For example, fluoride retention might be affected by environments or conditions that chronically affect urinary pH, including diet, drugs, altitude, and certain diseases (e.g., chronic obstructive pulmonary disease) (reviewed by Whitford 1996). Fluoride in drinking-water will be an invaluable reference source for all those concerned with the management of drinking-water containing fluoride and the health effects arising from its consumption, including water … At 2 mg/L, drinking water contributes 57% to 90% for average-water-intake individuals and 86% to 96% for high-water-intake individuals. 1991; Kurttio et al. Ready to take your reading offline? However, more research is needed to address uncertainties associated with extrapolating animal data on bone strength and fractures to humans. 0000002299 00000 n In those cases, other sources of exposure can be considered “background” and can be subtracted from the reference dose (EPA 2000d). trailer In 2005, EPA issued special guidance for assessing susceptibility to carcinogens during early life stages (EPA 2005b). FLUORIDE IN DRINKING WATER: A Scientific Review of EPA’s Standards Committee on Fluoride in Drinking Water Board on Environmental Studies and Toxicology Division on Earth and Life Studies . Staining and mottling of the anterior teeth should be distinguished from staining of the posterior teeth so that aesthetic consequences can be more easily assessed. However. beyond a cosmetic effect to create an adverse psychological effect or an adverse effect on social functioning is not known. The elderly are another population of concern because of their long-term accumulation of fluoride into their bones. The current enforceable drinking water standard for fluoride is 4.0 mg/L. In 1986, the EPA established a maximum allowable concentration for fluoride in drinking water of 4 milligrams per liter, a guideline designed to prevent the public from being exposed to harmful levels of fluoride. MCL or TT 1 (mg/L) 2. However, stage III skeletal fluorosis appears to be a rare condition in the United States, and the existing epidemiologic evidence is insufficient for determining whether stage II skeletal fluorosis is occurring in U.S. residents. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. However, the available data are insufficient to provide quantitative estimates of the differences between healthy individuals and people with renal disease. The SMCL was selected to prevent objectionable enamel fluorosis in a significant portion of the population. 1 mg/L. %PDF-1.4 %���� The committee judges that stage II skeletal fluorosis (the stage before mobility is significantly affected) should also be considered an adverse health effect. EPA established an SMCL of 2 mg/L on the basis of cosmetically “objectionable” enamel fluorosis, defined as discoloration and/or pitting of teeth. 0000001014 00000 n Crippling skeletal fluorosis (or clinical stage III) is the current basis of EPA’s MCLG. Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text. EPA sets MCLGs of zero for contaminants that are known or probable human carcinogens. Populations in need of special consideration when determining the MCLG and SMCL for fluoride include those at risk because their exposure to fluoride is greater than that of the average person or because they are. Individuals who consume well over 2 L of water per day will accumulate more fluoride and reach critical bone concentrations before the average water drinker exposed to the same concentration of fluoride in drinking water. Specifically, the benchmark dose is derived by modeling the data in the observed experimental range, selecting an incidence level within or near the observed range (e.g., the effective dose producing a 10% increased incidence of response), and determining the upper confidence limit on the model. 2000). © 2020 National Academy of Sciences. In Chapter 2, the committee shows that at 4 mg/L, drinking water is the primary contributor to total fluoride exposure, ranging from 72% to 94% for average-water-intake individuals and from 92% to 98% for high-water-intake individuals. Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. In 1986, EPA established an MCLG for fluoride of 4 mg/L to protect against “crippling” (clinical stage III) skeletal fluorosis. Safe Fluoride Levels In Drinking Water. Fluoride in Drinking Water reviews research on various health effects from exposure to fluoride, including studies conducted in the last 10 years. 1992). In 2005, EPA issued its new Guidelines for Carcinogen Risk Assessment (EPA 2005a) as a replacement for its 1986 guidelines (EPA 1986). Children are considered a special subpopulation because their health risks can differ from those of adults as a result of their immature physiology, metabolism, and differing levels of exposure due to factors such as greater food consumption per unit of body weight and outdoor play activities.

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