Document Type : Original Article
Authors
Abstract
Aims: The aims of this study were to determine fluoride concentration in drinking water and staple
foods consumed by residents of Dayyer port (Bushehr province, south of Iran) and to assess its
health risk via human intake in 2013. Materials and Methods: Health risk assessment due to
fluoride exposure via consumption of drinking water, date, vegetables and fish was conducted
in spring and summer of 2013 using the US‑EPA (United States—Environmental Protection
Agency) method, which considers hazard quotient (HQ) as a ratio of the estimated dose of a
contaminant to the reference dose. A fluoride ion‑selective electrode (ISE) measured the fluoride
contents of food samples. The sodium‑2‑(parasulfophenyl largo)‑1,8‑dihydroxy‑3,6‑naphtnalene
disulfonate colorimetric method (SPADNS) was used to determine fluoride concentration in
water samples. Results: The total estimated oral intake of fluoride for children in summer and
spring were 120.6 and 145.6 µg/kg/day, respectively. These values for adults were 99.2 and 112
µg/kg/day. This survey demonstrated that drinking water was the most important contributor of
dietary fluoride intake in the study area. Conclusion: HQ values for adults and children were >1
which approves that a potential health risk of fluorosis can exist. The recommendations for the
study area are supplying drinking water from alternative sources and defluoridation of drinking
water by an adsorption technique and membrane filtration, respectively. Furthermore, people are
suggested to have a good nutrition (especially rich of vitamin C) to reduce the risk of fluorosis.
Keywords
1. Fawell JK. Fluoride in drinking-water. Geneva: World Health
Organization; 2006.
2. Hussain I, Arif M, Hussain J. Fluoride contamination in drinking
water in rural habitations of Central Rajasthan, India. Environ Monit
Assess 2012;184:5151-8.
3. ArvetiN, SarmaM, Aitkenhead-PetersonJ, SunilK. Fluoride incidence
in groundwater: A case study from Talupula, Andhra Pradesh, India.
Environ Monit Assess 2011;172:427-43.
4. WHO. Guidelines for drinking-water quality: Recommendations.
Vol 1. Geneva: World Health Organization; 2006.
5. Mohapatra M, Anand S, Mishra B, Giles DE, Singh P. Review
of fluoride removal from drinking water. J Environ Manage
2009;91:67-77.
6. Susheela A, Mudgal A, Keast G. Fluoride in water: An overview.
Water front 1999;11-13.
7. Xiang Q, Liang Y, Chen L, Wang C, Chen B, Chen X, Zhou M. Effect
of fluoride in drinking water on children’s intelligence. Fluoride
2003;36:84-94.
8. Wang B, Zheng B, Zhai C, Yu G, Liu X. Relationship between fluorine
in drinking water and dental health of residents in some large cities
in China. Environ Int 2004;30:1067-73.
9. Barot V. Occurrence of endemic fluorosis in human population of
North Gujarat, India: Human health risk. Bull Environ Contam Toxicol
1998;61:303-10.
10. Maheshwari R. Fluoride in drinking water and its removal. J Hazard
Mater 2006;137:456-63.
11. Garg V, Malik A. Groundwater quality in some villages of Haryana,
India: Focus on fluoride and fluorosis. J Hazard Mater 2004;106:85-97.
12. Kundu N, Panigrahi M, Tripathy S, Munshi S, Powell M, Hart B.
Geochemical appraisal of fluoride contamination of groundwater in
the Nayagarh District of Orissa, India. Environ Geol 2001;41:451-60.
13. Ramanaiah S, Mohan SV, Rajkumar B, Sarma P. Monitoring of
fluoride concentration in ground water of Prakasham district in
India: Correlation with physico-chemical parameters. J Environ Sci
Eng 2006;48:129-34.
14. Chavoshi E, Afyuni M, Hajabbasi M, Khoshgoftarmanesh A,
Abbaspour K, Shariatmadari H, et al. Health risk assessment of
fluoride exposure in soil, plants, and water at Isfahan, Iran. Hum
Ecol Risk Assess 2011;17:414-30.
15. Mesdaghinia A, Vaghefi KA, Montazeri A, Mohebbi MR, Saeedi R.
Monitoring of fluoride in groundwater resources of Iran. Bull Environ
Contam Toxicol 2010;84:432-7.
16. Nouri J, Mahvi AH, Babaei A, Ahmadpour E. Regional pattern
distribution of groundwater fluoride in the Shush aquifer of
Khuzestan County, Iran. Fluoride 2006; 39:321.
17. Sunil Tejaswi K, Shetty S, Annapoorna B, Pujari SC, Reddy S,
Nandlal B. A Pioneering Study of Dental Fluorosis in the Libyan
Population. J Int Oral Health 2013;5:67-72.
18. Ncube E, Schutte C. The occurrence of fluoride in South African
groundwater: A water quality and health problem. Water SA
2005;31:35-40.
19. Srikanth R, Viswanatham K, Kahsai F, Fisahatsion A, Asmellash M.
Fluoride in groundwater in selected villages in Eritrea (North East
Africa). Environ Monit Assess 2002;75:169-77.
20. Oruc N. Occurrence and problems of high fluoride waters in Turkey:
An overview. Environ Geochem Health 2008;30:315-23.
21. Bo Z, Mei H, Yongsheng Z, Xueyu L, Xuelin Z, Jun D. Distribution and
risk assessment of fluoride in drinking water in the west plain region
of Jilin province, China. Environ Geochem Health 2003;25:421-31.
22. Edmunds WM, Smedley PL. Fluoride in natural waters. Essentials
of medical geology. New York: Springer; 2013. p. 311-6.
23. Jha S, Nayak A, Sharma Y. Fluoride occurrence and assessment
of exposure dose of fluoride in shallow aquifers of Makur, Unnao
district Uttar Pradesh, India. Environ Monit Assess 2009;156:561-6.
24. Perumal E, Paul V, Govindarajan V, Panneerselvam L. A brief review
on experimental fluorosis. Toxicol Lett 2013;223:236-51.
25. Haftenberger M, Viergutz G, Neumeister V, Hetzer G. Total fluoride
intake and urinary excretion in German children aged 3–6 years.
Caries Res 2001;35:451-7.
26. Jackson RD, Brizendine EJ, Kelly SA, Hinesley R, Stookey GK,
Dunipace AJ. The fluoride content of foods and beverages from
negligibly and optimally fluoridated communities. Community Dent
Oral Epidemiol 2002;30:382-91.
27. Maguire A, Zohouri FV, Hindmarch PN, Hatts J, Moynihan PJ.
excretion in 6-to 7-year-old children living in optimally, sub-optimally
and non-fluoridated areas. Community Dent Oral Epidemiol
2007;35:479-88.
28. Mahvi AH, Zazoli MA, Younecian M, Esfandiari Y. Fluoride content
of Iranian black tea and tea liquor. Fluoride 2006;39:266.29. Martínez-Mier E, Soto-Rojas AE, Ureña-Cirett JL, Stookey GK,
Dunipace AJ. Fluoride intake from foods, beverages and
dentifrice by children in Mexico. Community Dent Oral Epidemiol
2003;31:221-30.
30. Zohouri FV, Maguire A, Moynihan PJ. Sources of Dietary Fluoride
Intake in 6–7-Year-Old English Children Receiving Optimally,
Sub-optimally, and Non-fluoridated water. J Public Health Dent
2006;66:227-34.
31. Kramer L, Osis D, Wiatrowski E, Spencer H. Dietary fluoride in
different areas in the United States. Am J Clin Nutr 1974;27:590-4.
32. Myers HM. Fluorides and dental fluorosis. Monogr Oral Sci 1978;7:1.
33. Patterson J, Hakkinen PJ, Wullenweber AE. Human health risk
assessment: Selected internet and world wide web resources.
Toxicology 2002;173:123-43.
34. Erdal S, Buchanan SN. A quantitative look at fluorosis, fluoride
exposure, and intake in children using a health risk assessment
approach. Environ Health Perspect 2005;113:111-7.
35. Ghojazadeh M, Azar FP, Naghavi-Behzad M, Mahmoudi M,
Azami-Aghdash S, Jamali Z. Fluoride Concentration of Drinking
Waters and Prevalence of Fluorosis in Iran: A Systematic Review.
J Dent Res Dent Clin Dent Prospects 2013;7:1-7.
36. Jha S, Nayak A, Sharma Y. Site specific toxicological risk from
fluoride exposure through ingestion of vegetables and cereal
crops in Unnao district, Uttar Pradesh, India. Ecotoxicol Environ
Saf 2011;74:940-6.
37. Shyam R, Kalwania G. Health risk assessment of fluoride with other
parameters in ground water of Sikar city (India). Environ Earth Sci
2012;65:1275-82.
38. Zabin SA, Foaad M, Al-Ghamdi AY. Non-carcinogenic risk
assessment of heavy metals and fluoride in some water wells
in the Al-Baha Region, Saudi Arabia. Hum Ecol Risk Assess
2008;14:1306-17.
39. Battaleb-Looie S, Moore F, Jacks G, Ketabdari MR. Geological
sources of fluoride and acceptable intake of fluoride in an
endemic fluorosis area, southern Iran. Environ Geochem Health
2012;34:641-50.
40. Waziri M, Musa U, Stephen S, Hati. Assessment of Fluoride
Concentrations in Surface Waters and Groundwater Sources in
Northeastern Nigeria. Resour Enviro 2012;2:67-72.
41. McClure F. Fluorine in foods. Public Health Rep 1949;64:l061-74.
42. Messaïtfa A. Fluoride contents in groundwaters and the main
consumed foods (dates and tea) in Southern Algeria region. Environ
Geol 2008;55:377-83.
43. Heikens A, Sumarti S, Van Bergen M, Widianarko B, Fokkert L,
Van LeeuwenK, et al. The impact of the hyperacid Ijen Crater Lake: Risks
of excess fluoride to human health. Sci Total Environ 2005;346:56-69.
44. Dobaradaran S, Mahvi AH, Dehdashti S, Abadi DRV, Tehran I.
Drinking water fluoride and child dental caries in Dashtestan, Iran.
Fluoride 2008;41:220-6.
45. Moghaddam AA, Fijani E. Distribution of fluoride in groundwater
of Maku area, northwest of Iran. Environ Geol 2008;56:281-7.
46. Poureslami HR, Khazaeli P, Nooric GR. Fluoride in food and
water consumed in Koohbanan (Kuh-e Banan), Iran. Fluoride
2008;41:216-9.
47. Ramezani Gh, Valaei N, Eikani H. Prevalence of DMFT and fluorosis
in the students of Dayer city (Iran). J Indian Soc Pedo Prev Dent
2004;22:49-53.
48. Galagan DJ, Vermillion JR. Determining optimum fluoride
concentrations. Public health Rep. 1957;72:491-3.
49. Available from: http://www.waterintakecalculator.com/Index.html.
water intake calculator. MGD [Last accessed on 2014 May 29].
50. Chambers RD. Fluorine in organic chemistry. United States: CRC
Press; 2004.
51. Malde MK, Maage A, Macha E, Julshamn K, Bjorvatn K. Fluoride
content in selected food items from five areas in East Africa. J Food
Compost Anal 1997;10:233-45.
52. Eaton AD, Franson MA. Standard methods for the examination of
water and wastewater. Washington, DC: American Public Health
Association, 2005.
53. Battaleb-Looie S, Moore F, Malde M, Jacks G. Fluoride in
groundwater, dates and wheat: Estimated exposure dose in the
population of Bushehr, Iran J Food Compost Anal 2013;29:94-9.
54. Kalantari N, Ghaffarpour M, Kianfar H, Hooshiarrad A,
Bandaarianzade D, Abdollahi M, et al. Integrated plan of nutritional
condition of Bushehr province. Tehran: National Nutrition and Food
Technology Research Institute; 2001.
55. Barnes DG, Dourson M, Preuss P, Bellin J, Derosa C, Engler R,
et al. Reference dose (RfD): Description and use in health risk
assessments. Regul Toxicol Pharmacol 1988;8:471-86.
56. Zohouri FV, Rugg-Gunn AJ. Sources of dietary fluoride intake in
4-year-old children residing in low, medium and high fluoride areas
in Iran. Int J Food Sci Nutr 2000;51:317-26.
Organization; 2006.
2. Hussain I, Arif M, Hussain J. Fluoride contamination in drinking
water in rural habitations of Central Rajasthan, India. Environ Monit
Assess 2012;184:5151-8.
3. ArvetiN, SarmaM, Aitkenhead-PetersonJ, SunilK. Fluoride incidence
in groundwater: A case study from Talupula, Andhra Pradesh, India.
Environ Monit Assess 2011;172:427-43.
4. WHO. Guidelines for drinking-water quality: Recommendations.
Vol 1. Geneva: World Health Organization; 2006.
5. Mohapatra M, Anand S, Mishra B, Giles DE, Singh P. Review
of fluoride removal from drinking water. J Environ Manage
2009;91:67-77.
6. Susheela A, Mudgal A, Keast G. Fluoride in water: An overview.
Water front 1999;11-13.
7. Xiang Q, Liang Y, Chen L, Wang C, Chen B, Chen X, Zhou M. Effect
of fluoride in drinking water on children’s intelligence. Fluoride
2003;36:84-94.
8. Wang B, Zheng B, Zhai C, Yu G, Liu X. Relationship between fluorine
in drinking water and dental health of residents in some large cities
in China. Environ Int 2004;30:1067-73.
9. Barot V. Occurrence of endemic fluorosis in human population of
North Gujarat, India: Human health risk. Bull Environ Contam Toxicol
1998;61:303-10.
10. Maheshwari R. Fluoride in drinking water and its removal. J Hazard
Mater 2006;137:456-63.
11. Garg V, Malik A. Groundwater quality in some villages of Haryana,
India: Focus on fluoride and fluorosis. J Hazard Mater 2004;106:85-97.
12. Kundu N, Panigrahi M, Tripathy S, Munshi S, Powell M, Hart B.
Geochemical appraisal of fluoride contamination of groundwater in
the Nayagarh District of Orissa, India. Environ Geol 2001;41:451-60.
13. Ramanaiah S, Mohan SV, Rajkumar B, Sarma P. Monitoring of
fluoride concentration in ground water of Prakasham district in
India: Correlation with physico-chemical parameters. J Environ Sci
Eng 2006;48:129-34.
14. Chavoshi E, Afyuni M, Hajabbasi M, Khoshgoftarmanesh A,
Abbaspour K, Shariatmadari H, et al. Health risk assessment of
fluoride exposure in soil, plants, and water at Isfahan, Iran. Hum
Ecol Risk Assess 2011;17:414-30.
15. Mesdaghinia A, Vaghefi KA, Montazeri A, Mohebbi MR, Saeedi R.
Monitoring of fluoride in groundwater resources of Iran. Bull Environ
Contam Toxicol 2010;84:432-7.
16. Nouri J, Mahvi AH, Babaei A, Ahmadpour E. Regional pattern
distribution of groundwater fluoride in the Shush aquifer of
Khuzestan County, Iran. Fluoride 2006; 39:321.
17. Sunil Tejaswi K, Shetty S, Annapoorna B, Pujari SC, Reddy S,
Nandlal B. A Pioneering Study of Dental Fluorosis in the Libyan
Population. J Int Oral Health 2013;5:67-72.
18. Ncube E, Schutte C. The occurrence of fluoride in South African
groundwater: A water quality and health problem. Water SA
2005;31:35-40.
19. Srikanth R, Viswanatham K, Kahsai F, Fisahatsion A, Asmellash M.
Fluoride in groundwater in selected villages in Eritrea (North East
Africa). Environ Monit Assess 2002;75:169-77.
20. Oruc N. Occurrence and problems of high fluoride waters in Turkey:
An overview. Environ Geochem Health 2008;30:315-23.
21. Bo Z, Mei H, Yongsheng Z, Xueyu L, Xuelin Z, Jun D. Distribution and
risk assessment of fluoride in drinking water in the west plain region
of Jilin province, China. Environ Geochem Health 2003;25:421-31.
22. Edmunds WM, Smedley PL. Fluoride in natural waters. Essentials
of medical geology. New York: Springer; 2013. p. 311-6.
23. Jha S, Nayak A, Sharma Y. Fluoride occurrence and assessment
of exposure dose of fluoride in shallow aquifers of Makur, Unnao
district Uttar Pradesh, India. Environ Monit Assess 2009;156:561-6.
24. Perumal E, Paul V, Govindarajan V, Panneerselvam L. A brief review
on experimental fluorosis. Toxicol Lett 2013;223:236-51.
25. Haftenberger M, Viergutz G, Neumeister V, Hetzer G. Total fluoride
intake and urinary excretion in German children aged 3–6 years.
Caries Res 2001;35:451-7.
26. Jackson RD, Brizendine EJ, Kelly SA, Hinesley R, Stookey GK,
Dunipace AJ. The fluoride content of foods and beverages from
negligibly and optimally fluoridated communities. Community Dent
Oral Epidemiol 2002;30:382-91.
27. Maguire A, Zohouri FV, Hindmarch PN, Hatts J, Moynihan PJ.
excretion in 6-to 7-year-old children living in optimally, sub-optimally
and non-fluoridated areas. Community Dent Oral Epidemiol
2007;35:479-88.
28. Mahvi AH, Zazoli MA, Younecian M, Esfandiari Y. Fluoride content
of Iranian black tea and tea liquor. Fluoride 2006;39:266.29. Martínez-Mier E, Soto-Rojas AE, Ureña-Cirett JL, Stookey GK,
Dunipace AJ. Fluoride intake from foods, beverages and
dentifrice by children in Mexico. Community Dent Oral Epidemiol
2003;31:221-30.
30. Zohouri FV, Maguire A, Moynihan PJ. Sources of Dietary Fluoride
Intake in 6–7-Year-Old English Children Receiving Optimally,
Sub-optimally, and Non-fluoridated water. J Public Health Dent
2006;66:227-34.
31. Kramer L, Osis D, Wiatrowski E, Spencer H. Dietary fluoride in
different areas in the United States. Am J Clin Nutr 1974;27:590-4.
32. Myers HM. Fluorides and dental fluorosis. Monogr Oral Sci 1978;7:1.
33. Patterson J, Hakkinen PJ, Wullenweber AE. Human health risk
assessment: Selected internet and world wide web resources.
Toxicology 2002;173:123-43.
34. Erdal S, Buchanan SN. A quantitative look at fluorosis, fluoride
exposure, and intake in children using a health risk assessment
approach. Environ Health Perspect 2005;113:111-7.
35. Ghojazadeh M, Azar FP, Naghavi-Behzad M, Mahmoudi M,
Azami-Aghdash S, Jamali Z. Fluoride Concentration of Drinking
Waters and Prevalence of Fluorosis in Iran: A Systematic Review.
J Dent Res Dent Clin Dent Prospects 2013;7:1-7.
36. Jha S, Nayak A, Sharma Y. Site specific toxicological risk from
fluoride exposure through ingestion of vegetables and cereal
crops in Unnao district, Uttar Pradesh, India. Ecotoxicol Environ
Saf 2011;74:940-6.
37. Shyam R, Kalwania G. Health risk assessment of fluoride with other
parameters in ground water of Sikar city (India). Environ Earth Sci
2012;65:1275-82.
38. Zabin SA, Foaad M, Al-Ghamdi AY. Non-carcinogenic risk
assessment of heavy metals and fluoride in some water wells
in the Al-Baha Region, Saudi Arabia. Hum Ecol Risk Assess
2008;14:1306-17.
39. Battaleb-Looie S, Moore F, Jacks G, Ketabdari MR. Geological
sources of fluoride and acceptable intake of fluoride in an
endemic fluorosis area, southern Iran. Environ Geochem Health
2012;34:641-50.
40. Waziri M, Musa U, Stephen S, Hati. Assessment of Fluoride
Concentrations in Surface Waters and Groundwater Sources in
Northeastern Nigeria. Resour Enviro 2012;2:67-72.
41. McClure F. Fluorine in foods. Public Health Rep 1949;64:l061-74.
42. Messaïtfa A. Fluoride contents in groundwaters and the main
consumed foods (dates and tea) in Southern Algeria region. Environ
Geol 2008;55:377-83.
43. Heikens A, Sumarti S, Van Bergen M, Widianarko B, Fokkert L,
Van LeeuwenK, et al. The impact of the hyperacid Ijen Crater Lake: Risks
of excess fluoride to human health. Sci Total Environ 2005;346:56-69.
44. Dobaradaran S, Mahvi AH, Dehdashti S, Abadi DRV, Tehran I.
Drinking water fluoride and child dental caries in Dashtestan, Iran.
Fluoride 2008;41:220-6.
45. Moghaddam AA, Fijani E. Distribution of fluoride in groundwater
of Maku area, northwest of Iran. Environ Geol 2008;56:281-7.
46. Poureslami HR, Khazaeli P, Nooric GR. Fluoride in food and
water consumed in Koohbanan (Kuh-e Banan), Iran. Fluoride
2008;41:216-9.
47. Ramezani Gh, Valaei N, Eikani H. Prevalence of DMFT and fluorosis
in the students of Dayer city (Iran). J Indian Soc Pedo Prev Dent
2004;22:49-53.
48. Galagan DJ, Vermillion JR. Determining optimum fluoride
concentrations. Public health Rep. 1957;72:491-3.
49. Available from: http://www.waterintakecalculator.com/Index.html.
water intake calculator. MGD [Last accessed on 2014 May 29].
50. Chambers RD. Fluorine in organic chemistry. United States: CRC
Press; 2004.
51. Malde MK, Maage A, Macha E, Julshamn K, Bjorvatn K. Fluoride
content in selected food items from five areas in East Africa. J Food
Compost Anal 1997;10:233-45.
52. Eaton AD, Franson MA. Standard methods for the examination of
water and wastewater. Washington, DC: American Public Health
Association, 2005.
53. Battaleb-Looie S, Moore F, Malde M, Jacks G. Fluoride in
groundwater, dates and wheat: Estimated exposure dose in the
population of Bushehr, Iran J Food Compost Anal 2013;29:94-9.
54. Kalantari N, Ghaffarpour M, Kianfar H, Hooshiarrad A,
Bandaarianzade D, Abdollahi M, et al. Integrated plan of nutritional
condition of Bushehr province. Tehran: National Nutrition and Food
Technology Research Institute; 2001.
55. Barnes DG, Dourson M, Preuss P, Bellin J, Derosa C, Engler R,
et al. Reference dose (RfD): Description and use in health risk
assessments. Regul Toxicol Pharmacol 1988;8:471-86.
56. Zohouri FV, Rugg-Gunn AJ. Sources of dietary fluoride intake in
4-year-old children residing in low, medium and high fluoride areas
in Iran. Int J Food Sci Nutr 2000;51:317-26.
)