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The Lancet. Planetary Health Jun 2022The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental... (Review)
Review
The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science-policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.
Topics: Air Pollution; Fossil Fuels; Humans; Income; Mortality, Premature; Risk Factors
PubMed: 35594895
DOI: 10.1016/S2542-5196(22)00090-0 -
Environmental Health : a Global Access... Dec 2019After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention,... (Review)
Review
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.
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.
Topics: Adolescent; Adolescent Development; Child; Child Development; Child, Preschool; Fluorides; Humans; Infant; Infant, Newborn
PubMed: 31856837
DOI: 10.1186/s12940-019-0551-x -
Journal of Occupational Medicine and... Oct 2022Fumigants are gaseous pesticides or biocides which eradicate pests by suffocation or poisoning. Worker exposure to fumigants is mainly via inhalation, followed by dermal... (Review)
Review
Fumigants are gaseous pesticides or biocides which eradicate pests by suffocation or poisoning. Worker exposure to fumigants is mainly via inhalation, followed by dermal contact and ingestion, leading to various acute and chronic health effects. Implementation of appropriate workplace controls such as adequate ventilation, training and personal protective equipment ensure that exposure to fumigants are kept to the lowest level as practically possible. In addition, routine medical examinations also allow for doctors to identify and manage possible exposure to fumigants and ascertain workers' fitness to work.While management guidelines after an acute exposure to such fumigants is clear and consistent, the guidelines on routine medical examination for fumigators is sparse. Components of the medical examinations vary according to the fumigant, workers are exposed to and its chronic health effects. Hence, this paper highlights the health hazards of commonly utilised fumigants; Methyl Bromide, Hydrogen Cyanide, Hydrogen Phosphide and Sulfuryl Fluoride; and outlines the guidance for routine medical examinations for exposed fumigators.
PubMed: 36307823
DOI: 10.1186/s12995-022-00361-3 -
Materials (Basel, Switzerland) Jan 2023Fluoride is one of the elements commonly present in the human environment. Due to its characteristics, it is very widely used in medicine, dentistry, industry or... (Review)
Review
Fluoride is one of the elements commonly present in the human environment. Due to its characteristics, it is very widely used in medicine, dentistry, industry or agriculture. On the other hand, its universality possesses a real threat to the human body in the form of acute and chronic poisoning. The aim of this paper is to characterize the properties of fluoride and its effects on the human body, as well as the sources of its occurrence. Particular emphasis is placed on the safety of its use and optimal dosage intake, which prevents accumulation and reduces its potential side effects. The positive effect of proper fluoride supply is widely described. In order to avoid overdose, it is best to consult a specialist to properly select the dosage.
PubMed: 36770248
DOI: 10.3390/ma16031242 -
Environmental Health Perspectives Oct 2012Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on children's... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on children's neurodevelopment.
OBJECTIVE
We performed a systematic review and meta-analysis of published studies to investigate the effects of increased fluoride exposure and delayed neurobehavioral development.
METHODS
We searched the MEDLINE, EMBASE, Water Resources Abstracts, and TOXNET databases through 2011 for eligible studies. We also searched the China National Knowledge Infrastructure (CNKI) database, because many studies on fluoride neurotoxicity have been published in Chinese journals only. In total, we identified 27 eligible epidemiological studies with high and reference exposures, end points of IQ scores, or related cognitive function measures with means and variances for the two exposure groups. Using random-effects models, we estimated the standardized mean difference between exposed and reference groups across all studies. We conducted sensitivity analyses restricted to studies using the same outcome assessment and having drinking-water fluoride as the only exposure. We performed the Cochran test for heterogeneity between studies, Begg's funnel plot, and Egger test to assess publication bias, and conducted meta-regressions to explore sources of variation in mean differences among the studies.
RESULTS
The standardized weighted mean difference in IQ score between exposed and reference populations was -0.45 (95% confidence interval: -0.56, -0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. Subgroup and sensitivity analyses also indicated inverse associations, although the substantial heterogeneity did not appear to decrease.
CONCLUSIONS
The results support the possibility of an adverse effect of high fluoride exposure on children's neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.
Topics: Adolescent; Child; Child, Preschool; China; Developmental Disabilities; Drinking Water; Environmental Exposure; Environmental Monitoring; Fluorides; Humans; Intelligence Tests; Models, Biological; Neurotoxicity Syndromes
PubMed: 22820538
DOI: 10.1289/ehp.1104912 -
British Medical Journal Apr 1964
Topics: Fluoridation; Fluoride Poisoning; Halogenation; Toxicology
PubMed: 14102781
DOI: 10.1136/bmj.1.5387.907-c -
British Medical Journal Mar 1964
Topics: Fluoridation; Fluoride Poisoning; Halogenation; Toxicology
PubMed: 14102026
DOI: 10.1136/bmj.1.5385.766-d -
British Medical Journal Mar 1964
Topics: Fluoridation; Fluoride Poisoning; Halogenation; Toxicology
PubMed: 14102027
DOI: 10.1136/bmj.1.5385.767 -
American Journal of Translational... 2021Thyroid hormones have a direct effect on bone mineral homeostasis, leading to increased bone mineral resorption and calcium loss through the kidneys. Osteomalacia is...
Thyroid hormones have a direct effect on bone mineral homeostasis, leading to increased bone mineral resorption and calcium loss through the kidneys. Osteomalacia is conceptualized as a disorder of bone tissue characterized by inadequate or delayed mineralization of osteoid in mature cortical and spongy bone, and is associated with thyrotoxicosis. This article assessed the impact of thyrotoxicosis on the occurrence and development of osteomalacia for better diagnosis and treatment of the disease. We searched databases such as Pubmed with "osteomalacia" and "thyrotoxicosis", 15 papers were found; with "osteopenia" or "osteomalacia" or "osteoporosis" and "thyrotoxicosis", 129 papers were found. The causes of osteomalacia include insufficient intake of calcium, phosphorus and vitamin D, impaired absorption and metabolism of vitamin D, kidney diseases (nephrotic syndrome, chronic renal failure, renal tubular acidosis, Fanconi syndrome, etc.), hereditary and neoplastic hypophosphatemia, and other diseases such as heavy metal poisoning, high fluoride intake. At present, the pathogenesis of osteomalacia caused by thyrotoxicosis are mainly attributed to catabolism of vitamin D, vitamin D deficiency and mechanisms underlying calcium metabolism disorder. Since thyrotoxicosis can cause osteopenia and may coexist with osteomalacia, attention should be given to the changes of alkaline phosphatase, liver function and clinical symptoms. If necessary, chest X-ray and pelvic X-ray should be carried out to find out potential osteomalacia for timely treatment to avoid the occurrence of fracture and even deformity.
PubMed: 33594328
DOI: No ID Found -
Neurology India 2009Endemic skeletal fluorosis is widely prevalent in India and is a major public health problem. The first ever report of endemic skeletal fluorosis and neurological... (Review)
Review
Endemic skeletal fluorosis is widely prevalent in India and is a major public health problem. The first ever report of endemic skeletal fluorosis and neurological manifestation was from Prakasam district in Andhra Pradesh in the year 1937. Epidemiological and experimental studies in the endemic areas suggest the role of temperate climate, hard physical labor, nutritional status, presence of abnormal concentrations of trace elements like strontium, uranium, silica in water supplies, high fluoride levels in foods and presence of kidney disease in the development of skeletal fluorosis. Neurological complications of endemic skeletal fluorosis, namely radiculopathy, myelopathy or both are mechanical in nature and till date the evidence for direct neurotoxicity of fluoride is lacking. Prevention of the disease should be the aim, knowing the pathogenesis of fluorosis. Surgery has a limited role in alleviating the neurological disability and should be tailored to the individual based on the imaging findings.
Topics: Bone Diseases; Bone and Bones; Diagnosis, Differential; Endemic Diseases; Fluoride Poisoning; Fluorides; Humans; India; Neurotoxicity Syndromes; Occupational Diseases; Radionuclide Imaging
PubMed: 19305069
DOI: 10.4103/0028-3886.48793