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Beware Of Fluorosis! This Disease Is Spreading!

By Dr KS Sharma & Dr. M.Bapuji

30 December, 2015

Pic 1----- Condition of those who did not get proper treatment at right time Pic 2 and 3 ----- Fluorosis affected children in Madhya Pradesh. (Notice the bent legs). Same children after 2 years of treatment (Notice straight legs). Fluorosis victims can be identified with these teeth lesions : Typical horizontal yellw or brown line-markings, loss of shine etc in front pair of teeth in children and adults also

As per an estimate made a few years ago, 230 districts in 20 states , and 6.6 crore (66 million) people were threatened with fluorosis in India. Presently, this number could have crossed 10 crores (100 million). Union Health Ministry had identified around 230 fluorosis- affected districts in India, out of which 24 districts are in Karnataka state. It is estimated that people in more than 6000 villages of Karnataka are drinking water contaminated with higher fluoride involving a population of around 60 lakhs who face the threat of fluorosis, unless countered effectively and in time. Though Nalgonda District was widely known to be affected, the fact is today in Anadhra Pradesh and Telegana, virtually no district is totally free from fluorosis. Warangal, Karimnagar, Ranga Reddy Dts highly affected, followed by others. But vying with them, though far less known, are Guntur, Krishna ( ie., new capital region), Prakasam, Anantapur, Nellore, Kadapa, Kurnool Dts. followed by others in AP too. Metros like Bengaluru and Hyderabad also have dozens of habitats with high fluoride. Given the ever-rising numbers, one can imagine how terrible and serious the problem has become by now. It particularly affects the poorer, malnourished, manual worker population, ultimately crippling the people and their economy, personal as well as national. Children, women, more so the pregnant, old-aged people are more vulnerable. It is affecting crores of people, more debilitating than diabetes, high BP etc., but least tackled.

The Origin of Fluorosis

As the disease of fluorosis is spreading far and wide, it becomes necessary to know how and where it originates. It is to be noted that fluorosis is caused by drinking water with fluoride above permitted levels. While BIS-IS: 10500-2004 prescribed 1mg as desirable limit, which is also the upper limit as per ICMR, Govt took Fluoride in drinking water at 1.5 mg/Lit as maximum permissible. A person drinking water from under- ground sources, ie., from deeper wells/bore wells, has higher chances of being affected by fluorosis. Consumption of grains and vegetables, grown in a soil having higher fluoride content, also leads to fluorosis. Almost 90% population in India use ground water even for cooking and drinking. These days, even in cities, many houses are provided with bore well water. It is also very true that there is no control or regulation on the supply, sale and quality of bore well water. In an article aptly titled as India's groundwater is flooded with fluoride, in 2003, a former Director of Geological Survey of India warned about the dangerous effects of consuming water with high fluoride. Over the last few years, many more deep bore wells are coming up in the country in an unregulated manner. Apart from these , untreated effluents from various (coal-burning) industries like thermal plants, steel, cement, aluminium etc. are contaminating water sources including wells with fluoride and polluting even the air with its volatile form. Further, unlimited amount of chemical fertilizers, more so phosphates, used in the fields also adds to the fluoride content in the soil. In addition to high fluoride in water and foods grown in such water, it is also there in most popular brands of toothpastes( added with 1000 ppm of fluoride, check on the paste-tube you use), tobacco and its products like gutkas, black tea (without milk), most readymade foods containing kala namak, thus aggravating disease. Regular and prolonged intake of pain tablets by fluorosis-patients worsens the case with resultant kidney damage that in turn enhances retention of fluoride in the body. High fluoride in water can not be reduced by cloth-filtering, boiling, adding tulsi leaves, using copper vessels etc.

Fluorosis is of three types: dental, skeletal, and non-skeletal. Initially, fluoride damages the inner lining of gut-wall, thus impairing digestion with related symptoms. Then teeth get affected with typical mottling, with yellow and then brown horizontal discoloration. Slowly the disease spreads to the bones and joints, muscles, ligaments and nerves. Gradually over years , if not countered, the person becomes stiff and crippled. Even mental retardation may result from fluorosis, recent studies show.

Until recently many doctors opined that the physical disability caused by fluorosis has no cure. In fact there was no chapter on fluorosis in medical text books until 2013-14. But, as a result of extensive research, it is now known that the spread of the disease in the body can be slowed, arrested, and treated. Drinking water with low fluoride and intake of well balanced diets (protein-rich, with lot of greens, fruits ) led to very promising results in countering fluorosis. Regularly taking Calcium, Magnesium, Vitamins C, D and E , for a long time, ie, for 2-3 years, will help in preventing ill effects of fluorosis. Digestion improves, stiffness eases, and less pain in joints will be noticed. The pictures given here of three children prior to and after treatment for 2 years show the remarkable improvement in their condition. This definitely shows that the evil effects of fluorosis can and need to be countered.

Do you have fluorosis in your area?

Fluorosis is a disease caused by slow poison of higher fluoride in water, that affects particularly children and poor people, more so the toilers who work in hot Sun as they drink more water. It is more debilitating than diabetes or high blood pressure but least known as such. Not only common people, even many doctors are not conscious of the seriousness of this disease, which will make a person completely disabled if not tackled.

Observe primary school children aged below 10-12 years, whether they have mottling, yellow or brown horizontal coloration on frontal pair of teeth. If quite a few children have such features, yes, then you can definitely identify that village as fluoride affected. In such areas, many adults will have problems of indigestion. Neck becomes stiff and difficult to bend. In many cases, the affected person will have back pain and knee joint pain too. To ease these pains, many will be taking pain killers frequently. Hence when such symptoms are noticed among people, one can be sure that the people in the village are affected by fluorosis. After a few years, these symptoms will aggravate and make the victim disabled. Where there is fluorosis, it spreads silently unless countered in a multi-sided manner.

Fluorosis : STEPS for mitigation

If high-fluoride water, ie., with more than 1mg of fluoride per litre of water as per ICMR, is used in a village or town for drinking and cooking, people are bound to be affected by fluorosis. Even before confirming diagonosis of fluorosis , a few measures are listed below to counter and control fluorosis in such places.

If a habitation has water sources having high fluoride, residents should somehow and at any cost try to get good safe water with low fluoride for drinking and cooking at least for 15-20 days . If you notice that after such efforts, your digestion has improved, stiffness, aches and pains in the body and joints are less, then you are sure to realize that your problems are only because of higher fluoride in water. Then you will be ready to insist on, strive and fight for getting safe water.

Preventive steps : In areas with higher fluoride in drinking water , the following measures should be taken.

1) Obtain rain water from around your house and rooftop, filter and boil it and use it for both cooking and drinking. Note that surface waters are better, safer than borewell water in such areas. Use the poorer borewell water for bathing, washing clothes, utensils, cattle etc : Protect from pollution, save and restore rivers, streams, lakes, watersheds, small kuntas. Test ALL wells/borewells in your area whether they are safe or not, mark out unsafe sources. Note that in the same habitation, some wells can have lower fluoride than others, so identify, and mark as good, bad, worse wells.

2) Key points while cooking : Use only iodised salt. Avoid aluminium vessels for cooking and storing cooked food. Use plenty of onions, garlic, ginger, jeera, curry-leaves, tamarind, amla, lemon and jaggery( instead of sugar) in your food. We need more of calcium, Vitamins C, D, and E, anti-oxidants etc to counter fluorosis, so use more of such foods: Use plenty of milk and buttermilk, pulses, groundnuts and eggs, more so for children. Use plenty of green leaves, more so drumstick leaves with dal, in rasam, as chutney and powder. Note the leaves are richer in nutrition than drumsticks, richer than milk, carrots,and oranges many ways, and free of cost. Use powders, singly or mixed, of curry-leaves, drumstick leaves, tamarind (even coarse) leaves. Use more of foods rich in proteins like pulses, groundnuts, beans, rajma, horsegram, eggs. Use only whole grains of wheat, jowar, ragi, bajra, other millets, brown rice (not polished rice). Use more vegetables, more so tomatoes (raw richer than ripe), carrot, beetroot, gazar, radish, sweet potato, capsicum etc. Take fruits like guava, papaya, oranges, banana and star fruit(even diabetics in such areas can and should take them, drastically cutting down edible oil). Amla is excellent, so is horsegram(ulava charu best). Plant such trees in your village, on roadsides, in schools, offices. Ensure that mid-day meals for school children, anganwadis and balawadis , and tree-planting, afforestation programs are suitably reformulated as above.

3) Avoid tea. Black tea without milk should not be consumed at all. Avoid rock salt (kala namak) and readymade foods using it(see label).

4) Do not use fluoridated toothpaste, especially for children below 6 years. When you buy, see the small print on the paste tube or carton which show the fluoride content therein ( 1000ppm).

5) STOP chewing and oral and nasal use of tobacco , pan masala, gutka, betelnut as all of them add to the fluoride in water.

6) Spread the above Info through schools, teachers, anganwadis and balawadis, ASHA workers, PHCs,clinics, panchayat office, water outlets etc.

7) Measures to be followed by fluorosis- affected patients :

Simple measures of treatment with native food items like banana stem juice, banana flower, horse-gram, amla, drumstick leaves, greens, milk, curds, jiggery, tamarind, groundnuts, Til , proteinous foods, and supplements with Calcium, Magnesium Vit C D in addition to fluoride-free safe drinking water will help RECOVERY of patients affected with Fluorosis, will help reduce discomfort, pain etc in a short time. For details contact us.( NOTE : WHENEVER YOU GO TO NON-FLUOROTIC AREAS OR SOME ONE IS COMING FROM NON-FLUOROTIC AREAS, PL GET THESE VEGETABLES from there. BECAUSE, WHAT IS LOCALLY PRODUCED MAY CONTAIN FLUORIDE!)

AVOID Pain tablets, Fluoride-containing toothpastes.

Let us make ours as a Fluorosis- free state!

Dr KS Sharma, Fluorosis Mitigation Research and Resource Centre, FMRRC HUBLI Karnataka
Contact 0836-233046 or mail to [email protected]

Technical and Scientific Advisor : Dr. M.Bapuji, Visiting Professor, Acharya and BMReddy College of Pharmacy. Bengaluru. [email protected]

Fluorosis Mitigation Research and Resource Centre,
FMRRC, Gokul Road, HUBLI Karnataka . PIN 580 030
Founder and Chairman : Dr K S Sharma, FMRRC .

About Dr KS Sharma

Born 1934, Hubli-based.
Retd Professor of Law, Doctorate in Political science.
Independent Trade Union leader, organized one lakh unorganized dailywagers of Govt. of Karnataka into a Federation, and got them regularized through 30-year-long struggle. Soviet Land Awardee, Karnataka Sri, Kannada Sri, writer, poet, dramatist, journalist.

Technical and Scientific Advisor : Dr. M.Bapuji
Visiting Professor, Acharya and BM Reddy College of Pharmacy,
Hessarghatta Road, Achitnagar Post, Bangalore -560107

About Dr Bapuji. M.

( Born 1948) Senior Scientist, (Retired), CSIR, Regional Research Lab (now renamed as IMMT), Bhubaneswar 1973-2002.
Ph.D (guide: Prof L.R.Row) in Organic chemistry 1974 Andhra University.
DAAD post doc fellow at Tech Univ Berlin in Prof.F.Bohlmann's labs.

Presently :
--Visiting Prof., Acharya and BM Reddy college of Pharmacy, (DSIR Recognized) ,Bangalore.
-- Scientific adviser, Fluorosis Mitigation Research and Resource Center, Hubli, Karnataka .
--Engaged in Research and activity on Fluorosis on a voluntary basis. Compiled a Library of over 15000 pages on various aspects of Fluorosis.
-- Adviser, Forum for Research in Local Health Traditions, FRLHT, Bengaluru. (Ayurveda Research Inst, Deemed University).

Soft and hard Output:

--six patents and nine technologies in Industry (stopped imports of anthranilate group of chemicals)
--Sixty five publications, in diverse fields: organic chemistry, applied microbiology, microbial biotechnology, mangrove fungal pigments, antifouling, fish disease control etc.
--Guided Six Ph.Ds and several M.Phil and M.Sc dissertations in various areas of learning.
--Recognised Ph.D guide and adjudicator for Andhra, Nagarjuna, Kolkata, Jadavpur, Utkal and Baripada Univs and IIT(G)
--Principal Investigator for National Project on Drugs from Sea for 12 years.
--Discovered an eighty km long ridge reef at 110ft depth off south Odisha coast; described about 140 sedentary organisms for the first time from Odisha;
--established dedicated lab for microbes associated with marine sedentary fauna
--Ex- Director PG Courses at DLR College, G.Mamidada 2002-2007.
--For varying periods Sr Academic consultant, Adikavi Nanaya University and
Research adviser, Nagarjuna Agrichem, Srikakulam





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