FLUOROSIS

chronic intoxication with fluorine (usually combined with some other element to form a fluoride) that results in changes in the skeleton and ossification of tendons and ligaments. Exposure to fluoride in optimum amounts (about one part per million of fluoride to water) is claimed to be beneficial to the teeth (in the prevention of caries) and probably to bone development; fluorides ingested in very high amounts over a short period are general poisons that produce quick death. Mild chronic exposure (68 parts per million of water) will cause mottling of tooth enamel in children, but the bones are unaffected. In more severe chronic exposure, bone calcium is gradually replaced by fluorine; the bones become soft and crumbly and turn chalky white. Protrusions of new bone develop in abnormal places. There are few early symptoms, but late developments include stiffness, inability to move the spine, and neurologic symptoms when nerves of the spinal cord are compressed. Chronic exposure occurs from air pollution in certain areas, among workers in the insecticide, aluminum-mining, and phosphate-fertilizer industries, and in whole groups of people who live in areas with waters naturally high in fluorides. The latter form of exposure is not a significant cause of fluorosis in the Western Hemisphere, but in parts of India and Arabia bone affections are endemic.