Relationship of fluoride in drinking water to other drinking water parameters

Fluoride in drinking water and 32 other drinking water variables were evaluated in an epidemiologic study of 158 municipalities in the State of Iowa. The study included three study groups: two for controlled fluoridation and one for natural fluoride. Previous epidemiologic studies of fluoride in drinking water have rarely addressed other drinking water parameters. The results indicated that controlled fluoridation municipalities were more likely to have initiated other treatment practices such as chlorination. Natural fluoride drinking water concentrations were positively correlated with water source depth, and thereby related to other depth-associated variables such as radium 226, strontium, and nitrogen. Future epidemiologic studies evaluating the safety of fluoride in drinking water should address the potential for confounding by other water variables and treatment processes.