PREVALENCE OF ENDEMIC FLUOROSIS WITH GASTROINTESTINAL MANIFESTATIONS IN PEOPLE LIVING IN SOME NORTH-INDIAN VILLAGES

Numerous reports on epidemiological surveys of skeletal and dental flu orosis exist, but information is quite limited on non-skeletal manifes tations of fluoride toxicity. The present study was conducted to asses s the prevalence and severity of non-skeletal manifestations, especial ly gastrointestinal disturbances, in an area of skeletal and dental fl uorosis. The subjects, numbering 1958 inhabitants belonging to 489 fam ilies residing in four endemic villages of Fafidabad District of Harya na State, were interviewed on health complaints. The information was r ecorded in a precoded questionnaire. Every drinking water source was a nalysed for fluoride content. This led to the identification of 'safe' (fluoride 1 ppm or less) and 'contaminated' (fluoride above 1 ppm) so urces of water. Results revealed that among the subjects were people a ffected with: 1) Dental fluorosis (58%), 2) Skeletal fluorosis (27%), 3) Non-skeletal manifestations (41%) and 4) Gastrointestinal complaint s (26%). Those affected were consuming water contaminated with fluorid e ranging from 0.25-8.00 ppm. Among the total of 78 sources of water, 20 were ''safe' while the remaining 58 were more contaminated with flu oride from natural sources. It is concluded that in an endemic zone, w here the inhabitants are consuming water of high fluoride content, the occurrence of gastrointestinal complaints - viz., loss of appetite, n ausea, abdominal pain, flatulence, constipation and intermittant diarr hoea - is one of the early warning signs of fluoride toxicity and fluo rosis. When water with negligible amounts of fluoride (safe water) is provided, the complaints disappear within a fortnight.