Arun HS, Kishore Kumar BN. A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet taluk, Kolar. Indian J Public Health 2016;60:203-9.  Back to cited text no. 1
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