FLUOROSIS FEAR & REMEDY Author: J.P.Tungare HRG Evaluation Lab R&D Center Ion Exchange (I) Ltd. Patancheru, Hyderabad Introduction: Fluorosis - A dreaded, painful slow and sure killer has been steadily creeping in, deforming millions of Indians and making its present felt. Fluorosis is a highly advanced stage of fluoride poisoning and it is an irreversible, practically helpless body disorder. Around 3 4 % of Indian population would not mean much, but if one considers a whopping number of 25 millions, shows the high density of disease. Fluorosis is caused by intake of high amount of fluoride through water, food, and drugs, inhalation of air contaminated with fluorine and recently due to fluoridated toothpaste. The Indian sub-continent is rich fluoride bearing minerals like Fluorspar (CaF 2 ), Cryolite (Na 2 AlF 6 ), and Fluorapatite (Ca 10 F 2 (PO 4 ) 6 ). India s water and soil therefore are highly contaminated with fluoride. The worst affected area in the world is stated to be in KENYA where the water in the lake Nakuru is reported to contain 2800 ppm fluoride & underground water over 100 ppm fluoride Fluoride affected countries in the World: KENYA TANZANIA SUDAN ETHIOPIA UGANDA RWANDA BURUNDI MOZAMBIQUE ZAMBIA ZIMBABWE SOUTH SEA ISLAND ALGERIA CHINA ARGENTINA THILAND SENEGAL MOROCCO TURKEY INDIA AFGANISTAN PAKISTAN NEPAL AUSTRALIA JAPAN
Fluoride affected States in India: ANDHRA PRADESH PUNJAB TAMILNADU UTTAR PRADESH HARYANA RAJASTHAN GUJRAT MADHYA PRADESH KARNATAKA U.T. of DELHI BIHAR ORISSA MAHARASHTRA Historical findings: Year Findings 1937 Fluorosis is detected in Andhra Pradesh 1952 Taylor reported that fluoride might induce CANCER. He latter confirmed his findings 1960 Fluorosis is confirmed in Punjab, AP, Tamilnadu & Uttar Pradesh 1965 Taylor demonstrated effects of fluoride on the growth of Cancer cells 1976 Mohamed a researcher found chromosome aberration in humans diploid fibroblast and stated that The presence of fluoride in water may represent a GENETIC HAZARD TO MANKIND 1977 Forseman found that 82% of children fed with tinned milk and food are suffering from Fluorosis. 1979 Krook found high level of abortion and stillbirth in cattle s ingesting fodder containing 14 25 ppm fluoride. 1981 Emsley showed that fluorides are capable of entering a chemical reaction with DNA & RNA 1984 Tsusti showed that Hemister embryo cells treated with 75 125 ppm fluoride had undergone significant increase in chromosome aberration 1960-1980 Fluorosis is detected in Rajasthan, Haryana, Gujrat, Karnataka, MP, and U.T. of Delhi 1980-1987 Fluorosis is detected in Bihar, Orissa and Maharashtra
Water quality in fluoride affected areas of Gujarat: Place TDS, ppm TH, ppm as CaCO 3 Fluoride ppm as F Aklera 1602 100 6.0 928 Ansador 1212 84 10.0 772 Dhangla 2266 296 7.0 674 Sajantimba 918 102 7.0 586 Lonka 1804 102 4.0 1042 Haripar 4066 712 5.0 1400 Bhesan 948 76 5.5 690 M. Alkalinity ppm as CaCO 3 Water quality in fluoride affected areas of Rajasthan: PLACE (Jain Temple) ph Total Hardness ppm as CaCO 3 Fluoride ppm as F Total Alkalinity ppm as CaCO 3 Meetha Pani well 7.80 184 3.70 322 Padamsagar well 7.90 170 8.50 1112 Backyard Borewell 7.68 184 8.00 1064 Auratoli Borewell 7.70 158 3.75 1052 New Well 8.20 160 5.0 1028 HEALTH HAZARDS FROM FLUOROSIS Discoloration Of Teeth Calcium deposition in blood vessels Mottling of Enamel Blotted feeling of Stomach Deformation of Bones Muscle Weakness Outward Bending of legs Loss of Appetite Heart diseases Kidney Problem Liver Problem Paralysis Headache Cancer Constipation Allergy Diarrhea Stiffening of joints
Permissible limit of fluoride: (WHO guidelines) For drinking water: 1.5 ppm For waste water 2.0 ppm Facts about fluorosis: 1) 0.7 1.2 ppm F consumed during childhood prevents dental caries. 2.0 ppm F affects enamel of the Teeth 3.0 ppm F causes severe discoloration of the teeth 4.0 ppm F causes defective calcification of the teeth 8 10 ppm F consumed for longer periods causes deformation of bones. 20 ppm F consumed for 20 years causes crippling fluorosis 2) Assuming that a person drinks 2 its of water a day, 115 ppm F is a sublethal dose and 2000 ppm F is a lethal dose 3) Accumulation of fluoride in Human body results in pain in bones, joints and outward bending of legs from knee. This is called KNOK- KNEE SYNDROM. Almost all adults near Navajo Sager Dam in AP have been suffering from Knock-knee syndrome 4) Change in agricultural technique increased fluoride contamination. 5) Fluoride is only second to cyanide in stopping important metabolic function of body cells. Fluoride decreases life of RBC in the blood. Fluoride ion inhibit the growth of Vitamin B 12 which in turn causes a person to be anemic. 6) In the advance stage of skeletal fluorosis people have their back bent inward completely and are not able to stretch, stand and walk. They remain bed ridden. 7) Fluoride has little or no role in preventing dental caries. Good oral hygiene and calcium In diet can effectively take care of caries. 8) Awkwardly growing bones compress nerve which results in paralysis.
Hazards from floridated toothpastes 1. Fluoride has very little role in preventing dental carries 2. Fluorosis is detected also in non-fluoridated areas mostly Urban & Semi-Urban using fluoride toothpaste 3. Sodium mono-fluoro phosphate is added to the toothpaste to make it fluoridated, but it decomposes the toothpaste. 4. All fluoridated toothpaste contains 1000 3000 ppm fluoride in them. What is more alarming is that these paste are not evenly mixed resulting in 1000 ppm F in one squeeze and 3000 ppm F in another squeeze. 5. As per WHO fluoride toothpaste are causing hazards in India, they suggested to ban fluoride toothpaste. 6. In USA, children below 6 years are restricted from using fluoridated toothpaste. 7. KENYA is the first country in the world where fluoride toothpaste is totally banned. Deflouridation Techniques: Various methods are used to reduce the fluoride, some are as below. 1. Addition of Tamarind: In KENYA where fluoride content is more than 100 ppm, people add Tamarind, which decreases fluoride by 50% after 24 hours. 2. Activated carbon Treatment: Carbon from saw dust removes 350 450 mg/kg of dry material. Ions like Cl, SO 4 reduces fluoride removal capacity. The removal capacity of the fluoride was found very low after regenerating exhausted active carbon. 3. Treatment with Alumina: Removal efficiency at optimum ph was reported as 84%. Removal is a monolayer adsorption process. A total capacity of 12mg/gm of alumina shows remarkable variations. 4. Lime Treatment: This was found to be working well only for the removal of HF from the effluent. 5000 ppm F is reduced to < 8 ppm F by 35,000-ppm lime.
5. Treatment with Aluminum salts: A solution of Al salts is used with FeCl 3 as flocculants. 6. MgCl 2 salt treatment: Use of MgCl 2, at 2.0 g per liter added to waste water containing 50 ppm fluoride reduces it to 3 ppm F. 7. Electrolysis Treatment: A mixture of calcium compound 10g & diatomaceous earth 20g in 1000 liter is used for 1 ppm F Electrolysis is done with D.C. 10 Amp. /m 3. Formation of CaF 2 colloids to be absorbed on to the diatomaceous earth. Treated water fluoride was 0.4 ppm. 8. Treatment with Na2CO 3 & Al 2 (SO 4 ) 3 : This method is totally depend on hardness in the water. Increase in TH increases fluoride removal efficiency. The details of treatment applied is as below ( when TH is > 300 ppm) Raw water Fluoride ppm as F ppm dose of Al 2 (SO 4 ) 3 ppm dose of Na2CO 3 Treated water Fluoride ppm as F 2.0 300 150 0.72 2.0 500 250 0.40 4.0 500 250 1.22 6.0 500 250 1.50 6.0 1000 500 0.77 9. Magnesium salt + Lime: The reaction mechanism is as follows MgCl 2 + Ca(OH) 2 CaCl 2 + Mg(OH) 2 Mg(OH) 2 + NaF Mg(OH)F + NaOH 10. Calcium phosphate Treatment : When calcium phosphate is used with 10% NaOH the calcium salt binds the fluoride ion as shown below 2 Ca 3 (PO 4 ) + 3 NaOH Ca 5 F(OH)(PO 4 ) 3 + Na 3 PO 4 Ca 5 F(OH)(PO 4 ) 3 + NaF Ca 5 F(PO 4 ) 3 + NaOH 11. By Membrane Separation: BARC in Mumbai has successfully defluoridated water containing high fluoride associated with high TDS using Reverse Osmosis.
12. Nalgonda Technique: Established by Balusu and co-worker of NEERI, this method is under implementation at certain parts of India. In this method Alum and Lime is added to precipitate fluoride. The precipitated flocks settle down. The removal of F can be controlled by adjusting the alum dose, which depends upon the initial alkalinity of raw water. 13. Ion Exchange Process: In this process the water containing fluoride is passed through a bed of Ion exchange resin, which selectively adsorbs fluoride from the water. Resin is regenerated after exhaustion, thus making the process of fluoride removal economical. Disadvantages of precipitation methods: 1. Water containing low alkalinity cannot be defluoridated with ease. 2. Addition of alum increases sulfate level which causes gastro-intestinal irritation when present with Mg or Na.. 3. Settling of the flocks requires 12 to 24 hours. 4. High cost of civil construction such as tanks, drainage etc. 5. Removal of sludge and its transportation require regular attention and manpower. 6. Water gets contaminated with dust & foreign matter as it is open to the sky during overall treatment process Advantages of using ion exchange resins: 1. The method works on the principle of adsorption/ionic exchange, hence fluoride in the treated water obtained contains fluoride below desired limit. 2. These are supplied; as portable point of use units with different capacities based on customer s need. The units are handy, easy to operate and needs small floor place. 3. Work efficiently with water of different fluoride levels. It can treat water-containing fluoride as high as 25 ppm. In some cases pretreatment is necessary based on water quality. Post-treatment is necessary in certain cases. 4. Temporary hardness is also reduced in the treated water. 5. Use of resin is economical as it is regenerated and used again and again.
6. Process is continuous, needs no startup time. The units can be operated at any time and do not need continuous attention or monitoring. 7. Process is applicable for raw water and treating waste water bearing fluoride from industrial discharge. References: 1. Journal of Indian Water Works Association Jan. March 1994 2. Journal of Indian Water Works Association July. Sept 1999 3. Journal of Indian Water Works Association Jan. March 1986 4. An Overview of Deflouridation methods J. IPHE, India 1988 5. ENCOLOGY Vol. 9, No. 4 September 1994 6. C.A.Select ION EXCHANGE Issue 21, 1984 7. Deflouridation of water Ind.Jou. Env. Health Vol. 32, No. 3, 1990 8. Water Treatement by F.I.Belan (Mir Publishers) 9. Indian Journal of Env. Health Vol.35, No. 1, 1993 ******************