Determining the optimal fluoride concentration in drinking water for fluoride endemic regions in South India

Fluoride ion in drinking water is known for both beneficial and detrimental effects on health. The prevalence of fluorosis is mainly due to the intake of large quantities of fluoride through drinking water owing to more than 90% bioavailability. The objective of this study is to predict optimal fluoride level in drinking water for fluoride endemic regions by comprising the levels of fluoride and other water quality parameters in drinking water, prevalence of fluorosis, fluoride intake through water, food and beverages such as tea and coffee and also considering the progressive accumulation of fluoride in animal bones, by comparing with non fluoride endemic areas comprise of the same geological features with the aid of regression analysis. Result of this study shows that increase of fluoride level above 1.33 mg/l in drinking water increases the community fluorosis index (CFI) value more than 0.6, an optimum index value above which fluorosis is considered to be a public health problem. Regression plot between water fluoride and bone fluoride levels indicates that, every increase of 0.5 mg/l unit of water fluoride level increases the bone fluoride level of 52 mg/kg unit within 2 to 3 years. Furthermore, the consumption of drinking water containing more than 0.65 mg/l of fluoride can raise the total fluoride intake per day more than 4 mg, which is the optimum fluoride dose level recommended for adults by the Agency for Toxic Substances and Disease Registry. From the result, the people in fluoride endemic areas in South India are advised to consume drinking water with fluoride level within the limit of 0.5 to 0.65 mg/l to avoid further fluorosis risk.