Risk assessment of fluoride exposure in drinking water of Tunisia

- Fluoride concentrations were ≤2.4 mg L−1 in 100 water consumption points in Tunisia.
- Risk assessment of Fluoride exposure was assessed depending on the age of consumers.
- Approximately 75% of the Tunisian population is at risk for dental decay.
- 25% of Tunisians have a potential dental fluorosis risk.
- 20% of Tunisians might have a skeletal fluorosis risk.

The presence of fluoride in drinking water is known to reduce dental cavities among consumers, but an excessive intake of this anion might leads to dental and skeletal fluorosis. This study reports a complete survey of the fluoridated tap water taken from 100 water consumption points in Tunisia. The fluoride concentrations in tap water were between 0 and 2.4 mg L−1. Risk assessment of Fluoride exposure was assessed depending on the age of consumers using a four-step method: hazard identification, toxicity reference values selection (TRVs), daily exposure assessment, and risk characterization. Our findings suggest that approximately 75% of the Tunisian population is at risk for dental decay, 25% have a potential dental fluorosis risk, and 20% might have a skeletal fluorosis risk according to the limits of fluoride in drinking water recommended by WHO. More investigations are recommended to assess the exposure risk of fluoride in other sources of drinking water such as bottled water.