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Contribution to the ongoing discussion on fluoride toxicity.

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Current European fluoride exposure levels do not indicate a risk for human developmental neurotoxicity. Calculating benchmark doses is problematic due to inconsistent study data and confounding factors, necessitating a comprehensive risk analysis.

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Area of Science:

  • Environmental Health
  • Toxicology
  • Public Health

Background:

  • Fluoride in drinking water has been debated since the 1940s regarding health effects.
  • A recent review assessed health risks of current fluoride exposure levels in Europe.
  • An editorial questioned the absence of human benchmark dose (BMD) calculations for fluoride neurotoxicity.

Purpose of the Study:

  • To explain the challenges in calculating human benchmark doses (BMD) for fluoride neurotoxicity using available data.
  • To critically evaluate the existing scientific literature on fluoride and neurodevelopmental risks.
  • To emphasize the need for a holistic approach in risk assessment.

Main Methods:

  • Critically analyzed existing epidemiological studies on fluoride and neurodevelopment.
  • Assessed the limitations of studies, including control of confounding factors and data homogeneity.
  • Considered a broad range of evidence, including animal and in vitro studies, alongside human data.

Main Results:

  • Conclusions from available studies on fluoride neurotoxicity are inconsistent, with both positive and negative findings reported.
  • Studies reporting positive associations often fail to control for crucial confounding factors like other neurotoxicants.
  • Epidemiological studies reviewed have significant limitations impacting their reliability for risk assessment.

Conclusions:

  • Calculating reliable human benchmark doses for fluoride neurotoxicity is problematic with current data.
  • The totality of evidence, considering all study types, does not support classifying fluoride as a developmental neurotoxicant at current European exposure levels.
  • A comprehensive risk analysis integrating diverse data is essential for accurate public health assessments.