Pepa renzvimbo yeIAOMT rinopesana nekushandiswa kwefluoride rinosanganisira zvinopfuura mazana mashanu ezvinyorwa uye rinopa tsvakiridzo yakadzama yesainzi nezve njodzi dzinogona kuitika pahutano dzine chekuita nekufumurwa kwefluoride.
Pepa rinomiririrwa neIAOMT rinosanganisira zvinopfuura mazana mashanu zvinyorwa uye rinopa tsvakiridzo yakajeka yesainzi nezve njodzi dzinogona kuvepo dzehutano dzine chekuita nekuratidzwa kwe fluoride.
Fluorine (F) ndiyo yechipfumbamwe chinhu patafura ye periodic uye inhengo yemhuri ye halogen. Ine uremu hweatomiki hwe18.9984, ndiyo inonyanya kugadzikana pazvinhu zvese, uye inogadzira zvisungo zvine simba zvemagetsi. Inonyanya kukwezva kune divalent cations yecalcium uye magnesium. Mumamiriro ayo akasununguka, fluorine ine huturu hwakanyanya, yakajeka yeyero diatomic gasi. Nekudaro, fluorine haiwanzo kuwanikwa mune yayo yemahara mamiriro mune zvakasikwa nekuti kazhinji inogara ichibatanidza pamwe nezvimwe zvinhu semhedzisiro yayo yakakwira danho reactivity. Fluorine inowanzoitika semaminerari
fluorspar (CaF2), cryolite (Na3AlF6), uye fluorapatite (3Ca3 (PO4) 2 Ca (F, Cl) 2), uye ndiyo yegumi nenhatu yakawanda kwazvo pasi pano.
Fluoride (F-) ikemikari ion ye fluorine ine yakawedzera elektroni, nokudaro ichichipa iyo yakaipa mhosva. Kunze kwekuvapo kwaro kwemaminerari, pamwe nevhu, mvura nemhepo, fluoride inogadzirwawo nemakemikari kuti ishandiswe munharaunda fluoridation yemvura, zvigadzirwa zvemazino, nezvimwe zvinhu zvakagadzirwa. Fluoride haina kukosha mukukura kwevanhu nekusimudzira.1
Muchokwadi, hazvidiwe kune chero chiitiko chemuviri mumuviri wemunhu; nekudaro, hapana munhu achatambura nekushomeka fluoride. Muna 2014, Dr. Philippe Grandjean weHarvard Chikoro cheHuzhinji Hutano uye Dr.Philip J. Landrigan weIcahn Chikoro cheMishonga paGomo reSinai vakaratidza fluoride se imwe yemakemikari gumi nemaviri emaindasitiri anozivikanwa nekukonzera kusimudzira neurotoxicity muvanhu. 2
Chikamu 5.1: Nharaunda Yemvura Fluoridation
Kumadokero kweEurope, dzimwe hurumende dzakaratidza pachena njodzi yema fluoride, uye chete 3% yevekumadokero kwevagari veEurope vanonwa mvura ine fluoridated. 133 MuUnited States, pamusoro pe66% yevaAmerica vari kunwa mvura inoyerera.134 Kana iyo Environmental Protection Agency (EPA) kana hurumende yemubatanidzwa inorayira fluoridation yemvura muAmerica, uye danho rekushambidza mvura yemunharaunda inoitwa nehurumende kana maseru emunharaunda. .135 136 Zvisinei, iyo US Public Health Service (PHS) inogadza yakakurudzirwa fluoride kuwanda munharaunda yekumwa mvura kune avo vanosarudza fluoridate, uye Environmental Protection Agency (EPA) inoisa huwandu hunosvibisa hwemvura yekunwa yeruzhinji.
Mushure mekushambidzwa kwemvura muGrand Rapids, Michigan, yakatanga muna 1945, tsika iyi yakapararira kunzvimbo dzenyika yese mumakumi emakore akatevera. Aya mabasa akakurudzirwa nePublic Health Service (PHS) muma1950, 137 uye muna 1962, iyo PHS yakapa zviyero zve fluoride mumvura yekunwa yaizomira kwemakore makumi mashanu. Vakataura kuti fluoride yaizodzivirira caries yemazino50 uye iwo mwero wakakwana we fluoride yakawedzerwa kumvura yekunwa inofanira kubva pakati pe138 kusvika 0.7 mamirigiramu parita. 1.2 Zvisinei, iyo PHS yakadzikisa kurudziro iyi kune imwechete nhanho yemamirigiramu e139 litita muna0.7 nekuda kuwedzera kwemazino fluorosis (kukuvara kusingaperi kumazino anogona kuitika kuvana kubva pakuratidzirwa kwakanyanya kusvika kune fluoride) uye nekuwedzera kwezvisikwa zve fluoride inowoneka kumaAmerican.2015
Zvichakadaro, iyo Yakachengeteka Inonwa Mvura Mutemo yakavambwa muna 1974 kuchengetedza mhando yemvura yekunwa yeAmerica, uye yakapa mvumo EPA kudzora ruzhinji mvura yekunwa. Nekuti
yemutemo uyu, iyo EPA inogona kumisikidza inokwenenzverwa huwandu hwehutachiona hwehutachiona (MCLs) hwemvura yekunwa, pamwe neasinga tsindisirwe zvinangwa zvine mwero zvinosvibisa (MCLGs) uye zvisinganetsi mvura yekunwa zviyero zvechipiri zvakanyanya zvinosvibisa (SMCLs) .141 EPA inotsanangudza kuti MCLG ndiyo "mwero wepamusoro wemvura yekunwa isina kuzivikanwa kana kufungidzirwa kukuvadza hutano hwevanhu, zvichibvumira mukana wakaringana wekuchengeteka." 142 Pamusoro pezvo, iyo EPA inokodzera kuti masisitimu emunharaunda anodarika MCL ye fluoride "anofanirwa kuzivisa vanhu vanoshandisirwa hurongwa ihwohwo nekukasira, asi pasati papera mazuva makumi matatu hurongwa hwacho hwaziva nezve kutyorwa." 30
Muna 1975, iyo EPA yakaisa huwandu hwakanyanya hwehutachiona (MCL) ye fluoride mumvura yekunwa pa1.4 kusvika ku2.4 mamirigiramu pa lita. 144 Vakasimbisa muganho uyu kudzivirira zviitiko zvezino fluorosis. Muna 1981, South Carolina yakataura kuti mazino fluorosis ingori cosmetic, uye nyika yakakumbira EPA kuti ibvise MCL ye fluoride. 145 Semhedzisiro, muna 1985, iyo EPA yakagadza huwandu hwehutachiona hwehutachiona (MCLG) ye fluoride pamamirigiramu mana pa lita. 4 Panzvimbo pekuti mazino fluorosis anoshanda senzvimbo yekudzivirira (yaizodai yakadzika chengetedzo mazinga), iyi nhanho yepamusoro yakagadzwa senzira yekudzivirira kubva pamabhonzo fluorosis, chirwere chepfupa chinokonzerwa nefluoride yakawandisa. Kushandisa skeletal fluorosis semagumo kwakakonzera shanduko yeMLL ye fluoride, iyo yakakwidzwa kuita mamirigiramu mana pa litre muna 146. 4 Asi, mazino fluorosis akaiswa senzvimbo yekupedzisira yeSMCL ye fluoride yemamirigiramu maviri pa litre, iyo yakaiswa zvakare muna 1986. 147
Makakatanwa akatevera pamusoro pemirau mitsva iyi uye zvakatoguma nematanho epamutemo kupokana neEPA. South Carolina yakataura kuti pakanga pasina chikonzero cheiyo MCLG (yakanyanya kusvibisa chinangwa cheiyo fluoride, nepo Natural Resources Defense Council ichiti MCLG inofanira kudzikiswa zvichibva pamazino fluorosis. 149 Dare rakatonga richitsigira EPA, asi pakuwongorora fluoride zviyero, EPA yakanyorera National Research Council (NRC) yeNational Academy yeSainzi kuti iongororezve njodzi dzehutano hwe fluoride. 150 151
Chirevo kubva kuNational Research Council, chakaburitswa muna 2006, chakagumisa kuti EPA's MCLG (yakanyanya kusvibiswa chinangwa chefluoride inofanira kudzikiswa. 152 Pamusoro pekucherechedza mukana wekuti njodzi ye fluoride ne osteosarcoma (gomarara repfupa), 2006 National Research Council rondedzero yakaratidza kunetsekana nezve musculoskeletal mhedzisiro, yekubereka uye yekuvandudza mhedzisiro, neurotoxicity uye neurobehavioral mhedzisiro, genotoxicity uye carcinogenicity, uye mhedzisiro pane mamwe ma organ system.153
NRC yakagumisa kuti MCLG ye fluoride inofanirwa kudzikiswa muna 2006, asi EPA haisati yadzikisa mwero. 154 Muna 2016, Fluoride Action Network, IAOMT, nemamwe mapoka uye vanhu vakateterera EPA kuchengetedza veruzhinji, kunyanya vanogona kubatwa, kubva kuhutachiona hwehutachiona hwe fluoride nekurambidza kuwedzera zvine chinangwa kwe fluoride kumvura yekunwa. 155 Chikumbiro chakarambwa neEPA muna Kukadzi 2017.156
Chikamu 5.2: Mvura Yemabhodhoro
Kunge mushonga wemazino uye zvakawanda zvigadzirwa zvemazino, mvura yemumabhodhoro inogona zvakare kuve ne fluoride.
IUnited States Chikafu neDrug Administration (FDA) inoona nezve kuona kuti zviyero zvemvura yakabhoderedzwa zvinoenderana nematanho emvura yepombi akaisirwa neEPA 157 uye nematanho akakurudzirwa akaiswa neUS Public Public Service Service (PHS). 158 Iyo FDA inobvumidza mvura yakabhoderedzwa inosangana nematanho ayo 159 kusanganisira mutauro unoti kunwa mvura ine fluoridated kunogona kudzora njodzi yekuora kwemeno.
Chikamu 5.3: Chikafu
FDA yakapa mutongo wekuganhurira kuwedzerwa kwemakemikari e fluorine kuchikafu mukufarira hutano hweveruzhinji muna 1977. 161 Zvisinei, fluoride ichiripo muchikafu semhedzisiro yekugadzirira mumvura ine fluoridated, kusvikirwa nemishonga yezvipembenene nefetiraiza, nezvimwe zvinhu. Muna 2004, United States department rezvekurima (USDA) rakaparura dhatabhesi ye fluoride mazinga muzvinwiwa uye chikafu, uye mushumo uine zvakadzama zvinyorwa zvakaburitswa muna 2005.162. yakawedzera pamusoro pemakore gumi apfuura nekuda kwekushandiswa kwe fluoride mune mishonga ichangobva kubvumidzwa yezvipembenene.163 Zvimwe zvisina kujeka zvekuwedzera zvinowedzerwa izvozvi zvinoshandiswa zvakare zvine fluoride.164
Pamusoro pezvo, muna 2006, National Research Council yakakurudzira kuti “kubatsira mukufungidzira kusvibiswa kweimwe fluoride kubva mukumwa, vagadziri uye vagadziri vanofanirwa kupa ruzivo nezve izvo zvirimo fluoride yezvinhu zvekutengesa nezvinwiwa.” 165 Zvisinei, izvi hazvisi kuzoitika chero nguva padhuze neremangwana. Muna 2016, iyo FDA yakagadzirisa zvido zvekunyorera zvekudya zveNutrition uye Supplement Chokwadi zvinyorwa uye ikatonga kuti kuziviswa kwemazinga e fluoride ndeokuzvidira kune zvese zvigadzirwa zvine hungwaru zvakawedzera fluoride uye zvigadzirwa zvine zvakasarudzika zvinoitika fluoride. 166 Panguva iyoyo, iyo FDA hainawo kutanga Mazuva ese Referensi Kukosha (DRV) ye fluoride. 167
Mukupesana, muna 2016, iyo FDA yairambidza perfluoroalkyl ethyl ine chikafu-chekubata zvinhu (PFCSs), ayo anoshandiswa semafuta uye mvura inodzosera mapepa nebepa repepa. 168 Izvi zvakatorwa semhedzisiro yedhizikisi data uye chikumbiro chakamisikidzwa ne Natural Natural Defense Council nemamwe mapoka.
Kunze kwekufungisisa nezve fluoride muchikafu, kumisikidza yakachengeteka fluoride muchikafu nekuda kwemishonga yezvipembenene inogoverwa neDAA, EPA, uye Kudya Kwekuchengetedza uye Inspection Service yedhipatimendi rezvekurima reUS.169
Chikamu 5.4: Mishonga yekuuraya zvipuka
Mishonga yezvipembenene inotengeswa kana kugoverwa muUS inofanirwa kunyoreswa neEPA, uye iyo EPA inogona kumisikidza maronda emishonga yezvipembenene kana kufumurwa kwechikafu kuchinzi "kwakachengeteka." 170
Panyaya iyi, maviri maruva ane fluoride ane mishonga yekuuraya zvipuka anga ari iwo emakakatanwa:
1) Sulfuryl fluoride yakatanga kunyoreswa muna 1959 yekudzora termite muzvivakwa zvematanda171 uye muna 2004/2005 yekudzora zvipembenene muzvikafu zvakagadzirwa, senge tsanga dzezviyo, michero yakaomeswa, nzungu dzemiti, bhinzi yekocoa, bhinzi kofi, pamwe nechikafu kubata nekugadzirisa zvekudya.172 Nyaya dzehupfu hwevanhu uye kunyangwe kufa, nepo zvisingawanzoitika, zvakabatanidzwa nesulfuryl fluoride kuratidzwa kwakabatana nedzimba dzakarapwa nemushonga wezvipembenene. 173 Muna 2011, nekuda kwekutsvaga kutsvagisa uye kunetsekana kwakasimudzwa neFluoride Action Network ( FAN), iyo EPA yakaronga kuti sulfuryl fluoride haichakwanise kusangana nechengetedzo uye kuti shiviriro yemushonga unouraya zvipembenene inofanira kubviswa. 174 Muna 2013, indasitiri yemishonga yezvipembenene yakaisa danho rakakura rekubiridzira kukanzura chikumbiro cheEPA chekubvisa sulfuryl fluoride, uye iyo Chikumbiro cheEPA chakadzoserwa nechipo chakabatanidzwa muPurazi Bhiri ra2014. 175
2) Cryolite, iyo ine sodium aluminium fluoride, mushonga unouraya zvipembenene wakatanga kunyoreswa neEPA muna 1957.176 Cryolite ndiyo mushonga mukuru we fluoride unoshandiswa kurima chikafu muUS (nepo sulfuryl fluoride ichishandiswa se fumigant pane chikafu chekupedza kukohwa) . Cryolite inoshandiswa pamichero yemucitrus uye yematombo, miriwo, michero, uye mazambiringa, 177 uye vanhu vanogona kuburitswa kwazviri kuburikidza nechikafu chavo, sezvo cryolite inogona kusiya fluoride masara pane chikafu chaakaiswa. 178 Mune yayo 2011 yakarongedzwa sulfuryl fluoride, iyo EPA yakarongedzazve kubvisa dzese fluoride shiviriro mumishonga yezvipembenene.179 Saka izvi zvingadai zvaisanganisira cryolite; zvisinei, sezvakataurwa pamusoro apa, ichi chikumbiro chakapidigurwa.
Chikamu 5.5: Zvigadzirwa zvemazino zvekushandisa Kumba
Iyo FDA inoda kunyorerwa "anticaries zvinodhaka zvigadzirwa" zvinotengeswa kupfuura-the-counter, senge mushonga wemazino uye kushambidza muromo. Mazita akasarudzika ekunyorera anosarudzwa nemhando yeiyo
chigadzirwa (kureva gel kana kunama uye sukurudza), pamwe neiyo fluoride concentration (kureva 850-1,150 ppm, 0.02% sodium fluoride, nezvimwewo). 180 Yambiro zvakare yakakamurwa nemapoka emazera (kureva makore maviri zvichikwira, pasi pematanhatu. , Makore gumi nemaviri zvichikwira, nezvimwewo). Dzimwe yambiro dzinoshanda kune zvese zvigadzirwa, senge zvinotevera:
(1) Kune ese fluoride dentifrice (gel, peta, uye poda) zvigadzirwa. “Rambai pasingasvikirwe nevana vari pasi pemakore matanhatu ekuberekwa. [yakanyorwa nemabhii matema-tema] Kana yakawanda kupfuura yakashandiswa pakukwesha ikamedzwa netsaona, tanga wabatsirwa nachiremba kana kubvunza Poison Control Center ipapo ipapo. ”6
(2) Kune ese fluoride sukurudza uye kudzivirira mishonga gel zvigadzirwa. “Ramba uri kure kunosvika vana. [yakanyorwa nemabhii matema-tema] Kana yakashandiswa kupfuura ”(sarudza izwi rakakodzera:“ kukwesha ”kana kuti“ kugeza ”)“ yakamedzwa netsaona, tora rubatsiro rwekurapa kana kuti ubate Poison Control Center ipapo ipapo. ”182
Chinyorwa chekutsvagisa chakaburitswa muna2014 chakasimudza kunetsekana kwakakura pamusoro pekunyorwa uku. Kunyanya, vanyori vakagadza kuti pamusoro pe90% yezvigadzirwa zvavakaongorora zvakanyora yambiro yeFDA yekushandisa chete nevana vane makore anopfuura maviri kuseri kwetubhu remushonga wemazino uye mune diki font.183 Mamiriro akafanana akataurwa nezveyambiro kubva ku American Dental Association (ADA), rinova boka revatengesi uye kwete chehurumende. Vatsvakurudzi vakanyora kuti zvese zvemazino zvinofarirwa nekutenderwa kana kugamuchirwa neADA zvakaisa yambiro yeADA (kuti vana vanofanirwa kushandisa chiyero chepea chemushonga wemazino uye vachengetedzwe nemunhu mukuru kudzora kumedza) kuseri kwetubhu mune diki font .184 Maitiro ekutengesa aive
yakawedzera kuzivikanwa sekusimudzira mushonga wemazino sekunge chaive chigadzirwa chekudya, izvo zvakaongororwa nevatsvakurudzi yaive nzira inogona kutyisidzira kuti vana vamedze chigadzirwa.185
Kunyangwe dental floss yakarongedzwa neDFA seClass I chishandiso, 186 mazino floss ane fluoride (kazhinji stannous fluoride) inoonekwa seyakagadzirwa chigadzirwa187 uye inoda
premarket zvinoshandiswa.188 Dental floss inogona zvakare kunge iine fluoride iri muchimiro chemafuta anonhuhwirira; 189 zvisinei, hapana ruzivo rwekutonga nezverudzi urwu rwe fluoride mune mazino maruva
inogona kuwanikwa nevanyori veiyi nzvimbo pepa.
Chikamu 5.6: Zvigadzirwa Zvemazino zvekushandisa kuDental Office
Ruzhinji rwezvinhu zvinoshandiswa muhofisi yemeno zvinogona kuburitsa fluoride zvinodzorwa sechigadzirwa zvekurapa / zvemazino, senge mamwe mabheji ekuzadza zvinhu, 190 191 mamwe masenti emazino, 192 uye zvimwe zvinoumbwa nebwe zvinhu. 193 Kunyanya, mazhinji eaya zvinhu zvemazino zvinotsanangurwa neDFA seClass II Medical Devices, 194 zvichireva kuti iyo FDA inopa "kuvimbiswa kunonzwisisika kwekuchengetedzwa uye kugona kwechigadzirwa" pasina kuisa chigadzirwa pachiyero chepamusoro chekudzora.195 Zvakakosha, sechikamu cheiyo FDA maitiro, zvishandiso zvemazino zvine fluoride zvinoonekwa seyakagadzirwa zvigadzirwa, 196 uye fluoride maficha ekuburitswa anotarisirwa kupihwa sechikamu chekuzivisa musika usati watengeswa kwechigadzirwa.197 FDA inoenderera mberi ichiti: "Zvikumbiro zvekudzivirira mhango kana zvimwe zvinobatsira pakurapa inobvumidzwa kana ikatsigirwa nedata remakiriniki rakagadzirwa neongororo yeIDE [Investigational Device Exemption]. ” 198 Zvakare, nepo FDA ichitaura pachena nezve fluoride-ichisunungura mashandiro emamwe madhizaini ekudzosa mazino, iyo FDA haivasimudzire pachena pawebhusaiti yavo kuti ishandiswe mukudzivirira caries.199
Saizvozvowo, nepo fluoride varnishes ichibvumidzwa seClass II Medical Devices ekushandisa seyamberi liner uye / kana zino desensitizer, haibvumidzwe kuti ishandiswe mukudzivirira caries. 200 Naizvozvo, kana zvirevo zvekudzivirira caries kunoitwa nezve chigadzirwa chave kusvibiswa neakawedzera fluoride, izvi zvinoonekwa neDFA semushonga usingatenderwe, wakashatiswa. Uye zvakare, mirawo yeFDA inoita kuti chiremba / chiremba wemazino ave nemhosva yekushandisa-kurebesa kushandisa zvinodhaka zvinogamuchirwa. 201
Pamusoro pezvo, muna2014, iyo FDA yakabvumidza kushandiswa kwesirivheri diamine fluoride yekuderedza kunzwisisika kwemeno. 202 Mune chinyorwa chakaburitswa muna2016, komiti paYunivhesiti yeCalifornia, San Francisco, Chikoro cheDentistry, yakaziva kuti, nepo isiri-chitupa kushandiswa kwesirivheri diamine fluoride (senge mune caries manejimendi) zvave kutenderwa nemutemo, pane kudikanwa kweyakaenzana gwara, protocol, uye mvumo.
Zvakare zvakakosha kuti uzive ndeyekuti fluoride-ine pasita inoshandiswa panguva yemazino prophylaxis (kuchenesa) ine huwandu hwakakwira kwazvo hwe fluoride pane yekutengesa mushonga wemazino (kureva 850-1,500 ppm mune yakajairwa mushonga wemazino204 maringe ne4,000-20,000 ppm fluoride mupropy paste205). Fluoride paste haina kugamuchirwa neDFA kana iyo ADA senzira inoshanda yekudzivirira mazino emazino. 206
Chikamu 5.7: Mishonga Yezvinodhaka (Kusanganisira Zvokuwedzera)
Fluoride inowedzerwa nemaune kumishonga yemishonga (madonhwe, mapiritsi, uye lozenges anowanzoidzwa kunzi "zvinowedzera" kana "mavitamini") ayo anowanzo gadzirirwa vana, zvinonzi zvinodzivirira mhango. Muna 1975, FDA yakataurira kushandiswa kwe fluoride zvinowedzera nekubvisa mushonga mutsva weErnziflur fluoride. Mushure mekuita kweDFA pane Ernziflur lozenges vaive
yakaburitswa muFederal Register, chinyorwa chakabuda muDrug Therapy ichiti kubvumidzwa kweDFA kwakabviswa "nekuti hapana humbowo hwakasimba hwekushanda kwezvinodhaka sezvakarairwa, zvakakurudzirwa, kana kutaurwa mukunyorerwa kwahwo." 207 208 Chinyorwa ichi chakatiwo: " FDA nekudaro yakaraira vagadziri vemubatanidzwa fluoride uye vhitamini kugadzirira ayo avo
kuenderera mberi kwekushambadzira kuri kutyora izvo zvitsva zvinodhaka zvinodhaka zveFederal Kudya, Zvinodhaka, uye Zvekushongedza Mutemo; saka vakumbira kuti kushambadzwa kwezvigadzirwa izvi kumiswe. ”209 210
Muna 2016, FDA yakatumira imwezve tsamba yekuyambira pamusoro penyaya imwechete yemishonga mitsva isingatenderwe munzira dzakawanda kusanganisira mafluoride anowedzera akataurwa muna 1975. Tsamba yakanyorwa
Ndira 13, 2016, yakatumirwa kuKirkman Laboratories maererano nemhando ina dzakasiyana dzevana fluoride concoctions yakanyorwa semubatsiro mukudzivirira mazino emazino. 211 Tsamba yambiro yeDAA yakapa iyo kambani mazuva gumi nemashanu kuti iteedzerane nemutemo15 uye inoshanda seichi mumwe muenzaniso wevana zvinokuvadza vachigamuchira zvisina kugamuchirwa fluoride gadziriro, ino yave nyaya iri muUS kweanopfuura makore makumi mana.
Zvichakadaro, fluorine inowedzerwawo zvinobvumidzwa kune mimwe mishonga yemishonga. Zvimwe zvikonzero zvakave zvichionekwa nekuwedzera kwayo kumishonga zvinosanganisira zvirevo zvekuti inogona "kuwedzera mushonga wacho
kusarudza, kuitisa kuti inyungudike mumafuta, uye kudzikamisa kumhanya uko mushonga wacho unogadzirwa, nokudaro uchiubvumira kuwana nguva yakawanda yekushanda. ” 213 20-30% yemakemikari emakemikari akafungidzirwa kuti ane fluorine.214 Mimwe yemishonga inonyanya kufarirwa inosanganisira Prozac, Lipitor, uye Ciprobay (ciprofloxacin), 215 pamwe neimwe mhuri ye fluoroquinolone (gemifloxacin [inotengeswa seFactive] levofloxacin [inotengeswa seLevaquin], moxifloxacin [inotengeswa seAvelox], norfloxacin [inotengeswa seNoroxin], uye ofloxacin [inoshambadzirwa seFoxin uye generic ofloxacin]).
216
Nezve fluoroquinolones, iyo FDA yakaburitsa yambiro nyowani pamusoro pekuremadza mhedzisiro mu2016, makore mushure mekunge mishonga iyi yatanga kuunzwa kumusika. Mukuzivisa kwavo muna Chikunguru 2016, iyo FDA yakati:
Iyi mishonga inosanganisirwa nekuremadza uye ingangoita zvachose mhedzisiro mhedzisiro yetoni, mhasuru, majoini, tsinga, uye yepakati tsinga system iyo inogona kuitika pamwechete mumurwere mumwe chete. Nekuda kweizvozvo, isu takagadzirisazve yambiro yeBoxed, yambiro yakasimba yeDAA, kugadzirisa nyaya dzakakomba dzekuchengetedza. Isu takawedzerawo yambiro nyowani uye takagadzirisa zvimwe zvikamu zvechiratidzo chemushonga, kusanganisira murwere mushonga weMishonga. 217
Nekuda kweiyi mhedzisiro inonetesa, iyo FDA yakaraira kuti iyi mishonga inofanirwa kushandiswa chete kana pasina imwe nzira yekurapa inowanikwa kune varwere nekuti njodzi dzinokunda
mabhenefiti. 218 Panguva yeichi chiziviso che2016 FDA, zvakafungidzirwa kuti vanhu vanopfuura mamirioni makumi maviri nematanhatu vekuAmerica vaitora mishonga iyi gore rega. 26
Chikamu 5.8: Perfluorinated Makemikari
Per- uye polyfluoroalkyl zvinhu (PFASs), zvinonziwo zvigadzirwa zvinonhuhwirira kana makemikari anonhuhwirira (PFCs), zvinhu zvinoshandiswa mumakapeti, zvinotsvaira, zvipfeko, zvekubika,
kurongedza chikafu, pendi, bepa, uye zvimwe zvigadzirwa nekuti zvinopa kuramba moto uye oiri, gwapa, mafuta, uye kudzora mvura. 220 Semuenzaniso, perfluorooctanoic acid (PFOA) inoshandiswa kugadzira polytetrafluoroethylene (PTFE), iyo inoshandiswa muTeflon , Gore-tex, Scotchguard, uye Stainmaster. 221
Zvisinei, apo masayendisiti anopfuura mazana maviri kubva munyika makumi matatu nesere akasainira ku "Chirevo cheMadrid" muna 200, zvinetswa makumi maviri nezviviri nezvezvinhu zvakadaro pamwe nekubatana kwavo nehutano husina kunaka zvakaziviswa.
Pamusoro pezvo, mu2016, iyo EPA yakataura nezvePFSAs:
Zvidzidzo zvinoratidza kuti kuratidzwa kwePFOA nePFOS pamusoro pemamwe mazinga kunogona kukonzeresa mhedzisiro yehutano, kusanganisira kusimudzira mhedzisiro kune vacheche panguva yekuzvitakura kana kune vanoyamwiswa vacheche (semuenzaniso, huremu hwekuzvarwa, kukurumidza kuyaruka, maronda akasiyana), gomarara (semuenzaniso, testicular , itsvo), chiropa mhedzisiro (semuenzaniso, kukuvara kwemashuga), immune immune (semuenzaniso, kugadzirwa kweantibody uye kutapata), uye zvimwe zvinokanganisa (semuenzaniso, cholesterol inoshanduka) .225
Nekudaro, kuUS, kuyedza kuchangotanga kudzikisa kushandiswa kwemakemikari aya. Semuenzaniso, mu2016, iyo EPA yakaburitsa mazano ezvehutano ePFOA nePFOS mumvura yekunwa, ichiratidza mwero uri kana pazasi izvo zvinokanganisa hutano zvisati zvichitarisirwa kuti zvichaitika pamusoro pehupenyu hwese hwekuratidzwa se0.07 zvikamu pabhirioni (zvikamu makumi manomwe netriliyoni) ye PFOA ne PFOS. 70 Semumwe muenzaniso, mu226, iyo EPA yakabatana nemakambani masere kuburikidza nehurongwa hwehutariri hweaya makambani masere kudzikisa uye kubvisa PFOA na2006 Asi, iyo EPA ine
zvakare zvakanyorwa kuti "vanoramba vachinetseka" pamusoro pemakambani anogadzira izvi zvigadzirwa izvo zvisina kutora chikamu muchirongwa ichi. 228
Chikamu 5.9: Kubasa
Kujekesa kune fluorides (fluoride, perfluoride) munzvimbo yebasa inodzorwa neiyo Occupational Safety & Health Administration (OSHA). Hutano chinhu chinonyanya kutarisirwa mukufungisisa kweaya matanho ndeye skeletal fluorosis, uye iwo muganho maitiro ekuratidzwa kwebasa kune fluorides anogara akanyorwa se2.5 mg / m3.229
Mune chinyorwa cha2005 chakaburitswa muInternational Journal of Occupational uye Environmental Health uye chakaratidzwa muchikamu kuAmerican College of Toxicology Symposium, munyori Phyllis J. Mullenix, PhD, yakaratidza kudiwa kwekuchengetedzwa kwenzvimbo yebasa kubva kuma fluoride. 230 Zvakananga, Dr. Mullenix akanyora kuti nepo fluoride zviyero zvakaramba zvakaenzana:
Munguva pfupi yapfuura, data rakazowanikwa risingangoratidzi chete kuti zviyero izvi zvakapa dziviriro isina kukwana kune vashandi vanoburitswa ne fluorine uye fluoride, asi kuti kwemakumi emakore indasitiri ine ruzivo rwakakosha kuti vaone kusakwana kwemitemo uye kumisikidza mwero wekudzivirira. 231
Mumushumo wa2006 weNational Research Council (NRC) weNational Academy yeSainzi umo njodzi dzehutano dze fluoride dzakaongororwa, kunetsekana kwakasimudzwa nezvehukama hungavepo pakati pe fluoride ne osteosarcoma (gomarara repfupa), kutyoka kwemabhonzo, musculoskeletal mhedzisiro, kubereka uye kusimudzira mhedzisiro, neurotoxicity uye neurobehavioral mhedzisiro, genotoxicity uye carcinogenicity, uye mhedzisiro pane mamwe ma organ system. 232
Sezvo chirevo cheNRC chakaburitswa mu2006, zvimwe zvinoverengeka zvakakosha zvidzidzo zvekutsvaga zvakatsikiswa. Muchokwadi, mune 2016 mugari chikumbiro kuEPA kubva kuFluoride Action Network (FAN), IAOMT, uye mamwe mapoka, Michael Connett, Esq., Legal Director weFAN, yakapa runyorwa rwekutsva kutsva kunoratidza kukuvara kubva ku fluoride, iyo inonyanya kukosha, kunyanya nekuda kwenhamba yekuwedzera zvidzidzo zvevanhu: 233
Pakazara, Vanokumbira vakaona uye vakabatanidza 196 yakaburitswa zvidzidzo izvo zvakatarisana nemhedzisiro inokonzeresa yekuratidzwa kwe fluoride zvichitevera kuongororwa kweNRC, kusanganisira makumi matanhatu neshanu zvidzidzo zvevanhu, zvidzidzo zvemhuka zana neshanu, zvidzidzo zvemaseru gumi nematanhatu, uye ongororo nhatu dzakarongeka.
Iyo post-NRC zvidzidzo zvevanhu zvinosanganisira:
Ongororo makumi mashanu neshanu ichiongorora zvinoitwa ne fluoride pakuziva mashandiro, kusanganisira asi isingagumiri kuIQ, nezvose asi zvisere zvezviongororwa izvi zvichiratidza kukosha.
kushamwaridzana pakati pe fluoride kuratidza uye kusakwana kwekuziva. 234
• 3 zvidzidzo zvichiongorora zvinoitwa nefluoride pauropi hwechi "fetus", uye chimwe nechimwe chezvidzidzo zvitatu zvichiratidzira zvinokanganisa. 3
Zvidzidzo zvina zvichiongorora kushamwaridzana kwaFlororide nemamwe marudzi ekukuvadzwa neurotoxic, kusanganisira ADHD, maitiro akachinja eanaonatal, nezviratidzo zvakasiyana zveitsinga.
Iko post-NRC zvidzidzo zvemhuka zvinosanganisira:
• 105 zvidzidzo zvichiongorora kugona kwaFlororide kuburitsa neuroanatomical uye neurochemical shanduko, nezvose asi zviviri zveongororo dzichiwana imwe chete yekukuvadza mhedzisiro mune imwe yematanho akaedzwa.
• ongororo makumi matatu neshanu achiongorora zvinoitwa nefluoride pakudzidza nekurangarira, nezvose asi chimwe chete zvacho chichiwana chinokuvadza chimwe muzvikwata zvakarapwa fluoride.
Zvidzidzo gumi neshanu zvichiongorora zvinoitwa nefluoride pane mamwe maitiro eurourobehavior kunze kwekudzidza nekurangarira, nezvose asi imwe yezvidzidzo ichiwana mhedzisiro.
Iyo post-NRC maseru maseru anosanganisira:
• zvidzidzo gumi neshanu, zvinosanganisira zvidzidzo zviviri zvakatsvaga nekuwana mhedzisiro pamatanho e fluoride anogara achiitika muropa revaAmerica vanogara munharaunda dzakasanganiswa.17
Pamusoro peongororo dziri pamusoro, Vanokumbira vari kuendesa matatu post-NRC akarongeka ongororo ezvinyorwa, kusanganisira maviri anotarisana nevanhu / IQ zvinyorwa, uye imwe iyo
inotaura nezve mhuka / kubvuma zvinyorwa. 241
Zviripachena kuti akawanda ezvinyorwa zvekutsvagisa akatoratidza zvinogona kukuvadza vanhu kubva ku fluoride pamatanho akasiyana ekuratidzwa, kusanganisira iwo mazinga parizvino anoonekwa seakachengeteka. Kunyange hazvo chimwe nechimwe chezvinyorwa izvi chakakodzera kutariswa nekukurukurwa, chinyorwa chakapfupikiswa chakabatanidzwa pazasi muchimiro chetsananguro yakajairika yemhedzisiro yehutano ine chekuita nekuratidzwa kwe fluoride, iyo inoratidza zvinowoneka zvemishumo nezvidzidzo zvinoenderana.
Chikamu 6.1: Skeletal System
Fluoride inotorwa mumuviri wemunhu inopinda muropa kuburikidza nenzira yekugaya.242 Mazhinji eaya fluoride asina kuburitswa kuburikidza neweti anochengetwa mumuviri. Zvinowanzo taurwa kuti 99% yeiyi fluoride inogara mupfupa, 243 iyo inosanganisirwa muchimiro chekristaro uye inoungana nekufamba kwenguva. 244 Saka, hazvirambike kuti mazino nemapfupa zvinyama zvemuviri zvinoisa fluoride ku izvo isu tinofumurwa.
Muchokwadi, mune yavo 2006 mushumo, iyo National Research Council (NRC) hurukuro pamusoro penjodzi yekutyoka kwemapfupa kubva kune yakawandisa fluoride yakasimbiswa nekukosha kutsvagurudza. Kunyanya,
Chirevo ichi chakati: "Pakati pese, pakave nekubvumirana pakati pekomiti kuti pane humbowo hwesainzi hwekuti mune mamwe mamiriro ezvinhu fluoride inogona kunetesa pfupa uye kuwedzera mukana wekutyoka." 245
Chikamu 6.1.1: Dental Fluorosis
Kuratidzirwa kune yakawandisa fluoride muvana kunozivikanwa kukonzeresa mazino fluorosis, mamiriro umo mazino enamel anokuvadzwa zvisingadzoreke uye mazino anozopukutwa zvachose, kuratidza chena kana shava mottling pateni uye kuumba brittle mazino anotyoka uye kusvibisa nyore. yave ichizivikanwa nesainzi kubva kuma246 kuti kunyanya kufungidzirwa kune fluoride kunokonzeresa mamiriro aya, ayo anogona kubva kubva pakunyoro kusvika pakuomarara. Zvinoenderana nedhata kubva kuCenters for Disease Control and Prevention (CDC) yakaburitswa muna 1940, 2010% yevaAmerican vane makore 23-6 uye 49% yevana vane makore gumi nemaviri kusvika gumi nemashanu vanoratidza fluorosis kune imwe nhanho. 41 Izvi zvinowedzera zvakanyanya mumitengo yemazino fluorosis dzaive chinhu chakakosha muchisarudzo chePublic Health Service kusarudza kudzikisa huwandu hwayo hwemvura fluoridation danho muna12. 15
Mufananidzo 1: Dental Fluorosis Inotangira Kubva Kunyoro-Nyoro kusvika Kuhure
(Mifananidzo kubva kuna Dr. David Kennedy uye inoshandiswa nemvumo kubva kune vanobatwa nedental fluorosis.)
Mifananidzo yeDental Fluorosis, chiratidzo chekutanga che fluoride chepfu, kubva pakanyanyisa kusvika kune yakaoma; Mufananidzo naDr David Kennedy uye wakashandiswa nemvumo yevakabatwa nemazino fluorosis
Chikamu 6.1.2: Skeletal Fluorosis uye Arthritis
Kufanana nemazino fluorosis, skeletal fluorosis chinhu chisingarambike che oxpxposed kune fluoride. Skeletal fluorosis inokonzeresa mapfupa, kurwadza kwemajoini, yakaganhurirwa renji yekubatana, uye mukati
zviitiko zvakakomba, musana wakakombama zvachose.249 Kunyangwe ichionekwa isingawanzo muUS, mamiriro acho anoitika, 250 uye zvakambotaurwa kuti skeletal fluorosis inogona kunge iri yehutano hweveruzhinji kupfuura zvaimbozivikanwa.251
Sekutsvagurudzwa kwakaburitswa muna2016, hapasati paine kubvumirana kwesainzi nezvekuti yakawanda sei fluoride uye / kana kuti inguva yakareba sei fluoride inoda kutorwa mukati skeletal fluorosis isati yaitika. 252
Nepo vamwe vakuru vakuru vakati skeletal fluorosis inongoitika mushure memakore gumi kana kupfuura ekuburitswa, tsvagiridzo yakaratidza kuti vana vanogona kukura chirwere mukati memwedzi mitanhatu chete, 10
uye vamwe vanhu vakuru vakazvigadzira mukati memakore maviri kana manomwe chete.254 Saizvozvowo, nepo mamwe masimba akataura kuti 10 mg / zuva re fluoride rinodikanwa kugadzira skeletal fluorosis, tsvagiridzo yakaratidza kuti mwero wakaderera kwazvo wekuratidzwa kune fluoride (mu zvimwe zviitiko zvisingasviki 2ppm) zvinogona kukonzera chirwere. 255 Zvakare, kutsvagurudza kwakaburitswa muna2010 kwakasimbisa kuti mafupa emagetsi anopindura fluoride anosiyana nemunhu.
Mune varwere vane skeletal fluorosis, fluoride yakafungidzirwawo kuti inokonzera yechipiri hyperparathyroidism uye / kana kukonzera kukuvara kwemapfupa kwakafanana neyechipiri hyperparathyroidism. Mamiriro acho, ayo anowanzo guma kubva kuchirwere cheitsvo, anokonzereswa kana huwandu hwecalcium uye phosphorus muropa hwadzikira kwazvo.257 Ongororo dzinoverengeka dzakaunganidzwa neFluoride Action Network (FAN) dzinoongorora mukana wekuti fluoride ndeimwe inobatsira kuhutano huno. 258
Nekuti arthritic zviratidzo zvinosanganisirwa ne skeletal fluorosis, arthritis ndiyo imwe nzvimbo yekushushikana zvine chekuita ne fluoride exposures. Kunyanya mune izvi, kutsvagisa kwakabatanidza fluoride kune osteoarthritis, zvese zviripo kana pasina skeletal fluorosis. 259 Uyezve, temporomandibular joint disorder (TMJ) yanga ichibatanidzwa nemazino uye skeletal fluorosis. 260
Chikamu 6.1.3: Kanzera yePfupa, Osteosarcoma
Mu2006, iyo NRC yakurukura nezve inogona kubatanidza pakati pe fluoride exposure uye osteosarcoma. Rudzi urwu rwekenza yemapfupa yakazivikanwa se "boka rechitanhatu rakajairika kwazvo remamota akaipa muvana uye chechitatu chinonyanya kuzivikanwa bundu kune vechidiki." 261 Iyo NRC yakataura kuti nepo humbowo hwaive husinganzwisisike, fluoride yakaratidza kuva nekwanisi yekusimudzira kanzira. .262
Vakajekesa kuti osteosarcoma yaive yakakosha kunetseka, kunyanya nekuda kwe fluoride kuisirwa mupfupa uye mitogenic mhedzisiro ye fluoride pamapfupa maseru. 263
Nepo zvimwe zvidzidzo zvakakundikana kuwana mubatanidzwa pakati pe fluoride ne osteosarcoma, sekutsvaga kwakaitwa naDr. Elise Bassin vachiri kuHarvard School of Dental Medicine, kuratidzwa kwe fluoride pamatanho akakurudzirwa akaenzana nekuwedzera kanomwe muosteosarcoma apo vakomana vaive yakafumurwa pakati pemazera emakore mashanu nemanomwe. 264 Bassin tsvagiridzo, yakaburitswa muna 2006, ndiyo yega yekudzidza nezve osteosarcoma iyo yakatora njodzi dzakananga zera kuverengera. 265
Chikamu 6.2: Central Nervous System
Iko kugona kwe fluorides kukanganisa uropi kwakave kwakanyatso simbiswa. Mumushumo wavo wa2006, iyo NRC yakatsanangura kuti: "Pachishandiswa ruzivo rwunonyanya kutorwa kubva kuongororo yezvakaitika kare, zvemakemikari, uye mamorekuru, zviri pachena kuti mafluorides anokwanisa kukanganisa mabasa ehuropi nemuviri nenzira dzakananga uye dzisiri dzechokwadi. . ”266 Zvese kuora mwoyo neAlzheimer's
chirwere chakataurwa zvakare mune iyo NRC mushumo wekutarisirwa senge inogona kunge yakabatana ne fluoride. 267
Kunetseka uku kwakasimbiswa. Zvidzidzo nezve mvura fluoridation uye IQ mhedzisiro zvakanyatso kuongororwa mukutsvagisa kwakaburitswa muna Gumiguru wa2012 muEnharaunda Hutano Mafungiro. 268 Mune ino meta-ongororo, gumi nemaviri zvidzidzo zvakaratidza kuti nharaunda dzine fluoridated mvura mazinga ari pasi pe12 mg / L (avhareji we4 mg / L ) aive nemaIQ akaderera kupfuura mapoka ekudzora. 2.4 Kubva pakabuditswa ongororo ya269, ongororo dzinoverengeka dzekuwana IQ dzakadzikiswa munharaunda dzine isingasviki 2012 mg / L ye fluoride mumvura yave kuwanikwa. 4 Kuti zvive zvakanyatsojeka, mune chikumbiro chevagari kuEPA muna270, Michael Connett, Esq., Legal Director weFAN, akaona 2016 ongororo dzakaburitswa dzakadzora IQ munzvimbo dzine mwero we fluoride ikozvino inogamuchirwa seyakachengeteka neEPA. 23
Zvakare, muna 2014, ongororo yakaburitswa muThe Lancet yakanzi "Neurobehavioral effects of developmental toxicity." Muchirongwa ichi, fluoride yakanyorwa seimwe yemakemikari gumi nemaviri emaindasitiri
inozivikanwa kuunza budiriro neurotoxicity muvanhu.272 Vatsvagiri vakayambira kuti: "Kuremara kweNeurodevelopmental, kusanganisira autism, kucherechedza-kushomeka kusagadzikana kwehutano, dyslexia, nekumwe kukanganisika kwekuziva, zvinokanganisa mamirioni evana pasi rose, uye kumwe kuongororwa kunoratidzika kunge kuri kuwedzera muhuwandu. Makemikari ekumaindasitiri anokuvadza uropi huri kukura ndezvimwe zvezvikonzero zvinozivikanwa zvekuwedzera kwehuwandu hwevanhu. ”273
Chikamu 6.3: Mwoyo Sistimu
Zvinoenderana nenhamba dzakaburitswa muna2016, chirwere chemoyo ndicho chinokonzera rufu kune vese varume nevakadzi muUS, uye zvinodyira nyika madhora zviuru mazana maviri nemakumi maviri nemaviri pagore.
hukama hunogona kuitika pakati pe fluoride uye matambudziko emwoyo akakosha kwete chete kuti matanho akachengeteka agadziriswe e fluoride asiwo nzira dzekudzivirira dzinogadzirirwa chirwere chemoyo.
Kushamwaridzana pakati pe fluoride uye matambudziko emoyo kwafungidzirwa kwemakumi emakore. Chirevo cha2006 NRC chakatsanangura chidzidzo kubva muna 1981 naHanhijärvi naPenttilä vakataura kuti yakakwidziridzwa serum fluoride muvarwere vane kukundikana kwemoyo. 275 Fluoride yakave zvakare ine chekuita nekuverenga arterial, 276 arteriosclerosis, 277 kushaya moyo, 278 electrocardiogram kusagadzikana, 279 hypertension, 280 uye myocardial kukuvara.281 Pamusoro pezvo, vaongorori vechimwe chidzidzo kubva kuChina chakaburitswa muna 2015 vakapedzisa vachiti: "Mhedzisiro yacho yakaratidza kuti, NaF [sodium fluoride], nenzira inosungika -mabatiro uye kunyangwe pazasi yakadzika ye2 mg / L, yakachinja morphology. yeiyo cardiomyocyte, yakaderedzwa masero kushanda, yakawedzera mwero wekusungwa kwemoyo, uye yakawedzera huwandu hweapoptosis. ”282
Chikamu 6.4: Endocrine Sisitimu
Mhedzisiro yaFluoride pane endocrine system, iyo ine zvipembenene zvinodzora mahormone, zvakave zvakare zvakadzidzwa. Mune 2006 NRC mushumo, zvakanzi: "Muchidimbu, humbowo hwemhando dzinoverengeka hunoratidza kuti fluoride inokanganisa mashandiro endocrine basa kana mhinduro; migumisiro yeshanduko inokonzerwa ne fluoride inosiyana padanho uye nemutsa muvanhu vakasiyana. ”283 Rondedzero ya2006 NRC yakawedzera yaisanganisira tafura inoratidza kuderedzwa kwakanyanya kwefluoride kwakawanikwa kuchikanganisa kushanda kwetachiona, kunyanya pakanga paine kushayikwa iodine. present.284 Mumamwe makore achangopfuura, kukanganiswa kwefluoride pane endocrine system kwakasimbiswazve. Chidzidzo chakaburitswa muna2012 chaisanganisira sodium fluoride pane rondedzero yemakemikari anokanganisa makemikari (EDCs) ane yakaderera-madosi mhedzisiro, 285 uye chidzidzo chakataurwa mumushumo wa2013 kubva kuUnited Nations Nharaunda Chirongwa uye neWorld Health Organisation. 286
Zvichakadaro, kuwedzera kwehutachiona kusagadzikana kwakabatana ne fluoride. 287 Tsvagiridzo yakaburitswa mu2015 nevatsvagiri kuYunivhesiti yeKent muCanterbury, England, yakaratidza kuti mwero wakakwira we fluoride mumvura yekunwa inogona kufanotaura mwero wakakwira wehypothyroidism. Vakaenderera mberi vakatsanangura kuti: “Munzvimbo zhinji dzepasi, hypothyroidism chinhu chakanyanya kunetsa pahutano uye kuwedzera kune zvimwe zvinhu - sekushomeka iodhini - kuratidzwa kwe fluoride kunofanirwa kutariswa sechinhu chinopa mukana. Zvakawanikwa pakutsvagisa izvi zvinomutsa kunetsekana pamusoro pehusimbe hwemagariro fluoridation senzira yakachengeteka yehutano hweveruzhinji. ”288 Dzimwe ongororo dzakatsigira kubatana pakati pe fluoride ne hypothyroidism, 289 kuwedzera kwehutachiona hunokurudzira mahormone (THS), 290 uye kushayikwa kweIodine. 291
Zvinoenderana nenhamba dzakaburitswa neCenters for Disease Control and Prevention (CDC) mugore ra2014, vanhu mamirioni 29.1 kana 9.3% yevagari vane chirwere cheshuga.293 Zvakare, iro rinogona kuita basa re fluoride mumamiriro ezvinhu aya rakakosha kufunga. Chirevo che2006 NRC chakayambira:
Mhedziso kubva kuzvidzidzo zviripo ndeyekuti kukwana kwakakwana kwefluoride kunoratidzika kunge kunounza kuwedzera kweropa glucose kana kukanganisika glucose kushivirira mune vamwe vanhu uye kuwedzera kuomarara kwemamwe marudzi eshuga. Kazhinji, kukanganisika kweshuga metabolism kunoratidzika kunge kwakabatana neserum kana plasma fluoride kuwanda kweanosvika 0.1 mg / L kana yakakura mune zvese mhuka nevanhu (Rigalli et al. 1990, 1995; Trivedi et al. 1993; de al Sota et al. 1997) .294
Kutsvagurudza zvakare kwakabatana nechirwere cheshuga ine yakadzikira kugona kubvisa fluoride kubva mumuviri, 295 pamwe nechirwere (polydispsia-polyurea) chinoguma nekuwedzera kudya kwe fluoride, 296 uye
tsvagiridzo yakabatanidza insulin kudzivisa uye kuramba fluoride
Zvakare zvekushushikana ndezvekuti fluoride inoita kunge inokanganisa mashandiro epineal gland, iyo inobatsira kudzora circadian mutinhimira uye mahormone, kusanganisira mutemo we melatonin uye mahormone ekubereka. Jennifer Luke weRoyal Hospital yeLondon akaona huwandu hwakawanda hwe fluoride yakaunganidzwa mupineal gland298 uye zvakaratidza zvekare kuti aya mazinga
inogona kusvika kusvika 21,000 ppm, ichivapa yakakwira kupfuura iyo fluoride mazinga mupfupa kana mazino. 299 Dzimwe ongororo dzakabatanidza fluoride nemazinga e melatonin, 300 kushaya hope, 301 uye kutanga kuyaruka
muvasikana, 302 pamwe nemitero yepasi yekubereka (kusanganisira varume) uye kudzikisa testosterone mazinga.303
Chikamu 6.5: Renal System
Urini inzira huru yekuburitsa fluoride inoendeswa mumuviri, uye renal system yakakosha mukugadzirisa mafororide mazinga mumuviri. 304 305 Urinary kubuda kwe fluoride iri
yakakanganiswa nemurini pH, chikafu, kuvapo kwemishonga, uye zvimwe zvinhu. uye kubviswa mupfupa uye kugona kufemesa fluoride neitsvo. ”306
Chirevo cha2006 NRC chakacherechedzawo basa reitsvo mukufumurwa kwe fluoride. Vakati hazvishamise kuti varwere vane chirwere cheitsvo vawedzere plasma uye bone fluoride kuwanda.308 Vakaenderera mberi vachiti itsvo dzevanhu "dzinofanirwa kuisa fluoride zvakapetwa ka50 kubva muplasma kusvika weti. Zvikamu zvetsvo zvinogona kuve panjodzi yakanyanya ye fluoride chepfu kupfuura zvinyoro zvakawanda. ”309
Tichifunga nezveruzivo urwu, zvine musoro kuti vatsvagiranisi vakabatanidza kuratidzwa kwe fluoride kumatambudziko neiyo renal system. Zvikurukuru, vaongorori kubva kuToronto, Canada, vakaratidza kuti dialysis varwere vane renal osteodystrophy vaive nehupamhi hwe fluoride mupfupa uye vakagumisa kuti "bone fluoride inogona kudzora hutachiona nekukanganisa mineralization." 310 Uyezve, chidzidzo chevashandi vakafumurwa necryolite rakanyorwa naPhilippe Grandjean naJørgen H. Olsen rakaburitswa muna2004 vakaratidza kuti fluoride inoonekwa sechikonzero chinokonzeresa chegomarara redundiro uye chinokonzera kenza yemapapu.311
Chikamu 6.6: Yekufema Sisitimu
Mhedzisiro ye fluoride pane yekufema system yakanyanya kunyorwa muzvinyorwa nezve
kufumurwa kwebasa. Zviripachena, vashandi mumaindasitiri anosanganisira fluoride vari zvakanyanya
njodzi yepamusoro yekufemesa fluoride kupfuura avo vasingashande muindasitiri; zvisinei maindasitiri
kushandiswa kunogona zvakare kukanganisa maitiro ekufema evhareji vagari kuburikidza akasiyana siyana ekuratidzira
migwagwa.
Kufemerwa kwehydrogen fluoride inoshanda semuenzaniso wakatanhamara weiri basa rinoratidzwa
uye isiri-yehutano njodzi. Hydrogen fluoride inoshandiswa kugadzira mafiriji, mishonga yesora,
mishonga, high-octane peturu, aluminium, mapurasitiki, zvemagetsi zvinoriumba, fluorescent
magetsi, nematare egirazi (akadai seaya anoshandiswa mune zvimwe zvigadzirwa zvemagetsi),
312 zvakare
sekugadzirwa kwemakemikari euranium uye kucheneswa kwequartz. 313
Nzvimbo dzeChirwere Kudzora uye
Kudzivirira (CDC) yakatsanangura kuti pamusoro pekuratidzwa panzvimbo yebasa, isiri-yebasa
kufumurwa kune hydrogen fluoride kunogona zvakare kuitika munzvimbo dzekutengesa uye kuburikidza nekuzvivaraidza kunosanganisira
zvinhu zvakagadzirwa neicho chinhu, pamwe nechiitiko chisingawanzoitika chekuratidzwa nehukemikari hwehugandanga
mumiririri. 314
Hutano mhedzisiro kubva kuhydrogen fluoride inogona kukuvadza nhengo dzakasiyana dzakasiyana, kusanganisira idzo
inobatanidzwa nehurongwa hwekufema. Kufema makemikari kunogona kukuvadza nyama yemapapu uye kukonzera
kuzvimba uye kuunganidzwa kwemvura mumapapu (pulmonary edema) .315
Iwo akakwirira ekuratidzwa kune hydrogen fluoride anogona kukonzera kufa kubva kune anovakwa mumapapu, 316 nepo isingaperi, yakaderera nhanho.
inhalation inogona kukonzera kutsamwa uye kuzara kwemhino, huro, nemapapu. 317
Chaizvoizvo kubva pakuona kwekuita, indasitiri yealuminium ndiyo yanga iri musoro weakarongeka
yekuferefeta nezve fluoride's maitiro pane kufema masisitimu evashandi. Uchapupu hunobva kuna
akateedzana ezvidzidzo zvinoratidza kuwirirana pakati pevashandi pazvirimwa zvealuminium, kuratidzwa kune
fluoride, uye mweya wekufema, senge emphysema, bronchitis, uye kupera mapapu
basa.318
Chikamu 6.7: Digestive System
Pakumedza, kusanganisira kuburikidza nemvura inoyerera, fluoride inosvitswa nemudumbu
system apo ine hafu-yehupenyu yemaminitsi makumi matatu. 30
Huwandu hwe fluoride inonwiwa inoenderana
pamusoro pecalcium mazinga, iine yakanyanya kuwanda kwecalcium kudzikisa mudumbu
kunyudza.
320 321
Zvakare, sekutsvaga kwakaburitswa mu2015 neAmerican Institute ye
Chemical Injiniya, kudyidzana kwe fluoride mudumbu "kunoguma nekuumbwa kwe
hydrofluoric [HF] acid nekuita nehydrochloric [HCL] acid iripo mudumbu. Kuva
inokanganisa zvakanyanya, iyo HF acid yakaumbwa saizvozvo ichaparadza dumbu uye matumbo kumhara pamwe ne
kurasikirwa kwema microvilli. ”322
Imwe nzvimbo yekutsvaga yakanangana nekukanganisa kwe fluoride padumbu remudumbu ndeye tsaona
kumedza mushonga wemazino. Muna 2011, Poison Control Center yakagamuchira mafoni 21,513 XNUMX ane chekuita ne
kuwedzerwa kwemushonga wemazino wakatsetseka. 323
Huwandu hwevanhu vakakanganiswa vangangodaro
kuve wakakwirira zvakanyanya, zvakadaro. Kunetseka kwakasimudzwa kuti zvimwe zviratidzo zvemudumbu
inogona kunge isingafungidzirwe zviri nyore sekubatana ne fluoride kumedza, sekutsanangura kwakaitwa nevaongorori muna 1997
Vabereki kana vanochengeta vanogona kusacherekedza zviratidzo zvinosanganisirwa nehuremu hwe fluoride chepfu
kana anogona kuvati ndeye colic kana gastroenteritis, kunyanya kana vasina kuona mwana
kumedza fluoride. Zvimwechetezvo, nekuda kweasinga tsanangurike hunhu kusvika pakati nepakati
zviratidzo, kusiyanisa kwechiremba kuongororwa hakugone kuisa fluoride chepfu
isina nhoroondo ye fluoride kumedza. 324
Dzimwe nzvimbo dzegadziriro yekugaya dzinozivikanwawo kuti dzinokanganiswa ne fluoride. Semuenzaniso, iyo
2006 NRC mushumo wakadaidzira rumwe ruzivo nezve zvinoitika pane fluoride pachiropa: "Zvinogoneka
kuti kumedzwa kwehupenyu kwe5-10 mg / zuva kubva kunwa mvura ine fluoride pa4 mg / L inogona
inozove nemhedzisiro-refu pachiropa, uye izvi zvinofanirwa kuongororwa mune ramangwana
epidemiologic studies. ”325 Semumwe muenzaniso, fluoride mushonga wemazino unogona kukonzera stomatitis, senge
muromo uye maronda ekurwara mune vamwe vanhu. 326
Chikamu 6.8: immune system
Ma immune immune chimwezve chikamu chemuviri chinogona kukanganiswa ne fluoride. An
yakakosha kufunga ndeyekuti immune maseru anokura mumapfupa emapfupa, saka mhedzisiro ye fluoride
pane immune system inogona kuve yakabatana nekuwanda kwe fluoride mumarangwanda system. I2006
NRC mushumo wakatsanangura pachiitiko ichi:
Zvakangodaro, varwere vanogara munharaunda ine fluoridated nharaunda kana a
munharaunda umo mvura yekunwa zvakasikwa ine fluoride pa4 mg / L vane zvese
yakaunganidzwa fluoride mumasekonzi avo masisitimu uye inogona kunge iine yakanyanya fluoride
kuwanda mumapfupa avo. Bhonzo remapfupa ndipo panowanikwa maseru ekudzivirira uye izvo
inogona kukanganisa humoral immune pamwe nekugadzirwa kweantibhakitiriya kumakemikari ekunze. 327
Allergies uye hypersensitivities kune fluoride chimwe chinhu chinenjodzi chine chekuita ne immune
system. Kutsvakurudza kwakabudiswa muma1950, 1960, uye ma1970 kwakaratidza kuti vamwe vanhu vari
hypersensitive kune fluoride. 328 Zvinofadza kuti, vanyori vekutsvaga kwakaburitswa muna 1967 vakaratidza
kuti apo vamwe vachiri kusahadzika nenyaya yekuti fluoride mumushonga wemazino uye "mavitamini" anogona kukonzera
kushushikana, nyaya dzenyaya dzakaburitswa mupepanhau ravo dzakaratidza kuti zvinogadzikana ne
fluoride iripo.329 Dzimwe ongororo dzichangoburwa dzakasimbisa ichi chokwadi. 330
Chikamu 6.9: Integumentary Sisitimu
Fluoride inogona zvakare kukanganisa iyo yakazara manyorerwo, ayo anove neganda, exocrine gland,
vhudzi, nezvipikiri. Kunyanya, maitiro kune fluoride, kusanganisira fluoride anoshandiswa mumushonga wemazino, ane
yakabatanidzwa neacne uye mamwe mamiriro e dermatological. 331 332 333
Zvakare, inogona kutyisa
mamiriro anozivikanwa se fluoroderma anokonzerwa ne hypersensitive reaction kune fluorine, 334
uye rudzi urwu rwekuputika kweganda (halogenoderma) yave ichibatanidzwa nevarwere vanoshandisa
fluoridated mazino zvigadzirwa. 335
Pamusoro pezvo, vhudzi nezvipikiri zvakave zvichidzidziswa senge biomarkers e
kuratidzwa kwe fluoride.
336
Zvipikiri zvechipikiri zvinokwanisa kuratidza chisingaperi fluoride exposures337
uye kufumurwa kubva pamushonga wemazino, 338 uye kushandisa fluoride kuisa muzvipikiri kuratidza vana
panjodzi yemazino fluorosis yakaongororwa.339
Chikamu 6.10: Fluoride Toxicity
Yekutanga yakakura kesi yekufungidzirwa kwehupfu hwemaindasitiri kubva kune fluorine yaisanganisira njodzi pa
Meuse Valley muBelgium muma1930. Mhute uye mamwe mamiriro munzvimbo ino ine maindasitiri aive
yakabatana nekufa makumi matanhatu uye zviuru nezviuru zvevanhu vachirwara. Uchapupu hwakabva hwabatana
uku kukuvara kune fluorine kuburitswa kubva kumafekitori ari padyo.340
Imwe nyaya yekuisa chepfu mumaindasitiri yakaitika muna 1948 muDonora, Pennsylvania, nekuda kwemhute uye
kupisa kupisa. Mune ino chiitiko, gaseous inoburitswa kubva ku zinc, simbi, waya, uye chipikiri
galvanizing maindasitiri anga achifungidzirwa kuti ari kukonzera kufa kwevanhu makumi maviri uye zviuru zvitanhatu zvevanhu ku
kurwara nekuda kweichi fluoride chepfu. 341
Fluoride chepfu kubva pachigadzirwa chemazino muUnited States chakaitika muna 1974 pakave nemakore matatu
mukomana wekare wekuBrooklyn akafa nekuda kwefloride overdose kubva kumazino gel. Mutori wenhau weNew York
Times yakanyora nezve chiitiko ichi: "Maererano neNassau County toxicologist, Dr. Jesse Bidanset,
William akamedza 45 cubic masentimita e2 muzana stannous fluoride solution, yakapetwa katatu
342
Zviitiko zvakati wandei zve fluoride chepfu muUnited States zvave kutariswa munguva pfupi yadarika
makumi emakore, senge kuputika kwa1992 muHooper Bay, Alaska, nekuda kwekukwira kwakanyanya kwe fluoride mune yekupa mvura343 uye chepfu ya2015 yemhuri muFlorida semhedzisiro yesulfuryl
fluoride inoshandiswa pakurapa pamusha wavo. 344
Nepo iyo mienzaniso yakapihwa pamusoro iri zviitiko zveacute (yakakwira dosi, pfupi-pfupi) chepfu, isingagumi
(yakaderera dose, yakareba-nguva) chepfu inofanirwawo kutariswa. Zvirinani ruzivo nezve fluoride
chepfu yave kuwanikwa kubatsira kubatsira kugadzira kunzwisisika kwenyaya yacho. Kubasa
rakaburitswa muna 2015, vaongorori vakaongorora chokwadi chekuti chiratidzo chekutanga che fluoride chepfu ndeyemazino
fluorosis uye iyo fluoride inozivikanwa inokanganisa enzyme. 345
Pamusoro pezvo, ongororo yakaburitswa mu
2012 yakapa nhoroondo yakadzama yenjodzi dzefluoride chepfu inokanganisa maseru: "Inomutsa
dzinenge dzese dzinozivikanwa nzira dzekuratidzira dzemukati dzinosanganisira G protein-inotenderera nzira,
caspases, uye mitochondria- uye kufa receptors-dzakabatana nzira, pamwe nekukonzeresa huwandu
ye metabolic uye transcript shanduko, kusanganisira kutaura kweanoverengeka apoptosis ane hukama
majini, zvichizoguma nekufa kwesero. ”346
Iko kukurumidzira kwe fluoride chepfu kuti inyatsozivikanwa yakaongororwa muna 2005
bhuku rakanzi "Fluoride chepfu: chirahwe chine zvidimbu zvakavanzwa." Munyori Phyllis J.
Mullenix, PhD, yakatanga chinyorwa, icho chakapihwa muchidimbu kuAmerican College ye
Toxicology Symposium, nekuyambira: "Nhoroondo yekutsanangudza kwakaomarara kweiyo fluoride chepfu
mumabhuku ekurapa akaibvumira kuti ive imwe yevasina kunyatsonzwisiswa, vasina kuongororwa,
nekumiririra zvisizvo matambudziko ehutano muUnited States nhasi. ”347
Paunenge uchiverenga Chikamu chakapfuura che7 pamusoro pekufumurwa kune fluoride, zvinova pachena pachena kuti kutsvagurudza kwakadii kunodiwa pasati paine "yakachengeteka" nhanho yekuburitswa kwe fluoride inogona kunyatso simbiswa. Uku kushayikwa kweuchapupu kunosvika kure kupfuura izvo zvisiri kuzivikanwa parizvino, zvakadaro. Kushaikwa kweuchapupu kwakanyanya mune izvo zvinozivikanwa nezvekushandisa kwevanhu fluoride, kunyanya maererano neyavanonzi "bhenefiti" yekudzivirira caries.
Chikamu 8.1: Kushaikwa Kwekubudirira
Iyo fluoride mumazino uye zvimwe zvigadzirwa zvevatengi zvinowedzerwa nekuti zvinonzi zvinoderedza kuora kwemazino. Iwo mabhenefiti akataurwa eichi chimiro che fluoride ane chekuita nebasa rayo pameno ekudzivirira kufema kwebhakitiriya reStreptococcus mutans, bhakitiriya rinoshandura shuga nemastachi kuva asidi inonamira inopwanya enamel. yemazino inogadzira fluorohydroxyapatite (FHAP kana FAP), uye mhedzisiro yechiito ichi inonzi inosimbiswa remineralization uye yakaderedzwa demineralization yemazino. Nepo paine kutsigirwa kwesainzi kweiyi michina ye fluoride, zvakave zvakare zvakagadziriswa kuti fluoride inonyanya kushanda kudzora kuora kwemazino kumusoro (kureva kuikwesha yakananga pamazino nebhurosi rezino), zvichipesana nehurongwa (kureva. Kunwa kana kumwisa fluoride kuburikidza nemvura kana imwe nzira) .504
Kunyangwe iwo mabhenefiti epamusoro eiyo fluoride anga achinyatsoratidzwa mumabhuku esainzi, tsvagiridzo yakabvunzawo mabhenefiti aya. Semuenzaniso, vaongorori kubva kuYunivhesiti yeMassachusetts Lowell vakatsanangura nharo dzinoverengeka dzakabatana nemashandisirwo epamusoro e fluoride mune chinyorwa chakaburitswa muJenali yeEvidence-Yakavakirwa Dental Practice muna 2006. Mushure mekunyora ongororo ya1989 kubva kuNational Institute of Dental Research yakawana kushoma. misiyano muvana vanogamuchira fluoride uye avo vasiri kuwana fluoride, vanyori vakadudzira zvimwe zviono zvichiratidza kuti mwena mwero munyika dzakasimukira dzadzikira pasina kushandisa fluoride. 506 Vanyori vakaenderera mberi vachitaura nezvezvidzidzo zvinoratidza kuti fluoride haibatsire mukudzivirira gomba uye kuparara kwekuora (zvinova iyo yakajairika fomu yekutsvaira kwemeno kuUS) kana mukudzivirira kuora kwevana bhodhoro reino (rinozivikanwa munharaunda dzine varombo) .507
Semumwe muenzaniso, kutsvagurudza kwekutanga kwakashandiswa kutsigira fluoridation yemvura senzira yekudzora caries yemazino yakazoongororwa zvakare, uye mukana wedata rinotsausa wakazoonekwa. Pakutanga, kuderedzwa kwemazino akaora uye akazadzwa akaomeswa (DFT) akaunganidzwa mukutsvagurudza kwakadudzirwa seumboo hwekushanda kwemvura fluoridation. Zvakadaro, kutsvagurudza kwakazotevera kwaDkt John A. Yiamouyiannis kwakaratidza kuti fluoridation yemvura ingangodaro yakakonzera kunonoka kuputika kwemeno .508 Kupererwa kwakadaro kunonoka kunoguma nemazino mashoma uye nekudaro, kusavapo kwekuora, zvichireva kuti mwero wakaderera weDFT waive zvinokonzerwa nekushaikwa kwemeno kupesana nezvinonzi zvinokonzerwa ne fluoride pamazino emeno.
Mimwe mienzaniso muzvinyorwa zvesainzi yakabvunza mashandisiro anoita fluoride mukudzivirira kuora kwezino. Ongororo ya2014 yakasimbisa kuti fluoride's anti-caries athari inoenderana necalcium uye magnesium muzino enamel asiwo kuti remineralization maitiro mune zino enamel haibvi pane fluoride.509 Tsvagiridzo yakaburitswa muna 2010 yakaratidza kuti pfungwa ye "fluoride inosimbisa mazino" haigone kuonekwa sekiriniki yakakosha kune chero kuderera kwecaries yakabatana nekushandisa fluoride.510 Uyezve, kutsvagisa kwakaratidza kuti systemic fluoride exposure ine mashoma (kana paine) maitiro pamazino, 511 512 uye vaongorori vakapawo data rekuti mazino fluorosis (chiratidzo chekutanga che fluoride toxicity513) iri pamusoro munharaunda dzeUS dzine mvura ye fluoridated kusiyana nevasina iyo.
Zvakare mimwe mishumo inoratidza kuti sezvo nyika dzaive dzichikura, kuwora kwehuwandu muhuwandu hwevanhu kwakakwira kusvika pakakwirira kusvika pamasere kusvika masere akaora, asipo, kana mazino akazadzwa (muma1960) uye ndokuratidza kuderera kunoshamisa (mazinga nhasi), zvisinei ne fluoride shandisa. Izvo zvakafungidzirwa kuti kuwedzerwa kwehutsanana hwemukanwa, kuwana kweanodzivirira masevhisi, uye nekuwedzera kuziva kwekukuvara kweshuga ndiko kunokonzera kudzikira kunooneka kwekuora kwemeno. Chero zvingave zvikonzero zvingave, zvinofanirwa kucherechedzwa kuti maitiro ekudonha kwemazino akaitika pamwe uye pasina kushandiswa kwesystemic yemvura inoyerera, 515 saka zvinoita sekunge zvimwe zvinhu kunze kwe fluoride zvakakonzera shanduko iyi. Mufananidzo 2 pazasi unoratidza maitiro ekuora kwemazino nenyika dzakashatiswa uye dzisina-fluorid kubva 1955-2005.
Mufananidzo 2: Kuora kwemazino Maitiro muFluoridated uye Unfluoridated Nyika, 1955-2005
Dzimwe pfungwa dzinoverengeka dzakakosha mune chero sarudzo pamusoro pekushandisa fluoride kudzivirira caries. Chekutanga, zvinofanirwa kucherechedzwawo kuti fluoride haisi chinhu chakakosha mukukura kwevanhu nekusimudzira.516 Chechipiri, fluoride yakaonekwa seimwe yemakemikari gumi nemaviri emabhizimusi "anozivikanwa nekukonzera kukura kwehutachiona muvanhu." 12 Uye pakupedzisira, muAmerica. Dental Association (ADA) inodaidzira kumwe kutsvagurudza muna517 maererano neyakagadziriswa fluoride chiito uye mhedzisiro:
Tsvagurudzo inodikanwa maererano nemhando dzakasiyana dzemusoro fluorides kuona maitiro avo ekuita uye caries-ekudzivirira mhedzisiro kana ichishandiswa padanho razvino rekumashure fluoride kuratidzwa (kureva, fluoridated mvura uye fluoride mushonga wemazino) muUnited States. Zvidzidzo zvine chekuita nemazano ekushandisa fluoride kukurudzira kusungwa kana kudzoreredzwa kwecaries kufambira mberi, pamwe nemhedzisiro yefluoride mhedzisiro pamazino anoputika, zvinodikanwa zvakare.518
Chikamu 8.2: Kusava neUchapupu
Mareferenzi kune kusatarisika kwematanho ayo mafororidhi zvinokanganisa pahurongwa hwevanhu zvakagadzirwa mukati meiyi nzvimbo pepa. Zvisinei, zvakakosha kudzokorora kushomeka kwehumbowo hwakabatana nekushandiswa kwe fluoride, uye nekudaro, Tafura yechina inopa yakadimburirwa runyorwa rweyambiro yakasimba kubva kuhurumende, sainzi, uye nezvimwe zviremera zvine chekuita nenjodzi uye kusava nechokwadi zvine chekuita nekushandisa zvigadzirwa zvine fluoridated.
Tafura 4: Akasarudzwa Makotesheni pamusoro peFluoride Yambiro Yakakamurwa neMuchina / Maitiro uye Chitubu
| CHIDZIDZO / MAITIRO ANOTAURIRWA | QUOTE / S | SOURCE YENYAYA |
|---|---|---|
| Fluoride yekushandisa mazino, kusanganisira mvura fluoridation | "Kuwanda kwemazino anopararira muhuwandu hwevanhu hakuna kukanganiswa nekuwanda kwe fluoride mu enamel, uye kuwanda kweiyo enamel fluoride hakusi iko kunonyanya kushanda mukudzivirira kupora kwemazino." "Ongororo shomanana dzinoongorora kushanda kwemushonga wemazino we fluoride, gel, sukurudza, uye varnish pakati pevanhu vakuru zviripo." | Nzvimbo dzeDzidziso Kudzora uye Kudzivirira (CDC). Kohn WG, Maas WR, Malvitz DM, Presson SM, Shaddik KK. Mazano ekushandisa fluoride kudzivirira uye kudzora mazino emazino muUnited States. Kurwara uye Kufa Kwevhiki nevhiki Chirevo: Kurudziro uye Mishumo. 2001 Aug 17: i-42. |
| Dhijitari Referensi Inotora: Yakakurudzirwa Dietary Mvumo uye Inokwana Inotora | "Pakazara, pakave nekubvumirana pakati pekomiti kuti pane humbowo hwesainzi hwekuti mune mamwe mamiriro ezvinhu fluoride inogona kunetesa pfupa uye kuwedzera mukana wekutyoka." | National Research Council. Fluoride Mukunwa Mvura: Ongororo yeSainzi Yematanho EPA. Iyo National Academies Press: Washington, DC 2006. |
| Fluoride mumvura yekunwa | "Zvinokurudzirwa Maximum Contaminant Level Goal (MCLG) ye fluoride mumvura yekunwa inofanira kuva zero." | Katoni RJ. Kudzokorora kwe2006 United States National Research Council Rondedzero: Fluoride muMvura Inonwa. Fluoride. 2006 Jul 1; 39 (3): 163-72. |
| Mvura inoyerera | "Fluoride exposure ine hukama hwakaomarara zvine chekuita nekurumwa kwemazino uye inogona kuwedzera njodzi yemazino njodzi muvana vasina kudya zvinovaka muviri nekuda kwekupera kwecalcium uye enamel hypoplasia ..." | Peckham S, Awofeso N. Mvura fluoridation: kuongororwa kwakakomba kwehunhu hwemhedzisiro yekumedza fluoride sehutano hweveruzhinji kupindira. Iyo Scientific World Journal. 2014 Kukadzi 26; 2014. |
| Fluoride mune zvigadzirwa zvemazino, chikafu, uye yekumwa mvura | "Nekuti kushandiswa kwezvigadzirwa zvemazino zvine fluoridated uye kudyiwa kwechikafu nezvinwiwa zvinogadzirwa nemvura inoyerera zvakawedzera kubva HHS payakakurudzira huwandu hwakakwana hwe fluoridation, vanhu vazhinji vanogona kusangana ne fluoride yakawanda kupfuura zvaifungidzirwa." | Tiemann M.Fluoride mumvura yekunwa: ongororo ye fluoridation uye nyaya dzemutemo. BiblioGov. 2013 Kubvumbi 5. Congressional Research Service Report yeCongress. |
| Fluoride inodya muvana | "Kudya" kwakakwana "kwe fluoride kwave kugamuchirwa kwakawanda kwemakumi emakore sepakati pe0.05 ne0.07 mg fluoride pakirogiramu imwe yehuremu asi kunobva pane humbowo hushoma hwesainzi." "Izvi zvakawanikwa zvinoratidza kuti kuwana chinzvimbo chisina cari kunogona kunge kusinei nekudyiwa kwe fluoride, nepo fluorosis iri pachena zvakanyanya zvichienderana nefluoride." | Warren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber ‐ Gasparoni K. Kufungisisa nezve yakanakisa fluoride yekushandisa uchishandisa mazino fluorosis uye mhedzisiro yemazino mhedzisiro- kudzidza kwenguva refu. Zvinyorwa zveParuzhinji Hutano Dentistry. 2009 Kurume 1; 69 (2): 111-5. |
| Fluoride-inoregedza meno ekugadzirisa zvinhu (kureva mazino ekuzadza) | "Zvisinei, hazviratidzwe nevanotarisira zvidzidzo zvemakiriniki kuti chiitiko checaries chechipiri chinogona kudzikiswa zvakanyanya nekuburitsa fluoride kwezvinhu zvekudzorera. " | Wiegand A, Buchalla W, Attin T. Ongororo nezve fluoride-inoburitsa zvinhu zvekugadzirisa-fluoriderelease uye kutora maitiro, antibacterialactivity uye pesvedzero pane cariesformation. Zvemazino Zvinhu. 2007 Mar 31; 23 (3): 343-62. |
| Dental zvinhu: sirivheri diamine fluoride | "Nekuti sirivheri diamine fluoride inyowani kuAmerican mazino uye dzidzo yemazino, panodiwa gwara rakagadziriswa, protocol, uye mvumo." "Hazvina kujeka kuti chii chichaitika kana kurapwa kukamiswa mushure memakore 2-3 uye kutsvagiswa kuchidikanwa." | Horst JA, Ellenikiotis H, Milgrom PM, UCSF Sirivheri Caries Arrest Committee. UCSF Protocol yeCaries Kusungwa Uchishandisa Sirivheri Diamine Fluoride: Pfungwa, Zviratidzo, uye Chibvumirano. Zvinyorwa zveCalifornia Dental Association. 2016 Jan; 44 (1): 16. |
| Nyaya yemusoro fluoride yekushandisa mazino | “Dare racho raive nedanho repasi re chokwadi nezve kubatsirwa kwe 0.5% fluoride paste kana gel pameno anogara evana uye pamidzi midzi nekuti paive nedata shoma pamashandisirwo epamba zvigadzirwa izvi. " “Kutsvagisa kunodiwa maererano nekubudirira pamwe nenjodzi dzezvimwe zvigadzirwa munzvimbo dzinotevera: kuzvishongedza, simba-rekushandisa, simba rekushandisa pamba majekiseni, mazino kana madonhwe; 2 muzana zvine hunyanzvi yakashandiswa sodium fluoride gel; dzimwe nzira dzekuendesa, senge furo; Zvakanyanya Kunaka Panguva Yepamuviri mafomu ekushandisa eiyo fluoride varnish uye gels; miniti-kumwe kunyorera kweAPF gel; uye mubatanidzwa wezvigadzirwa (kushandiswa pamba uye kushandiswa zvinehunyanzvi). ” | Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, Hujoel PP, Iafolla T, Kohn W, Kumar J, Levy SM. Topical fluoride yekudzivirira caries: Executive chidimbu cheakagadziridzwa emakiriniki ekurudzira uye kutsigira kwakarongeka kuongorora. Zvinyorwa zveAmerican Dental Association. 2013; 144 (11): 1279-1291. |
| Fluoride "zvinowedzera" (mahwendefa) | "Kusawirirana kuri pachena pakati pemhedzisiro kunoratidza kuti kune mashoma mashandiro pamapiritsi e fluoride." | Tomasin L, Pusinanti L, Zerman N. Basa remapiritsi e fluoride muprophylaxis yemazino emeno. Kuongorora kwemabhuku. Annali diStomatologia. 2015 Jan; 6 (1): 1. |
| Mishonga, fluorine mumushonga | "Hakuna munhu anogona kufungidzira zvine mutsigo zvinoitika mumuviri wemunhu mushure mekugadzirwa kwemakemikari akabuda." | Strunecká A, Patočka J, Connett P. fluorine mukurapa. Zvinyorwa zveApplied Biomedicine. 2004; 2: 141-50. |
| Kunwa mvura ne poly- uye perfluoroalkyl zvinhu (PFASs) | "Kunwa kusvibiswa kwemvura nezvinhu zvepoly-uye perfluoroalkyl (PFASs) kunoisa njodzi mukukura, immune, metabolic, uye endocrine hutano hwevatengi." "... ruzivo pamusoro pemvura yekunwa PFAS yakafumurwa saka irikushaikwa kweanenge chetatu chevanhu vemuUS." | Hu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, Lohmann R, Carignan CC, Blum A, Balan SA, Higgins CP. Kutsvaga kwePoly-uye Perfluoroalkyl Substances (PFASs) muUS Kunwa Mvura Yakabatanidzwa kune Maindasitiri Sites, Mauto eMoto Kudzidzisa Nzvimbo, uye Wastewater Kurapa Zvirimwa. Environmental Science & Technology Tsamba. 2016 Gumiguru 11 |
| Kuburitswa pabasa kune fluoride uye fluoride chepfu | “Ongororo yeruzivo rwusina kuburitswa maererano nemhedzisiro yekufemerwa kwenguva refu kwe fluoride uye fluorine inoratidza kuti pari zvino mashandiro anoita vanhu kudzivirira kwakakwana. ” | Mullenix PJ. Fluoride chepfu: chirahwe chine zvidimbu zvakavanzika. International Zvinyorwa zveKushanda uye Hutano Hutano. 2005 Gumiguru 1; 11 (4): 404-14 |
| Kuongorora kwechengetedzo zviyero zvekuratidzwa kune fluorine uye fluorides | "Dai taingofunga nezvehukama hwe fluoride yecalcium, taizonzwisisa kugona kukuru kwe fluoride yekukuvadza masero, nhengo, gland, uye zvinyama." | Prystupa J. Fluorine-ongororo yazvino yezvinyorwa. Iyo NRC uye ATSDR yakavakirwa kuongorora kwechengetedzo zviyero zvekuratidzwa kune fluorine uye fluorides. Toxicology Maitiro uye Maitiro. 2011 Kukadzi 1; 21 (2): 103-70. |
Chikamu 8.3: Kushaikwa kweMitemo
Kumwe kunetseka kukuru pamusoro pekuratidzwa kwe fluoride kubva pamvura yekunwa uye chikafu zvine chekuita nekugadzirwa kwema fluoride anoshandiswa munharaunda dzemvura. Zvinoenderana neCentre for Disease Control and Prevention (CDC), matatu marudzi e fluoride anowanzo shandiswa munharaunda fluoridation yemvura:
- Fluorosilicic acid: mhinduro yemvura-inoshandiswa neakawanda masisitimu emvura muUnited States. Fluorosilicic acid inonziwo hydrofluorosilicate, FSA, kana HFS.
- Fluorosilicic acid: mhinduro yemvura-inoshandiswa neakawanda masisitimu emvura muUnited States. Fluorosilicic acid inonziwo hydrofluorosilicate, FSA, kana HFS.
- Sodium fluorosilicate: yakaoma yekuwedzera, yakanyungudutswa ikava mhinduro usati wawedzerwa kumvura. Sodium fluoride: yakaoma yekuwedzera, inowanzo shandiswa mune diki mvura masystem, yakanyungudutswa ikava mhinduro isati yawedzerwa kumvura.
Gakava rakamuka pamusoro pehukama hwemaindasitiri kune izvi zvigadzirwa. CDC yatsanangura kuti dombo rephosphorite rinopiswa ne sulfuric acid kugadzira 95% ye fluorosilicic acid inoshandiswa mukushambidza kwemvura.520 CDC yakaenderera mberi ichitsanangura kuti: "Nekuti kugoverwa kwezvigadzirwa zve fluoride kune hukama nekugadzirwa kwefosfeti yefetireza, chigadzirwa che fluoride chinogona inochinja-chinjawo zvichienderana nezvinhu zvakaita sekushomeka kwemari yekunze nekushambadzira kwekutengesa kunze kwenyika. ”521 Gwaro rehurumende kubva kuAustralia rakaburitsa pachena kuti hydrofluosilicic acid, sodium silicofluoride uye sodium fluoride zvese" zvinowanzotorwa kubva kune vagadziri vephosphate fetereza. "522 Kudzivirirwa vanotsigira kuburitswa kwe fluoride vakabvunza kana hukama hwemaindasitiri hwakadai hune hunhu uye kana kubatana kwemaindasitiri nemakemikari aya kunogona kukonzera kuvharirwa kwehutano hunokonzerwa nekuratidzwa kwe fluoride.
Nyaya yakatarwa yetsika inomuka nekubatanidzwa kwakadai kwemaindasitiri ndeyekuti mapoka anotyairwa purofiti anoita kunge anotsanangura zvinodiwa nekuchinja kweiyo inoita "yakanakisa" tsvagiridzo-yakavakirwa, uye panguva ino, sainzi isina rusarura inova yakaoma kubhadhara, kugadzira, kutsikisa, uye zivisa. Izvi zvinodaro nekuti kubhadhara mari yekudzidza yakakura kunogona kudhura zvakanyanya, asi maindasitiri-anoverengeka anokwanisa nyore kutsigira ivo vega vaongorori. Ivo vanogona zvakare kukwanisa kushandisa nguva vachiongorora nzira dzakasiyana dzekuzivisa data (sekusiya dzimwe nhamba kuti vawane mhedzisiro inofadza), uye ivo vanogona zvakare kukwanisa kushambadza chero chinhu chetsvagurudzo inotsigira zviitiko zvavo. Nehurombo, nhoroondo yakaratidza kuti masangano emakambani anokwanisa kunyange kukwanisa kushungurudza masayendisiti akazvimirira senzira yekupedzisa basa ravo kana iro basa richiratidza kukuvara kunogadzirwa nekusvibisa kwemaindasitiri uye zvinosvibisa.
Chokwadi, chiitiko ichi chesainzi isina kuenzana chakaonekwa mukutsvaga kwe fluoride. Vanyori vewongororo yakaburitswa muScientific World Journal muna 2014 vakajekesa kuti: “Kunyangwe fluoridation yekuisira mvura yakave nzira ine nharo yehutano hweveruzhinji kubva payakatanga, vaongorori - avo vanosanganisira masayendisiti anoremekedzwa pasi rose nevadzidzi - vakagara vachiona zvakaoma kuburitsa kutsoropodza zvinyorwa zvemunharaunda yemvura fluoridation mumabhuku evadzidzi emazino uye ehutano eruzhinji. ”523
Pamusoro pezvo, kukakavara kwechido kunogona kuve kwakanangana zvakananga nezvidzidzo nezve kufumurwa kwekudya kune zvigadzirwa zvemafuta (PFCs). Mune chinyorwa chakaburitswa muna2012, kutsvagirwa nezve chikafu chinodyiwa kubva kuPFCs kwakaongororwa nenyika. Munyori akaburitsa pachena kuti data kubva kuUS rakanga rakaganhurirwa, raingova nekuburitswa kwegore ra2010 nevanoverengeka vevaongorori vezvidzidzo zveAmerica, pamwe ne3M yakatsigirwa tsvagiridzo yakashanda sekutsvagurudza kwekutanga pasati paburitswa 2010 (uye inonzi yakawanda sampuli yechikafu yaive nehutachiona hwakadzika pasi pekuonekwa.) 524 Asi, vaongorori vezvidzidzo vakaburitsa zvakawonekwa zvakasiyana kupfuura mushumo we3M uye vakanyora mubhuku ravo ra2010: "Zvisinei nekurambidzwa kwechigadzirwa, takawana maPOPs [anoramba achingosvibisa makemikari] muchikafu cheUS, nemisanganiswa yeiyi makemikari anodyiwa neruzhinji rweAmerica pamatanho akasiyana. Izvi zvinoratidza kudiwa kwekuwedzeredza kuyedzwa kwechikafu chemakemikari anosemesa. ”525
Kurwisana kwekufarira kwave kuchizivikanwawo kuti vapinde mumahofisi ehurumende anobatanidzwa mune zvine chepfu zvemakemikari mutemo. Chinyorwa cha2014 cheNewsweek chakanyorwa naZoë Schlanger chine musoro unoti "Ko EPA Inofarira Indasitiri Pakuongorora Njodzi Dzemakemikari?" yaisanganisira chirevo kubva kuna ecologist Michelle Boone akataura kuti '' rese kana iro rakawanda data rakashandiswa pakuongorora kwenjodzi rinogona kubva mukutsvaga kwakapihwa neindasitiri, kunyangwe iri pachena [kupokana kwekufarira]. '”526
Zvinonzwisisika zviri nyore kuti indasitiri yemazino ine kurwisana kukuru kwekufarira ne fluoride nekuti purofiti inoitwa nemakambani anogadzira zvigadzirwa zvemazino zvine fluoride. Pamusoro pezvo, maitiro anosanganisira fluoride anotungamirwa nachiremba wemazino uye vashandi vezvemazino vanogona zvakare kuwana purofiti kumahofisi emazino, 527 528 uye mibvunzo yetsika yakamutswa pamusoro pekusundira aya fluoride maitiro kune varwere.529
Zvichienderana nehunhu hwekurapa uye mazino maitiro, dombo repakona rehutano hweveruzhinji inozivikanwa seyambiro yekuchengetedza inofanirwa kutariswa futi. Hwaro hwekutanga hwemutemo uyu hwakavakirwa pamhiko yezvekurapa yemazana emakore "kutanga, usakuvadza." Asi, mashandisiro azvino uno echinangwa chekuchengetedza anonyatsotsigirwa nechibvumirano chepasi rose.
MunaNdira 1998, kumusangano wepasi rose waisanganisira vesainzi, magweta, vanogadzira mitemo, uye vanoona nezvezvakatipoteredza kubva kuUS, Canada neEurope, gwaro rakasainwa rakazosainwa ndokuzivikanwa se "Wingspread Statement on the Precautionary Principle." 530 Mairi, kutevera kurairwa kunopihwa: “Kana chiitiko chikamutsa kutyisidzira kwekukuvadza hutano hwevanhu kana nharaunda, matanho ekudzivirira anofanira kutorwa kunyangwe hazvo chimwe chikonzero uye hukama hukama husina kunyatso sainwa nesainzi. Muchirevo chechinyorwa chino mutsigiri wechiitiko, kwete cheruzhinji, anofanira kutakura mutoro weuchapupu. ”531
Hazvishamisi kuti kudiwa kwekushandisa kwakakodzera kwechengetedzo kwakabatana nekushandiswa kwe fluoride. Vanyori vechinyorwa cha2006 chakanzi "Zvinorevei Nheyo Yekudzivirira Kune Huchapupu-Huchitsigira Mazino?" yakaratidza kudiwa kwekuverengera kuwanda kwekuwedzera kubva kune ese fluoride masosi uye kusiyanisa kwevanhu, uku vachitaurawo kuti vatengi vanogona kusvika "zvakakwana" fluoridation mazinga vasina kumbonwa mvura ine fluoridated. musimboti wekuti ushandiswe mukushandiswa kwe fluoride, uye vakatora pfungwa iyi nhanho imwe vachienda mberi apo pavakaratidza kuti nzwisiso yedu yemazuva ano yemazino emeno "inoderedza chero basa rakakura remangwana re fluoride mukudzivirira kwecaries." 532
Fluoride Position Paper Vanyori
Dr. Jack Kall, DMD, FAGD, MIAOMT, iFellow of Academy yeGeneral Dentistry uye Mutungamiriri wekare wechitsauko cheKentucky. Iye iAccredited Master yeInternational Academy yeOral Medicine uye Toxicology (IAOMT) uye kubvira 1996 akashanda saSachigaro we' Board of Directors. Anoshanda zvakare paBioregulatory Medical Institute's (BRMI) Board of Advisors. Iye inhengo yeInstitute for Functional Medicine uye American Academy yeOral Systemic Health.
Dr. Griffin Cole, MIAOMT akagamuchira Mastership yake muInternational Academy yeOral Medicine uye Toxicology muna 2013 uye akanyora Academy's Fluoridation Brochure uye yepamutemo Scientific Review pamusoro pekushandiswa kweOzone mumidzi canal therapy. Ndiye Mutungamiriri wekare weIAOMT uye anoshanda paBoard of Directors, Mentor Committee, Fluoride Committee, Conference Committee uye ndiye Fundamentals Course Director.
Dr. David Kennedy akashanda mazino kwemakore anopfuura 30 uye akasiya basa rekiriniki muna 2000. Ndiye Mutungamiriri Wekare weIAOMT uye akadzidzisa vanachiremba vemazino nevamwe vashandi vehutano pasi rose pamusoro pezvidzidzo zvekudzivirira mazino, mercury toxicity, uye fluoride. Dr. Kennedy anozivikanwa pasi rese semumiriri wemvura yekunwa yakachengeteka, biological dentistry uye mutungamiri anozivikanwa mumunda wekudzivirira mazino. Dr. Kennedy munyori ane hunyanzvi uye dhairekita wefirimu rakahwina-rakahwina reFluoridegate.
