Pampiri ea boemo ba IAOMT khahlano le tšebeliso ea fluoride e kenyelletsa litemana tse fetang 500 mme e fana ka lipatlisiso tse felletseng tsa mahlale mabapi le likotsi tse ka bang teng tsa bophelo bo botle tse amanang le ho pepesetsoa ha fluoride.
Pampiri ea boemo ba IAOMT khahlano le litlhaloso tse fetang 500 mme e fana ka lipatlisiso tse qaqileng tsa mahlale mabapi le likotsi tse ka bang teng tsa bophelo bo botle tse amanang le ho pepeseha ha fluoride.
Fluorine (F) ke karolo ea borobong tafoleng ea periodic mme ke setho sa lelapa la halogen. E na le boima ba athomo ea 18.9984, ke eona e sebetsang ka ho fetesisa linthong tsohle, 'me e theha litlamo tse matla tsa motlakase. E khahloa ka ho khetheha ke li-cation tse nang le divalent tsa calcium le magnesium. Ha e le maemong a eona a mahala, fluorine ke khase e nang le chefo e bosootho bo feteletseng e bosehla. Leha ho le joalo, hangata fluorine ha e fumanoe e lokolohile ka tlhaho hobane hangata e kopana le likarolo tse ling ka lebaka la boemo ba eona bo phahameng ba ts'ebetso. Fluorine hangata e hlaha e le liminerale
fluorspar (CaF2), cryolite (Na3AlF6), le fluorapatite (3Ca3 (PO4) 2 Ca (F, Cl) 2), 'me ke karolo ea bo13 e fumanehang ka bongata lefatšeng.
Fluoride (F-) ke k'hemik'hale ea fluorine e nang le lielektrone tse eketsehileng, ka hona e fana ka tefiso e mpe. Ntle le boteng ba tlhaho ba liminerale, hammoho le mobu, metsi le moea, fluoride e boetse e entsoe ka lik'hemik'hale hore e sebelisoe metseng ea metsi ea fluoridation, lihlahisoa tsa meno le lintho tse ling tse entsoeng. Fluoride ha e bohlokoa molemong oa kholo le kholo ea motho.1
Ebile, ha e hlokoe bakeng sa ts'ebetso efe kapa efe ea 'mele' meleng oa motho; ka hona, ha ho motho ea tla hlokofatsoa ke fluoride e haelloang. Ka 2014, Ngaka Philippe Grandjean oa Sekolo sa Harvard sa Bophelo bo Botle ba Sechaba le Ngaka Philip J. Landrigan oa Sekolo sa Bongaka sa Icahn Thabeng ea Sinai ba ile ba supa fluoride e le e 'ngoe ea lik'hemik'hale tse 12 tsa indasteri tse tsejoang li baka nts'etsopele ea methapo ea kutlo bathong. 2
Karolo ea 5.1: Ho Hlakisoa ha Metsi Metseng
Europe Bophirima, mebuso e meng e amohetse pepeneneng likotsi tsa fluoride, mme ke 3% feela ea baahi ba Europe bophirima ba noang metsi a fluoridated. 133 United States, MaAmerika a fetang 66% a ntse a noa metsi a nang le fluorid.134 Setsi sa Ts'ireletso ea Tikoloho (EPA) kapa mmuso oa koporasi ha o laele fluoridation ea metsi Amerika, mme qeto ea ho tšolla metsi a sechaba e etsoa ke mmuso kapa masepala oa lehae. .135 136 Leha ho le joalo, US Public Health Service (PHS) e theha likhakanyo tse khothalelitsoeng tsa fluoride metsing a nooang a sechaba bakeng sa ba khethang ho ba fluoridate, mme Setsi sa Ts'ireletso ea Tikoloho (EPA) se beha maemo a silafatsang bakeng sa metsi a nooang a sechaba.
Kamora hore fluoridation ea metsi Grand Rapids, Michigan, e qale ka 1945, tloaelo ena e ile ea namela libakeng tse ling ho pholletsa le naha lilemong tse mashome tse latelang. Boiteko bona bo ile ba khothaletsoa ke Lefapha la Bophelo ba Sechaba (PHS) lilemong tsa bo-1950, 137 le ka 1962, PHS e ile ea fana ka litekanyetso tsa fluoride ea metsi a nooang e neng e tla ema lilemo tse 50. Ba boletse hore fluoride e ka thibela ho bola ha meno138 le hore maemo a nepahetseng a fluoride a ekelitsoeng metsing a nooang a lokela ho ba lipakeng tsa limiligrama tse 0.7 ho isa ho 1.2 ka litara. 139 Leha ho le joalo, PHS e theotse khothaletso ena boemong bo le bong ba limiligrama tse 0.7 ka litara ka selemo sa 2015 ka lebaka keketseho ea meno a fluorosis (tšenyo e sa feleng ea meno e ka hlahang ho bana ho tloha ho tlholeho e fetelletseng ho ea ho fluoride) le ho eketseha ha mehloli ea tlhahiso ea fluoride ho MaAmerika.140
Ho sa le joalo, Molao oa Metsi a noang a Sireletsehileng o thehiloe ka 1974 ho sireletsa boleng ba metsi a nooang a Amerika, mme o file EPA matla a ho laola metsi a nooang a sechaba. Hobane
ea molao ona, EPA e ka beha maemo a ts'ebetsong a nang le litšila (MCL) bakeng sa metsi a nooang, hammoho le lipheo tse sa qobelloang tsa maemo a silafatsang (MCLG) le litekanyetso tse sa qobelloang tsa metsi a nooang a maemo a phahameng a silafatsang a phahameng (SMCLs) .141 EPA e hlakisa hore MCLG ke "boemo bo phahameng ka ho fetisisa ba ntho e silafatsang metsi a nooang moo ho ke keng ha e-ba le tšusumetso e mpe kapa e lebelletsoeng bophelong bo botle ba batho, e lumellang tšireletso e lekaneng." 142 Ntle le moo, EPA e fana ka tumello ea hore litsamaiso tsa metsi tsa sechaba tse fetang MCL bakeng sa fluoride "li tlameha ho tsebisa batho ba sebeletsang tsamaiso eo kapele kamoo ho ka khonehang, empa pele ho feta matsatsi a 30 sistimi e utloile ka tlolo ea molao eo." EA-143-TK
Ka 1975, EPA e ile ea beha boemo bo phahameng bo silafatsang (MCL) bakeng sa fluoride metsing a nooang ho tloha ho 1.4 ho isa ho 2.4 milligrams ka litha e le nngwe. 144 Ba thehile moeli ona ho thibela linyeoe tsa fluorosis ea meno. Ka 1981, Carolina Boroa e ile ea pheha khang ea hore meno a fluorosis ke litlolo feela, 'me mmuso o kopile EPA ho felisa MCL bakeng sa fluoride. 145 Ka lebaka leo, ka 1985, EPA e ile ea theha sepheo se phahameng sa tšilafalo (MCLG) bakeng sa fluoride ka limiligrama tse 4 ka litara. 146 Sebakeng sa fluorosis ea meno e sebetsa e le pheletsong ea ts'ireletso (e neng e ka hloka maemo a tlase a polokeho), boemo bona bo phahameng bo thehiloe e le mokhoa oa ho itšireletsa khahlanong le masapo a fluorosis, lefu la masapo le bakoang ke fluoride e fetelletseng. Ho sebelisa masapo a fluorosis joalo ka ha ntlha ea ho qetela le eona e hlahisitse phetoho bakeng sa MCL bakeng sa fluoride, e ileng ea phahamisoa ho ea ho limiligrama tse 4 ka litara ka 1986. 147 Leha ho le joalo, fluorosis ea meno e ile ea sebelisoa e le pheletso ea SMCL bakeng sa fluoride ea limiligrama tse 2 ka litara, eo e ne e boetse e behiloe ka 1986. 148
Phehisano e ile ea latela melaoana ena e mecha mme ea ba ea fella ka liketso tsa molao khahlano le EPA. South Carolina e phehile khang ea hore ha ho na tlhoko ea MCLG (sepheo se phahameng sa litšila) bakeng sa fluoride, ha Lekhotla la Ts'ireletso ea Lisebelisoa tsa Tlhaho le pheha khang ea hore MCLG e lokela ho theoloa ho ipapisitsoe le meno fluorosis. 149 Lekhotla le ahlotse ka tumello ea EPA, empa ha e lekola litekanyetso tsa fluoride, EPA e ngolisitse Lekhotla la Naha la Patlisiso (NRC) la National Academy of Sciences ho lekola bocha likotsi tsa bophelo tsa fluoride. 150 151
Tlaleho e tsoang Lekhotleng la Naha la Lipatlisiso, e lokollotsoeng ka 2006, e fihletse qeto ea hore MCLG ea EPA (sepheo se phahameng sa tšilafalo) bakeng sa fluoride e lokela ho theoloa.152 Ntle le ho hlokomela monyetla oa kotsi ea fluoride le osteosarcoma (kankere ea masapo), 2006 Tlaleho ea Lekhotla la Naha la Lipatlisiso e bontšitse matšoenyeho mabapi le litlamorao tsa mesifa, tsoalo le kholo, phello ea methapo ea pelo le litlamorao tsa boits'oaro, genotoxicity le carcinogenicity, le litlamorao litsing tse ling tsa mmele.153
NRC e phethile ka hore MCLG ea fluoride e lokela ho theoloa ka 2006, empa EPA e ntse e sa tlameha ho theola boemo bona. 154 Ka 2016, Fluoride Action Network, IAOMT, le lihlopha tse ling tse 'maloa le batho ka bomong ba kopile EPA ho sireletsa sechaba, haholo-holo batho ba kotsing, ho tsoa likotsing tsa neurotoxic tsa fluoride ka ho thibela tlatsetso e nang le morero ea fluoride ho metsi a nooang.155 Kopo eo e ile ea haneloa ke EPA ka Hlakola 2017.156.
Karolo ea 5.2: Metsi a Botlolo
Joalo ka sesepa sa meno le lihlahisoa tse ngata tsa meno, metsi a libotlolo a ka ba le fluoride.
Tsamaiso ea Tsamaiso ea Lijo le Lithethefatsi ea United States (FDA) e ikarabella ho netefatsa hore litekanyetso tsa metsi a libotlolo li lumellana le litekanyetso tsa metsi a pompo a behiloeng ke EPA 157 le maemo a khothalletsoang a behiloeng ke US Public Health Service (PHS). 158 FDA e lumella metsi a libotlolo a fihlelang litekanyetso tsa eona 159 ho kenyelletsa puo e reng ho noa metsi a nang le fluoridated ho ka fokotsa kotsi ea ho bola ha leino.
Karolo ea 5.3: Lijo
FDA e ile ea etsa qeto ea ho lekanyetsa ho tlatsetsoa ha metsoako ea fluorine lijong molemong oa bophelo bo botle ba sechaba ka 1977. 161 Leha ho le joalo, fluoride e ntse e le teng lijong ka lebaka la ho itokisetsa metsing a fluoridated, ho pepesehela meriana e bolaeang likokonyana le manyolo, le lintlha tse ling. Ka 2004, Lefapha la Temo la United States (USDA) le ile la tsebisa lethathamo la maemo a fluoride ka lino tse tahang le lijo, 'me tlaleho e nang le litokomane tse qaqileng e phatlalalitsoe ka 2005.162 Ha tlaleho ena e ntse e le bohlokoa, maemo a fluoride lijong le linoaneng a kanna a ba teng e eketsehile lilemong tse leshome tse fetileng ka lebaka la ts'ebeliso ea fluoride meriana e bolaeang likokonyana e lumelletsoeng haufinyane haholo.163 Lijo tse ling tse sa tobang tsa lijo tse sebelisoang hona joale li na le fluoride.164
Ho feta moo, ka 2006, Lekhotla la Naha la Lipatlisiso le khothalelitse hore "ho thusa ho hakanyetsa phepelo ea fluoride e le ngoe ho tsoa ho keneng, baetsi le bahlahisi ba lokela ho fana ka leseli ka lihlahisoa tsa fluoride tsa lijo le lino tse tahang." 165 Leha ho le joalo, sena se ke ke sa etsahala neng kapa neng haufi le bokamoso. Ka 2016, FDA e ntlafalitse tlhoko ea eona ea ho ngola lijo bakeng sa mangolo a Nutrition le Supplement Facts mme ea etsa qeto ea hore liphatlalatso tsa maemo a fluoride ke tsa boithatelo bakeng sa lihlahisoa tse nang le fluoride le lihlahisoa tse ekelitsoeng ka boomo. Boleng ba Ts'ebetso ea Letsatsi le Letsatsi (DRV) bakeng sa fluoride
Ho fapana le moo, ho 2016, FDA e ile ea thibela perfluoroalkyl ethyl e nang le lintho tse amanang le lijo (PFCSs), tse sebelisoang e le lihlahisoa tsa oli le metsi bakeng sa pampiri le pampiri. Ketso ena e nkuoe ka lebaka la tlhaiso-leseling e chefo le kopo e kentsoeng ke Lekhotla la Ts'ireletso ea Lisebelisoa tsa Tlhaho le lihlopha tse ling.
Ntle le lintlha tsa fluoride lijong, ho theha fluoride e bolokehileng lijong ka lebaka la chefo e bolaeang likokonyana e arolelanoa ke FDA, EPA, le Ts'ireletso ea Lijo le Ts'ebetso ea Ts'ebetso ea Lefapha la Temo la US.
Karolo ea 5.4: Likokoanyana tse bolaeang likokonyana
Meriana e bolaeang likokonyana e rekisoang kapa e ajoang US e tlameha ho ngolisoa le EPA, mme EPA e ka theha mamello bakeng sa masala a chefo e bolaeang likokoanyana haeba lihlahisoa tse tsoang lijong li nkuoa li "sireletsehile." 170
Mabapi le sena, chefo e bolaeang likokonyana e nang le fluoride e bile taba ea ngangisano:
1) Sulfuryl fluoride e ngolisitsoe ka lekhetlo la pele ho 1959 bakeng sa taolo ea bohloa mehahong ea lehong171 le 2004/2005 bakeng sa taolo ea likokoanyana lijong tse sebetsitsoeng, joalo ka lithollo tsa lijo-thollo, litholoana tse omisitsoeng, linate tsa lifate, linaoa tsa cocoa, linaoa tsa kofi, hammoho le lijo ho sebetsana le lits'ebeletso tsa phepelo ea lijo. 172 Maemo a chefo ea motho esita le lefu, ha a sa tloaelehang, a amahanngoa le pepese ea sulfuryl fluoride e amanang le malapa a phekotsoeng ka moriana o bolaeang likokoanyana. 173 Ka 2011, ka lebaka la lipatlisiso tse ntlafalitsoeng le litletlebo tse hlahisitsoeng ke Fluoride Action Network ( FAN), EPA e khothalelitse hore sulfuryl fluoride ha e sa kopana le maemo a polokeho le hore mamello ea sebolayang sena e lokela ho tlosoa. 174 Ho 2013, indasteri ea chefo e bolaeang likokoanyana e ile ea etsa boiteko bo matla ba ho qhekella tlhahiso ea EPA ea ho felisa sulfuryl fluoride, le Tlhahiso ea EPA e fetotsoe ke pehelo e kenyellelitsoeng ho Bill Bill ea 2014
2) Cryolite, e nang le sodium aluminium fluoride, ke sebolayaditshenekegi se se neng sa kwadisiwa la ntlha le EPA ka 1957.176 Cryolite ke sebolayaditshenekegi se segolo sa fluoride se se dirisetswang go lema dijo kwa US (fa sulfuryl fluoride e dirisiwa jaaka fumigant mo dijong tsa morago ga thobo) . Cryolite e sebelisoa litholoana tsa lilamunu le tsa lejoe, meroho, monokotsoai le morara, 177 mme batho ba ka e fumana ka lijo tsa bona, kaha cryolite e ka siea masala a fluoride lijong tseo e li sebeliselitsoeng. sulfuryl fluoride, EPA e boetse e etsa tlhahiso ea ho tlosa mamello eohle ea fluoride meriana e bolaeang likokonyana.178 Ka hona e ka be e kenyelelitse cryolite; leha ho le joalo, joalo ka ha ho boletsoe kaholimo, tlhahiso ena e ile ea hlakoloa.
Karolo ea 5.5: Lihlahisoa tsa meno tse ka sebelisoang lapeng
FDA e hloka ho ngolisoa "lihlahisoa tsa lithibela-mafu" tse rekisoang kontareng, joalo ka sesepa sa meno le ho hlatsoa molomo. Mantsoe a khethehileng bakeng sa ho ngolisoa a khethoa ka sebopeho sa
sehlahisoa (e leng gel kapa ho peista le ho hlatsoa), hammoho le khakanyo ea fluoride (ke hore, 850-1,150 ppm, 0.02% ea sodium fluoride, jj.) Litemoso tse 180 le tsona li arotsoe ke lihlopha tsa lilemo (ke hore, lilemo tse peli ho ea holimo, tlasa tse tšeletseng. , Lilemo tse 12 le ho feta, jj.). Litemoso tse ling li sebetsa ho lihlahisoa tsohle, tse kang tse latelang:
(1) Bakeng sa lihlahisoa tsohle tsa meno a meno a fluoride (gel, peista le phofo). “Boloka moo bana ba ka tlase ho lilemo tse tšeletseng ba ka fihleloang ke bana. [e ngotsoe ka mongolo o motenya] Haeba ho sebelisoa ntho e 'ngoe ho hlatsoa meno ka phoso ho ka etsoa, fumana thuso ea bongaka kapa u ikopanye le Setsi sa Taolo ea Chefo hona hoo. ”
(2) Bakeng sa tsohle rinse fluoride le lihlahisoa tsa kalafo e thibelang e ka gel. “Lula moo bana ba sa fihlelleheng. [e ngotsoe ka mongolo o motenya] Haeba e sebelisoa ho feta ”(khetha lentsoe le loketseng:“ ho hlatsoa ”kapa“ ho hlatsoa ”)“ e metsoa ka phoso, fumana thuso ea bongaka kapa ikopanye le Setsi sa Taolo ea Chefo hona hoo. ”182
Sengoloa sa lipatlisiso se phatlalalitsoeng ka 2014 se hlahisitse lipelaelo tse kholo mabapi le mabitso ana. Haholo-holo, bangoli ba thehile hore lihlahisoa tse fetang 90% tseo ba li hlahlobileng li thathamisitse tlhokomeliso ea FDA hore e ka sebelisoa feela ke bana ba ka holimo ho lilemo tse peli mokokotlong oa tube ea sesepa sa meno le ka fonte e nyane. 183 Maemo a tšoanang a tlalehiloe ka litemoso tse tsoang ho American Dental Association (ADA), e leng sehlopha sa khoebo eseng mokhatlo oa mmuso. Bafuputsi ba ile ba ngola hore menoana eohle ea meno e amoheloang kapa e amoheloa ke ADA e behile tlhokomeliso ea ADA (hore bana ba lokela ho sebelisa sesepa sa menoana le ho laoloa ke motho e moholo ho fokotsa ho koenya) ka morao ho tube ka fonte e nyane Mekhoa ea ho bapatsa e ne e le
e boetse e tsejoa e le ho khothaletsa sesepa sa meno joalo ka ha eka ke sehlahisoa sa lijo, seo bafuputsi ba ileng ba lumela hore ke leqheka le ka bakang bana ka mokhoa o kotsi.
Le ha meno a meno a arotsoe ke FDA e le sesebelisoa sa Sehlopha sa I, 186 floss ea meno e nang le fluoride (hangata stannous fluoride) e nkuoa e le sehlahisoa se kopaneng187 mme e hloka
Likopo tsa premarket.188 Dental floss le eona e ka ba le fluoride ka sebopeho sa metsoako e nkhang hamonate; 189 leha ho le joalo, ha ho na leseli la taolo mabapi le mofuta ona oa fluoride ho meno a meno
e ka fumanoa ke bangoli ba pampiri ena ea boemo.
Karolo ea 5.6: Lihlahisoa tsa Meno tse Sebelisitsoeng Ofising ea Meno
Boholo ba lisebelisoa tse sebelisoang ofising ea meno tse ka lokollang fluoride li laoloa e le lisebelisoa tsa bongaka / meno, joalo ka lisebelisoa tse ling tsa ho tlatsa lehoakhoa, 190 191 lisamente tse ling tsa meno, 192 le lisebelisoa tse ling tsa lehoakhoa. 193 Haholo-holo, boholo ba tsona thepa ea meno e khethiloe ke FDA e le lisebelisoa tsa bongaka tsa sehlopha sa bobeli sa bongaka, 194 ho bolelang hore FDA e fana ka "netefatso e utloahalang ea polokeho le ts'ebetso ea sesebelisoa" ntle le ho beha sehlahisoa boemong bo phahameng ka ho fetisisa ba taolo ea taolo.195 Habohlokoa, e le karolo ea tlhophiso ea FDA Tsamaiso, lisebelisoa tsa meno tse nang le fluoride li nkuoa e le lihlahisoa tse kopaneng, 196 le lifaele tsa sekhahla sa ho lokolloa ha fluoride li lebelletsoe ho fanoa e le karolo ea tsebiso ea pele ho mmaraka bakeng sa sehlahisoa.197 FDA e tsoela pele ho re: "Likopo tsa thibelo ea masoba kapa melemo e meng ea kalafo ke e lumelletsoe haeba e tšehetsoa ke tlhaiso-leseling ea bongaka e ntlafalitsoeng ke lipatlisiso tsa IDE [Investigational Device Exemption]. ” 198 Ho feta moo, ha FDA e bua phatlalatsa ka mokhoa o lokollang fluoride oa lisebelisoa tse ling tsa ho hlaphoheloa ha meno, FDA ha e ba khothaletse phatlalatsa webosaeteng ea bona hore e ka sebelisoa ho thibela caries.199
Ka mokhoa o ts'oanang, ha li-varnish tsa fluoride li amoheloa e le lisebelisoa tsa bongaka tsa sehlopha sa bobeli sa bongaka hore li ka sebelisoa e le lesela la lesela le / kapa meno a hlatsoang meno, ha li amoheloe hore li ka sebelisoa ho thibela caries. 200 Ka hona, ha ho etsoa likopo tsa thibelo ea caries ka sehlahisoa se seng se entsoe. e silafalitsoe ke fluoride e eketsehileng, sena se nkuoa ke FDA e le sethethefatsi se sa amoheleheng, se silafalitsoeng. Ntle le moo, melao ea FDA e etsa hore ngaka / ngaka ea meno e ikarabelle ka boeona bakeng sa ts'ebeliso ea litlhare tse amoheloang ntle le leibole. EA-201-TL
Ntle le moo, ka 2014, FDA e lumelletse ts'ebeliso ea silevera ea diamine fluoride bakeng sa ho fokotsa kutlo ea leino. Ts'ebeliso ea silevera ea diamine fluoride (joalo ka ts'ebetsong ea caries) e se e lumelloa ke molao, ho na le tlhoko ea tataiso, melaoana le tumello e emeng.
Ho bohlokoa hape ho elelloa hore pente e nang le fluoride e sebelisitsoeng nakong ea meno ea ho thibela meno (ho hloekisa) e na le maemo a phahameng haholo a fluoride ho feta sesepa sa meno se rekisoang (ke hore 850-1,500 ppm ka sesepa sa meno se tloaelehileng204 khahlanong le 4,000-20,000 ppm fluoride ka prophy paste205). Pente ea fluoride ha e amoheloe ke FDA kapa ADA e le tsela e sebetsang ea ho thibela ho senyeha ha meno. 206
Karolo ea 5.7: Lithethefatsi tsa Meriana (Ho kenyeletsoa Lisebelisoa)
Fluoride e kenyelletsoa ka boomo litokisetsong tsa meriana (marotholi, matlapa, le li-lozenges tseo hangata li bitsoang "li-supplements" kapa "livithamini") tseo hangata li laeloang bana, tseo ho thoeng li thibela likoti. Ka 1975, FDA e ile ea bua ka ts'ebeliso ea litlatsetso tsa fluoride ka ho tlosa kopo e ncha ea lithethefatsi bakeng sa Ernziflur fluoride. Kamora hore liketso tsa FDA ho li-lozenges tsa Ernziflur li
e phatlalalitsoeng ho Federal Register, sengoloa se hlahile ho Therapy ea Therapy se bolelang hore tumello ea FDA e tlositsoe "hobane ha ho na bopaki bo matla ba ts'ebeliso ea lithethefatsi joalo ka ha ho laetsoe, ho khothaletsoa, kapa ho hlahisoa ho ngoliloeng ha eona." 207 208 Sengoloa se boetse se itse: "The Kahoo FDA e elelitse bahlahisi ba li-fluoride tse kopaneng le litokisetso tsa vithamine hore
tsoelo-pele ea ho bapatsa e khahlanong le lipehelo tse ncha tsa lithethefatsi tsa Federal Food, Drug, and cosmetic Act; ka hona ba kopile hore papatso ea lihlahisoa tsena e emisoe. ”209 210
Ka 2016, FDA e ile ea romella lengolo le leng la tlhokomeliso ka taba e tšoanang ea litlhare tse ncha tse sa amoheloang ka mefuta e mengata ho kenyeletsoa litlatsetso tsa fluoride tse lebisitsoeng ho 1975. Lengolo, le ngotsoe
La 13 Pherekhong 2016, e ile ea romeloa ho Kirkman Laboratories mabapi le mefuta e mene e fapaneng ea metsoako ea bana ea fluoride e ngotsoeng e le lithuso ho thibela meno. 211 Lengolo la tlhokomeliso la FDA le ne le fa k'hamphani matsatsi a 15 hore a ikobele molao212 mme e ntse e le joalo Mohlala o mong oa bana ba fumanang litokisetso tse sa amoheleheng tsa fluoride ka kotsi, tseo e seng e le bothata ho la US ho feta lilemo tse 40.
Ho sa le joalo, fluorine e boetse e lumelloa ka mokhoa o amohelehang litlhare tse ling tsa meriana. Mabaka a mang a fumanoeng a tlatselletsa litlhare a kenyelletsa lipolelo tsa hore e ka "eketsa lithethefatsi
ho khetha, ho e nolofalletsa ho qhibiliha ka mafura, le ho fokotsa lebelo leo sethethefatsi sena se silafatsoang ka lona, kahoo se le fe nako e eketsehileng ea ho sebetsa. ” 213 20-30% ea metsoako ea meriana e hakantsoe hore e na le fluorine. levofloxacin [e rekisoang e le Levaquin], moxifloxacin [e rekisoang e le Avelox], norfloxacin [e rekisoang e le Noroxin], le ofloxacin [e rekisoa e le Floxin le generic ofloxacin]).
216
Mabapi le fluoroquinolones, FDA e fane ka temoso e ncha mabapi le ho holofatsa litla-morao ka 2016, lilemo kamora hore litlhare tsena li tsebisoe 'marakeng ka lekhetlo la pele. Phatlalatsong ea bona ea Phupu 2016, FDA e itse:
Meriana ena e amahanngoa le litla-morao tse holofatsang le tse ka bang teng tsa mesifa, mesifa, manonyeletso, methapo le tsamaiso ea methapo e bohareng e ka hlahang hammoho ho mokuli a le mong. Ka lebaka leo, re ntlafalitse tlhokomeliso e matla ka ho fetisisa ea Boxed Warning, ho rarolla mathata ana a tebileng a polokeho. Hape re kentse tlhokomeliso e ncha ra ba ra ntlafatsa likarolo tse ling tsa lengolo la litlhare, ho kenyeletsoa le Guide ea Meriana ea Mokuli. 217
Ka lebaka la litla-morao tsena tse fokolisang, FDA e ile ea eletsa hore lithethefatsi tsena li lokela ho sebelisoa ha feela ho se na mokhoa o mong oa kalafo o fumanehang bakeng sa bakuli hobane likotsi li feta
Nakong ea phatlalatso ena ea 218 FDA, ho ne ho hakanngoa hore MaAmerika a fetang limilione tse 2016 a ne a noa meriana ena selemo le selemo. EA-26-TK
Karolo ea 5.8: Metsoako e pentiloeng
Lintho tsa Per- le polyfluoroalkyl (PFASs), tseo hape ho thoeng ke metsoako e entsoeng ka litlolo kapa lik'hemik'hale tse nkhang hamonate (PFCs), ke lintho tse sebelisoang likhapeteng, ho hloekisang, liphahlo, ho pheha,
ho paka lijo, lipente, pampiri le lihlahisoa tse ling hobane li fana ka khanyetso ea mollo le oli, letheba, mafura le phepelo ea metsi. 220 Mohlala, perfluorooctanoic acid (PFOA) e sebelisetsoa ho etsa polytetrafluoroethylene (PTFE), e sebelisoang Teflon , Gore-tex, Scotchguard le Stainmaster. 221
Leha ho le joalo, ha bo-rasaense ba fetang 200 ba tsoang linaheng tse 38 ba saena "Polelo ea Madrid" ka 2015, ho ile ha phatlalatsoa lipelaelo tse 223 ka lintho tse joalo le kamano ea tsona le bokuli.
Ntle le moo, ho 2016, EPA e boletse ka li-PFSA:
Liphuputso li bonts'a hore ho pepesehela PFOA le PFOS maemong a itseng ho ka baka litlamorao tse mpe tsa bophelo bo botle, ho kenyeletsoa le litlamorao tsa kholo ho masea nakong ea bokhachane kapa ho masea a anyesitsoeng (mohlala, boima ba 'mele bo tlaase, ho kena bohlankaneng kapele, phapang ea masapo), mofetše (mohlala, testicular , liphio), litlamorao tsa sebete (mohlala, tšenyo ea lisele), litlamorao tsa 'mele (mohlala, tlhahiso ea lisireletsi le boits'ireletso ba mmele), le litlamorao tse ling (mohlala, phetoho ea k'holeseterole) .225
Kahoo, naheng ea Amerika, boiteko bo sa tsoa qala ho fokotsa ts'ebeliso ea lik'hemik'hale tsena. Mohlala, ho 2016, EPA e fane ka likeletso tsa bophelo bo botle bakeng sa PFOA le PFOS metsing a nooang, ho supa boemo kapa litla-morao tsa litlamorao tse mpe tsa bophelo bo botle tse sa lebelloang hore li ka ba teng nakong eohle ea phephetso e le likarolo tsa 0.07 ka bilione (likarolo tse 70 ho trillion) Bakeng sa PFOA le PFOS. 226 E le mohlala o mong, ho 2006, EPA e ile ea ikopanya le lik'hamphani tse robeli ka lenaneo la botsamaisi bakeng sa lik'hamphani tsena tse robeli ho fokotsa le ho felisa PFOA ka 2015.227 Leha ho le joalo, EPA e na le
hape ho ngotsoe hore "ba lula ba tšoenyehile" ka lik'hamphani tse hlahisang lihlahisoa tsena tse sa nkang karolo lenaneong lena.228
Karolo ea 5.9: Mosebetsing
Ho hlahisa li-fluoride (fluoride, perfluoride) mosebetsing ho laoloa ke Occupational Safety & Health Administration (OSHA). Ntlha ea bophelo bo botle e hlokomeloang haholo ke litekanyetso tsena ke skeletal fluorosis, 'me litekanyetso tse behiloeng molemong oa ho pepeseha ha fluorides li lula li thathamisitsoe e le 2.5 mg / m3.229
Sehloohong sa 2005 se phatlalalitsoeng ho International Journal of Occupational and Environmental Health mme se hlahisitsoe karolo ho American College of Toxicology Symposium, mongoli Phyllis J. Mullenix, PhD, o supile tlhoko ea ts'ireletso e ntle ea sebaka sa mosebetsi ho li-fluoride. 230 Haholo-holo, Dr. Mullenix o ngotse hore ha maemo a fluoride a lula a sa fetohe:
Haufinyane tjena tlhaiso-leseling e fumanehile eseng feela hore litekanyetso tsena li fane ka ts'ireletso e sa lekanang ho basebetsi ba pepesehileng ka fluorine le fluoride, empa hore indasteri e na le leseli le hlokahalang bakeng sa mashome a lilemo ho tseba maemo a ho se lekane le ho beha maemo a sireletsang a ho pepeseha. EA-231
Tlalehong ea 2006 ea Lekhotla la Naha la Lipatlisiso (NRC) ea Setsi sa Naha sa Saense moo likotsi tsa bophelo bo botle ba fluoride li ileng tsa hlahlojoa, ho ile ha hlahisoa matšoenyeho mabapi le mekhatlo e ka bang teng lipakeng tsa fluoride le osteosarcoma (mofets'e oa masapo), ho robeha ha masapo, litlamorao tsa mesifa, litlamorao tsa ho ikatisa le kholo, neurotoxicity le litlamorao tsa boits'oaro, genotoxicity le carcinogenicity, le litlamorao ho litsamaiso tse ling tsa setho. 232
Ho tloha ha tlaleho ea NRC e lokolloa ka 2006, ho phatlalalitsoe lithuto tse ling tse amanang le lipatlisiso. Ebile, ka kopo ea moahi ea 2016 ho EPA e tsoang Fluoride Action Network (FAN), IAOMT, le lihlopha tse ling, Michael Connett, Esq., Motsamaisi oa Molao oa FAN, o fane ka lenane la lipatlisiso tse ncha tse bonts'ang kotsi ea fluoride, e leng ea bohlokoa haholo, haholoholo ka lebaka la palo ea lithuto tsa batho tse eketsehileng: 233
Ka kakaretso, Bakopi ba supile le ho hokela lithuto tse 196 tse phatlalalitsoeng tse sebetsaneng le litlamorao tsa ts'oaetso ea fluoride kamora tlhahlobo ea NRC, ho kenyeletsoa lithuto tsa batho tsa 61, lithuto tsa liphoofolo tsa 115, lithuto tsa sele tsa 17 le litlhahlobo tse 3 tse hlophisehileng.
Lithuto tsa batho tsa post-NRC li kenyelletsa:
• Liphuputso tse 54 tse batlisisang phello ea fluoride ts'ebetsong ea ts'ebeliso ea kelello, ho kenyeletsoa empa e sa lekanyetsoe ho IQ, mme lithuto tsohle ntle le tse 8 li fumane lipalo tsa bohlokoa
mekhatlo pakeng tsa ho pepeseha ha fluoride le likhaello tsa kutloisiso. 234
• Liphuputso tse 3 tse batlisisang phello ea fluoride bokong ba "fetal", 'me patlisiso ka' ngoe e tlaleha litlamorao tse mpe. 3
• Liphuputso tse 4 tse batlisisang kamano ea fluoride le mefuta e meng ea likotsi tsa neurotoxic, ho kenyeletsoa ADHD, boitšoaro bo fetotsoeng ba bongoana, le matšoao a fapaneng a methapo.
Lithuto tsa liphoofolo tsa post-NRC li kenyelletsa:
• Ho etsoa lipatlisiso tse 105 tse batlisisang bokhoni ba fluoride ba ho hlahisa liphetoho tsa methapo le methapo ea kutlo, 'me lithuto tsohle ntle le tse peli li fumane bonyane tšusumetso e le' ngoe bonyane litekong tse le 'ngoe tse lekiloeng.
• Liphuputso tse 31 tse batlisisang phello ea fluoride ho ithuteng le mohopolong, mme lithuto tsohle li fumane bonyane phello e le 'ngoe e mpe lihlopheng tse tšoaroang ke fluoride.
• Liphuputso tse 18 tse batlisisang tšusumetso ea fluoride maemong a mang a boits'oaro ntle le ho ithuta le mohopolo, 'me lithuto tsohle li fumana litlamorao.
Lithuto tsa sele tsa post-NRC li kenyelletsa:
• Liphuputso tse 17, ho kenyeletsoa lithuto tse 2 tse fupulileng le ho fumana litlamorao maemong a fluoride a etsahalang khafetsa maling a Maamerika a lulang metseng ea fluoridated.240
Ntle le lithuto tse kaholimo, Bakopi ba fana ka litlhahlobo tse tharo tse latelang tsa NRC tsa lingoliloeng, ho kenyeletsoa tse peli tse buang ka lingoliloeng tsa batho / IQ, le e 'ngoe eo
e bua ka dingolwa tsa phoofolo / temohisiso. 241
Ho hlakile hore lingoloa tse ngata tsa lipatlisiso li se li ntse li supile kotsi e ka hlahelang batho ho tsoa fluoride maemong a fapaneng a pepeso, ho kenyeletsoa le maemo ao hona joale a nkoang a bolokehile. Leha e 'ngoe le e' ngoe ea lingoliloeng tsena e hloka tlhokomelo le puisano, lenane le khutsufalitsoeng le kenyellelitsoe ka tlase ka sebopeho sa tlhaloso e akaretsang ea litlamorao tsa bophelo bo botle tse amanang le phepelo ea fluoride, e nang le lintlha tsa bohlokoa tsa litlaleho le lithuto tse amehang.
Karolo ea 6.1: Sisteme ea Marapo
Fluoride e kenngoang 'meleng oa motho e kenella maling ka tšilo ea lijo.242 Boholo ba fluoride e sa ntšoeng ka moroto e bolokiloe' meleng. Ka kakaretso ho boleloa hore 99% ea fluoride ena e lula masapong, 243 moo e kenyellelitsoeng mohahong oa kristale mme e bokellana ha nako e ntse e tsamaea.244 Kahoo, ho ke ke ha latoloa hore meno le masapo ke lisele tsa 'mele tse tsepamisang fluoride ho tseo re pepesetsoang.
Ebile, tlalehong ea eona ea 2006, puisano ea Lekhotla la Naha la Lipatlisiso (NRC) mabapi le kotsi ea ho robeha ha masapo ho tsoa fluoride e fetelletseng e ile ea tšehetsoa ke lipatlisiso tse kholo. Ka ho khetheha,
Tlaleho e itse: "Ka kakaretso, ho bile le tumellano hara komiti ea hore ho na le bopaki ba mahlale ba hore maemong a mang fluoride e ka fokolisa masapo le ho eketsa menyetla ea ho robeha." 245
Karolo ea 6.1.1: Fluorosis ea meno
Ho pepesehela fluoride e fetelletseng ho bana ho tsejoa e le ho baka meno a fluorosis, boemo boo meno a meno a senyehang ka ho sa feleng 'me meno a fifala ka ho sa feleng, a bonts'a mokhoa o mosoeu kapa o mosootho o bosootho le ho etsa meno a robehang a robehang le ho ba bonolo. e se e amohetsoe ka mahlale ho tloha lilemong tsa bo-246 hore ho pepesehela fluoride ho feta tekano ho baka boemo bona, bo ka bang bobebe ho isa boemong bo boima. Ho latela tlhaiso-leseling e tsoang ho Litsi tsa Taolo le Thibelo ea Mafu (CDC) e lokollotsoeng ka 1940, 2010% ea Maamerika a lilemo li 23-6 le 49% ea bana ba lilemo li 41-12 ba bonts'a fluorosis ho isa bohōleng bo itseng. 15 Keketseho ena e matla ea sekhahla sa fluorosis ea meno e bile ntlha ea bohlokoahali qetong ea Ts'ebeletso ea Bophelo ba Sechaba ea ho theola likhothaletso tsa boemo ba metsi a fluoridation ka 247
Setšoantšo sa 1: Fluorosis ea meno e tloha ho Bonolo haholo ho isa Boima
(Linepe tse tsoang ho Dr. David Kennedy 'me li sebelisoa ka tumello ho tsoa ho bahlaseluoa ba fluorosis ea meno.)
Lifoto tsa Dental Fluorosis, lets'oao la pele la chefo ea fluoride, ho tloha bobeng bo boholo ho isa ho bo matla; Setšoantšo ke Dr. David Kennedy mme se sebelisitsoe ka tumello ea bahlaseluoa ba meno a fluorosis
Karolo ea 6.1.2: Skeletal Fluorosis le Ramatiki
Joalo ka meno a fluorosis, skeletal fluorosis ke phello e ke keng ea latoloa ea ho pepesehela pepeneneng ho fluoride. Skeletal fluorosis e baka masapo a teteaneng, bohloko ba manonyeletso, mefuta e fokolang ea motsamao o kopaneng, le ho
Maemong a boima, mokokotlo o thata ka ho felletseng.249 Le ha ho nkuoa e le ntho e sa tloaelehang Amerika, boemo bona bo a etsahala, 250 mme ho sa tsoa boleloa haufinyane hore masapo a fluorosis e ka ba taba ea bophelo bo botle ba sechaba ho feta kamoo ho neng ho tsejoa pele.251
Joalokaha lipatlisiso tse phatlalalitsoeng ka 2016 li hlokometse, ha ho so lumellane ka mahlale mabapi le hore na fluoride le / kapa hore na ho hlokahala hore ho nkoe li-fluoride tse kae pele ho marapo a fluorosis. EA-252-TK
Le ha ba bang ba boholong ba khothalelitse skeletal fluorosis hore e hlahe feela kamora lilemo tse 10 kapa ho feta tsa ho pepeseha, lipatlisiso li bontšitse hore bana ba ka ba le lefu lena nakong ea likhoeli tse tšeletseng, 253
'me batho ba bang ba baholo ba e hlahisitse ka nako e ka etsang lilemo tse peli ho isa ho tse supileng.254 Ka mokhoa o ts'oanang, ha ba bang ba boholong ba boletse hore 10 mg / letsatsi la fluoride hoa hlokahala ho nts'etsapele marapo fluorosis, lipatlisiso li tlalehile hore maemo a tlase haholo a ho pepesehela fluoride (ka Maemong a mang a ka tlase ho 2ppm) le ona a ka baka lefu lena. 255 Ho feta moo, lipatlisiso tse phatlalalitsoeng ka 2010 li netefalitse hore karabelo ea lisele tsa masapo ho fluoride e fapana ka motho ka mong.
Ho bakuli ba nang le skeletal fluorosis, ho 'nile ha belaelloa hore fluoride e baka hyperparathyroidism ea bobeli le / kapa e baka tšenyo ea masapo e ts'oanang le hyperparathyroidism ea bobeli. Boemo bona, bo atisang ho bakoa ke lefu la liphio, bo bakoa ke ha maemo a khalsiamo le phosphorus maling a le tlase haholo. tlatsetsa phellong ena ea bophelo bo botle. EA-257-TK
Hobane matšoao a ramatiki a amahanngoa le skeletal fluorosis, ramatiki ke sebaka se seng se tšoenyang mabapi le ho pepeseha ha fluoride. Haholo-holo ntlheng ena, lipatlisiso li hokahantse fluoride le lefu la masapo a mabeli, a nang le skeletal fluorosis kapa a se na eona.259 Ho feta moo, lefu la kopanelo la temporomandibular (TMJ) le amahanngoa le meno le masapo a fluorosis.
Karolo ea 6.1.3: Kankere ea Lesapo, Osteosarcoma
Ka 2006, NRC e buile ka kamano e ka bang teng lipakeng tsa ts'oaetso ea fluoride le osteosarcoma. Mofuta ona oa mofetše oa masapo o amohetsoe e le "sehlopha sa botšelela se tsebahalang haholo sa lihlahala tse kotsi baneng le hlahala ea boraro e tsebahalang haholo bakeng sa bacha." 261 NRC e boletse hore leha bopaki bo ne bo sa sebetse, fluoride e bonahala e na le monyetla oa ho khothaletsa mofetše. .262
Ba hlakisitse hore osteosarcoma e ne e le taba ea bohlokoa haholo, haholoholo ka lebaka la ho beha fluoride masapong le phello ea mitogenic ea fluoride liseleng tsa masapo.
Le ha lithuto tse ling li hlotsoe ho fumana kamano lipakeng tsa fluoride le osteosarcoma, ho latela lipatlisiso tse phethetsoeng ke Dr. Elise Bassin ha a le Harvard School of Dental Medicine, ho pepesehela fluoride maemong a khothalelitsoeng ho amanang le keketseho ea makhetlo a supileng ea osteosarcoma ha bashanyana ba ne ba le teng. e senotsoeng pakeng tsa lilemo tse hlano le tse supileng.264 Patlisiso ea Bassin, e phatlalalitsoeng ka 2006, ke eona feela thuto e mabapi le osteosarcoma e nkileng likotsi tse ikhethileng lilemong.
Karolo ea 6.2: Sisteme ea methapo e bohareng
Monyetla oa li-fluoride ho ama bokong o thehiloe hantle. Tlalehong ea bona ea 2006, NRC e hlalositse: "Motheong oa tlhaiso-leseling e tsoang haholo lithutong tsa hisitori, tsa lik'hemik'hale le tsa limolek'hule, ho hlakile hore li-fluoride li na le bokhoni ba ho sitisa mesebetsi ea boko le 'mele ka mekhoa e tobileng le e sa tobang. . ”266 Ka bobeli 'dementia' le Alzheimer's
Lefu le boetse le boletsoe tlalehong ea NRC bakeng sa ho nkuoa e le lona le ka amanang le fluoride
Matšoenyeho ana a netefalitsoe. Liphuputso tse mabapi le fluoridation ea metsi le litlamorao tsa IQ li ile tsa hlahlojoa ka hloko lipatlisisong tse phatlalalitsoeng ka Mphalane 2012 ho Maikutlo a Bophelo ba Tikoloho. 268 Tlhahlobisong ena ea litlhahlobo, lithuto tse 12 li bontšitse hore sechaba se nang le metsi a nang le fluoridated ka tlase ho 4 mg / L (karolelano ea 2.4 mg / L ) li ne li na le li-IQ tse tlase ho feta lihlopha tse laolang. 269 Ho tloha ha ho phatlalatsoa tlhahlobo ea 2012, lithuto tse ling tse ngata tse fumaneng li-IQ tse fokotsehileng sechabeng se nang le fluoride e ka tlase ho 4 mg / L ka metsing li se li fumaneha. 270 Ho nepahala ho feta, Kopo ea moahi ho EPA ka 2016, Michael Connett, Esq., Motsamaisi oa Molao oa FAN, o supile lithuto tse 23 tse tlalehang li fokotsa IQ libakeng tse nang le maemo a fluoride hajoale a amoheloang a bolokehile ke EPA.
Ho feta moo, ka 2014, ho ile ha phatlalatsoa tlhaiso-leseling ho The Lancet e nang le sehlooho se reng "Liphello tsa boits'oaro ba ts'ebeliso ea chefo" Tlhahlobisong ena, fluoride e ne e le lethathamong la lik'hemik'hale tse 12 tsa indasteri
tse tsejoang ho baka nts'etsopele ea methapo ea kutlo ho batho.272 Bafuputsi ba ile ba lemosa: "Bokooa ba Neurodevelopmental, ho kenyelletsa le autism, lefu la ho se ele hloko, bothata ba ho kula, le mathata a mang a kelello, li ama bana ba limilione lefats'eng ka bophara, 'me litlhahlobo tse ling li bonahala li eketseha khafetsa. Lik'hemik'hale tsa indasteri tse lematsang boko bo ntseng bo hola ke tse ling tsa lisosa tse tsebahalang tsa keketseho ena. ”273
Karolo ea 6.3: Sisteme ea pelo
Ho ea ka lipalo-palo tse phatlalalitsoeng ka 2016, lefu la pelo ke sesosa se ka sehloohong sa lefu bakeng sa banna le basali naheng ea Amerika, 'me le jella naha $ 207 billion selemo le selemo.
Kamano e ka bang teng lipakeng tsa fluoride le mathata a pelo le methapo ha e bohlokoa feela bakeng sa mehato e bolokehileng bakeng sa fluoride empa hape le mehato ea thibelo e tla theoa bakeng sa lefu la pelo.
Kamano lipakeng tsa mathata a fluoride le pelo le methapo e se e belaelloa ka mashome a lilemo. Tlaleho ea 2006 NRC e hlalositse phuputso e tsoang ho 1981 ke Hanhijärvi le Penttilä e tlalehileng serum fluoride e phahameng ho bakuli ba nang le ho hloleha ha pelo. 275 Fluoride e boetse e amana le calcification ea arterial, 276 arteriosclerosis, 277 lefu la pelo, 278 electrocardiogram e sa tloaelehang, 279 khatello ea kelello, 280 le 281 le tšenyo ea myocardial.2015 Ho feta moo, bafuputsi ba phuputso e tsoang Chaena e phatlalalitsoeng ka 2 ba phethile ka ho re: "Liphetho li bonts'itse hore NaF [sodium fluoride], e ipapisitse le mokhoa oa ho tsepamisa mohopolo ebile e le tlase ho 282 mg / L, e fetotse morpholoji ea li- cardiomyocyte, ho fokotsa matla a lisele, ho eketsa lebelo la ho tšoaroa ha pelo, le ho matlafatsa boemo ba apoptosis. ”XNUMX
Karolo ea 6.4: Sistimi ea Endocrine
Liphello tsa fluoride tsamaisong ea endocrine, e nang le litšoelesa tse laolang lihomone, le tsona li ithutiloe. Tlalehong ea 2006 ea NRC, ho itsoe: "Ka bokhutšoanyane, bopaki ba mefuta e 'maloa bo bontša hore fluoride e ama tšebetso e tloaelehileng ea endocrine kapa karabelo; litlamorao tsa liphetoho tse bakiloeng ke fluoride li fapana ho ea ka maemo le mosa ho batho ba fapaneng. ”283 Tlaleho ea 2006 NRC e boetse e kenyelelitse tafole e bonts'a hore na tekanyetso e tlase haholo ea fluoride e fumanoe e sitisa ts'ebetso ea qoqotho, haholo ha ho na le khaello ea iodine hona joale.284 Lilemong tsa morao tjena, phello ea fluoride tsamaisong ea endocrine e hatisitsoe hape. Phuputso e phatlalalitsoeng ka 2012 e kenyellelitse sodium fluoride lenaneng la lik'hemik'hale tse senyang li-endocrine (EDCs) tse nang le litlamorao tse tlase, 285 mme phuputso e bontšitsoe tlalehong ea 2013 e tsoang ho Lenaneo la Tikoloho la Machaba a Kopaneng le Mokhatlo oa Lefatše oa Bophelo. 286
Khabareng, sekhahla se eketsehileng sa ts'oaetso ea qoqotho se amahantsoe le fluoride. 287 Patlisiso e phatlalalitsoeng ka 2015 ke bafuputsi Univesithing ea Kent e Canterbury, England, ba hlokometse hore maemo a phahameng a fluoride metsing a nooang a ka bolela maemo a phahameng a hypothyroidism. Ba ile ba tsoela pele ho hlalosa: “Libakeng tse ngata tsa lefats'e, hypothyroidism ke ntho e ka sehloohong e amehileng ka bophelo bo botle mme ntle le lintlha tse ling-joalo ka khaello ea iodine- ho pepesehela fluoride ho lokela ho nkuoa e le sesosa. Liphuputso tsa boithuto li hlahisa matšoenyeho a khethehileng mabapi le bonnete ba fluoridation ea sechaba e le mokhoa o bolokehileng oa bophelo bo botle ba sechaba. ”288 Liphuputso tse ling li tšehelitse kamano lipakeng tsa fluoride le hypothyroidism, 289 keketseho ea qoqotho e hlohlelletsang li-hormone (THS), 290 le khaello ea iodine. EA-291-TL
Ho latela lipalo-palo tse fanoeng ke Setsi sa Taolo le Thibelo ea Mafu (CDC) ka 2014, batho ba limilione tse 29.1 kapa 9.3% ea baahi ba na le lefu la tsoekere.293 Hape, karolo e ka bang teng ea fluoride maemong ana e bohlokoa ho elelloa. Tlaleho ea 2006 NRC e lemositse:
Sephetho sa lithuto tse fumanehang ke hore ho pepeseha ha fluoride e lekaneng ho bonahala ho baka keketseho ea tsoekere ea mali kapa mamello ea tsoekere e sa sebetseng ho batho ba bang le ho eketsa ho teba ha mefuta e meng ea lefu la tsoekere. Ka kakaretso, metabolism ea tsoekere e senyehileng e bonahala e amahanngoa le serame kapa lero la plasma fluoride le ka bang 0.1 mg / L kapa ho feta liphoofolong le bathong (Rigalli et al. 1990, 1995; Trivedi et al. 1993; de al Sota et al. 1997) .294
Liphuputso li boetse li amahantse lefu la tsoekere le nang le matla a fokolang a ho tlosa fluoride 'meleng, 295 hammoho le syndrome (polydispsia-polyurea) e lebisang ho eketseheng ho kenella ha fluoride, 296 le
lipatlisiso li boetse li hokahantse thibelo ea insulin le ho hanyetsa fluoride.297
Ntho e 'ngoe e tšoenyang ke hore fluoride e bonahala e kena-kenana le ts'ebetso ea phaeneal, e thusang ho laola morethetho oa li-circadian le lihormone, ho kenyeletsoa taolo ea melatonin le lihormone tsa ho ikatisa. Jennifer Luke oa Royal Hospital ea London o supile maemo a phahameng a fluoride a bokellaneng mokhoeng oa phaene298 mme a tsoela pele ho bonts'a hore maemo ana
e ka fihla ho 21,000 ppm, e li fang holimo ho feta maemo a fluoride lesapong kapa meno. 299 Liphuputso tse ling li hokahantse fluoride le maemo a melatonin, ho hlobaela ka makhetlo a 300, 301 le bohlankana kapa boroetsaneng.
ho banana, 302 mmoho le sekhahla sa tsoalo se tlase (ho kenyeletsoa banna) le ho fokotsa maemo a testosterone.303
Karolo ea 6.5: Sisteme ea Renal
Moroto ke tsela e kholo ea ho ntša fluoride e isitsoeng 'meleng,' me tsamaiso ea renal e bohlokoa molemong oa taolo ea likarolo tsa fluoride 'meleng. 304 305 Ho ntša metsi ka mosing oa fluoride ke
e susumetsoang ke pH ea moroto, lijo, boteng ba lithethefatsi le lintlha tse ling.306 Bafuputsi ba sengoloa sa 2015 se phatlalalitsoeng ke Royal Society of Chemistry ba hlalositse: le ho ntšoa masapong le ho ntša metsi ka liphio. ”307
Tlaleho ea 2006 NRC le eona e ananetse karolo ea liphio phumutsong ea fluoride. Ba hlokometse hore ha ho makatse hore bakuli ba nang le lefu la liphio ba eketse lipalo tsa plasma le bone fluoride. 308 Ba boetse ba re liphio tsa batho "li tlameha ho tsepamisa fluoride ka makhetlo a ka bang 50 ho tloha lero la mali ho ea ho moroto. Likarolo tsa ts'ebetso ea renal li ka ba kotsing e kholo ea chefo ea fluoride ho feta lisele tse ngata tse bonolo. ”309
Ka lebaka la tlhaiso-leseling ena, hoa utloahala hore bafuputsi ba hlile ba hokahantse ho pepeseha ha fluoride le mathata a sistimi ea renal. Haholo-holo, bafuputsi ba tsoang Toronto, Canada, ba bontšitse hore bakuli ba dialysis ba nang le lefu la masapo le nang le lefu la masapo ba ne ba e-na le fluoride e ngata masapong mme ba fihlela qeto ea hore "bone fluoride e ka fokotsa ho fokola ha masapo ka ho sitisa matsoai." 310 Ho feta moo, phuputso ho basebetsi ba pepesitsoeng ke cryolite e ngotsoeng ke Philippe Grandjean le Jørgen H. Olsen e phatlalalitsoeng ka 2004 e khothalelitse hore fluoride e nkoe e le sesosa sa kankere ea senya le sesosa sa kankere ea matšoafo.
Karolo ea 6.6: Sisteme ea Phefumoloho
Liphello tsa fluoride tsamaisong ea ho hema li ngotsoe ka ho hlaka lingoliloeng mabapi le
Ho pepeseha mosebetsing. Ho hlakile hore basebetsi indastering e kenyelletsang fluoride ba bangata
kotsi e kholo ea ho hema fluoride ho feta ba sa sebetseng indastering; leha ho le joalo ke indasteri
Ts'ebeliso e ka ama le mekhoa ea phefumoloho ea baahi ba mahareng ka ho pepeseha ho fapaneng
litsela.
Ho hema ha hydrogen fluoride ho sebetsa e le mohlala o motle oa mosebetsi o pakiloeng habeli
le kotsi ea bophelo bo botle e seng mosebetsing. Hydrogen fluoride e sebelisetsoa ho etsa lihatsetsi, libolayalehola,
meriana, oli e phahameng ea octane, aluminium, polasetiki, likarolo tsa motlakase, fluorescent
mabone a lebone, le tšepe ea khalase le khalase (joalo ka tse sebelisitsoeng lisebelisoa tse ling tsa elektroniki),
312 hape
joalo ka tlhahiso ea lik'hemik'hale tsa uraniamo le tlhoekiso ea quartz. 313
Litsi tsa Taolo ea Mafu le
Thibelo (CDC) e hlalositse hore ntle le likotsi mosebetsing, ha se mosebetsi
Ho pepeseha ha hydrogen fluoride ho ka etsahala le libakeng tsa mabenkele le ka lintho tsa ho itlosa bolutu tse amang
lintho tse entsoeng ka ntho eo, hammoho le ketsahalo e sa tloaelehang ea ho pepesetsoa bokhukhuni ba lik'hemik'hale
moemeli.314
Litlamorao tsa bophelo bo tsoang ho hydrogen fluoride li ka senya litho tse fapaneng tse fapaneng, ho kenyeletsoa le tsona
e amehang le sistimi ea ho hema. Ho hema lik'hemik'hale ho ka senya lisele tsa matšoafo le sesosa
ho ruruha le ho bokellana ha metsi matšoafong (pulmonary edema) .315
Maemo a phahameng a ho pepesetsoa haedrojide ea hydrogen a ka baka lefu ho tsoa matlong a matšoafo, 316 ha a sa foleng, a le tlase
Ho hema ho ka baka ho koata le ho ferekana ha nko, 'metso le matšoafo. 317
Haholo-holo ponong ea mosebetsi, indasteri ea aluminium e bile taba ea batho ba bangata
ea lipatlisiso mabapi le tšusumetso ea fluoride mekhoeng ea ho hema ea basebetsi. Bopaki bo tsoang ho a
letoto la lithuto li bonts'a kamano pakeng tsa basebetsi ba limela tsa aluminium, tse pepesetsoeng ho
fluoride, le litlamorao tsa ho hema, joalo ka emphysema, bronchitis le ho fokola ha matšoafo
tshebetso.318
Karolo ea 6.7: Sisteme ea Ts'ilo ea lijo
Ha ho kenoa, ho kenyelletsa le metsi a nang le fluoridated, fluoride e monngoa ke masapo
system moo e nang le halofo ea bophelo ea metsotso e 30
Palo ea fluoride e kenngoeng e its'etleha
hodima maemo a khalsiamo, ka bongata ba calcium e theohang masapo
monko.
320 321
Hape, ho latela lipatlisiso tse phatlalalitsoeng ka 2015 ke Setsi sa Amerika sa
Lik'hemik'hale tsa Lik'hemik'hale, tšebelisano ea fluoride tsamaisong ea mala "e baka ho theoa ha
hydrofluoric [HF] acid ka ho sebetsana le acid e hydrochloric [HCL] e ka mpeng. Ho ba
e senyang haholo, asiti ea HF e entsoeng joalo e tla senya mala le mala
tahlehelo ea li-microvilli. ”322
Karolo e 'ngoe ea lipatlisiso e amanang le tšusumetso ea fluoride pampitšaneng ea meno ke ka phoso
ho noa sesepa sa meno. Ka 2011, Setsi sa Taolo ea Chefo se amohetse mehala e 21,513 e amanang le
tšebeliso e fetelletseng ea sesepa sa meno se nang le fluoridated. 323
Linomoro tsa batho ba amehileng li kanna tsa
e phahame haholo, leha ho le joalo. Matšoenyeho a hlahisitsoe ke matšoao a mang a mala
e kanna ea se nkoe e le bonolo ha e amana le ho kenella ha fluoride, joalo ka ha bafuputsi ba hlalositse ka 1997:
Batsoali kapa bahlokomeli ba kanna ba se ke ba bona matšoao a amanang le chefo e bonolo ea fluoride
kapa a ka ba tšoaea colic kapa gastroenteritis, haholo haeba ba sa bone ngoana
noa fluoride. Ka mokhoa o ts'oanang, ka lebaka la sebopeho se sa totobalang sa bonolo ho isa boemong bo itekanetseng
matšoao, tlhahlobo ea phapang ea ngaka ha e na monyetla oa ho kenyelletsa chefo ea fluoride
ntle le nalane ea ho kenella ha fluoride. 324
Likarolo tse ling tsa sistimi ea tšilo ea lijo le tsona li tsejoa li angoa ke fluoride. Mohlala,
Tlaleho ea 2006 NRC e bitsitse tlhaiso-leseling e batsi ka phello ea fluoride sebeteng: “Ho ka etsahala
hore ho noa bophelo ba 5-10 mg / letsatsi ho tloha metsing a nooang a nang le fluoride ho 4 mg / L ho ka etsahala
ho ba le litlamorao tsa nako e telele sebeteng, 'me sena se lokela ho batlisisoa nakong e tlang
lithuto tsa lefu la seoa. ”325 E le mohlala o mong, sesepa sa meno sa fluoride se ka baka stomatitis, joalo ka
molomo le liso tsa kankere ho batho ba bang. EA-326-TZ
Karolo ea 6.8: Sesole sa 'mele
Masole a mmele ke karolo e nngwe ya mmele e ka angwang ke fluoride. An
Taba ea bohlokoa ke hore lisele tsa 'mele tse itšireletsang mafung li hlaha' mokong, kahoo phello ea fluoride
sesole sa 'mele se ka amana le ho ata ha fluoride tsamaisong ea masapo. 2006
Tlaleho ea NRC e hlalositse boemo bona:
Leha ho le joalo, bakuli ba lulang sechabeng sa fluoridated kapa a
Sechaba moo metsi a nooang ka tlhaho a nang le fluoride ho 4 mg / L a nang le tsohle
fluoride e bokellaneng tsamaisong ea masapo mme e ka ba le fluoride e phahameng haholo
mahloriso masapong a bona. Moko oa masapo ke moo lisele tsa boits'ireletso li hlahang teng le hore
e ka ama boits'ireletso ba mmele bo nyonyehang le tlhahiso ea lisireletsi tsa lik'hemik'hale tsa kantle ho naha
Matšoafo le hypersensitivities ho fluoride ke karolo e 'ngoe ea kotsi e amanang le boits'ireletso ba mmele
sistimi. Liphuputso tse phatlalalitsoeng ka bo-1950, bo-1960, le bo-1970 li bontšitse hore batho ba bang ba
hypersensitive to fluoride.328 Ho khahlisang ke hore bangoli ba lipatlisiso tse phatlalalitsoeng ka 1967 ba bontšitse
hore ha ba bang ba ntse ba belaella taba ea hore fluoride ka sesepa sa meno le "livithamini" li ka baka
ho hlonama, litlaleho tsa linyeoe tse hlahisitsoeng phatlalatsong ea tsona li netefalitse khatello ea maikutlo ho
fluoride e teng.329 Liphuputso tse ling tsa moraorao li netefalitse taba ena. EA-330-TL
Karolo ea 6.9: Sisteme ea Litaba
Fluoride e ka ama tšebetso ea lingoliloeng, e nang le letlalo, litšoelesa tsa 'mele.
moriri, le manala. Ka ho khetheha, liketso tsa fluoride, ho kenyelletsa le fluoride e sebelisitsoeng ho sesepa sa meno, li na le
e hokahantsoe le makhopho le maemo a mang a letlalo. 331 332 333
Ho feta moo, e ka 'nang ea tšosa bophelo
Boemo bo tsejoang e le fluoroderma bo bakoa ke khatello ea maikutlo ho fluorine, 334
mme mofuta ona oa ho phatloha ha letlalo (halogenoderma) ho amahanngoa le bakuli ba sebelisang
lihlahisoa tsa meno tse nang le fluoridated.335
Ntle le moo, moriri le manala li ithutiloe e le biomarkers tsa
ho pepeseha ha fluoride.
336
Likhetsi tsa lipekere li khona ho bonts'a likhahla tse sa foleng tsa fluoride337
le ho pepeseha ho sesepa sa meno, 338 le ho sebelisa likhakanyo tsa fluoride lipekere ho khetholla bana
kotsing ea mafu a meno e se e hlahlobiloe.339
Karolo ea 6.10: Fluoride Toxicity
Nyeoe ea pele e kholo ea nyeoe ea liindasteri e tsoang ho fluorine e ne e ama koluoa ea
Meuse Valley e Belgium lilemong tsa bo-1930. Moholi le maemo a mang sebakeng sena se tsoetseng pele li
e amanang le lefu la 60 mme batho ba likete tse 'maloa ba kula. Bopaki bo se bo boletse ho tloha ka nako eo
mahlatsipa ana a tsoang ho lifeme tse haufi
Nyeoe e 'ngoe ea chefo ea liindasteri e etsahetse ka 1948 Donora, Pennsylvania, ka lebaka la moholi le
ho fetoha ha mocheso. Ketsahalong ena, likhase tse tsoang ho zinc, tšepe, terata le lenala li tsoa
liindasteri tsa galvanizing ho belaelloa hore li bakile lefu la 20 le batho ba likete tse tšeletseng ho
ho kula ka lebaka la chefo ea fluoride. 341
Chefo ea fluoride e tsoang sehlahisoa sa meno United States e etsahetse ka 1974 ha e ne e le lilemo tse tharo
Moshanyana oa khale oa Brooklyn o hlokahetse ka lebaka la ho fetela holimo ha fluoride ho tsoa ho gel ea meno. Moqolotsi oa litaba oa New York
Times e ngotse ka ketsahalo ena: “Ho latela setsebi sa chefo Seterekeng sa Nassau, Dr. Jesse Bidanset,
William o kentse li-cubic sentimeter tse 45 tsa 2% ea stannous fluoride solution, makhetlo a mararo
e ne e lekane ho bolaea. ”342
Maemong a 'maloa a maholo a chefo ea fluoride United States a fihletse tlhokomelo morao tjena
mashome a lilemo, joalo ka ho phatloha ha 1992 Hooper Bay, Alaska, ka lebaka la maemo a phahameng a fluoride phepelong ea metsi343 le chefo ea 2015 ea lelapa le leng Florida ka lebaka la sulfuryl
fluoride e sebelisitsoeng kalafong ea bohloa malapeng a bona. 344
Ha mehlala e fanoeng kaholimo e le maemong a chefo e matla (e phahameng, ea nako e khuts'oane), e sa foleng
(tekanyetso e tlase, chefo ea nako e telele) le eona e lokela ho tsotelloa. Bonyane tlhahisoleseling mabapi le fluoride
chefo e ntse e fumaneha ho thusa ho theha kutloisiso e betere ea taba. Mosebetsing
e phatlalalitsoeng ka 2015, bafuputsi ba ile ba lekola lintlha tsa hore letšoao la pele la chefo ea fluoride ke meno
fluorosis le fluoride eo ke moferefere o tsebahalang oa enzyme. 345
Ntle le moo, tlhahlobo e phatlalalitsoeng ho
2012 e fane ka tlaleho e qaqileng ea likotsi tsa phello ea chefo ea fluoride liseleng: “E kenya tšebetsong
hoo e batlang e le litsela tsohle tse tsebahalang tsa li-intracellular tse kenyelletsang litsela tse itšetlehileng ka G,
caspases, le mitochondria- le mekhoa ea ho amohela li-receptors, hammoho le ho baka mefuta e mengata
ea liphetoho tsa metabolism le phetolelo, ho kenyeletsoa polelo ea tse 'maloa tse amanang le apoptosis
liphatsa tsa lefutso, qetellong li lebisa lefung la sele. ”346
Potlako ea hore chefo ea fluoride e ka tsejoa haholo e ile ea hlahlojoa ka 2005
sengoliloeng se nang le sehlooho "Chefo ea fluoride: selotho se nang le likotoana tse patehileng." Sengoli Phyllis J.
Mullenix, PhD, e qalile sengoloa, se ileng sa hlahisoa ka karolo e 'ngoe American College of
Toxicology Symposium, ka tlhokomeliso: “Nalane ea litlhaloso tse makatsang tsa chefo ea fluoride
lingoliloeng tsa bongaka li e lumelletse hore e be e 'ngoe ea tse sa utloisisisoang ka ho fetisisa, e sa tsejoeng hantle,
le ho emela mathata a bophelo bo botle United States kajeno. ”347
Ha re bala Karolo e fetileng ea 7 mabapi le ho pepesehela fluoride, ho hlakile ka mokhoa o hlakileng hore na ho hlokahala lipatlisiso tse ling tse kae pele boemo bofe kapa bofe bo "sireletsehileng" ba ho pepeseha ha fluoride bo ka thehoa ka mokhoa o lekaneng. Ho haella ha bopaki ho fihla hole le se sa tsejoeng hajoale. Ho haella ha bopaki ho teng haholo ho se seng se tsebahala ka tšebeliso ea batho ea fluoride, haholoholo mabapi le "molemo" oa eona oa ho thibela ho bola.
Karolo ea 8.1: Ho haelloa ke Ts'ebetso
Fluoride ea menoana ea meno le lihlahisoa tse ling tsa bareki ea eketsoa hobane ho thoe e fokotsa ho senyeha ha meno. Melemo e hlahisitsoeng ea mofuta ona oa fluoride e amana le ts'ebetso ea ona meno a thibelang ho hema ha baktheria ea Streptococcus mutans, e leng baktheria e fetolang tsoekere le stches hore e be asiti e manamisitsoeng e qhibilihang enamel. 504 Ka ho khetheha, tšebelisano ea fluoride le karolo ea diminerale. meno a hlahisa fluorohydroxyapatite (FHAP kapa FAP), mme sephetho sa ketso ena ho thoe se ntlafatsoa remineralization le ho fokotsa demineralization ea meno. Le ha ho na le ts'ehetso ea mahlale ea mochini ona oa fluoride, ho boetse ho netefalitsoe hore fluoride e sebetsa haholo ho fokotsa ho bola ha leino ka sehloho (ke hore, ho e hohla ka kotloloho ho meno ka borashe ba meno), ho fapana le ka mokhoa oa ts'ebetso (ke ho noa kapa ho noa fluoride ka metsi kapa mekhoa e meng) .505
Leha melemo ea lihlooho tsa fluoride e hlalositsoe ka ho hlaka libukeng tsa mahlale, lipatlisiso le tsona li belaetse melemo ena. Ka mohlala, bafuputsi ba Univesithi ea Massachusetts Lowell ba hlalositse likhang tse 'maloa tse amanang le ts'ebeliso ea lihlooho tsa fluoride sengoloeng se phatlalalitsoeng ho Journal of Evidence-Based Dental Practice ka 2006. Kamora ho qotsa phuputso ea 1989 ho Setsi sa Naha sa Patlisiso ea Meno e sa fumaneng letho. phapang ea bana ba fumanang fluoride le ba sa fumaneng fluoride, bangoli ba bontšitse liphuputso tse ling tse bonts'ang hore litefiso tsa linaha linaheng tse tsoetseng pele li fokotsehile ntle le ts'ebeliso ea fluoride. 506 Bangoli ba boetse ba supa lithuto tse bontšang hore fluoride ha e thuse ho thibela ho bola le ho cheka ha mokoti (e leng mofuta o atileng ka ho fetesisa oa ho bola ha leino US) kapa ho thibela ho bola ha leino la botlolo ea bana (le atileng haholo sechabeng se futsanehileng).
E le mohlala o mong, lipatlisiso tsa pele tse sebelisitsoeng ho ts'ehetsa fluoridation ea metsi e le mokhoa oa ho fokotsa ho senyeha ha meno hamorao li ile tsa hlahlojoa hape, 'me ho ile ha fumanoa monyetla oa tlhaiso-leseling e khelosang. Qalong, phokotso ea meno a bolileng le a tlatsitsoeng (DFT) a bokelletsoeng lipatlisisong a ile a hlalosoa e le bopaki ba tšebetso ea fluoridation ea metsi. Le ha ho le joalo, patlisiso e ileng ea latela ea Ngaka John A. Yiamouyiannis e hlahisitse hore fluoridation ea metsi e ka be e kentse letsoho ho lieheng ho phatloha ha meno. 508 Ho phatloha ho joalo ho liehang ho ka baka meno a fokolang mme ka hona, ho ba sieo ha ho bola, ho bolelang hore litefiso tse tlase tsa DFT li ne li le teng. ha e le hantle e bakoa ke khaello ea meno ho fapana le litlamorao tsa fluoride ho meno a meno.
Mehlala e meng libukeng tsa mahlale e belaella ts'ebeliso ea fluoride ho thibela ho bola ha meno. Tlhahlobo ea 2014 e netefalitse hore phello ea anti-caries ea fluoride e its'etleha hodima khalsiamo le magnesium leineng la meno empa hape le hore ts'ebetso ea remineralization leino la meno ha ea itšetleha ka fluoride.509 Patlisiso e phatlalalitsoeng ka 2010 e supile hore mohopolo oa "meno a matlafatsang a fluoride" 510 Ho feta moo, lipatlisiso li bontšitse hore ho pepeseha ha fluoride ea systemic ho na le phello e fokolang (haeba ho le teng) meno, 511 512 mme bafuputsi ba boetse ba fane ka data ea hore meno a fluorosis (lets'oao la pele la chefo ea fluoride513) e phahame metseng ea Amerika e nang le metsi a nang le fluoride ho fapana le a se nang ona.
Leha ho le joalo litlaleho tse ling li bonts'a hore ha linaha li ntse li hola, sekhahla sa ho bola sechabeng se ile sa nyolohela tlhorong ea meno a bolileng, a lahlehileng kapa a tlatsitsoeng ka bo-1960 ho isa lilemong tsa bo-515 'me a bonts'a ho fokotseha ho hoholo (maemo a kajeno), ho sa natsoe fluoride sebedisa. Ho nahanoa hore keketseho ea bohloeki ba molomo, phihlello ea lits'ebeletso tsa thibelo, le tlhokomeliso e eketsehileng ea litlamorao tse mpe tsa tsoekere li ikarabella bakeng sa ho fokotseha ho bonahalang ha ho bola ha meno. Hore na mabaka e ka ba afe, ho lokela ho hlokomeloe hore mokhoa ona oa ho bola ha leino o etsahetse ka ntle le ts'ebeliso ea ts'ebeliso ea metsi a fluoridated, 2 ka hona ho tla bonahala eka lisosa tse ling ntle le fluoride li bakile phetoho ena. Setšoantšo sa 1955 ka tlase se bonts'a mekhoa ea ho bola ha leino ke linaha tse nang le fluoridated le tse se nang fluoride ho tloha ka 2005-XNUMX.
Setšoantšo sa 2: Mekhoa ea ho senyeha ha meno linaheng tse nang le fluoridated le tse sa silafatsoang, 1955-2005
Lintlha tse ling tse 'maloa li bohlokoa ho qeto efe kapa efe mabapi le ho sebelisa fluoride ho thibela caries. Taba ea mantlha, ho lokela ho hlokomeloe hore fluoride ha se karolo ea bohlokoa bakeng sa kholo ea motho le nts'etsopele.516 Ea bobeli, fluoride e amohetsoe e le e 'ngoe ea lik'hemik'hale tse 12 tsa indasteri "tse tsejoang li baka nts'etsopele ea methapo ea kutlo bathong." 517 Mme qetellong, Amerika Mokhatlo oa meno (ADA) o batlile lipatlisiso tse ling ka 2013 mabapi le ts'ebetso ea liketso tsa fluoride le litlamorao:
Patlisiso e ea hlokahala mabapi le li-fluoride tse fapaneng tsa lihlooho ho tseba mekhoa ea tsona ea ts'ebetso le litlamorao tsa thibelo ha e sebelisoa maemong a hajoale a tlhahiso ea fluoride ea morao-rao (ke hore, metsi a fluoridated le sesepa sa meno sa meno) ho United States. Liphuputso mabapi le maano a ho sebelisa fluoride ho hlohlelletsa ho ts'oaroa kapa ho khutlisoa hoa tsoelo-pele ea caries, hammoho le phello ea lihlooho tsa fluoride ho meno a tsoang, le tsona lia hlokahala.
Karolo ea 8.2: Ho haella ha Bopaki
Ho builoe ka ho se lebelloe ha maemo ao litlamorao tsa fluoride tsamaisong ea motho li etsahetseng pampiring ena eohle. Leha ho le joalo, ho bohlokoa ho pheta khaello ea bopaki bo amanang le ts'ebeliso ea fluoride, ka hona, Tafole ea 4 e fana ka lenane le khutsufalitsoeng la litemoso tse thata tse tsoang ho ba boholong mmusong, ho tsa mahlale le tse ling tse mabapi le likotsi le lipelaelo tse amanang le ts'ebeliso ea lihlahisoa tsa fluoridated.
Tafole ea 4: Likhopotso tse khethiloeng mabapi le litemoso tsa fluoride li hlophisitsoe ka sehlahisoa / ts'ebetso le mohloli
| SEHLAHISOA / SEBETSO SE BONOLO | QOTSO / S | MOTSOALI LITLHAKISO |
|---|---|---|
| Fluoride bakeng sa ts'ebeliso ea meno, ho kenyeletsoa le fluoridation ea metsi | Ho ata ha meno a mangata sechabeng ha ho amane ka ho felletseng le hore na fluoride e ngata hakae, 'me mofuta o phahameng oa enamel fluoride ha o hlile ha o sebetse ho thibela ho bola ha meno. ” "Ho na le liphuputso tse fokolang tse fumanehang mabapi le katleho ea sesepa sa meno sa fluoride, gel, rinse le varnish har'a batho ba baholo." | Litsi tsa Tlhokomelo le Thibelo ea Maloetse (CDC). Kohn WG, Maas WR, DM ea Malvitz, Presson SM, Shaddik KK. Litlhahiso tsa tšebeliso ea fluoride ho thibela le ho laola ho senyeha ha meno United States. Tlaleho ea Boloetse le Bofelo ba beke le beke: Litlhahiso le Litlaleho. 2001 Phato 17: i-42. |
| Ho kenoa ha litšupiso tsa lijo: Ho khothalletsoa litumello tsa phepelo ea lijo le ho kenella ho lekaneng | "Ka kakaretso, ho bile le tumellano hara komiti hore ho na le bopaki ba mahlale ba hore maemong a mang fluoride e ka fokolisa masapo le ho eketsa menyetla ea ho robeha." | Lekhotla la Naha la Lipatlisiso. Fluoride Metsing a Nwang: Tlhahlobo ea Saense ea Litekanyetso tsa EPA. Khatiso ea Naha ea Likolo tsa thuto: Washington, DC 2006. |
| Fluoride metsing a nooang | "Morero o khothalletsoang oa Maximum Contaminant Level (MCLG) oa fluoride metsing a nooang e lokela ho ba zero." | Lebokose RJ. Tlhahlobo ea Tlaleho ea Lekhotla la Naha la Lipatlisiso la United States la 2006: Fluoride Metsing a Nwang. Fluoride. 2006 Phupu 1; 39 (3): 163-72. |
| Fluoridation ea metsi | "Ho pepeseha ha fluoride ho na le kamano e rarahaneng ha ho bapisoa le ho senyeha ha meno 'me ho ka eketsa kotsi ea meno a meno ho bana ba sa fepehang hantle ka lebaka la ho felloa ke calcium le enamel hypoplasia ..." | Peckham S, Awofeso N. Fluoridation ea metsi: tlhahlobo e hlokolosi ea litlamorao tsa fluoride e kenelletseng joalo ka ts'ebeliso ea bophelo ba sechaba. Tlaleho ea Scientific World. 2014 Hlakola 26; 2014. |
| Fluoride lihlahisoa tsa meno, lijo le metsi a nooang | "Hobane tšebeliso ea lihlahisoa tsa meno a nang le fluoridated le ts'ebeliso ea lijo le lino tse entsoeng ka metsi a fluoridated li eketsehile ho tloha ha HHS e khothaletsa maemo a nepahetseng bakeng sa fluoridation, batho ba bangata joale ba ka pepesetsoa fluoride e ngata ho feta kamoo ba neng ba lebelletse." | Tiemann M.Fluoride ka metsing a nooang: tlhahlobo ea fluoridation le litaba tsa taolo. BiblioGov. 2013 Apr 5. Tlaleho ea Tšebeletso ea Patlisiso ea Khonkrese ea Congress. |
| Ho kenella ka fluoride ho bana | “Palo ea 'fluoride' e amoheloang ka bongata e 'nile ea amoheloa hohle ka mashome a lilemo e le pakeng tsa 0.05 le 0.07 mg fluoride ka kilogram ea boima ba' mele empa e ipapisitse le bopaki bo fokolang ba mahlale.” "Liphuputso tsena li fana ka maikutlo a hore ho fihlella boemo bo sa sebetseng ho ka 'na ha se amane hakaalo le ho sebelisoa ha fluoride, ha ho hlakile hore fluorosis e its'etleha haholo ho noeng ha fluoride." | Warren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber ‐ Gasparoni K. Ho nahanoa ka tšebeliso e nepahetseng ea fluoride e sebelisang meno ea fluorosis le sephetho sa meno a meno-thuto ea nako e telele. Journal ea Bongaka ba Meriana ea Bophelo bo Botle. 2009 Mar 1; 69 (2): 111-5. |
| Lisebelisoa tsa ho khutlisa meno ka fluoride (ke ho tlatsa meno) | “Leha ho le joalo, ha ho pakoe ke batho bao e tla ba lithuto tsa bongaka hore na ketsahalo ea likotsi tsa bobeli e ka fokotsoa haholo ha fluoride e ntša lisebelisoa tsa ho hlaphoheloa. ” | Wiegand A, Buchalla W, Attin T. Tlhatlhobo mabapi le lisebelisoa tse fanang ka ts'ehetso ea fluoride-fluoriderelease le uptakecharacteristics, antibacterialactivity le phello ho cariesformation. Lisebelisoa tsa Meno. 2007 Mar 31; 23 (3): 343-62. |
| Lisebelisoa tsa meno: diamine fluoride ea silevera | "Hobane silevera ea diamine fluoride e ncha ho tsa meno ea Amerika le thuto ea meno, ho na le tlhoko ea tataiso e lumellanang, tumellano le tumello." "Ha ho hlake hore na ho tla etsahala'ng haeba kalafo e emisoa kamora lilemo tse 2-3 mme ho hlokahala lipatlisiso." | Horst JA, Ellenikiotis H, Tonakholo ea Milgrom, Komiti ea Tšoaro ea CSF Silver Caries. Protocol ea UCSF ea Caries Arrest e Sebelisang Silver Diamine Fluoride: Mabaka, Lipontšo le Tumello. Tlaleho ea Mokhatlo oa Maiketsetso oa California. 2016 Jan; 44 (1): 16. |
| Li-fluoride tsa lihlooho tsa tšebeliso ea meno | “Sehlopha se ne se na le boemo bo tlase ba bonnete mabapi le molemo oa Karolo ea 0.5 lekholong ea fluoride paste kapa gel meno a sa feleng a bana le methapong ea metso hobane ho ne ho na le tlhaiso-leseling e fokolang mabapi le ts'ebeliso ea lapeng ea lihlahisoa tsena. ” “Ho hlokahala lipatlisiso mabapi le katleho le likotsi tsa lihlahisoa tse itseng libakeng tse latelang: ho itlotsa, matla a ngaka, matla a tšebeliso ea lapeng a fluoride, menoana ea meno kapa marotholi; 2% e sebelisitse gel fluoride ea sodium ka botsebi; mekhoa e meng ea ho tsamaisa, joalo ka foam; mefuta e nepahetseng ea tšebeliso ea li-varnish tsa fluoride le li-gel; tšebeliso ea motsotso o le mong ea APF gel; le metsoako ea lihlahisoa (tšebeliso ea lapeng le ho sebelisoa ka botsebi). ” | Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, Hujoel PP, Iafolla T, Kohn W, Kumar J, Levy SM. Li-fluoride tsa lihlooho bakeng sa thibelo ea caries: Kakaretso ea phethahatso ea likhothaletso tse ntlafalitsoeng tsa bongaka le ts'ehetso ea tlhahlobo e hlophisitsoeng. Sengolo sa Mokhatlo oa Amerika oa Meno. 2013; 144 (11): 1279-1291. |
| Fluoride "supplements" (matlapa) | Ho se lumellane ho totobetseng lipakeng ho bontša hore ho na le tšebetso e lekanyelitsoeng matlapeng a fluoride. ” | Tomasin L, Pusinanti L, Zerman N. Karolo ea matlapa a fluoride ho prophylaxis ea meno a meno. Annali diStomatologia. 2015 Jan; 6 (1): 1. |
| Meriana, fluorine ea bongaka | Ha ho na motho ea ka bolelang ka boikarabello se etsahalang 'meleng oa motho kamora ho sebelisoa ha metsoako e nang le fluor. ” | Strunecká A, Patočka J, Connett P. Fluorine litabeng tsa bongaka. Journal ea Applied Biomedicine. 2004; 2: 141-50. |
| Metsi a nooang a nang le lintho tsa poly- le perfluoroalkyl (PFASs) | "Tšilafalo ea metsi a nooang a nang le poly le perfluoroalkyl substance (PFASs) e beha kotsi ho kholo ea kholo, ea 'mele, ea ts'oaetso le ea endocrine ea bareki." "… Tlhaiso-leseling ka metsi a nooang a PFAS ha a fumanehe bakeng sa hoo e ka bang karolo ea boraro ea baahi ba Amerika." | Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, Lohmann R, Carignan CC, Blum A, Balan SA, Higgins CP. Ho fumanoa ha Poly-le Perfluoroalkyl Substances (PFASs) Metsing a Noa a US a hokahaneng le libaka tsa indasteri, libaka tsa koetliso ea mollo oa sesole le limela tsa kalafo ea metsi a litšila. Litlhaku tsa Saense le Theknoloji ea Tikoloho. 2016 Mphalane 11 |
| Ho pepeseha mosebetsing ho chefo ea fluoride le fluoride | “Tlhahlobo ea tlhaiso-leseling e sa hatisoang mabapi le litlamorao tsa ho hema ho sa foleng ha fluoride le fluorine e senola hore maemo a teng mosebetsing a fana ka tšireletso e sa lekaneng. ” | Mullenix PJ. Chefo ea fluoride: selotho se nang le likotoana tse patehileng. Koranta ea Machabeng ea Bophelo bo Botle Mosebetsing le Tikolohong. 2005 Mphalane 1; 11 (4): 404-14 |
| Tekolo ea litekanyetso tsa polokeho bakeng sa ho pepesehela fluorine le fluorides | "Haeba re ne re ka nahana feela ka kamano ea fluoride le calcium, re ne re tla utloisisa bokhoni bo pharalletseng ba fluoride ba ho senya lisele, litho, litšoelesa le lisele." | Prystupa J. Fluorine — tlhahlobo ea lingoliloeng ea hajoale. Tlhahlobo ea NRC le ATSDR ea litekanyetso tsa polokeho bakeng sa ho pepesehela fluorine le fluoride. Mekhoa le Mekhoa ea Toxicology. 2011 Feb 1; 21 (2): 103-70. |
Karolo ea 8.3: Ho haella ha Boitšoaro
Kameho e 'ngoe e kholo mabapi le ho pepeseha ha fluoride metsing a nooang le lijo e amana le tlhahiso ea li-fluoride tse sebelisoang phepelong ea metsi a sechaba. Ho ea ka Setsi sa Taolo le Thibelo ea Maloetse (CDC), mefuta e meraro ea fluoride hangata e sebelisoa bakeng sa fluoridation ea metsi a sechaba:
- Fluorosilicic acid: tharollo ea metsi e sebelisoang ke lits'ebetso tse ngata tsa metsi United States. Fluorosilicic acid e boetse e bitsoa hydrofluorosilicate, FSA, kapa HFS.
- Fluorosilicic acid: tharollo ea metsi e sebelisoang ke lits'ebetso tse ngata tsa metsi United States. Fluorosilicic acid e boetse e bitsoa hydrofluorosilicate, FSA, kapa HFS.
- Sodium fluorosilicate: motsoako o ommeng, o qhibilihang ka har'a tharollo pele o kenyelletsoa metsing. "Sodium fluoride: motsoako o ommeng, o sebelisoang hangata tsamaisong e nyane ea metsi, o qhibiliha hore e be tharollo pele o eketsoa metsing.
Phehisano e hlahile mabapi le maqhama a indasteri le metsoako ena. CDC e hlalositse hore lefika la phosphorite le futhumetse ka sulfuric acid ho etsa 95% ea fluorosilicic acid e sebelisitsoeng ho fluoridation ea metsi.520 CDC e boetse e hlalositse: "Hobane phepelo ea lihlahisoa tsa fluoride e amana le tlhahiso ea manyolo a phosphate, tlhahiso ea sehlahisoa sa fluoride e ka hape e feto-fetoha ho latela lintlha tse kang litheko tse sa rateheng tsa phapanyetsano ea kantle ho naha le thekiso ea kantle ho naha ea manyolo. ”521 Tokomane ea mmuso e tsoang Australia e boletse pepeneneng hore haidrofluosilicic acid, sodium silicofluoride le sodium fluoride kaofela" hangata li tsoa ho baetsi ba manyolo a phosphate. "522 Safety babuelli ba pepeso ea fluoride ba belaetse hore na maqhama a joalo a indasteri a na le boits'oaro le hore na khokahano ea indasteri le lik'hemik'hale tsena e ka baka ho koaheloa ha litlamorao tsa bophelo bo botle tse bakoang ke ho pepeseha ha fluoride.
Taba e ikhethileng ea boits'oaro e hlahang ka lebaka la ho nka karolo ha indasteri joalo ke hore lihlopha tse khannoang ke phaello li bonahala li hlalosa litlhoko tse fetohang tsa se etsang lipatlisiso tse "ntle ka ho fetisisa" tse thehiloeng bopaking, mme khabareng, mahlale a hlokang leeme a ba thata ho tšehetsa, ho hlahisa, ho phatlalatsa, le ho phatlalatsa. Lebaka ke hobane ho tšehetsa thuto e kholo ho ka ba theko e boima haholo, empa mekhatlo e thehiloeng indastering e ka khona ho tšehetsa bafuputsi ba bona habonolo. Hape ba ka khona ho qeta nako ba lekola mekhoa e fapaneng ea ho tlaleha data (joalo ka ho tlohella lipalo-palo tse itseng ho fumana sephetho se setle), hape ba ka khona ho tsebahatsa karolo efe kapa efe ea lipatlisiso tse tšehetsang mesebetsi ea bona. Ka bomalimabe, nalane e bonts'itse hore likhoebo tse ikemetseng li ka ba tsa khona ho hlekefetsa bo-ramahlale ba ikemetseng e le mokhoa oa ho phethela mosebetsi oa bona haeba mosebetsi oo o bontša kotsi e hlahisoang ke litšila le litšila tsa indasteri.
Ho joalo, boemo bona ba mahlale a sa leka-lekanang bo amohetsoe lipatlisisong tsa fluoride. Bangoli ba tlhahlobo e phatlalalitsoeng ho Scientific World Journal ka 2014 ba ile ba qaqisa: "Le ha metsi a maiketsetso a metsi e bile leano le tsekisano ho tsa bophelo bo botle ba sechaba ho tloha ha e qala, bafuputsi-ba kenyeletsang bo-rasaense ba hlomphuoang machabeng le barutehi-ba lula ba thatafalloa ho phatlalatsa tse nyatsang lingoliloeng tse buang ka metsi a tsoang metseng ka har'a lingoliloeng tsa meno le tsa bophelo bo botle ba sechaba. ”523
Ntle le moo, khohlano ea lithahasello e ka amana ka kotloloho le lithuto tse mabapi le ho pepeseha ha phepo ho metsoako e tlotsitsoeng ka metsi (PFCs). Sengoliloeng se phatlalalitsoeng ka 2012, lipatlisiso mabapi le ho ja lijo ho tsoa ho li-PFC li ile tsa hlahlojoa ke naha. Sengoli se senotse hore tlhaiso-leseling e tsoang US e ne e na le moeli haholo, e neng e entsoe feela ka phatlalatso ea 2010 ke bafuputsi ba bangata ba thuto ea Amerika, ekasitana le phuputso e tšehelitsoeng ke 3M e neng e sebeletsa e le lipatlisiso tsa mantlha pele ho phatlalatso ea 2010 (mme a re boholo ba lisampole ea lijo li ne li na le maemo a silafetseng a ka tlase ho phumano.) 524 Leha ho le joalo, bafuputsi ba thuto ba hlahisitse liphuputso tse fapaneng ho feta tlaleho ea 3M mme ba ngola sengoliloeng sa bona sa 2010: "Leha lihlahisoa tsa lihlahisoa li thibetsoe, re fumane li-POPs [litšila tse phehellang tse silafatsang] lijong tsa Amerika, le metsoako ena lik'hemik'hale li jeoa ke sechaba sa Amerika maemong a fapaneng. Sena se fana ka maikutlo a tlhoko ea ho holisa teko ea lijo bakeng sa litšila tsa lik'hemik'hale. ”525
Likhohlano tsa lithahasello le tsona li tsejoa ho kenella mekhatlong ea mmuso e amehang taolong ea lik'hemik'hale tse chefo. Sengoloa sa 2014 sa Newsweek sa Zoë Schlanger se nang le sehlooho se reng "Na EPA e Rata Indasteri Ha e Lekola Likotsi Tsa Khemik'hale?" e kenyelelitse qotsulo ho setsebi sa tikoloho Michelle Boone e bolelang hore "'kaofela kapa boholo ba tlhaiso-leseling e sebelisitsoeng litekong tsa kotsi e kanna ea tsoa lipatlisisong tse fanoeng ke indasteri, leha ho hlakile [likhohlano tsa lithahasello].'” 526
Ho tsebahala habonolo hore indasteri ea meno e na le khohlano e kholo ea lithahasello le fluoride hobane phaello e etsoa ke likhoebo tse hlahisang lihlahisoa tsa meno tse nang le fluoride. Ntle le moo, lits'ebetso tse amanang le fluoride tse tsamaisoang ke ngaka ea meno le basebetsi ba meno le tsona li ka fumana phaello bakeng sa liofisi tsa meno, 527 528 le lipotso tsa boits'oaro li hlahisitsoe mabapi le ho hatella mekhoa ena ea fluoride ho bakuli.529
Mabapi le boits'oaro ba litloaelo tsa bongaka le tsa meno, lejoe la sekhutlo la leano la bophelo bo botle ba sechaba le tsejoang e le molao-motheo oa boipheliso le lona le lokela ho tsotelloa. Taba ea mantlha ea leano lena e thehiloe holima kano ea bongaka ea makholo a lilemo ea hore "pele, u se ke oa ntša kotsi" Empa, ts'ebeliso ea sejoale-joale ea molao oa boipheliso e hlile e tšehelitsoe ke tumellano ea machabeng.
Ka Pherekhong 1998, kopanong ea machabeng e neng e kenyelletsa bo-ramahlale, babuelli ba molao, baetsi ba melao, le litsebi tsa tikoloho ba tsoang US, Canada le Europe, ho ile ha tekenoa polelo e hlophisitsoeng ka molao 'me ea tsejoa e le "Phatlalatso ea Phatlalatso ho Molao-motheo oa Tlhokomelo." 530 Ho eona, ho fanoa ka likeletso tse latelang: “Ha ketsahalo e hlahisa litšokelo tsa kotsi bophelong ba batho kapa tikolohong, ho lokela ho nkuoa mehato ea boipaballo leha likamano tse ling tsa sesosa le phello li sa theoa ka botlalo ka mahlale. Moelelong ona mosireletsi oa ketsahalo, eseng sechaba, o lokela ho jara moroalo oa bopaki. ”531
Ha ho makatse hore tlhoko ea ts'ebeliso e nepahetseng ea molao oa ts'ireletso e amahanngoa le ts'ebeliso ea fluoride. Bangoli ba sengolo sa 2006 se neng se re “Molao-motheo oa Tlhokomelo o Bolela'ng Bopaking ba ho Phekola meno?” e khothalelitse tlhoko ea ho ikarabella bakeng sa liphatlalatso tse fumanehang ho tsoa mehloling eohle ea fluoride le ho fapana hoa baahi, ha e ntse e re bareki ba ka fihlela maemo a "ntle" a fluoridation ntle le ho noa metsi a nang le fluoridated. Molao-motheo o lokelang ho sebelisoa ts'ebelisong ea fluoride, mme ba nkile mohato ona mohato o mong ho ea pele ha ba etsa tlhahiso ea hore kutloisiso ea rona ea sejoale-joale ea meno a meno "e fokotsa karolo efe kapa efe e kholo ea bokamoso ba fluoride lithibelong tsa caries." 532
Fluoride Position Paper Bangoli
Dr. Jack Kall, DMD, FAGD, MIAOMT, ke Setho sa Academy of General Dentistry le Mopresidente oa nakong e fetileng oa khaolo ea Kentucky. Ke Monghali ea Amoheletsoeng oa International Academy of Oral Medicine le Toxicology (IAOMT) mme ho tloha ka 1996 o sebelitse e le Molula-setulo oa Boto ea Batsamaisi ba eona. O boetse o sebetsa ho Boto ea Baeletsi ea Bioregulatory Medical Institute (BRMI). Ke setho sa Institute for Functional Medicine le American Academy for Oral Systemic Health.
Dr. Griffin Cole, MIAOMT o ile a fumana Mastership ea hae ho International Academy of Oral Medicine le Toxicology ka 2013 'me a ngola Bukana ea Academy's Fluoridation le Tlhahlobo ea Scientific ea molao mabapi le tšebeliso ea Ozone ka phekolo ea metso ea metso. Ke Mopresidente oa nakong e fetileng oa IAOMT mme o sebeletsa Boto ea Batsamaisi, Komiti ea Mentor, Komiti ea Fluoride, Komiti ea Likopano ebile ke Mookameli oa Thuto ea Mantlha.
Dr. David Kennedy o ile a sebelisa bongaka ba meno ka lilemo tse fetang 30 'me a tlohela mosebetsi oa bongaka ka 2000. Ke Mopresidente oa Nakong e Fetileng oa IAOMT mme o kile a ruta lingaka tsa meno le litsebi tse ling tsa bophelo bo botle lefats'eng lohle ka litaba tsa bophelo bo botle ba meno, chefo ea mercury, le fluoride. Dr. Kennedy o tsejoa lefatšeng ka bophara e le 'muelli oa metsi a nooang a sireletsehileng, ngaka ea meno ea likokoana-hloko' me ke moetapele ea tsebahalang lefapheng la thibelo ea meno. Dr. Kennedy ke sengoli se hloahloa le motsamaisi oa filimi e hapileng likhau ea Fluoridegate.
