|
The study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological lesions. Even today its early stages are misdiagnosed in endemic
areas.
Endemic fluorosis induced by high concentrations of fluoride in water and soils is a major health problem in several countries, particularly in volcanic areas. Here we describe for the first time the features of endemic fluorosis in the Herculaneum victims of the 79 AD eruption, resulting from long-term exposure to high levels of environmental fluoride which still occur today.
Our observations on morphological, radiological, histological and chemical skeletal and dental features of this ancient population now suggest that in this area fluorosis was already endemic in Roman times. This evidence merged with currently available epidemiologic data reveal for the Vesuvius area population a permanent fluoride health hazard, whose public health and socio-economic impact is currently underestimated. The present guidelines for fluoridated tap water might be reconsidered accordingly, particularly around Mt Vesuvius and in other fluoride hazard areas with high natural fluoride levels.
Our findings on the pathologic skeletal and dental features of the ancient residents of Herculaneum now indicate that fluorosis was endemic already during Roman times. This evidence and currently available epidemiologic data show a permanent fluoride health hazard for the population living around Vesuvius. At present, the major public health and socio-economic impact of this hazard is underestimated. For several years, the local authorities have allowed a maximum fluoride content of 2.5 mg/L in tap water throughout the area, a value that exceeds WHO as well as national
guidelines.
Effects on the skeleton are the best indicators of the toxic responses to fluoride and are considered to have direct public health relevance. According to WHO recommendations, in areas with high fluoride levels and warm climate it would be appropriate to lower the maximum value of 1.5 mg/L established for naturally occurring fluoride in drinking water. Therefore in setting guidelines for fluoride in the densely populated Vesuvius area, the following predisposing factors for fluorosis should be better evaluated: ambient temperature, volume of water intake, other trace elements in the water, a diet based on beverages and food preparation in naturally fluoridated boiled water, and water storage methods. Bearing in mind that progressively higher fluoride intakes lead to increasing risks of dental and skeletal fluorosis, the adoption of low-cost defluoridation methods should be seriously considered and
encouraged.
In evaluating all the possible health consequences of exposure to fluoride concentrations higher than the established WHO parameters, it should also be taken into account that the maximum fluoride content of 5.0 mg/L accepted in natural mineral waters protects only the population over 15 years old and only if there is no exposure to fluoride from other sources, as experienced by communities living in volcanic and other fluoride hazard
areas.
Source
Petrone P, Giordano M, Giustino S, Guarino FM (2011) Enduring Fluoride Health Hazard for the Vesuvius Area Population: The Case of AD 79 Herculaneum. PLoS ONE 6(6): e21085.
doi:10.1371/journal.pone.0021085
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0021085
.
(MDN)
|
