Abstract
BackgroundThe prevalence of brick tea-type fluorosis is high in Tibet because of the habit of drinking brick tea in this region. Brick tea-type fluorosis has become an urgent public health problem in China.MethodsA cross-sectional survey was conducted to investigate prevalence of brick tea-type fluorosis in all districts of Tibet using a stratified cluster sampling method. Dental fluorosis in children aged 8–12 years and clinical skeletal fluorosis in adults were diagnosed according to the national criteria. A total of 423 children and 1320 adults participated in the study. Samples of drinking water, brick tea, brick tea infusion (or buttered tea), and urine were collected and measured for fluoride concentrations by the fluoride ion selective electrode method.ResultsThe fluoride level in all but one of the brick tea samples was above the national standard. The average daily fluoride intake from drinking brick tea in all seven districts in Tibet was much higher than the national standard. The prevalence of dental fluorosis was 33.57%, and the prevalence of clinical skeletal fluorosis was 46.06%. The average daily fluoride intake from drinking brick tea (r = 0.292, P < 0.05), urine fluoride concentrations in children (r = 0.134, P < 0.05), urine fluoride concentrations in adults (r = 0.162, P < 0.05), and altitude (r = 0.276, P < 0.05) were positively correlated with the prevalence of brick tea-type fluorosis. Herdsmen had the highest fluoride exposure and the most severe skeletal fluorosis.ConclusionsBrick tea-type fluorosis in Tibet is more serious than in other parts of China. The altitude and occupational factors are important risk factors for brick tea-type fluorosis.
Highlights
99% of all fluoride retained in the human body is found in mineralized tissues, mainly in bone and in enamel and dentin.[1]
Exposure to high levels of fluoride can cause dental fluorosis (DF)—an undesirable developmental defect of tooth enamel during amelogenesis—and skeletal fluorosis (SF)—a condition marked by osteosclerosis and ligament calcifications and often accompanied by osteoporosis, osteomalacia, or osteopenia.[2,3,4]
The median fluoride level of the 106 samples was 732.81 mg/kg, which was more than twice the national standard
Summary
99% of all fluoride retained in the human body is found in mineralized tissues, mainly in bone and in enamel and dentin.[1]. People can be chronically exposed to high levels of fluoride from drinking brick tea and are at risk of brick tea-type fluorosis. Brick tea-type fluorosis is characterized by mild DF in children and severe SF in adults It was discovered by epidemiologic surveys in the 1980s among the minorities in remote western and northern border districts in China.[6]. The average daily fluoride intake from drinking brick tea in all seven districts in Tibet was much higher than the national standard. The average daily fluoride intake from drinking brick tea (r = 0.292, P < 0.05), urine fluoride concentrations in children (r = 0.134, P < 0.05), urine fluoride concentrations in adults (r = 0.162, P < 0.05), and altitude (r = 0.276, P < 0.05) were positively correlated with the prevalence of brick tea-type fluorosis. The altitude and occupational factors are important risk factors for brick tea-type fluorosis
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