Risk Assessment of Fluoride Intake from Tea in the Republic of Ireland and its Implications for Public Health and Water Fluoridation.

Declan T Waugh,William Potter,Hardy Limeback,Michael Godfrey

doi:10.3390/ijerph13030259

Declan T Waugh, William Potter + Show 2 more

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https://doi.org/10.3390/ijerph13030259

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Abstract

The Republic of Ireland (RoI) is the only European Country with a mandatory national legislation requiring artificial fluoridation of drinking water and has the highest per capita consumption of black tea in the world. Tea is a hyperaccumulator of fluoride and chronic fluoride intake is associated with multiple negative health outcomes. In this study, fifty four brands of the commercially available black tea bag products were purchased and the fluoride level in tea infusions tested by an ion-selective electrode method. The fluoride content in all brands tested ranged from 1.6 to 6.1 mg/L, with a mean value of 3.3 mg/L. According to our risk assessment it is evident that the general population in the RoI is at a high risk of chronic fluoride exposure and associated adverse health effects based on established reference values. We conclude that the culture of habitual tea drinking in the RoI indicates that the total cumulative dietary fluoride intake in the general population could readily exceed the levels known to cause chronic fluoride intoxication. Evidence suggests that excessive fluoride intake may be contributing to a wide range of adverse health effects. Therefore from a public health perspective, it would seem prudent and sensible that risk reduction measures be implemented to reduce the total body burden of fluoride in the population.

Highlights

Fluoride is a halogen found in soil, water, rocks, air, plants and animals in different quantities [1].The major sources of internal exposure of individuals to fluorides are the diet, dental products, dermal absorption from chemicals or pharmaceuticals, ingestion or parenteral administration of fluoride-containing drugs, tobacco consumption, exposure to industrial emissions and ingestion of fluoride-containing soil [2]
Our results demonstrate that the high fluoride levels measured in black tea prepared from packaged black tea bag products sold in the Republic of Ireland (RoI) are consistent with concentrations found in similar products sold in Taiwan [43,46]; China [44,45]; Poland [47]; Slovenia [49]; UK [51]; Germany [123]; Norway [124]
Based on the fluoride levels in tea and reference levels for AI and Upper Intake Level (UL) our results suggest that the general population in the RoI is at risk of excessive intake of fluoride and that fluoridation of drinking water further contributes to the risk of fluoride intoxication

Summary

Introduction

Fluoride is a halogen found in soil, water, rocks, air, plants and animals in different quantities [1].The major sources of internal exposure of individuals to fluorides are the diet, dental products, dermal absorption from chemicals or pharmaceuticals, ingestion or parenteral administration of fluoride-containing drugs, tobacco consumption, exposure to industrial emissions and ingestion of fluoride-containing soil [2]. Fluoride is a halogen found in soil, water, rocks, air, plants and animals in different quantities [1]. It is acknowledged that of all the common foodstuffs, tea has one of the highest potentials for increasing the daily fluoride intake [2,3,4]. The tea plant, Camellia sinensis has been known since the 1930s to be a hyperaccumulator of fluoride [5,6]. Tea trees accumulate and store fluoride by absorbing it from the air and soil. Fluoride accumulates mostly in the leaves of the tea plant [2]. A substantial amount of fluoride is released during tea infusion. Because soluble fluoride is absorbed by the gastrointestional track, the bioavailability of fluoride from tea is

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