불소의 독성이 알려지는게 싫은 사람들은 누구일까?

2019년 현재에도 불소의 독성에 관한 연구와 발표는 계속 되고 있습니다.

물론 충치예방효과에 대한 논문도 계속 발표되고 있습니다.

그러나 이상하게도 불소의 독성에 관한 연구에 대해서는 잘 알려지지 않고 있습니다.

불소에 대해 가장 잘 알고 있는 충치예방 전문가 들이 이런 연구결과들이 알려지는걸 원치 않아서는 아닐까요?

혹은 불소를 20세기의 위대한 공중보건사업의 하나라고 떠들어 대던 관료들이 부끄러워서 일까요?

불소가 충치예방효과가 있다면 부작용도 있습니다.

그러나 부작용은 잘 알려지지 않고 자꾸 무시 됩니다.

그 정도의 양은 무해하다고!

그러나 양심 있는 전문가들은 그정도의 양은 무해하니 괞찮다고 말하지 않습니다.

해로울 수 있으니 조심하라고 말합니다.

그리고 불소가 약이라면 충치예방효과외의 부작용도 함께 말해 주어야 합니다!

August 19, 2019

Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada

임신기 불소노출과 태아의 IQ수치와의 관계 : 캐나다연구

Rivka Green, MA¹; Bruce Lanphear, MD^2,3; Richard Hornung, PhD⁴; et al

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JAMA Pediatr. 2019;173(10):940-948. doi:10.1001/jamapediatrics.2019.1729

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Key Points

Question Is maternal fluoride exposure during pregnancy associated with childhood IQ in a Canadian cohort receiving optimally fluoridated water?

Findings In this prospective birth cohort study, fluoride exposure during pregnancy was associated with lower IQ scores in children aged 3 to 4 years.

Meaning Fluoride exposure during pregnancy may be associated with adverse effects on child intellectual development, indicating the possible need to reduce fluoride intake during pregnancy.

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Abstract

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Importance The potential neurotoxicity associated with exposure to fluoride, which has generated controversy about community water fluoridation, remains unclear.

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Objective To examine the association between fluoride exposure during pregnancy and IQ scores in a prospective birth cohort.

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Design, Setting, and Participants This prospective, multicenter birth cohort study used information from the Maternal-Infant Research on Environmental Chemicals cohort. Children were born between 2008 and 2012; 41% lived in communities supplied with fluoridated municipal water. The study sample included 601 mother-child pairs recruited from 6 major cities in Canada; children were between ages 3 and 4 years at testing. Data were analyzed between March 2017 and January 2019.

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코호트 연구(cohort study): 전향성 추적조사연구를 말합니다. 특정 요인에 노출된 집단과 노출 되지 않은 집단을 추적하고 연구 대상 질병의 발생률을 비교하여 요인과 질병 발생관의 관계를 조사하는 연구 방법입니다. 연구 설계중에도 신뢰성이 매우 높은 연구 방법입니다.

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Exposures Maternal urinary fluoride (MUF_SG), adjusted for specific gravity and averaged across 3 trimesters available for 512 pregnant women, as well as self-reported maternal daily fluoride intake from water and beverage consumption available for 400 pregnant women.

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Main Outcomes and Measures Children’s IQ was assessed at ages 3 to 4 years using the Wechsler Primary and Preschool Scale of Intelligence-III. Multiple linear regression analyses were used to examine covariate-adjusted associations between each fluoride exposure measure and IQ score.

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Results Of 512 mother-child pairs, the mean (SD) age for enrollment for mothers was 32.3 (5.1) years, 463 (90%) were white, and 264 children (52%) were female. Data on MUF_SG concentrations, IQ scores, and complete covariates were available for 512 mother-child pairs; data on maternal fluoride intake and children’s IQ were available for 400 of 601 mother-child pairs. Women living in areas with fluoridated tap water (n = 141) compared with nonfluoridated water (n = 228) had significantly higher mean (SD) MUF_SG concentrations (0.69 [0.42] mg/L vs 0.40 [0.27] mg/L; P = .001; to convert to millimoles per liter, multiply by 0.05263) and fluoride intake levels (0.93 [0.43] vs 0.30 [0.26] mg of fluoride per day; P = .001). Children had mean (SD) Full Scale IQ scores of 107.16 (13.26), range 52-143, with girls showing significantly higher mean (SD) scores than boys: 109.56 (11.96) vs 104.61 (14.09); P = .001. There was a significant interaction (P = .02) between child sex and MUF_SG (6.89; 95% CI, 0.96-12.82) indicating a differential association between boys and girls. A 1-mg/L increase in MUF_SG was associated with a 4.49-point lower IQ score (95% CI, −8.38 to −0.60) in boys, but there was no statistically significant association with IQ scores in girls (B = 2.40; 95% CI, −2.53 to 7.33). A 1-mg higher daily intake of fluoride among pregnant women was associated with a 3.66 lower IQ score (95% CI, −7.16 to −0.14) in boys and girls.

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Conclusions and Relevance In this study, maternal exposure to higher levels of fluoride during pregnancy was associated with lower IQ scores in children aged 3 to 4 years. These findings indicate the possible need to reduce fluoride intake during pregnancy.

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본 연구의 결론은 임신기 고농도 불소노출이 3~4세 아이의 IQ를 낮추는 것과 관련이 있다는 것입니다. 따라서 임신기에 불소 섭취를 줄이기 위한 노력이 필요합니다. 특히 수돗물을 불소화한 미국과 캐나다에서는 큰 이슈가 됩니다.

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우리나라는 다행이 수돗물이 불소화 되지는 않아 크게 걱정할 필요는 없지만 매일 사용하는 고농도 불소치약등 은 조심할 필요가 있습니다.

불소의 신경독성(뇌발달, ,IQ) 관련 2019년 12월 최신 논문: 리뷰 저널

 

Environ Health. 2019 Dec 19;18(1):110. doi: 10.1186/s12940-019-0551-x.

Developmental fluoride neurotoxicity: an updated review.

불소의 신경독성 발현: 최신 리뷰

Grandjean P^1,2.

Author information

1

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. pgrandjean@health.sdu.dk.

2

Department of Public Health, University of Southern Denmark, Odense, Denmark. pgrandjean@health.sdu.dk.

Abstract

BACKGROUND:

After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and has become controversial for two reasons. First, topical fluoride application in the oral cavity appears to be a more direct and appropriate means of preventing caries. Second, systemic fluoride uptake is suspected of causing adverse effects, in particular neurotoxicity during early development. The latter is supported by experimental neurotoxicity findings and toxicokinetic evidence of fluoride passing into the brain.

전신적인 불소섭취가 부작용을 유발한다고 의심 받고 있으며 특히, 뇌 발달 초기의 신경독성에서 그렇다.

METHOD:

An integrated literature review was conducted on fluoride exposure and intellectual disability, with a main focus on studies on children published subsequent to a meta-analysis from 2012.

RESULTS:

Fourteen recent cross-sectional studies from endemic areas with naturally high fluoride concentrations in groundwater supported the previous findings of cognitive deficits in children with elevated fluoride exposures. Three recent prospective studies from Mexico and Canada with individual exposure data showed that early-life exposures were negatively associated with children's performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and tentative benchmark dose calculations suggest that safe exposures are likely to be below currently accepted or recommended fluoride concentrations in drinking water.

CONCLUSION:

The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable. Recognition of neurotoxic risks is necessary when determining the safety of fluoride-contaminated drinking water and fluoride uses for preventive dentistry purposes.

최근의 전염병학적 연구결과들을 종합하면 뇌 발달 초기의 높은 불소 섭취는 IQ를 낮추는 결과를 초래할 수 있다고 판단할 수 있다.  따라서 불소를 함유한 물이나 불소를 이용한 예방치료시 불소의 신경독성에 관한 안전에 대한 고려가 필요하다.

 

Indian J Dent Res. 2018 May-Jun;29(3):358-363. doi: 10.4103/ijdr.IJDR_505_16.

A systematic analysis on possibility of water fluoridation causing hypothyroidism.

수돗물 불소화가 갑상선질환에 미칠 수 있는 영향에 관한 체계적 분석

Chaitanya NCSK¹, Karunakar P², Allam NSJ¹, Priya MH¹, Alekhya B¹, Nauseen S¹.

Author information

1

Department of Oral Medicine and Radiology, Principal, Panineeya Institute of Dental Sciences, Hyderabad, Telangana, India.

2

Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences, Hyderabad, Telangana, India.

Abstract

Background:

Community water fluoridation is widely used worldwide and its role in preventive dental health care is well established. However, there is sufficient evidence of the ill effects of excessive fluoride content in water, causing skeletal and dental fluorosis. Alongside, there was also extraskeletal and dental manifestations of excessive fluorides reported. They include the effect on thyroid function, but the literature regarding this is sparse.

Aim:

The present systematic review aims to analyze the data from controlled studies about the effect of fluoride on thyroid function.

Materials and Methods:

A systematic literature search was performed using PUBMED, MEDLINE, EMBASE, COCHRANE Library, EBSCO search, and the internet search, with language restriction to English. The search included published studies which dealt with the association of fluorine with hypothyroidism, from January 1981 to November 2015. Literature search was done using keywords: fluoride and hypothyroidism, dental fluorosis and thyroid disorders, systemic fluorosis and thyroid disease, excessive water fluoridation and hypothyroidism, thyroid and fluoride, fluorosis and its adverse effects.

Results:

Out of 166 publications, related to search strategy, 37 full articles which were related with the association of fluoride and hypothyroidism were acquired for further inspection. Out of the 37 articles, 10 articles met the inclusion criteria. The data were extracted and placed in an excel sheet and were analyzed. The analysis suggested a positive correlation of excess fluoride and hypothyroidism.

Conclusion:

The present systematic review suggests a positive correlation between excess fluoride and hypothyroidism. This calls the need for further well-controlled studies in this otherwise emerging alarming issue. It also calls for considerable community network through health informatics for problem sensitization.

KEYWORDS:

Hypothyroidism; systematic analysis; water fluoridation

Cochrane Database Syst Rev. 2017 Oct 23;10:CD011850. doi: 10.1002/14651858.CD011850.pub2.

 

Environ Int. 2019 Nov;132:105012. doi: 10.1016/j.envint.2019.105012. Epub 2019 Aug 8.

Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

불소 노출이 미국 청소년들의 간과 신장 기능에 미칠 수 있는 영향

Malin AJ¹, Lesseur C², Busgang SA², Curtin P², Wright RO³, Sanders AP³.

Author information

1

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Ashley.malin@mssm.edu.

2

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

3

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Abstract

BACKGROUND:

Hepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth.

METHODS:

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013-2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons.

RESULTS:

The average age of adolescents was 15.4 years. Median water and plasma fluoride concentrations were 0.48 mg/L and 0.33 μmol/L respectively. A 1 μmol/L increase in plasma fluoride was associated with a 10.36 mL/min/1.73 m² lower estimated glomerular filtration rate (95% CI: -17.50, -3.22; p = 0.05), a 0.29 mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50; p = 0.05), and a 1.29 mg/dL lower blood urea nitrogen concentration (95%CI: -1.87, -0.70; p < 0.001). A 1 mg/L increase in water fluoride was associated with a 0.93 mg/dL lower blood urea nitrogen concentration (95% CI: -1.44, -0.42; p = 0.007).

CONCLUSIONS:

Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.

Hum Exp Toxicol. 2019 Mar;38(3):269-279. doi: 10.1177/0960327118814161. Epub 2018 Nov 25.

Exploring the role of excess fluoride in chronic kidney disease: A review.

과도한 불소노출이 신장질환에 미치는 영향: 리뷰저널

Dharmaratne RW¹.

Author information

1

National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS, USA.

Abstract

This review covers nearly 100 years of studies on the toxicity of fluoride on human and animal kidneys. These studies reveal that there are direct adverse effects on the kidneys by excess fluoride, leading to kidney damage and dysfunction. With the exception of the pineal gland, the kidney is exposed to higher concentrations of fluoride than all other soft tissues. Therefore, exposure to higher concentrations of fluoride could contribute to kidney damage, ultimately leading to chronic kidney disease (CKD). Among major adverse effects on the kidneys from excessive consumption of fluoride are immediate effects on the tubular area of the kidneys, inhibiting the tubular reabsorption; changes in urinary ion excretion by the kidneys disruption of collagen biosynthesis in the body, causing damages to the kidneys and other organs; and inhibition of kidney enzymes, affecting the functioning of enzyme pathways. This review proposes that there is a direct correlation between CKD and the consumption of excess amounts of fluoride. Studies particularly show immediate adverse effects on the tubular area of human and animal kidneys leading to CKD due to the consumption of excess fluoride. Therefore, it is very important to conduct more investigations on toxicity studies of excess fluoride on the human kidney, including experiments using human kidney enzymes, to study more in depth the impact of excess fluoride on the human kidney. Further, the interference of excess fluoride on collagen synthesis in human body and its effect on human kidney should also be further investigated.

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