Akwụkwọ ọnọdụ IAOMT megide iji fluoride gụnyere ihe karịrị 500 ntụle ma na-enye nyocha sayensị zuru ezu gbasara ihe egwu ahụike nwere metụtara ikpughe fluoride.
Akwụkwọ ọkwa nke IAOMT gụnyere ihe karịrị amaokwu 500 ma na-enye nyocha sayensị zuru ezu banyere ihe egwu ahụike metụtara metụtara ọkụ fluoride.
Fluorine (F) bụ ihe nke itoolu na tebụl oge na ọ bụ onye so na ezinụlọ halogen. Ọ nwere atọmịk nke 18.9984, bụ nke kachasị arụ ọrụ nke ihe niile, wee mepụta agbụ electronegative siri ike. Ọ na-adọrọ mmasị ya karịsịa na cations dị egwu nke calcium na magnesium. Na steeti ya n'efu, fluorine bụ gas na-egbu egbu nke na-acha odo odo. Agbanyeghị, a naghị ahụkarị fluorine na nnwere onwe ya na okike n'ihi na ọ fọrọ nke nta ka ọ bụrụ na ya na ihe ndị ọzọ na-agwakọta n'ihi oke reactivity Fluorine na-apụtakarị dị ka mineral
fluorspar (CaF2), cryolite (Na3AlF6), na fluorapatite (3Ca3 (PO4) 2 Ca (F, Cl) 2), ma ọ bụ iri na atọ kachasị elu n'ụwa.
Fluoride (F-) bụ kemịkal kemịkalụ nke nwere mmiri ọkụ nke nwere mgbakwunye elektrọn, si otú ahụ na-enye ya ụgwọ adịghị mma. Ewezuga ịdị adị nkịtị na mineral, yana na ala, mmiri, na ikuku, fluoride na-arụkwa kemịkal maka iji mmiri fluoridation obodo, ngwaahịa eze na ihe ndị ọzọ emepụtara. Fluoride adịghị mkpa maka uto na uto mmadụ.1
N'ezie, a chọghị ya maka usoro ọmụmụ ọ bụla na ahụ mmadụ; N'ihi ya, ọ dịghị onye ga-arịa ụkọ fluoride. Na 2014, Dr. Philippe Grandjean nke vardlọ Akwụkwọ Harvard nke Ahụike Ọha na Dr. Philip J. Landrigan nke clọ Akwụkwọ Ọgwụ nke Icahn na Ugwu Saịnaị chọpụtara fluoride dị ka otu n'ime kemịkalụ ụlọ ọrụ mmepụta ihe iri na abụọ maara na ọ na-ebute neurotoxicity nke mmepe na mmadụ. 2
Nkebi nke 5.1: Fluoridation Mmiri Ọha
N’ebe ọdịda anyanwụ Europe, gọọmentị ụfọdụ achọpụtala n’ụzọ doro anya ihe ọghọm nke fluoride, naanị 3% nke ndị bi na ọdịda anyanwụ Europe na-a drinksụ mmiri fluoride. 133 Na United States, ihe karịrị 66% nke ndị America na-a drinkingụ mmiri fluor.134 Ma Protectionlọ Ọrụ Na-ahụ Maka Gburugburu Ebe Obibi (EPA) ma ọ bụ gọọmentị etiti nyere iwu ka mmiri fluoridation na America, ma ọ bụ obodo ma ọ bụ obodo ime mkpebi ịme mmiri fluoridate. .135 136 Agbanyeghị, Servicelọ Ọrụ Ahụike Ọha na United States (PHS) na-ewepụta ọtụtụ nri fluoride na mmiri ọ communityụ communityụ obodo maka ndị họọrọ fluoridate, yana tolọ Ọrụ Nchedo Gburugburu Ebe Obibi (EPA) na-esetịpụ ọkwa na-emerụ emerụ maka mmiri ọ publicụ publicụ ọha na eze.
Mgbe fluoridation mmiri dị na Grand Rapids, Michigan, bidoro na 1945, omume a gbasara na mpaghara obodo niile n'ime iri afọ ndị sochirinụ. Ndị Ọrụ Ahụike Ọha (PHS) gbara ume na mbọ ndị a na 1950s, 137 na 1962, PHS nyere ụkpụrụ maka fluoride na mmiri ọ drinkingụ drinkingụ nke ga-eguzo maka afọ 50. Ha kwuru na fluoride ga-egbochi ọrịa caries 138 na ọkwa kachasị mma nke fluoride agbakwunyere na mmiri ọ shouldụ shouldụ kwesịrị ịdị site na 0.7 ruo 1.2 milligram kwa lita. 139 Agbanyeghị, PHS gbadara nkwanye a na ọkwa otu nke 0.7 milligrams kwa lita na 2015 n'ihi otu mmụba nke fluorosis eze (mmebi na-adịgide adịgide nke ezé nke nwere ike ime na ụmụaka site na ịkarị oke fluoride) yana mmụba nke isi mmalite nke fluoride na-ekpughere ndị America.140
Ka ọ dị ugbu a, e guzobere Iwu Mmiri Na-a Safeụ Nchekwa na 1974 iji kpuchido ogo mmiri ọ Americanụ Americanụ America, ma nye EPA ikike ịhazi mmiri ọ publicụ publicụ ọha na eze. N'ihi na
nke iwu a, EPA nwere ike ịtọ ntọala kachasị mmerụ (MCLs) maka mmiri ọ drinkingụ drinkingụ, yana oke ebumnuche kachasị emerụ emerụ (MCLGs) na ụkpụrụ mmiri ọ drinkingụ drinkingụ na-enweghị ike ị nweta nke ọkwa kachasị elu (SMCLs) .141 EPA akọwapụtara na MCLG bụ “oke mmetọ kachasị na mmiri ọ drinkingụ whichụ nke na-enweghị mmetụta ọ bụla ma ọ bụ atụ anya na ọ ga-emetụta ahụike mmadụ, na-enye oke oke nchekwa.” 142 Ọzọkwa, EPA tozuru na sistemụ mmiri ogbe nke gafere MCL maka fluoride "ga-agwa ndị ọrụ nke sistemụ ahụ rụọ ọrụ ozugbo ọ bara uru, mana ọ gafere 30 ụbọchị mgbe sistemu ahụ matara maka mmebi ahụ." Ogbe 143
Na 1975, EPA setịpụrụ ọkwa kachasị mmetọ (MCL) maka fluoride na mmiri ọ drinkingụ atụ na 1.4 na 2.4 milligram kwa lita. 144 Ha guzobere oke a iji gbochie ọrịa fluorosis eze. Na 1981, South Carolina rụrụ ụka na eze fluorosis bụ naanị ịchọ mma, na steeti rịọrọ EPA ka ewepu MCL maka fluoride. 145 N'ihi nke a, na 1985, EPA guzobere ihe mgbaru ọsọ kachasị emerụọ emerụ (MCLG) maka fluoride na 4 milligram kwa lita. 146 Karia fluorosis eze na-arụ ọrụ dị ka njedebe nchekwa (nke ga-achọ ọkwa nchekwa dị ala), e guzobere ọkwa a dị elu dị ka ụzọ iji chebe megide fluorosis skeletal, ọrịa ọkpụkpụ nke oke fluoride kpatara. N'iji fluorosis nke skeletal mee ihe dika ihe ndi ozo mekwara ka mgbanwe nke MCL maka fluoride, nke eweputara na 4 milligram kwa lita na 1986. 147 Ma, etinyere onu ogwu uzo dika SMPL maka fluoride nke 2 miligram kwa lita, nke edebekwara na 1986. 148
Esemokwu malitere na iwu ọhụrụ ndị a, ọbụnakwa rụpụtara ọrụ iwu megide EPA. South Carolina kwusiri ike na ọ dịghị mkpa maka MCLG ọ bụla (ihe mgbaru ọsọ kachasị emetọ) maka fluoride, ebe Council Council na-agbachitere Natural Resources na-ekwu na a ga-eweda MCLG dabere na eze fluorosis. 149 Alọ ikpe kpebiri na ihu ọma EPA, mana na nyocha nke ụkpụrụ fluoride, EPA kpọbatara National Research Council (NRC) nke National Academy of Sciences iji tụleghachi ihe egwu ahụike nke fluoride.150 151
Nkwupụta ahụ sitere na National Research Council, nke ewepụtara na 2006, kwubiri na EPA's MCLG (ebumnuche kachasị njọ) maka fluoride kwesịrị iweda ya. 152 Na mgbakwunye na ịmata ikike nke fluoride na osteosarcoma (ọrịa cancer ọkpụkpụ), 2006 Nchịkọta Council Council na-ekwu banyere nchegbu gbasara mmetụta musculoskeletal, ọmụmụ na mmepe, mmetụta neurotoxicity na neurobehavioral, genotoxicity na carcinogenicity, na mmetụta dị na akụkụ ahụ ndị ọzọ. 153
NRC kwubiri na MCLG maka fluoride kwesịrị ịgbada na 2006, mana EPA ka ga-agbadata ọkwa ahụ. 154 Na 2016, Fluoride Action Network, IAOMT na ọtụtụ ndị ọzọ na ndị mmadụ rịọrọ EPA ka ọ kpuchido Ọhaneze, ọkachasị ndị nwere ike ịnwe ike, site na nsogbu nke fluoride site na igbochi mgbakwunye mgbakwunye fluoride na mmiri ọ drinkingụ.155ụ. 2017.156 EPA ekweghị arịrịọ ahụ na February XNUMX
Nkeji 5.2: Bottled Water
Dị ka ntacha eze na ọtụtụ ngwaahịa eze, mmiri mmiri nwere ike ịnwe fluoride.
Administrationlọ Ọrụ Na-ahụ Maka Ọgwụ na Ọgwụ na United States (FDA) bụ ọrụ maka ijide n'aka na ụkpụrụ maka mmiri a gbanyere na mmiri dabara na ụkpụrụ maka mmiri mgbata nke EPA 157 setịpụrụ na ọkwa akwadoro nke US Public Health Service (PHS) setịpụrụ. 158 FDA na-anabata mmiri mmiri mmiri nke na-eme ihe kwekọrọ na ya 159 iji tinye asụsụ na-ekwu na ị drinkingụ mmiri fluorid nwere ike belata ihe ize ndụ nke ire ere ezé.160
Nkebi 5.3: Nri
FDA kpebiri iwelata mgbakwunye nke ogige fluorine na nri maka ọdịmma ahụike ọha na 1977. 161 Agbanyeghị, fluoride ka dị na nri n'ihi nkwadebe na mmiri fluorid, ikpughe ọgwụ na pesticides na ihe ndị ọzọ. Na 2004, Ngalaba Ọrụ Ugbo nke United States (USDA) malitere ebe nchekwa data nke fluoride n'ọtụtụ ihe ọveraụveraụ na ihe ọveraụveraụ na nri, wee bipụta akụkọ nwere akwụkwọ zuru ezu na 2005.162. mụbara n'ime afọ iri gara aga n'ihi iji fluoride eme ihe ugbu a karịa ọgwụ ahụhụ. 163 Somefọdụ ihe mgbakwunye nri na-enweghị isi ugbu a na-enwe fluoride.164
Na mgbakwunye, na 2006, Kansụl Na-eme Nchọpụta Na-atụ aro ka “iji nyere aka na ịtụle nnabata fluoride ọ bụla site na ingestion, ndị nrụpụta na ndị na-emepụta kwesịrị inye ozi banyere fluoride ọdịnaya nke nri na mmanya ọ ”ụ .ụ.” n'ọdịnihu dị nso. Na 165, FDA degharịrị akwụkwọ nri ya chọrọ maka aha Nutrition na Supplement Facts ma kpebie na nkwupụta nke ọkwa fluoride bụ afọ ofufo maka ngwaahịa ndị ejiri ụma gbakwunye fluoride na ngwaahịa ndị na-eme fluoride n'ụzọ nkịtị.2016 N'oge ahụ, FDA adịghị eguzobe Ihe Ntuziaka Kwa (bọchị (DRV) maka fluoride. 166
N'ụzọ megidere nke ahụ, na 2016, FDA machibidoro perfluoroalkyl ethyl nke nwere ihe oriri na-akpọtụrụ nri (PFCSs), nke a na-eji dị ka ndị na-ere mmanụ na mmiri maka akwụkwọ na akwụkwọ. 168 Emere ihe a site na data toxicological na arịrịọ nke Council Natural Defense Defense Council na ndị ọzọ dị iche iche gbara akwụkwọ.
Ndị ọzọ karịa ntụle ndị a maka fluoride na nri, na-eme ka ọkwa fluoride dị mma na nri n'ihi ọgwụ ahụhụ na -ekere, FDA, EPA, na Ngalaba Nchekwa Nri na Nnyocha nke ngalaba US Agriculture.
Nkebi 5.4: Pesticides
Pesticides rere ma ọ bụ kesaa na US ga-aha na EPA, na EPA nwere ike igosipụta ndidi maka pesticide fọduru ma ọ bụrụ na ngosipụta si nri na-e weere dị ka "mma."
Na nke a, ọgwụ ọgụ abụọ nwere fluoride bụ ihe esemokwu:
1) Edebara Sulfuryl fluoride edebanye aha na 1959 maka ịchịkwa oge na usoro osisi 171 yana 2004/2005 maka ịchịkwa ụmụ ahụhụ na nri esiri esi, dị ka ọka ọka, mkpụrụ osisi a mịrị amị, akụ osisi, agwa koko, agwa kọfị, yana nri njikwa na nhazi ihe oriri. 172 Ọnọdụ nke nsị mmadụ na ọbụna ọnwụ, ọ bụ ezie na ọ dị obere, ejikọtara ya na sulfuryl fluoride metụtara ụlọ ndị a na-agwọ pesticide.173 Na 2011, n'ihi nyocha emelitere na nchegbu nke Fluoride Action Network ( FAN), EPA kwuru na sulfuryl fluoride anaghịzi agbaso ụkpụrụ nchekwa yana na ndidi maka pesticide a ga-ewepụ ya. 174 Na 2013, ụlọ ọrụ na-egbu pesticide gbalịsiri ike ime ka echiche EPA kwụsị iwepụta sulfuryl fluoride, yana EPA tụgharịrị site na ndokwa gụnyere na 2014 Farm Bill. 175
2) Cryolite, nke nwere sodium aluminom fluoride, bụ ahụhụ nke edebara aha mbụ ya na EPA na 1957.176 Cryolite bụ ọgwụ puruoride bụ isi nke eji eme ihe na nri na US (ebe a na-eji sulfuryl fluoride mee ihe dị ka onye na-eri nri na nri ụta) . A na-eji Cryolite mee na citrus na mkpụrụ osisi okwute, akwụkwọ nri, mkpụrụ osisi, na mkpụrụ vaịn, 177 na ndị mmadụ nwere ike kpughere ya site na nri ha, ebe cryolite nwere ike ịhapụ nri fluoride na nri nke etinyere ya na ya. sulfuryl fluoride, EPA kwukwara na ọ ga-ewepụ nnabata fluoride na pesticides.178 Nke a ga-abụrịrị na ọ gụnyere cryolite; otu o sila dị, dị ka e kwuru n’elu, a gbanwere atụmatụ a.
Nkebi nke 5.5: Ngwa eze maka iji n'ụlọ
FDA na-achọ ịkọ aha maka "ọgwụ ndị na-egbochi ọgwụ ọgwụ" a na-ere n'elu-na-counter, dị ka ntacha eze na asacha ọnụ. Specific wording maka labeling ẹkedọhọde dị ka ụdị nke
Ngwaahịa (yabụ gel ma ọ bụ mado ya ma sachaa ya), yanakwa site na mgbakorọ fluoride (yabụ 850-1,150 ppm, 0.02% sodium fluoride, wdg.). 180 Wdọ aka na ntị na-ekewa site na ọgbọ dị iche iche (yabụ afọ abụọ na okenye, n'okpuru isii) , Afọ 12 na okenye, wdg). Somefọdụ ịdọ aka na ntị metụtara ngwaahịa niile, dị ka ndị a:
(1) Maka ngwaahịa fluoride dentifrice (gel, mado, na ntụ ntụ). “Emela ka ụmụaka ndị na-erubeghị afọ isii ghara iru ya. Ọ bụrụ na ihe karịrị iji ya mee ihe ezé ezé, ọ bụrụ na o nweghị ihe ọzọ ejiri ya, chọọ enyemaka ahụike ma ọ bụ kpọtụrụ ebe a na-ahụ maka nsị. ”6
(2) Maka fluoride itucha na ọgwụ mgbochi gel ngwaahịa. “Anọchila ụmụaka. Ọ bụrụ na ihe karịrị iji ya '' (họrọ okwu kwesịrị ekwesị: '' ihichapụ 'ma ọ bụ' ịsachasị ') "" loro na mberede, kpọọ enyemaka ahụike ma ọ bụ kpọtụrụ Poison Control Center ozugbo. "
Otu isiokwu nyocha bipụtara na 2014 kpalitere nchegbu dị mkpa gbasara aha a. Kpọmkwem, ndị ode akwụkwọ gosipụtara na ihe karịrị 90% nke ngwaahịa ha nyochapụtara depụtara ịdọ aka ná ntị FDA maka naanị ụmụaka gafere afọ abụọ na azụ nke tub nke ezé ezé na obere font.183 A na-akọkwa ụdị ọnọdụ ahụ maka ịdọ aka na ntị sitere na American Dental Association (ADA), nke bu otu ndi ahia na abughi ndi ochichi. Ndị ọrụ nyocha ahụ dere na ihe niile ezé ezé ahụ nwere nkwado ma ọ bụ nnabata nke ADA debere ịdọ aka na ntị ADA (na ụmụaka kwesịrị iji obere ezé ezé ma bụrụ ndị okenye ga-ahụ maka ibelata ihe) na azụ ọkpọ ahụ na obere font .184 Marketing azum bu
achọpụtara ọzọ dị ka ịkwado eze dị ka a ga - asị na ọ bụ ngwaahịa nri, nke ndị nyocha ahụ kwenyere bụ ụzọ aghụghọ nke nwere ike ibute ụmụaka ka ha ilo ngwaahịa ahụ. 185
Agbanyeghi na FDA were onodu ahihia mee ihe dika ihe Klas I, a na ewere 186 floss dent nke nwere fluoride (nke na adighi ike fluoride) dika ihe mejuputara
Ihe omumu ihe mbu .188 Dental floss nwekwara ike ịnwe fluoride n'ụdị ogige perfluorinated; 189 agbanyeghị, enweghị usoro iwu nchịkwa gbasara ụdị fluoride dị na eze.
enwere ike ịchọta ya site n'aka ndị edemede nke akwụkwọ ọkwa a.
Nkebi nke 5.6: Ngwa eze maka iji na Dental Office
A na-achịkwa imirikiti ihe eji arụ ọrụ na eze eze nke nwere ike ịhapụ fluoride dị ka ngwaọrụ ahụike / eze, dịka ụfọdụ ihe na-ejuputa ihe, 190 191 ụfọdụ ciment, 192 na ụfọdụ ihe resin mejupụtara. 193 Karịsịa, ọtụtụ n'ime ndị a eze ihe na nkewa eze dị ka Class II Medical Devices, 194 nke pụtara na FDA na-enye "mmesi obi ike dabara adaba na nchekwa ngwaọrụ yana arụmọrụ ya" na-edoghị ngwaahịa ahụ n'ọkwa kachasị nke njikwa usoro.195 N'ụzọ dị oke mkpa, dịka akụkụ nke nhazi ọkwa nke FDA. usoro, ngwaọrụ eze na fluoride ka a na-ahụta dịka ngwaahịa, 196 na profaịlụ ntọhapụ fluoride ka a na-atụ anya ka enye dị ka akụkụ nke ọkwa azụmaahịa maka ngwaahịa a. 197 FDA gara n'ihu kwuo, sị: “Nkwupụta nke mgbochi oghere ma ọ bụ uru ọgwụgwọ ndị ọzọ bụ kwere ma ọ bụrụ na ị na-akwado data ahụike site na nchọpụta nke IDE [Nnyocha Ngwaọrụ Nnyocha]. ” 198 Ọzọkwa, mgbe FDA na-ekwupụta n'ihu ọha banyere usoro nke ịhapụ fluoride nke ụfọdụ ngwaọrụ mweghachi eze, FDA anaghị akwalite ha n'ihu ọha na weebụsaịtị ha iji mee ihe na mgbochi caries.199
N'otu aka ahụ, ọ bụ ezie na a kwadoro vorọlọ fluoride dị ka Ngwaọrụ Ahụike nke II maka iji ya dị ka oghere oghere na / ma ọ bụ ezé ezé ezé, a kwadoghị ha iji mee ihe na mgbochi caries. 200 Ya mere, mgbe a na-azọrọ maka igbochi caries banyere ngwaahịa dịbu na-agwakọta ya na fluoride agbakwunyere, nke a na-ewere FDA dị ka ọgwụ a na-akwadoghị, nke a na-akwa iko. Tụkwasị na nke ahụ, ụkpụrụ FDA na-eme ka dọkịta / dọkịta ezé n'onwe ya nwee ike iji ọgwụ ọjọọ eme ihe. Ogbodo 201
Tụkwasị na nke ahụ, na 2014, FDA kwere ka iji ọlaọcha diamine fluoride mee ihe maka mbenata nha nha nha. 202 N'isiokwu bipụtara na 2016, kọmitii na Mahadum California, San Francisco, oflọ Akwụkwọ Dentistry, ghọtara nke ahụ, na-enweghị aha iji ọlaọcha diamine fluoride (dị ka nchịkwa caries) bụ nke iwu kwadoro ugbu a, ọ dị mkpa maka ntuziaka, usoro iwu, na nkwenye ziri ezi. 203
Ihe ọzọ dị mkpa iji rịba ama bụ na ntụ ọka nwere fluoride nke eji mee ihe n'oge prophylaxis (nhicha) nwere ọkwa dị elu nke fluoride karịa ezé ezé ere (ya bụ 850-1,500 ppm na ezé ezé ezé 204 na 4,000-20,000 ppm fluoride na prophy paste205). FDA ma ọ bụ ADA anaghị anabata ntụ ọka fluoride dị ka ụzọ dị mma iji gbochie caries ezé. 206
Nkebi nke 5.7: Ọgwụ Ọgwụ (Gụnyere Ntinye)
A na-ama ụma etinye fluoride na ọgwụ ọgwụ (tụlee, mbadamba, na lozenges ndị a na-akpọkarị "mgbakwunye" ma ọ bụ "vitamin") bụ nke a na-enyekarị maka ụmụaka, na-ekwu na ọ ga-egbochi oghere. Na 1975, FDA kwuru banyere iji mgbakwunye fluoride site na iwepu ngwa ọgwụ ọhụrụ maka Ernziflur fluoride. Mgbe ihe FDA mere na Ernziflur lozenges bụ
bipụtara na Federal Register, otu isiokwu pụtara na Ọgwụ Ọgwụ na-ekwupụta na nkwenye FDA wepụrụ "n'ihi na enweghị nnukwu ihe akaebe nke arụmọrụ ọgwụ dị ka edepụtara, atụ aro, ma ọ bụ na-atụ aro na akara ya." 207 208 Isiokwu ahụ kwukwara, sị: " Ya mere FDA nyere ndị na-emepụta ngwakọta fluoride na vitamin nkwadebe na ha
ịga n'ihu ahịa bụ imebi usoro ọgwụ ọhụrụ nke Federal Food, Drug, and Cosmetic Act; n'ihi ya, ha rịọrọ ka a kwụsị ire ahịa ngwaahịa ndị a. ”209 210
Na 2016, FDA zipụkwara akwụkwọ ozi ịdọ aka na ntị ọzọ banyere otu mbipụta nke ọgwụ ọhụrụ a na-akwadoghị n'ọtụtụ ụdị gụnyere mgbakwunye nri fluoride nke edebara na 1975. Akwụkwọ ozi, akara ụbọchị
E zigara Jenụwarị 13, 2016 na Kirkman Laboratories gbasara ụdị anọ dị iche iche nke plọatric fluoride concoctions akpọrọ dị ka enyemaka na mgbochi nke caries ezé.211 Akwụkwọ ozi ịdọ aka na ntị nke FDA nyere ụlọ ọrụ 15 ụbọchị iji kwenye na iwu212 ma rụọ ọrụ dị ka Ihe omuma atu ozo nke umuaka n’enye ndi mmadu nsogbu n’adighi njikere, nke bu okwu di na US karie iri ano.
Ka ọ dị ugbu a, a na-agbakwunye fluorine na ọgwụ ndị ọzọ na-ere ọgwụ. Somefọdụ ihe ndị a chọpụtarala maka ọgwụ mgbakwunye ya na-agụnye azọrọ na ọ nwere ike “ịbawanye ọgwụ ọgwụ
Nhọrọ, mee ka ọ na-agbaze na abụba, ma belata ọsọ nke ọgwụ ọgwụ ọgwụ, si otú a na-enye ya oge ka ọ na-arụ ọrụ. ” E mere atụmatụ na 213 20-30% nke ogige ọgwụ nwere fluor.214 offọdụ ọgwụ ndị kachasị ewu ewu gụnyere Prozac, Lipitor, na Ciprobay (ciprofloxacin), 215 yana ndị ọzọ nke ezinụlọ fluoroquinolone (gemifloxacin [ahịa dị ka Factive], levofloxacin [ahịa dị ka Levaquin], moxifloxacin [ahịa dị ka Avelox], norfloxacin [ahịa dị ka Noroxin], na nkeloxacin [ahịa dị ka Floxin na ọnyà ofloxacin]).
216
N'ihe banyere fluoroquinolones, FDA nyere ịdọ aka ná ntị ọhụrụ banyere igbochi mmetụta dị na 2016, afọ mgbe emechara ọgwụ ndị a n'ahịa. Na ọkwa ọkwa ha nke July 2016, FDA kwuru, sị:
A na - ejikọta ọgwụ ndị a na nkwarụ na mmetụta na - adịgide adịgide nke akwara, akwara, nkwonkwo, irighiri akwara, na usoro nhụjuanya nke etiti nwere ike ime n'otu onye ọrịa. N'ihi ya, anyị degharịrị Boxed Warning, ịdọ aka ná ntị kachasị ike nke FDA, iji dozie nsogbu nchekwa ndị a. Anyị gbakwunyekwara ịdọ aka ná ntị ọhụrụ ma melite akụkụ ndị ọzọ nke ọgwụ ọgwụ, gụnyere Ntuziaka Ọgwụ Ọrịa.217
N'ihi mmetụta ndị a na-akụda mmụọ, FDA dụrụ ọdụ na a ga-eji ọgwụ ndị a eme ihe naanị mgbe enweghị usoro ọgwụgwọ ọzọ maka ndị ọrịa n'ihi na ihe egwu dị na ya karịrị
uru.218 N'oge nke ọkwa 2016 FDA a, e mere atụmatụ na ihe karịrị nde ndị America 26 na-a drugsụ ọgwụ ndị a kwa afọ. 219
Nkebi nke 5.8: Perfluorinated Compounds
Per- na polyfluoroalkyl bekee (PFASs), nke a na-akpọkwa ogige ndị na-esi ísì ụtọ ma ọ bụ kemịkal perfluorinated (PFCs), bụ ihe eji eme ihe na kapeeti, ndị na-ehicha ihe, uwe, ihe esi nri,
nkwakọ nri, agba, akwụkwọ, na ngwaahịa ndị ọzọ n'ihi na ha na-enye nguzogide ọkụ na mmanụ, unyi, griiz, na mmiri na-asọ oyi. 220 221 Dịka ọmụmaatụ, a na-eji perfluorooctanoic acid (PFOA) mee polytetrafluoroethylene (PTFE), nke a na-eji na Teflon , Gore-tex, Scotchguard, na Stainmaster.222
Kaosinadị, mgbe ihe karịrị ndị sayensị 200 sitere na mba 38 banyere na "Nkwupụta nke Madrid" na 2015, a kpọsara nchegbu 223 banyere ụdị ihe ndị a na ụzọ ha nwere ike isi nweta ọrịa.
Na mgbakwunye, na 2016, EPA kwuru banyere PFSAs:
Nnyocha na-egosi na ikpughe PFOA na PFOS n'ọtụtụ ọkwa nwere ike ịkpata nsogbu ahụike, gụnyere nsonye mmepe maka ụmụaka ebu n'afọ n'oge ime ime ma ọ bụ nye ụmụ ọhụrụ ara (eg, obere ibu ọmụmụ, ọganihu ngwa ngwa, oge mgbanwe afọ), cancer (eg, testicular , akụrụ), imeju mmetụta (eg, mmebi anụ ahụ), mmetụta na-enweghị ike (dịka, mmepụta antibody na ọgụ), yana mmetụta ndị ọzọ (dịka, mgbanwe cholesterol) .225
Yabụ, na United States, mbọ na nso nso a malitere ibelata ojiji nke kemịkal ndị a. Dịka ọmụmaatụ, na 2016, EPA nyere ndụmọdụ gbasara ahụike maka PFOA na PFOS na mmiri ọ drinkingụ drinkingụ, na-achọpụta ọkwa dị na ma ọ bụ n'okpuru nke nsogbu ahụike na-atụghị anya na ọ ga-eme n'oge ndụ ọhụụ dịka akụkụ 0.07 kwa ijeri (akụkụ 70 kwa ijeri) maka PFOA na PFOS.226 Dịka ihe atụ ọzọ, na 2006, EPA sonyeere ndị ọrụ ya na ụlọ ọrụ asatọ site na mmemme nlekọta maka ụlọ ọrụ asatọ a iji belata ma kpochapụ PFOA site na 2015.227 N'agbanyeghị nke ahụ, EPA nwere
edere na ha "na-echegbu onwe ha" banyere ụlọ ọrụ na-emepụta ngwaahịa ndị a na-esonyeghị na mmemme a. 228
Nkebi 5.9: Ọrụ
Ngosipụta nke fluorides (fluoride, perfluoride) na-arụ ọrụ na-achịkwa &lọ Ọrụ Nchedo na Ahụike (OSHA). Ihe ahụike kachasị echebara maka ụkpụrụ ndị a bụ fluorosis skeletal, yana ụkpụrụ njedebe maka ikpughe ọrụ na fluorides ka edepụtara dịka 2.5 mg / m3.229
N'ime akwụkwọ 2005 bipụtara na International Journal of Health and Environmental Health ma gosipụta ya na American College of Toxicology Symposium, onye edemede bụ Phyllis J. Mullenix, PhD, mere ka a mata mkpa ọ dị maka nchekwa ọrụ ebe ka mma site na fluorides.230 Kpọtụrụ, Dr. Mullenix dere na ka ụkpụrụ fluoride dịgidere:
Naanị n'oge na-adịbeghị anya enwere data na-egosi na ọ bụghị naanị na ụkpụrụ ndị a enyela nchebe zuru oke maka ndị ọrụ ekpughere fluorine na fluorides, mana na ọtụtụ iri afọ ụlọ ọrụ enwetala ozi dị mkpa iji chọpụta ụkpụrụ 'erughị eru na ịtọ ntọala mbata nke oke nchekwa. Ogbe 231
Na nyocha nke 2006 nke National Research Council (NRC) nke National Academy of Sciences nke a tụlere ihe egwu ahụike nke fluoride, e welitere nchegbu gbasara mkpakọrịta nwere ike ịdị n'etiti fluoride na osteosarcoma (ọrịa kansa ọkpụkpụ), mgbaji ọkpụkpụ, akwara mgbu, omumu na uto uto, neurotoxicity na neurobehavioral mmetụta, genotoxicity na carcinogenicity, na utịp ke ọzọ ngwa usoro.232
Kemgbe ewepụtara akụkọ NRC na 2006, a na-ebipụta ọtụtụ nyocha nyocha ndị ọzọ dị mkpa. N'ezie, na arịrịọ nwa amaala 2016 nye EPA site na Fluoride Action Network (FAN), IAOMT na ndị ọzọ, Michael Connett, Esq., Onye isi iwu nke FAN, nyere ndepụta nke nchọpụta ọhụụ gosipụtara mmerụ site na fluoride, nke dị oke mkpa, ọkachasị n'ihi ọnụọgụ ọmụmụ ụmụ mmadụ ndị ọzọ: 233
Na mkpokọta, ndị na-arịọ arịrịọ achọpụtala ma tinye akwụkwọ ọmụmụ 196 bipụtara nke kwuru okwu banyere mmetụta neurotoxic nke ikuku fluoride na-esote nyocha nke NRC, gụnyere ọmụmụ mmadụ mmadụ 61, ọmụmụ ụmụ anụmanụ 115, nyocha mkpụrụ ndụ 17, yana nyocha nyocha 3.
Ihe omumu mmadu nke post-NRC gunyere:
• Ihe ọmụmụ 54 na-enyocha mmetụta nke fluoride na arụmọrụ, gụnyere ma ọ bụghị nanị na IQ, na ihe niile ma 8 nke ọmụmụ a na-achọpụta ọnụ ọgụgụ
mkpakọrịta n'etiti etiti ọkụ na nghọta mperi.234
• Nnyocha 3 na-enyocha mmetụta fluoride na ụbụrụ nwa ebu n'afọ, na nke ọ bụla n'ime ihe ọmụmụ 3 na-akọ mmetụta na-emetụta
• Nnyocha 4 na-enyocha mkpakọrịta fluoride na ụdị ndị ọzọ na-adịghị emerụ ahụ, gụnyere ADHD, gbanwere omume nwa ọhụrụ, na mgbaàmà dị iche iche dị iche iche.236
Ihe omumu ihe omuma nke post-NRC gunyere:
• Ihe ọmụmụ 105 na-enyocha ikike nke fluoride iji mepụta mgbanwe neuroanatomical na neurochemical, yana ihe niile mana 2 nke ọmụmụ ahụ na-achọta opekata mpe otu ihe ọghọm na opekata mpe otu usoro nyocha a nwalere.237
Ihe ọmụmụ 31 na-enyocha mmetụta nke fluoride na mmụta na ebe nchekwa, yana naanị otu n'ime ọmụmụ na-achọpụta opekata mpe mmetụta na-emebi na otu ndị a na-emeso fluoride.238
• Nnyocha 18 na-enyocha mmetụta nke fluoride na mpaghara ndị ọzọ nke neurobehavior ma e wezụga mmụta na ebe nchekwa, yana ihe niile ma otu n'ime ọmụmụ ahụ na-achọpụta mmetụta.239
Ihe omumu ihe omuma nke post-NRC gunyere:
• Nnyocha 17, gụnyere ọmụmụ 2 nke nyochachara ma chọta nsonaazụ na ọkwa fluoride nke na-eme n'ọbara nke ndị America bi na obodo fluoridated.240
Na mgbakwunye na nkuzi ndị a dị n'elu, Ndị na-arịọ arịrịọ na-edo onwe ha ụzọ nyocha atọ nke NRC nke akwụkwọ, gụnyere abụọ na-ekwu maka akwụkwọ mmadụ / IQ, na nke ahụ
na-ekwu banyere akwụkwọ anụmanụ / cognition. 241
O doro anya na ọtụtụ isiokwu nyocha achọpụtalarị ihe nwere ike imerụ mmadụ ahụ na fluoride na ọkwa dịgasị iche iche, gụnyere ọkwa dị ka ihe nchekwa. Ọ bụ ezie na nke ọ bụla n'ime isiokwu ndị a kwesịrị nlebara anya na mkparịta ụka, edepụtara ndepụta dị n'okpuru n'okpuru ụdị nkọwa zuru oke nke mmetụta ahụike metụtara ikuku fluor, nke gosipụtara isi akụkọ na ọmụmụ dị mkpa.
Nkebi nke 6.1: Skeletal System
Fluoride nke ana-abanye n’ime ahụ mmadụ na-abanye n’ọbara site na akụkụ nri nri.242 Imirikiti fluoride a na - ahapụ anaghị anyụchaa mamịrị na - echekwa n’ime ahụ. A na - ekwukarị na 99% nke fluoride a bi na ọkpụkpụ, 243 ebe a na - etinye ya na ngwongwo kristal ma na - agbakọta oge. nke anyi kpughere.
N'ezie, na akụkọ 2006 ya, mkparịta ụka nke National Research Council (NRC) banyere ihe egwu nke ọkpụkpụ ọkpụkpụ site na oke fluoride gosipụtara nyocha dị mkpa. Kpọmkwem,
Akụkọ ahụ kwuru, sị: “N'ozuzu ya, ndị kọmitii ahụ kwenyere na e nwere ihe sayensị na-egosi na n'okpuru ọnọdụ ụfọdụ, fluoride nwere ike ime ka ọkpụkpụ daa mbà ma mee ka ohere nke mgbawa dịkwuo elu.”
Nkebi nke 6.1.1: Ọrịa eze
Ngosipụta nke oke fluoride na ụmụaka bụ ihe a maara na-akpata fluorosis eze, ọnọdụ nke enamel ezé na-emebi kpamkpam na ezé na-agbanwe kpamkpam, na-egosipụta ụkpụrụ na-acha ọcha ma ọ bụ na-acha aja aja ma na-akpụ ezé na-agbawa agbawa na-agba agba na-adị mfe.246 It bụ ihe sayensị matara kemgbe afọ 1940 na-ekpughepụkarị ihe na fluoride na-ebute ọnọdụ a, nke nwere ike ịmalite site na obere nwayọ na oke. Dị ka data sitere na erslọ Ọrụ Maka Nchịkwa na Mgbochi Ọrịa (CDC) wepụtara na 2010, 23% nke ndị America dị afọ 6-49 na 41% nke ụmụaka dị afọ 12-15 na-egosipụta fluorosis ruo ogo ụfọdụ. 247 Ndị a dị egwu na-abawanye na ọnụego nke fluorosis eze. bụ ihe dị mkpa na mkpebi nke Ọha Ahụike Ọha na eze kpebiri iji belata ọkwa mmiri fluoridation ya na 2015.248
Nyocha 1: Dentro fluorsis Ranging sitere na nro di nro
(Foto sitere n'aka Dr. David Kennedy ma jiri ya mee ihe site na ikikere site n'aka ndị ọrịa eze na-arịa.)
Foto nke Fluorosis Dental, ihe ịrịba ama mbụ nke nsi fluoride, sitere na nke dị nwayọọ ruo oke njọ; Foto nke Dr. David Kennedy sere ma jiri ikike nke ndị ọrịa fluorosis metụtara
Nkebi 6.1.2: Skeletal Fluorosis na Ogbu na nkwonkwo
Dị ka eze fluorosis, skeletal fluorosis bụ mmetụta a na - apụghị ịgbagha agbagha nke oke ngosipụta na fluoride. Skeletal fluorosis na-eme ka okpukpu buru ibu, mgbu nkwonkwo, oke nkwonkwo nkwonkwo, na
nsogbu siri ike, ọkpụkpụ azụ kpamkpam.249 Ọ bụ ezie na a na-ewere ya dị ka ihe na-adịghị ahụkebe na US, ọnọdụ ahụ na-eme, 250 na nso nso a ka atụpụtara na skeletal fluorosis nwere ike ịbụ nke okwu ahụike ọha na eze karịa nke a maara na mbụ
Dika nyocha edeputara na 2016, ekwuputabeghi otutu nkwekorita nke sayensi banyere uzo fluoride na / ma obu ogologo uzo fluoride kwesiri ibanye tupu skeletal fluorosis eme. Ogbe 252
Ọ bụ ezie na ụfọdụ ndị ọchịchị ekwuola na ọkpụkpụ fluorosis na-eme naanị mgbe afọ 10 ma ọ bụ karịa gosipụtara, nyocha egosiwo na ụmụaka nwere ike ibute ọrịa na obere ọnwa isii, 253
na ụfọdụ ndị okenye etolitela ya ihe dị ka afọ abụọ ma ọ bụ asaa.254 N'otu aka ahụ, ebe ụfọdụ ndị isi nyere aro na 10 mg / ụbọchị nke fluoride dị mkpa iji mepụta skeletal fluorosis, nyocha egosila na ọkwa dị ala karị nke ikpughe na fluoride (na ụfọdụ ikpe na-erughị 2ppm) nwekwara ike ịkpata ọrịa ahụ. 255 Ọzọkwa, nchọpụta e bipụtara na 2010 gosipụtara na mmeghachi omume anụ ahụ na fluoride dịgasị iche site na mmadụ. 256
N'ebe ndị ọrịa nwere ọrịa fluorosis, a na-enyo fluoride na ọ na-akpata hyperparathyroidism nke abụọ na / ma ọ bụ na-akpata mmebi ọkpụkpụ nke yiri hyperparathyroidism nke abụọ. Ọnọdụ a, nke na-ebutukarị na ọrịa akụrụ, na-ebute mgbe ọkwa nke calcium na phosphorous n'ime ọbara dị oke ala. 257 Ọtụtụ nyocha ndị Fluoride Action Network (FAN) chịkọtara na-enyocha ohere nke fluoride bụ otu na-enye aka na mmetụta ahụike a. Ogbe 258
Ebe ọ bụ na mgbaàmà ogbu na nkwonkwo jikọtara ya na skeletal fluorosis, ogbu na nkwonkwo bụ ebe ọzọ a na-echegbu onwe ya n'ihe metụtara ngosipụta fluoride. Karịsịa na nke a, nyocha ejiri fluoride jikọtara ya na ọrịa ogbu na nkwonkwo, ma ma ọ bụ na-enweghị ọkpụkpụ fluorosis.259 Tụkwasị na nke ahụ, ejikọtara nkwonkwo nkwonkwo oge (TMJ) na eze na ọkpụkpụ fluorosis.260
Nkebi nke 6.1.3: Ọrịa cancer nke Ọkpụkpụ, Osteosarcoma
Na 2006, NRC kwurịtara njikọ dị n'etiti ekpughere fluoride na osteosarcoma. Achọpụtala ụdị ọrịa kansa nke a dị ka "nke isii nke ọrịa cancer kachasị njọ na ụmụaka na nke atọ kachasị njọ maka ndị nọ n'afọ iri na ụma." 261 NRC kwuru na ọ bụ ezie na ihe akaebe na-agbanwe agbanwe, fluoride pụtara na ọ nwere ikike iji kwalite ọrịa kansa Ochie 262
Ha kọwapụtara na osteosarcoma bụ nnukwu nchegbu, ọkachasị n'ihi fluoride na-etinye ọkpụkpụ na mmetụta mitogenic nke fluoride na mkpụrụ ndụ ọkpụkpụ.263
Ọ bụ ezie na ụfọdụ ọmụmụ enwebeghị ike ịchọta mkpakọrịta dị n'etiti fluoride na osteosarcoma, dịka nchọpụta nke Dr. Elise Bassin mechara mgbe ọ nọ na Harvard School of Dental Medicine, ikpughe na fluoride na ọkwa ndị a tụrụ aro metụtara njikọta okpukpu asaa nke osteosarcoma mgbe ụmụ nwoke nọ ekpughere n'agbata afọ ise na asaa.264 nyocha Bassin, nke e bipụtara na 2006, bụ naanị ọmụmụ gbasara osteosarcoma nke werela ihe ọghọm dị afọ na akaụntụ.265
Nkebi nke 6.2: Sistem na-akpata ụjọ
Emeela ka fluoride nwee ike imetụta ụbụrụ. NRC na 2006, NRC kọwara: “Site na ozi nke sitere na ihe omumu ihe omumu, ihe omimi, na ihe omimi, o doro anya na fluorides nwere ikike igbochi oru nke aru na aru site na uzo ozo. . ”266 Ma oria ne Alzheimer na
A na-ekwukwa ọrịa na akụkọ NRC maka ịtụle dịka enwere ike ijikọ ya na fluoride.267
E gosipụtawo nchegbu ndị a. A na-enyocha ọmụmụ banyere fluoridation mmiri na IQ mmetụta nke ọma na nyocha edepụtara na October nke 2012 na Atụmatụ Ahụike Gburugburu Ebe obibi.268 Na nyocha a, ọmụmụ ihe 12 gosipụtara na obodo ndị nwere mmiri mmiri fluoridated n'okpuru 4 mg / L (nkezi nke 2.4 mg / L ) nwere obere IQ karịa ndị na-achịkwa ya. 269 Kemgbe e bipụtara nyocha nke 2012, ọtụtụ nyocha ndị ọzọ na-achọpụta IQs dị obere na obodo ndị na-erughị 4 mg / L nke fluoride na mmiri adịla. 270 Iji bụrụ nke ziri ezi karị, na arịrịọ nwa amaala na EPA na 2016, Michael Connett, Esq., Onye isi iwu na-akwado FAN, chọpụtara ihe ọmụmụ 23 na-akọ na ị belata IQ na mpaghara nke fluoride dị ugbu a nabatara dị ka nchekwa site na EPA.271
Ọzọkwa, na 2014, e bipụtara nyochaa na The Lancet nke isiokwu ya bụ "Neurobehavioral mmetụta nke mmepe toxicity." N'ime nyocha a, edepụtara fluoride dịka otu n'ime kemịkal mepere emepe iri na abụọ
mara na ọ na-ebute neurotoxicity na-eto eto na ụmụ mmadụ.272 Ndị nnyocha ahụ dọrọ aka ná ntị, sị: “Nkwarụ nkwonkwo nkwonkwo, gụnyere nkwarụ, nsogbu ọrịa anya, na nsogbu ndị ọzọ na-emetụtaghị uche, na-emetụta ọtụtụ nde ụmụaka gburugburu ụwa, ụfọdụ ndị na-eme nchọpụta na-arịwanye elu ugboro ugboro. Chemical Chemicals na-emerụ ụbụrụ na-etolite etolite so n'ihe ndị kpatara ihe ịrị elu a. - 273
Nkebi nke 6.3: Usoro obi
Dabere na ọnụọgụ edepụtara na 2016, ọrịa obi bụ ihe kacha akpata ọnwụ maka ụmụ nwoke na ụmụ nwanyị na US, ọ na-efu mba ahụ ijeri $ 207 kwa afọ. 274 Yabụ, ịmata
Mmekọrịta dị n'etiti fluoride na nsogbu obi dị mkpa ọ bụghị naanị maka usoro nchekwa iji guzobe fluoride kamakwa maka usoro mgbochi iji guzobe maka ọrịa obi.
A na-enyo na mkpakọrịta dị n'etiti nsogbu fluoride na ọrịa obi na ọtụtụ afọ. Nkwupụta 2006 NRC kọwara ihe ọmụmụ sitere na 1981 site n'aka Hanhijärvi na Penttilä nke kọọrọ elu fluoride dị elu na ndị ọrịa nwere nsogbu obi .275 Fluoride nwekwara njikọ metụtara ịkọwapụta akwara, 276 arteriosclerosis, ọrịa obi 277, 278 electrocardiogram abnormalities, 279 hypertension, 280 and Mmebi ahụ myocardial.281 Tụkwasị na nke a, ndị nchọpụta nke otu nnyocha sitere na China bipụtara na 2015 kwubiri, sị: “Nsonaazụ gosiri na, NaF [sodium fluoride], na ịta ahụhụ dabere na usoro na ọbụna na obere ịta nke 2 mg / L, gbanwere usoro ihe omimi nke cardiomyocytes, belata ike ịdị adị nke mkpụrụ ndụ, mụbaa njide nke obi obi, ma mekwuo ogo apoptosis. ”282
Nkebi 6.4: Usoro Endocrine
Enweela ihe ọmụmụ Fluoride na endocrine system, nke mejupụtara gland na-edozi homonụ. Na akụkọ 2006 NRC, ekwuru, sị: “Na nchịkọta, ihe akaebe nke ọtụtụ ụdị na-egosi na fluoride na-emetụta ọrụ ma ọ bụ mmeghachi omume endocrin nkịtị; mmetụta nke mgbanwe fluoride na-akpata na-adị iche na ogo na ụdị dị iche iche na ndị dị iche iche. ”283 2006 NRC akụkọ gara n'ihu gụnyere tebụl na-egosi etu esi achọpụta oke fluoride iji mebie ọrụ gị, ọkachasị mgbe ụkọ ayood dị ugbu a. 284 N'ime afọ ndị na-adịbeghị anya, emegharịrị mmetụta nke fluoride na sistemụ endocrine. Otu nnyocha e bipụtara na 2012 gụnyere sodium fluoride na ndepụta nke kemịkal na-akụda ọgwụ (EDCs) nwere mmetụta dị ala, 285 na nyocha ahụ ka edepụtara na akụkọ 2013 sitere na United Nations Environment Programme na World Health Organisation.286
Ka ọ dị ugbu a, ọnụọgụ ọnụọgụ nke ọrịa thyroid na-emetụta fluoride.287 Research bipụtara na 2015 site n'aka ndị nchọpụta na Mahadum Kent na Canterbury, England, kwuru na ọkwa dị elu nke fluoride na mmiri ọ drinkingụ drinkingụ nwere ike ịkọ ọkwa dị elu nke hypothyroidism. 288 Ha gara n'ihu ịkọwa: “N'ọtụtụ akụkụ ụwa, hypothyroidism bụ nnukwu nsogbu ahụike na mgbakwunye na ihe ndị ọzọ — dịka ụkọ iodine— ekpughere fluoride dị ka ihe so akpata ya. Ihe nchoputa nke ihe omumu a na-ewelite nchegbu banyere odi nma nke fluoridation nke obodo dika usoro nchebe nke ọha na eze. Ogbe 289
Dabere na ọnụọgụ nke forlọ Ọrụ Maka Mgbochi na Mgbochi Ọrịa (CDC) wepụtara na 2014, nde mmadụ 29.1 ma ọ bụ 9.3% nke ndị bi na-arịa ọrịa shuga.293 Ọzọkwa, ikike nke fluoride nwere na ọnọdụ a dị mkpa ịtụle. Nkwupụta 2006 NRC dọrọ aka ná ntị:
Nkwubi okwu a sitere na ihe omumu a bu na ekpughere fluoride zuru oke na-eme ka mmuta nke glucose ma obu nkwarụ nke glucose na ụfọdụ ndị mmadụ na-abawanye ogo nke ụfọdụ ụdị ọrịa shuga. N'ozuzu, glucose metabolism dị nro na-egosi na ọ na-ejikọta ọbara ma ọ bụ plasma fluoride nke ihe dị ka 0.1 mg / L ma ọ bụ karịa na anụmanụ na ụmụ mmadụ (Rigalli et al. 1990, 1995; Trivedi et al. 1993; de al Sota et al. 1997). 294
Nnyocha a jikọtara ọrịa shuga yana ike belata umepu fluoride na ahụ, 295 yana ọrịa (polydispsia-polyurea) nke na-ebute mmụba nke fluoride, 296 na
Nnyocha emewokwa ka mgbochi insulin na iguzogide fluoride.297
Ihe ọzọ na-enye nsogbu bụ na fluoride yiri ka ọ na-egbochi ọrụ nke pineal gland, nke na-enyere aka ịchịkwa usoro rhythms na homonụ circadian, gụnyere nhazi nke melatonin na homonụ ọmụmụ. Jennifer Luke nke Hospitallọ Ọgwụ Royal nke London achọpụtala nnukwu fluoride a gbakọtara na gland 298 wee gosipụta na ọkwa ndị a
nwere ike iru ihe ruru 21,000 ppm, na-eme ka ha dị elu karịa ogo fluoride na ọkpụkpụ ma ọ bụ ezé.299 Nnyocha ndị ọzọ ejikọtara fluoride na ogo melatonin, ụra nke 300, 301 na oge uto.
n'ime ụmụ agbọghọ, 302 yana ala ọmụmụ (gụnyere ụmụ nwoke) ma belata ọkwa testosterone.303
Nkebi 6.5: Renal System
Mmamịrị bụ ụzọ dị mkpa nke ekpopụ ọkụ maka fluoride, ma usoro akụrụngwa dị mkpa maka ịhazi ọkwa fluoride na ahụ. 304 305 Urinary excretion of fluoride bụ
mmamịrị pH, nri, ọnụnọ nke ọgwụ, na ihe ndị ọzọ na-emetụta. 306 Ndị na-eme nchọpụta nke akụkọ 2015 nke Royal Society of Chemistry bipụtara kọwara, sị: “Ya mere, plasma na ọnụego mwepụ nke akụrụ bụ oke nhazi ahụike nke nri fluoride kpebisiri ike, iji na mwepu n'ọkpụkpụ na ikike mwepụ nke fluoride site na akụrụ. ”307
Nkwupụta 2006 NRC n'otu aka ahụ ghọtara ọrụ nke akụrụ na ngosipụta fluoride. Ha kwuru na ọ bụghị ihe ijuanya na ndị ọrịa bu ọrịa akụrụ na-amụba ụba plasma na ọkpụkpụ fluoride na-arịwanye elu.308 Ha gara n'ihu kwuo na akụrụ mmadụ "ga-etinye fluoride dị ka okpukpu 50 site na plasma ruo mmamịrị. Akụkụ ụfọdụ nke sistemụ gbasara akụrụ nwere ike ịnọ n'ihe egwu nke fluoride na-egbu egbu karịa ọtụtụ anụ ahụ dị nro. ”309
N'iburu n'uche ozi a, ọ bụ ihe ezi uche dị na ndị na-eme nchọpụta jikọtara ngosipụta nke fluoride na nsogbu nke usoro akụrụ. Karịsịa, ndị na-eme nchọpụta sitere na Toronto, Canada, gosipụtara na ndị na-arịa ọrịa ọnya afọ na akụrụ osteodystrophy nwere nnukwu fluoride na ọkpụkpụ ma kwubie na "ọkpụkpụ fluoride nwere ike belata microhardness ọkpụkpụ site na itinye aka na ịnweta mineral." 310 Ọzọkwa, a na-amụ banyere ndị ọrụ gụrụ mkpu na cryolite Nke Philippe Grandjean na Jørgen H. Olsen bipụtara na 2004 tụrụ aro ka ewere fluoride dị ka ihe nwere ike bute ọrịa kansa akpa nwa yana ihe so akpata ọrịa kansa akpa ume.
Nkebi 6.6: Usoro iku ume
A na-edepụta mmetụta nke fluoride na sistem iku ume nke ọma n'akwụkwọ
Ngosiputa oru. N’ụzọ doro anya, ndị ọrụ n’ụlọ ọrụ ndị metụtara fluoride dị ọtụtụ
ihe ize ndụ dị elu nke ịmịnye fluoride karịa ndị na-adịghị arụ ọrụ na ụlọ ọrụ ahụ; agbanyeghị ụlọ ọrụ mmepụta ihe
ojiji nwekwara ike imetụta sistemu iku ume nke ụmụ amaala nkezi site na ọtụtụ ikpughe
ụzọ gasị.
Ikuku ume nke hydrogen fluoride na-abụ ihe atụ kachasị elu nke ọrụ akaebe pụtara ìhè
na nsogbu ahụike na-abụghị ọrụ. A na-eji hydrogen fluoride eme ihe maka friji, ahịhịa,
ọgwụ, mmanụ octane dị elu, aluminom, plastik, akụrụngwa eletriki, ọkụ
oriọna oriọna, na igwe na iko (dị ka nke eji ụfọdụ ngwaọrụ eletrọnị),
312 nakwa
dị ka mmepụta uranium na quartz ọcha.313
Centlọ Ọrụ Maka Nchịkwa Ọrịa na
Mgbochi (CDC) akọwaala na mgbakwunye na ikpughe n'ebe ọrụ, na-abụghị ọrụ
Ihe ngosi nke hydrogen fluoride nwekwara ike ime na ebe a na-ere ahịa na site n'ihe omume ntụrụndụ metụtara
ihe ejiri ihe ahu megharia, ya na ihe egwu di egwu nke ikpughe na iyi egwu egwu
Onye nnọchite anya.314
Mmetụta ahụike sitere na hydrogen fluoride nwere ike imebi ọtụtụ akụkụ dị iche iche, gụnyere ndị ahụ
tinyere usoro iku ume. Iku ume kemịkal nwere ike imerụ anụ ahụ ngụgụ ma kpatara
Ọzịza na mmiri mmiri na-emepụta na ngụgụ (ede akpa ume) .315
Nnukwu ikpughe nke hydrogen fluoride nwere ike ibute ọnwụ site na nrụpụta na ngụgụ, 316 ka ọ na-adịghị ala ala, ọkwa dị ala
inhalation nwere ike ibute mgbakasị na mkpọchi nke imi, akpịrị, na ngụgụ.317
Kpamkpam site na ọrụ, ụlọ ọrụ aluminom bụ isiokwu nke usoro
nke nyocha banyere mmetụta fluoride na-emetụta usoro iku ume nke ndị ọrụ. Ihe akaebe sitere na a
usoro ọmụmụ na-egosi mmekọrịta dị n'etiti ndị ọrụ na osisi aluminom, na-ekpughepụ ya
fluoride, na nsonaazụ iku ume, dị ka emphysema, bronchitis, ma belata ume
oru.318
Nkebi 6.7: Sistem Diges
Mgbe ọ na-eri nri, gụnyere site na mmiri fluoride, eriri afọ na-amịkọrọ fluoride
usoro ebe o nwere ọkara ndụ nke nkeji 30
Ọnụ ọgụgụ nke fluoride etinye obi na-adabere
n'elu ọkwa calcium, nke nwere ogo dị ukwuu nke calcium na-agbada eriri afọ
absorption.
320 321
Ọzọkwa, dị ka nnyocha e bipụtara na 2015 site na American Institute of
Chemical Engineers, mmekọrịta fluoride na sistemu eriri afọ “na - eweta
hydrofluoric [HF] acid site na ịzaghachi na hydrochloric [HCL] acid dị n'ime afọ. Ịbụ
ukwuu corrosive, na HF acid mere kpụrụ ga-ebibi afo na nsia lining na
ọnwụ nke microvilli. ”322
Akụkụ ọzọ nke nyocha metụtara mmetụta fluoride na akụkụ eriri afọ bụ ihe ọghọm
ingestion nke ntacha eze. Na 2011, Poison Control Center natara oku 21,513 metụtara
ngafe nke ahịhịa ezé dị ọcha. 323
Onu ogugu ndi mmadu metutara nwere ike
bụrụ nke ka elu, n'agbanyeghị. E welitewo nchegbu banyere ụfọdụ mgbaàmà nke eriri afọ
enweghị ike ịtụle ngwa ngwa dị ka njikọta nke nri fluoride, dịka ndị nchọpụta kọwara na 1997:
Ndị nne na nna ma ọ bụ ndị na-elekọta ha nwere ike ọ gaghị achọpụta mgbaàmà metụtara na nsi nsi fluoride
ma ọ bụ nwee ike ịkọwa ha na colic ma ọ bụ ọrịa afọ, karịsịa ma ọ bụrụ na ha ahụghị nwa ahụ
ingest nri. N'otu aka ahụ, n'ihi ọdịdị na-enweghị atụ nke ịdị nwayọọ na nke agafeghị oke
ihe mgbaàmà, nchọpụta dị iche iche nke dibịa enweghị ike ịgụnye nsị fluoride
na-enweghị akụkọ ihe mere eme nke fluoride ingestion.324
A makwaara na fluoride na-emetụta akụkụ ndị ọzọ nke usoro nsị. Iji maa atụ,
Nkwupụta 2006 NRC kpọrọ maka ịmatakwu banyere mmetụta fluoride na imeju: “Ọ ga-ekwe omume
na ị inụ mmiri nke 5-10 mg / ụbọchị site na mmiri ọ containingụ containingụ nke nwere fluoride na 4 mg / L nwere ike
pụta na-enwe mmetụta na-adịte aka na imeju, na nke a ga-enyocha n'ọdịnihu
ihe omumu banyere oria ojoo. ”325 dika ihe omuma atu ozo, ihe eji ete eze eji eme nri nwere ike ibute stomatitis dika
ọnụ na ọnya canker na ụfọdụ ndị mmadụ. 326
Nkebi 6.8: Sistem ọgụ
Usoro ahụ ji alụso ọrịa ọgụ bụ akụkụ ọzọ nke ahụ nke fluoride na-emetụta. An
ihe dị mkpa bụ na mkpụrụ ndụ na-enweghị ike na-etolite na ụmị ọkpụkpụ, yabụ mmetụta nke fluoride
na usoro ahụ ji alụso ọrịa ọgụ nwere ike ịbụ ihe metụtara njupụta nke fluoride na sel skeletal. Na 2006
Akụkọ NRC kọwara nke ọma na nke a:
Ka o sina dị, ndị ọrịa bi na obodo fluoridated ma ọ bụ a
Obodo ebe mmiri ọ drinkingụ drinkingụ nwere fluoride na 4 mg / L nwere
akwakọba fluoride na skeleel skeleel ha ma nwee ike inwe nnukwu fluoride
itinye uche n'ọkpụkpụ ha. Ọkpụkpụ bụ ebe mkpụrụ ndụ na-adịghị ike na-eto na nke ahụ
nwere ike imetụta nsogbu ọgụ na mmepụta nke nje na kemịkalụ si mba ọzọ. 327
Nfụkasị na hypersensitivities ka fluoride bụ ihe ọzọ dị ize ndụ metụtara dịghịzi
sistemụ. Nnyocha e bipụtara n’afọ ndị 1950, 1960, na nke 1970 gosiri na ụfọdụ mmadụ dị
hypersensitive to fluoride.328 N'ụzọ na-akpali mmasị, ndị edemede nke nyocha bipụtara na 1967 kwuru
na ọ bụ ezie na ụfọdụ ka na-ajụ eziokwu banyere fluoride na eze na ezé “vitamin” nwere ike ịkpata
enwe mmetụta uche, akụkọ ikpe ahụ e bipụtara na mbipụta ha gosipụtara na mmeghachi omume nfụkasị na
Fluoride dị adị. 329 Nnyocha ọmụmụ emere ọhụụ gosipụtara eziokwu a. Ogbolu 330
Nkebi 6.9: Usoro njikọ
Fluoride nwekwara ike ịmetụta sistemụ njikọta, nke mejupụtara akpụkpọ ahụ, gland exocrine,
ntutu, na mbọ. Karịsịa, mmeghachi omume nke fluoride, gụnyere fluoride eji na ntacha eze, nwere
ejikọtara ya na ihe otutu na ọnọdụ ọgwụgwọ ndị ọzọ. 331 332 333
Ọzọkwa, a nwere ike lifethreatening
Ọnọdụ a maara dị ka fluoroderma bụ ihe kpatara mmeghachi omume nke fluorine, 334
na ụdị agbawa akpụkpọ a (a halogenoderma) ejikọtara ndị ọrịa na-eji
ngwaahịa ọgwụ fluoridated.335
Ọzọkwa, a mụọla ntutu na mbọ dị ka ndị na-akụ mmiri
ikpughe fluoride.
336
Ntupu ntu ntu nwere ike igosipụta ekpughepụru fluoride na-adịghị ala ala 337
na nkwupụta site na ezé ezé, 338 na iji mgbatị fluoride na mbọ iji chọpụta ụmụaka
a nọrọ n’ihe ize ndụ maka fluorosis eze na-enyocha.339
Nkebi nke 6.10: Ọrịa Fluoride
Ọnọdụ izizi nke nsi sitere na ụlọ ọrụ mmebi sitere na fluorine metụtara ọdachi na
Ndagwurugwu Meuse na Belgium na 1930s. Ajọ na ọnọdụ ndị ọzọ dị na mpaghara mepere emepe a
jikọtara ọnwụ 60 na ọtụtụ puku mmadụ na-arịa ọrịa. Ihe akaebe egosiwo kemgbe
mmerụ ahụ a na-egbu fluorine na ụlọ ọrụ ndị dị nso
Ọzọ ikpe nke nsi nsi ulo oru mere na 1948 na Donora, Pennsylvania, n'ihi foogu na
mgbanwe ikuku. N'oge a, a na-ewepụta gas dị na zinc, nchara, waya, na ntu
A na-enyo ụlọ ọrụ na-ekpo ọkụ na-akpata ọnwụ 20 na puku mmadụ isii
daa ọrịa n’ihi nsị fluoride.341
Ọrịa fluoride sitere na ngwaahịa eze na United States mere na 1974 mgbe ọ dị afọ atọ
Nwa nwoke ochie nke Brooklyn nwụrụ n'ihi ị aụbiga mmanya ókè site na gel gel. Onye na-ede akụkọ maka New York
Times dere banyere ihe ahụ merenụ, sị: “Dị ka onye ọkà n'ihe banyere ọgwụ na-akpata njide na Nassau County, bụ́ Dr. Jesse Bidanset si kwuo,
William riri sentimita 45 cubic nke 2 pasent stannous fluoride, okpukpu atọ
ezuola ịnwụ. ”342
Ọtụtụ isi okwu banyere nsị fluoride na United States enwetawo nlebara anya na nso nso a
ọtụtụ iri afọ, dịka ntiwapụ nke 1992 na Hooper Bay, Alaska, n'ihi oke fluoride na mmiri 343 na nsị 2015 nke ezinụlọ na Florida n'ihi sulfuryl
Fluoride eji n’eji ogwugwo na ulo ha.344
Ọ bụ ezie na ihe atụ ndị enyere n’elu bụ nke oke nsị (nnukwu ọgwụ, mkpụmkpụ) nsị, adịghị ala ala
(obere dose, ogologo oge) nsị ga-atụle. Ma ọ dịkarịa ala ozi gbasara fluoride
nsị na-enweta iji nyere aka mepụta nghọta ka mma banyere nsogbu a. Na-arụ ọrụ
bipụtara na 2015, ndị nyocha nyochara eziokwu na akara izizi nke nsi fluoride bụ eze
fluorosis na fluoride bụ ihe enzyme disruptor mara
Ọzọkwa, a nyochaa bipụtara na
2012 nyere nkọwa zuru ezu banyere ihe ọghọm nke nsị fluoride na mkpụrụ ndụ: “Ọ na-arụ ọrụ
ihe fọrọ nke nta ka ọ bụrụ ụzọ mgbaàmà intracellular niile a maara gụnyere ụzọ G na-adabere na ya,
caspases, na mitochondria- na usoro ihe jikọrọ ndị na-anabata ọnwụ, yana ịkpalite ọtụtụ
nke mgbanwe metabolic na transcript, tinyere okwu nke ọtụtụ metụtara apoptosis
mkpụrụ ndụ ihe nketa, na-eduga n'ọnwụ mkpụrụ ndụ. ”
A nyochara ngwa ngwa maka nsí fluoride ka a mara ebe niile na 2005
n'akwụkwọ a kpọrọ “Fluoride nsi: ihe egwuregwu na-egbochi iberibe iberibe.” Onye edemede Phyllis J.
Mullenix, PhD, malitere edemede ahụ, nke e gosipụtara na akụkụ ya na American College of
Toxicology Symposium, site na ịdọ aka na ntị: “Akụkọ banyere enigmatic nke nsi nsi
na akwụkwọ ahụike nyere ya ohere ka ọ bụrụ otu n'ime nghọtahie, nghọtahie,
ma kọwahie nsogbu ahụike na United States taa. ”347
Mgbe ị gụrụ Nkebi nke 7 nke mbụ gbasara ihe na-ekpughe na fluoride, ọ ga-apụta ìhè nke ọma otu esi achọ nyocha ọzọ tupu ọkwa ọ bụla "nchekwa" maka ihe ngosi fluoride nwere ike ịtọ nke ọma. Otú ọ dị, enweghị ihe akaebe erughị ihe a na-amaghị ugbu a. Enweghi ihe akaebe pụtakwara nke ukwuu n'ihe a maara nke ọma banyere ojiji fluoride na-eme ka ihe a kpọrọ mmadụ, ọkachasị maka "uru" a na-ebo ebubo ya nke igbochi caries.
Nkebi 8.1: Enweghị nrụrụ
A na-agbakwunye fluoride na eze na ngwaahịa ndị ọzọ na-azụ ahịa n'ihi na ọ na-ekwu na ọ na-ebelata caries eze. Uru a na-atụ aro n'ụdị fluoride a metụtara ọrụ ya na ezé nke igbochi iku ume nje nke Streptococcus mutans, nje nke na-agbanwe shuga ma sie ike n'ime acid nke na-agbaze enamel. 504 Karịsịa, mmekọrịta nke fluoride na akụkụ nke ịnweta ezé na-emepụta fluorohydroxyapatite (FHAP ma ọ bụ FAP), a na-ekwupụtakwa na nsonaazụ nke ihe a na-eme ka ọ dịkwuo mma ma na-ebelata nchịkwa nke ezé. Ọ bụ ezie na e nwere nkwado sayensị maka usoro fluoride a, e guzobekwara na fluoride na-arụ ọrụ nke ọma iji belata ire ure nke ezé (yabụ ịtinye ya ezé na ezé ezé), ma ọ bụghị n'usoro (yabụ ị drinkingụ ma ọ bụ ị fluụ mmiri site na mmiri ma ọ bụ ụzọ ndị ọzọ) .505
Agbanyeghị na egosiputala uru ndị dị na fluoride n'akwụkwọ nke sayensị, nchọpụta n'otu aka ahụ jikwa uru ndị a. Dịka ọmụmaatụ, ndị na-eme nchọpụta si Mahadum Massachusetts Lowell kọwara ọtụtụ esemokwu metụtara ojiji nke fluoride n'isiokwu e bipụtara na Journal of Evidence-based Dental Practice na 2006. Mgbe ha kwuchara ihe ọmụmụ 1989 sitere na National Institute of Dental Research nke chọtara ntakịrị Esemokwu ndị dị na ụmụaka na-anata fluoride na ndị na-anaghị enweta fluoride, ndị ode akwụkwọ rụtụrụ aka na ọmụmụ ndị ọzọ na-egosi na ọnụego oghere dị na mba ndị mepere emepe belatara na-ejighị fluoride eme ihe. ụdị ọrịa ezinyere nke zuru oke na United States) ma ọ bụ na igbochi ire ire eze karama (nke jupụtara n'ọtụtụ obodo dara ogbenye).
Dị ka ihe atụ ọzọ, nnyocha emere n’oge gara aga iji kwado fluoridation mmiri dị ka ụzọ iji belata caries ezé mechara tụleghachi, ma chọpụta ihe ọmụma na-eduhie eduhie. Na mbido, Mbelata nke ezé rụrụ arụ na nke jupụtara na ezé (DFT) anakọtara na nyocha ka atụgharịrị dị ka ihe akaebe maka nrụpụta ọrụ nke fluoridation mmiri. Agbanyeghị, nchọpụta na-esote nke Dr. John A. Yiamouyiannis tụrụ aro na fluoridation mmiri nwere ike iso mee ka ọgbụgba ezé na-egbu oge. 508 Suchdị mgbapụ a na-egbu oge ga-eme ka ezé pere mpe ya mere, enweghị ire ere, nke pụtara na ọnụego dị ala nke DFT nke kpatara ezé ezé ma ọ bụ nsogbu nke fluoride na caries ezé.
Ihe omuma ndi ozo n’akwukwo sayensi juru aju iji ojiji nke fluoride gbochie ire eze. Nnyocha e mere na 2014 gosipụtara na mmetụta fluoride na-egbochi caries na-adabere na calcium na magnesium na enamel ezé kamakwa na usoro nyocha na enamel ezé adabereghị na fluoride. 509 Research bipụtara na 2010 chọpụtara na echiche nke "fluoride na-ewusi ezé" Agaghị enwe ike iwere ya dị ka ihe dị mkpa na-ahụ maka nhụjuanya ọ bụla na caries metụtara fluoride.510 Ọzọkwa, nyocha na-atụ aro na ikpughe usoro fluoride nwere ntakịrị (ma ọ bụrụ na ọ bụla) mmetụta na ezé, 511 512 na ndị na-eme nchọpụta enyewokwa data na fluorosis eze (ihe ịrịba ama mbụ nke fluoride toxicity513) dị elu na obodo US nwere mmiri fluoridated na ndị na-enweghị ya.
Akụkọ ndị ọzọ na-egosi na ka mba dị iche iche na-etolite, ọnụego ire ere nke ọnụ ọgụgụ mmadụ n'ogo ruru ịrị anọ na ezé rụrụ arụ, ezughị ezu, ma ọ bụ nke jupụtara ezé (n'afọ ndị 1960) wee gosipụta mbelata dị ukwuu (ọkwa taa), n'agbanyeghị fluoride jiri. E kwuputala na ịbawanye nsacha ọnụ, ịnweta ọrụ mgbochi, na ịmatakwu banyere mmetụta na-emebi shuga bụ ihe kpatara mbelata ezé nke ire eze. N’agbanyeghi ihe kpatara ya, ekwesiri iburu n’uche na odighi ire eze adighi na etinyere ya na mmiri fluoridated 515 ya mere o gha egosi na ihe ndi ozo n’abughi fluoride kpatara mgbanwe a. Onyonyo 2 dị n’okpuru na-egosiputa ọnọdụ ire ure nke mba ndị fluoridated na ndị na-abụghị fluoridated si 1955-2005
Nyocha 2: Tokpụrụ Nrụrụ Aka Ezé na Mba Ndị Fluoridated na Ndị A Na-enweghị Mgbanwe, 1955-2005
Ọtụtụ ihe ndị ọzọ dị mkpa na mkpebi ọ bụla maka iji fluoride iji gbochie caries. Nke mbu, ekwesiri ighota na fluoride abughi ihe di nkpa maka uto na mmepe nke mmadu.516 Nke abuo, amatala fluoride dika otu n’ime kemikal ulo oru iri na abuo “nke amara na oria neurotoxicity na aru mmadu.” 12 Na ikpe azu, onye America Tù Dental (ADA) kpọrọ oku ka ha nyochakwuo na 517 banyere usoro nke ọrụ fluoride na mmetụta:
A choro nyocha banyere fluorides dị iche iche iji chọpụta usoro ha si arụ ọrụ yana caries-mgbochi mgbochi mgbe a na-eji ya na ọkwa ugbu a nke ikuku fluoride (ya bụ, mmiri fluoridated na ezé ezé ezé) na United States. Ihe omumu banyere uzo eji eji fluoride eme ihe iji jide ma obu gbanwee oganihu caries, ya na ihe omuma nke fluoride nke oma n’etinye ezé, dikwa mkpa.518
Nkebi 8.2: Enweghị Akaebe
Eruola amụma na ọkwa enweghị ọkwa nke ogo fluoride na sistemụ mmadụ na-arụ kemgbe akwụkwọ ọkwa a. Agbanyeghị, ọ dị mkpa ikwughachi enweghị ihe akaebe metụtara ojiji nke fluoride, yabụ, Isiokwu 4 na-enye ndepụta dị nkenke nke ịdọ aka ná ntị siri ike sitere n'aka gọọmentị, sayensị na ndị isi ndị ọzọ dị mkpa gbasara ihe egwu na ejighị n'aka metụtara iji ngwaahịa fluoridation.
Isiokwu 4: ahọpụtara ahoro banyere ịdọ aka na ntị banyere Fluoride nke Ngwaahịa / Usoro yana Isi mmalite
| Ngwaahịa / usoro kwuru | EGO / S | ISI NKE OZI |
|---|---|---|
| Fluoride maka iji eze eme ihe, gụnyere fluoridation mmiri | "Njupụta nke caries ezé na ọnụ ọgụgụ mmadụ enweghị njikọ na ntinye nke fluoride na enamel, na ụba nke enamel fluoride adịchaghị mkpa ka ọ ghara igbochi ọrịa ezé." “Ọ bụ nchọnchọ ole na ole na-atụle ịdị irè nke ihe eji ete eze, gel, itucha, na varnish n’etiti ndị toro eto dị.” | Erslọ Ọrụ Maka Nchịkwa na Mgbochi Ọrịa (CDC). Kohn WG, Maas WR, Malvitz DM, Presson SM, Shaddik KK. Ndụmọdụ maka iji fluoride mee ihe iji gbochie ma chịkwaa caries eze na United States. Ọrịa na Ọnwụ kwa izu Akụkọ: Ndụmọdụ na Akụkọ. 2001 Ọgọst 17: i-42. |
| Ntinye Aka Nri nri: Akwadoro ego maka nri nri na ezigbo oriri | N'ozuzu ya, ndị kọmitii ahụ kwenyere na e nwere ihe ndị sayensị na-egosi na n'ọnọdụ ụfọdụ fluoride nwere ike ime ka ọkpụkpụ belata ma nwekwuo ohere nke mgbaji. " | Researchlọ Ọrụ Nyocha Mba. Fluoride na mmiri ọ Dụrinụ: Ntụle sayensi nke ụkpụrụ EPA. National Academies Press: Washington, DC 2006. |
| Fluoride na mmiri ọ drinkingụ drinkingụ | "Ebumnuche kachasị nke dị oke ebumnuche (MCLG) maka fluoride na mmiri ọ drinkingụ drinkingụ kwesịrị ịbụ efu." | Katọn RJ. Nyochaa nke 2006 United States Council Council Council: Fluoride na Mmiri Na-arinụ. Fluoride. 2006 Jul 1; 39 (3): 163-72. |
| Mmiri fluoridation | "Fluoride ikpughe nwere mmekọrịta dị mgbagwoju anya n'ihe gbasara ọrịa caries ma nwee ike ibute ọrịa caries dị na ụmụaka na-edozi ahụ n'ihi oke calcium na enamel hypoplasia ..." | Peckham S, Awofeso N. Mmiri fluoridation: nyocha dị oke egwu banyere mmetụta physiological nke inlọ inide dị ka enyemaka ahụike ọha na eze. Akwụkwọ sayensị World. 2014 Feb 26; 2014. |
| Fluoride na ngwaahịa eze, nri, na mmiri ọ drinkingụ drinkingụ | "Ebe ọ bụ na iji ọgwụ ezé na-eri nri na ihe ọ beụveraụ mmiri na-abawanye ụba ebe ọ bụ na HHS kwadoro ọkwa kachasị mma maka fluoridation, ọtụtụ mmadụ nwere ike ịpụta karịa fluoride karịa ka a tụrụ anya ya." | Tiemann M. Fluoride na mmiri ọ drinkingụ drinkingụ: nyocha nke nsogbu fluoridation na usoro iwu. BiblioGov. 2013 Apr 5. Congressional Research Service Report maka ọgbakọ omebe iwu. |
| Fluoride na-eri ụmụaka | A nabatala nri 'kachasị mma' nke fluoride kemgbe ọtụtụ iri afọ dị ka ihe dị ka 0.05 na 0.07 mg fluoride kwa kilogram nke arọ ahụ mana ọ dabere na oke mmụta sayensị. ' Nchọpụta ndị a na-egosi na ị nweta ọnọdụ enweghị caries nwere ike ọ nwere obere ihe metụtara oriri fluoride, ebe o doro anya na fluorosis na-adaberekarị na nri fluoride. ” | Warren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber ‐ Gasparoni K. Ntụle maka ezigbo nri fluoride site na iji fluorosis eze na eze caries pụta-ọmụmụ ogologo oge. Akwụkwọ nke Dentistry Ahụike ọha na eze. 2009 Mar 1; 69 (2): 111-5. |
| Fluoride na-ahapụ ihe ndị na-eweghachi eze (ya bụ, ezé eze) | “Otú ọ dị, ọ bụghị nke a na-egosi n’ọmụmụ ihe ọmụmụ ka ọ dị A pụrụ ibelata ihe omume nke caries nke abụọ site ná nhapụ a na-ewepụta ihe ndị na-eme ka mmiri dịghachi mma. ” | Wiegand A, Buchalla W, Attin T. Nyocha banyere fluoride-na-ewepụta ihe ndị na-eme mgbanwe-fluoridere na nnabata akụrụngwa, antibacterialactivity na mmetụta na cariesformation. Ngwongwo eze. 2007 Mar 31; 23 (3): 343-62. |
| Ngwongwo eze: ọlaọcha diamine fluoride | "Ebe ọ bụ na ọlaọcha diamine fluoride dị ọhụrụ na dentistry na ezé ndị America, ọ dị mkpa maka ụkpụrụ nduzi, nkwekọrịta, na nkwenye ziri ezi." "O doghị anya ihe ga - eme ma ọ bụrụ na a kwụsị ọgwụgwọ mgbe afọ 2-3 gachara ma chọọ nyocha." | Horst JA, Ellenikiotis H, Milgrom PM, UCSF Silver Na-elekọta Kọmị Njide. Usoro UCSF maka Caries Jidere Iji Silver Diamine Fluoride: Ebumnuche, Ngosipụta, na Nkwenye. Akwụkwọ akụkọ nke California Dental Association. 2016 Jan; 44 (1): 16. |
| Nde Fluoride maka iji eze | “Ogwe ahụ nwere ọkwa dị ala nke n'aka banyere uru nke Ihe dị ka pasent 0.5 nke mmanụ ma ọ bụ gel dị na ezé na-adịgide adịgide nke ụmụaka na n'ebe mgbọrọgwụ mgbọrọgwụ n'ihi na e nwere ihe ọmụma ole na ole banyere iji ihe ndị a eme ihe n'ụlọ. ” “Ọ dị mkpa ime nnyocha banyere ịdị irè na ihe egwu dị na ngwaahịa a kapịrị ọnụ na mpaghara ndị a: itinye onwe gị n'ọrụ, ike ọgwụ, iji fluoride eji eme ụlọ, ihe nrịcha eze ma ọ bụ ntụpọ; Pasent 2 jiri sodium fluoride gel tinye n'ọrụ; usoro nnyefe ọzọ, dị ka ụfụfụ; ngwa ngwa kachasị mma maka fluoride varnish na gels; otu nkeji nke APF gel; na ngwakọta nke ngwaahịa (iji ụlọ na iji ọrụ eme ihe). ” | Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, Hujoel PP, Iafolla T, Kohn W, Kumar J, Levy SM. Topor fluoride maka caries mgbochi: Nchịkọta nchịkọta nke usoro nlekọta ahụike emelitere ma na-akwado nyocha usoro. Akwụkwọ akụkọ nke American Dental Association. Ọrịa. 2013; 144 (11): 1279-1291. |
| Fluoride "mgbakwunye" (mbadamba) | "Esemokwu esemokwu n'etiti nsonaazụ ahụ na-egosi na enwere oke arụmọrụ na mbadamba fluoride." | Tomasin L, Pusinanti L, Zerman N. Ọrụ nke mbadamba nkume fluoride na prophylaxis nke caries eze. Nyocha akwụkwọ. Akwụkwọ mgbasa ozi. 2015 Jenụwarị; 6 (1): 1. |
| Pharmaceuticals, fluorine na nkà mmụta ọgwụ | “Ọ dịghị onye ga-eji ezi uche buo amụma banyere ihe na-eme n'ahụ mmadụ mgbe a chịchara ihe ndị mejupụtara mmiri ọgwụ.” | Strunecká A, Patočka J, Connett P.Fluorine na ọgwụ. Journalof tinyere Biomedicine. 2004; 2: 141-50. |
| Kingụ mmiri na poly- na perfluoroalkyl bekee (PFASs) | "Dkingụ mmiri na-a withụ mmiri na poly-na perfluoroalkyl bekee (PFASs) na-ebute ihe egwu dị na mmepe, ahụike, na-emetụta ahụ ike, na endocrine nke ndị na-azụ ahịa." "… Ozi gbasara mmiri ọ drinkingụ drinkingụ PFAS ikpughe na-enweghị ihe fọrọ nke nta ka ọ bụrụ otu ụzọ n'ụzọ atọ nke ndị bi na United States." | Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, Lohmann R, Carignan CC, Blum A, Balan SA, Higgins CP. Nchọpụta nke Poly-na Perfluoroalkyl Subamins (PFASs) na US Na-arinụ Mmiri Ejikọtara na saịtị Ndị Ọrụ, Ebe Ọzụzụ Ọkụ Ndị Agha, na Osisi Ọgwụ Mmiri. Akwụkwọ edemede Science na Teknụzụ. 2016 Ọkt 11 |
| Ngosiputa aru oru na fluoride na nsi fluoride | “Nyochaa ozi a na-agbasabeghị banyere nsonaazụ fluoride na fluorine na-adịghị ala ala na-ekpughe na ụkpụrụ ọrụ ndị a na-arụ ugbu a na-enye nchebe zuru ezu. ” | Mullenix PJ. Ngbu fluoride: ihe omimi na izo ya. Akwụkwọ bụ International Journal of Work and Environmental Health. 2005 Ọkt 1; 11 (4): 404-14 |
| Nyochaa ụkpụrụ nchekwa maka ikpughe fluorine na fluorides | “Ọ bụrụ na anyị atụlee naanị njikọ dị na fluoride maka calcium, anyị ga-aghọta ike fluoride nwere ibibi mkpụrụ ndụ, akụkụ ahụ, gland, na anụ ahụ.” | Prystupa J. Fluorine - nyocha akwụkwọ ugbu a. Ihe nyocha NRC na ATSDR gbadoro anya banyere onodu nchedo maka ekpomhere ha na fluorine na fluorides. Usoro Toxicology na hodszọ. 2011 Feb 1; 21 (2): 103-70. |
Nkeji 8.3: Enweghị ụkpụrụ omume
Ihe ọzọ na-echegbu fluoride site na mmiri ọ drinkingụ drinkingụ na nri metụtara fluoride a na-eji enye mmiri. Dabere na Centlọ Ọrụ Maka Nchịkwa na Mgbochi Ọrịa (CDC), a na-ejikarị ụdị fluoride atọ eme ihe maka mmiri fluoridation obodo:
- Fluorosilicic acid: ihe eji eji mmiri esi mmiri nke United States. A na-akpọkwa Fluorosilicic acid dị ka hydrofluorosilicate, FSA, ma ọ bụ HFS.
- Fluorosilicic acid: ihe eji eji mmiri esi mmiri nke United States. A na-akpọkwa Fluorosilicic acid dị ka hydrofluorosilicate, FSA, ma ọ bụ HFS.
- Sodium fluorosilicate: ihe akọrọ akọrọ, etisasịwo n'ime ihe ngwọta tupu agbakwunye ya na mmiri.
Esemokwu bilitere na njikọ ụlọ ọrụ mmepụta ihe na ihe ndị a. CDC kọwara na a na-eji sọlfọ sulfurite mee ka okwute phosphorite wee mepụta pasent 95 nke fluorosilicic acid eji na fluoridation. na-agbanwekwa dabere n'ihe ndị dịka ọnụ ahịa mgbanwe mba ọzọ na-adịghị mma na ire ahịa fatịlaịza na mbupụ. Ndị na-akwado maka nkwupụta fluoride ajuju ma ọ bụrụ na njikọ ụlọ ọrụ dị otú a dị mma ma ọ bụrụ na njikọ ụlọ ọrụ na kemịkal ndị a nwere ike ibute mkpuchi ahụike nke nsonaazụ fluoride kpatara.
Otu ụkpụrụ omume doro anya nke na-ebilite na ntinye aka na ụlọ ọrụ dị otú a bụ na otu ndị otu uru bara uru yiri ka ha na-akọwa ihe ndị na-agbanwe agbanwe nke ihe mejupụtara nyocha kachasị mma, yana ka ọ dị ugbu a, sayensị na-enweghị isi na-esiri ike ịkwado, mepụta, bipụta, ma kpọsaa. Nke a bụ n'ihi na ịkwado nnukwu ọmụmụ ihe nwere ike ịdị oke ọnụ, mana ụlọ ọrụ na-arụ ọrụ ụlọ ọrụ nwere ike ịkwado ndị nyocha nke ha n'ụzọ dị mfe. Ha nwekwara ike iwepụta oge na-enyocha ụzọ dị iche iche esi kọọ data ahụ (dịka ịhapụ ụfọdụ ọnụọgụ iji nweta nsonaazụ dị mma), ha nwekwara ike ịga n'ihu ịkwusa akụkụ ọ bụla nke nyocha ahụ na-akwado ọrụ ha. Na nwute, akụkọ ihe mere eme egosila na ụlọ ọrụ ụlọ ọrụ nwedịrị ike iwepụ ndị ọkà mmụta sayensị nwere onwe ha dị ka ụzọ isi kwụsị ọrụ ha ma ọ bụrụ na ọrụ ahụ na-egosi mmerụ nke mmetọ ụlọ ọrụ na ihe mmetọ na-ebute.
N’ezie, a chọpụtarala ọnọdụ dị otu a nke sayensị n’erughị eru na nyocha a na-amụ banyere fluoride. Ndị dere nnyocha e bipụtara na Scientific World Journal na 2014 kọwara nke ọma: “Ọ bụ ezie na iji mmiri mee ka mmiri ghara ịpụta mmiri abụwo usoro arụmụka ọha na eze na-ese okwu kemgbe ọ malitere ya, ndị nchọpụta — ndị gụnyere ndị ọkà mmụta sayensị na ndị a na-akwanyere ùgwù n’ụwa nile — achọpụtawo na ọ na-esiri ha ike ibipụta oké egwu ederede banyere mmiri eji eme mmiri na eze na akwụkwọ akụkọ ahụike ọha na eze. ”523
Tụkwasị na nke ahụ, esemokwu nke ọdịmma nwere ike ịdaba na ọmụmụ banyere ngosipụta nri na-edozi na ogige perfluorinated (PFCs). N’isiokwu e bipụtara na 2012, mba nyochara nyocha banyere iri nri sitere na PFC. Onye edemede ahụ kpughere na data sitere na US dị oke oke, gụnyere naanị akwụkwọ 2010 nke ọtụtụ ndị nyocha agụmakwụkwọ America, yana nyocha nke 3M nyere nkwado nke jere ozi dị ka isi nyocha tupu akwụkwọ 2010 (ma kwuo na ọtụtụ ihe atụ 524 N'agbanyeghị nke ahụ, ndị na-eme nchọpụta agụmakwụkwọ mepụtara nchọpụta dị iche iche karịa akụkọ nke 3M ma dee n'akwụkwọ ha nke 2010: "N'agbanyeghị mmachibido ngwaahịa, anyị hụrụ POPs [na-aga n'ihu na-emetọ ihe oriri] na nri US, na ngwakọta nke ndị a kemịkalụ ndị America na-eri na ọkwa dịgasị iche iche. Nke a na-egosi mkpa ọ dị ịgbasa nyocha nke nri maka kemịkal kemịkal. ”525
Amatawokwa esemokwu dị iche iche na-abanye n'ụlọ ọrụ gọọmentị metụtara usoro kemịkal na-egbu egbu. Akwụkwọ akụkọ Newsweek nke 2014 nke Zoë Schlanger dere nke isiokwu ya bụ "Ndi EPA Na-ahụ Ọrụ Mmepe Mgbe Asschọpụta Ihe Ọjọọ Chemical?" gụnyere nkwupụta sitere n'aka ọkà mmụta gburugburu ebe obibi bụ Michelle Boone nke boro ebubo na '' ihe niile ma ọ bụ ọtụtụ data ejiri na nyocha ihe egwu nwere ike ịbịa site na nyocha nke ụlọ ọrụ na-eweta, n'agbanyeghị doro anya [esemokwu nke mmasị]. '"526
O doro anya na ụlọ ọrụ eze nwere nnukwu esemokwu na fluoride n'ihi na ọ bụ ụlọ ọrụ na-emepụta ngwaahịa eze nke nwere fluoride. Tụkwasị na nke a, usoro metụtara fluoride nke dọkịta na eze na ndị ọrụ eze na-enye nwekwara ike irite uru maka ụlọ ọrụ eze, 527 528 na ajụjụ gbasara ụkpụrụ banyere ịwelite usoro ndị a nke fluoride na ndị ọrịa.529
N'ihe gbasara ụkpụrụ omume nke ahụike na eze, a ghaghị ịtụle isi nkuku nke amụma ahụike ọha na eze nke a maara dị ka usoro ịdọ aka na ntị. Ebumnuche bụ isi nke amụma a bụ nke ewulitere na narị afọ gara aga iji oathụọ iyi iyi iji “buru ụzọ, emekpala ahụ.” N'agbanyeghị nke ahụ, usoro nkwekọrịta nke oge a na-akwado nkwado ụwa.
Na Jenụwarị 1998, na ọgbakọ mba ụwa metụtara ndị sayensị, ndị ọka iwu, ndị na-eme iwu, na ndị na-ahụ maka gburugburu ebe obibi sitere na US, Canada na Europe, e debanyere aha edepụtara wee bụrụ nke akpọrọ "Nkwupụta Wingspread on the Precautionary Principle." 530 N'ime ya, ndị A na-enye ndụmọdụ na-esonụ: “Mgbe ihe omume na-eweta iyi egwu nke mmerụ ahụ ike mmadụ ma ọ bụ gburugburu ebe obibi, a ga-akpachara anya ọ bụrụgodi na ihe kpatara na mmetụta mmekọrịta esiteghị na sayensị. N'ebe a, onye na-akwado ọrụ kwesịrị ịdị na-ebu ibu nke ịgba akaebe, ọ bụghị ọha na eze
Ọ bụghị ihe mgbagwoju anya, ejikọtara mkpa maka itinye usoro iwu nke ọma na ojiji nke fluoride. Ndị edemede nke isiokwu 2006 nke isiokwu ya bụ "Gịnị Ka cakpụrụ Nchedo Pụtara Maka Dentistry Dabere na Ihe Egwu?" na-atụ aro mkpa ọ dị ịkọ akụkọ maka ngosipụta agwakọta sitere na isi mmalite fluoride na mgbanwe ndị mmadụ, na-ekwukwa na ndị ahịa nwere ike iru "ezigbo" usoro fluoridation na-enweghị mgbe ha na-a drinkingụ mmiri fluorid.532 Ọzọkwa, ndị nyocha nke nyocha e bipụtara na 2014 kwuru banyere ọrụ maka ịdọ aka na ntị. kpụrụ a ga-etinye aka na ojiji nke fluoride, ha wee nwee echiche a otu ụzọ mgbe ha tụrụ aro na nghọta anyị nke oge a banyere ọrịa caries “na-ebelata ọrụ ọ bụla dị mkpa maka fluoride na mgbochi caries.” 533
Ndị dere akwụkwọ ọnọdụ Fluoride
Dr. Jack Kall, DMD, FAGD, MIAOMT, bụ onye otu nke Academy of General Dentistry na onye isi oche gara aga nke isi Kentucky. Ọ bụ nna ukwu enwetara ikike nke International Academy of Oral Medicine and Toxicology (IAOMT) na kemgbe 1996 jere ozi dị ka onye isi oche nke Board of Directors. Ọ na-ejekwa ozi na Board of Advisors Bioregulatory Medical Institute (BRMI). Ọ bụ onye otu Institute for Functional Medicine na American Academy for Oral Systemic Health.
Dr. Griffin Cole, MIAOMT nwetara Mastership ya na International Academy of Oral Medicine and Toxicology na 2013 wee depụta broshuọ Fluoridation Academy na nyocha sayensị sayensị na ojiji ozone na usoro ọgwụgwọ mgbọrọgwụ. Ọ bụ onye isi oche gara aga nke IAOMT ma na-eje ozi na Board of Directors, Kọmitii Mentor, Kọmitii Fluoride, Kọmitii Mgbakọ na ọ bụ onye isi nchịkwa isi.
Dr. David Kennedy na-eme dentistry maka ihe karịrị afọ 30 ma lara ezumike nká na ụlọ ọgwụ na 2000. Ọ bụ Onye isi oche gara aga nke IAOMT ma kụziere ndị dọkịta ezé na ndị ọkachamara ahụike ndị ọzọ n'ụwa nile banyere isiokwu nke mgbochi eze ahụike, mercury toxicity, na fluoride. A na-amata Dr. Kennedy gburugburu ụwa dị ka onye na-akwado maka mmiri ọṅụṅụ dị mma, dentistry bayoloji na ọ bụ onye ndu a ma ama na ngalaba nke mgbochi eze. Dr. Kennedy bụ onye odee na onye ntụzi ihe nkiri na-emeri ihe nkiri Fluoridegate.
