背景:社区水氟化是预防龋齿的有效公共卫生策略,yet.存在对潜在健康问题的担忧。这项研究探讨了自来水氟化物水平与儿科疾病负担之间的关系,以及6岁时的神经发育结果。
方法:这项全国性的基于人群的队列研究包括出生在韩国城市的有或没有自来水氟化项目的儿童,在2006年至2012年之间,目标是处理过的自来水中的氟化物浓度为0.8±0.2mg/L。使用了国家健康保险服务的数据,从出生到2018年。研究了暴露于氟化自来水与先前被确定为可能与氟化物暴露有关的16种儿童疾病的发病率之间的关系。此外,我们评估了不同领域的神经发育结果,包括粗电机,精细电机,认知,语言,社交技能,和自助功能。这些评估是使用来自针对6岁儿童的全面国家健康筛查计划的数据进行的。
结果:未接触氟化物的组包括22,881名儿童,而氟化物暴露组包括29,991名儿童(52%为男性)。氟化物暴露组的儿童患龋齿和骨折的风险降低[风险比(95%置信区间,CI),0.76(0.63-0.93)和0.89(0.82-0.93),与未暴露组相比,分别]和肝衰竭风险增加[1.85,(1.14-2.98)]。此外,异常神经发育筛查结果的风险比增加了9%,但这在统计学上是不确定的(95%CI,0.95-1.26).
结论:含氟自来水与儿童肝衰竭风险增加相关,但骨折风险降低。氟化自来水与6年神经发育筛查结果之间的关系尚不清楚。强调需要进一步研究来澄清这种关联。
BACKGROUND: Community water fluoridation is an effective public health strategy for preventing dental caries, yet. Concerns exist about potential health problems. This study explores associations between tap water fluoride levels and pediatric disease burden, as well as neurodevelopmental outcomes at 6 years of age.
METHODS: This nationwide population-based cohort study included children born in Korean cities with and without tap water fluoridation projects, between 2006 and 2012, aiming for a fluoride concentration of 0.8 ± 0.2 mg/L in treated tap water. Data from the National Health Insurance Service were used, spanning from birth to 2018. The relationship between exposure to fluoridated tap water and incidence of 16 childhood diseases that were previously identified as potentially linked to fluoride exposure were examined. Additionally, we evaluated the neurodevelopmental outcomes across various domains, including gross motor, fine motor, cognition, language, social skills, and self-help functions. These assessments were performed using data from a comprehensive national health screening program for children aged six years.
RESULTS: A fluoride-unexposed group included 22,881 children, whereas a fluoride-exposed group comprised 29,991 children (52% males). Children in the fluoride-exposed group had a decreased risk of dental caries and bone fractures [hazard ratio (95% confidence interval, CI), 0.76 (0.63-0.93) and 0.89 (0.82-0.93), respectively] and increased risk of hepatic failures [1.85, (1.14-2.98)] compared to those in the unexposed group. Additionally, the risk ratio of abnormal neurodevelopmental screening outcomes increased by 9%, but this was statistically uncertain (95% CI, 0.95-1.26).
CONCLUSIONS: Fluoridated tap water was associated with an increased risk of hepatic failure but a decreased risk of bone fractures in children. The association between fluoridated tap water and neurodevelopmental screening outcomes at 6 years remains unclear, highlighting the need for further studies to clarify this association.