Iphepha le-IAOMT elimelene nokusetshenziswa kwe-fluoride lihlanganisa izingcaphuno ezingaphezu kuka-500 futhi linikeza ucwaningo lwesayensi olunemininingwane mayelana nobungozi bezempilo obungaba khona obuhlobene nokuchayeka kwe-fluoride.
Iphepha lesikhundla le-IAOMT elimelene nokubandakanya izingcaphuno ezingaphezu kuka-500 futhi linikeza ucwaningo oluningiliziwe lwesayensi mayelana nobungozi bezempilo obungaba khona obuhlobene nokuchayeka kwe-fluoride.
I-Fluorine (F) iyinto yesishiyagalolunye etafuleni lezinsuku futhi iyilungu lomndeni we-halogen. Inesisindo se-athomu esingu-18.9984, iyona esebenza kahle kunazo zonke izinto, futhi yakha izibopho eziqinile ze-electronegative. Iheha ikakhulukazi ama-cation e-divalent we-calcium ne-magnesium. Esimweni sayo samahhala, i-fluorine iyigesi e-diatomic ephuzi kakhulu enobuthi, ephaphathekile. Kodwa-ke, i-fluorine ayitholakali esimweni sayo samahhala emvelweni ngoba cishe njalo ihlangana nezinye izinto njengomphumela wezinga layo eliphakeme lokuphinda lisebenze. I-fluorine ivame ukwenzeka njengamaminerali
i-fluorspar (CaF2), i-cryolite (Na3AlF6), ne-fluorapatite (3Ca3 (PO4) 2 Ca (F, Cl) 2), futhi iyinto yesi-13 egcwele kakhulu emhlabeni.
I-Fluoride (F-) iyi-ion yamakhemikhali ye-fluorine equkethe i-electron eyengeziwe, ngaleyo ndlela iyinikeze icala elibi. Ngaphandle kobukhona bayo bemvelo kumaminerali, kanye nasenhlabathini, emanzini nasemoyeni, i-fluoride nayo yenziwe ngamakhemikhali ukuze isetshenziswe emphakathini we-fluoridation wamanzi, imikhiqizo yamazinyo, nezinye izinto ezenziwe. I-fluoride akubalulekile ekukhuleni nasekuthuthukeni komuntu.1
Eqinisweni, ayidingeki kunoma iyiphi inqubo yomzimba emzimbeni womuntu; ngenxa yalokho, akekho umuntu oyohlushwa i-fluoride yokushoda. Ngo-2014, uDkt. Philippe Grandjean waseHarvard School of Public Health noDkt. Philip J. Landrigan wase-Icahn School of Medicine eNtabeni iSinayi bachaza i-fluoride njenge eyodwa yamakhemikhali ezimboni ayi-12 aziwa ngokudala i-neurotoxicity yentuthuko kubantu. 2
Isigaba 5.1: Ukuhlanzwa Kwamanzi Omphakathi
ENtshonalanga Yurophu, abanye ohulumeni baye babalahla obala ubungozi be-fluoride, kanti yi-3% kuphela yabantu baseNtshonalanga Yurophu abaphuza amanzi ane-fluorid. 133 E-United States, abantu baseMelika abangaphezu kwama-66% baphuza amanzi ane-fluorid.134 I-Environmental Protection Agency (i-EPA) noma uhulumeni wesifundazwe awugunyazi ukufudumeza amanzi eMelika, kanye nesinqumo sokuguqula amanzi omphakathi senziwe nguhulumeni noma umasipala wendawo .135 136 Kodwa-ke, i-US Public Health Service (PHS) isungula ukugxila kwe-fluoride enconywayo emanzini okuphuza omphakathi kulabo abakhetha ukuguquguqula, futhi i-Environmental Protection Agency (EPA) ibeka amazinga angcolisayo amanzi okuphuza omphakathi.
Ngemuva kokuguqulwa kwamanzi e-Grand Rapids, eMichigan, kwaqala ngo-1945, lo mkhuba wasakazeka ezindaweni zonke ezweni lonke emashumini eminyaka alandela. Le mizamo yakhuthazwa yi-Public Health Service (PHS) ngawo-1950, 137 nango-1962, i-PHS yakhipha amazinga e-fluoride emanzini okuphuza ayengama iminyaka engama-50. Bathe i-fluoride izovimbela ama-caries amazinyo138 nokuthi amazinga afanele we-fluoride engezwe emanzini okuphuza kufanele abe phakathi kuka-0.7 kuya ku-1.2 milligram ngelitha. 139 Kodwa-ke, i-PHS yehlise lesi sincomo saya ezingeni elilodwa lama-milligrams ayi-0.7 ilitha ngo-2015 ngenxa ukwanda kwe-fluorosis yamazinyo (ukulimala okungapheli emazinyweni okungenzeka ezinganeni kusuka ekuvezweni ngokweqile kuya ku-fluoride) kanye nokwanda kwemithombo yokuchayeka kwe-fluoride kwabaseMelika.140
Khonamanjalo, i-Safe Drinking Water Act yasungulwa ngo-1974 ukuvikela ikhwalithi yamanzi okuphuza aseMelika, futhi yagunyaza i-EPA ukuthi ilawule amanzi okuphuza omphakathi. Ngoba
yalo mthetho, i-EPA ingabeka amazinga angcolisa okuphoqeleka (ama-MCL) wamanzi okuphuza, kanye nezinhloso zezinga lokungcola okungaphoqeleleki (ama-MCLG) namazinga okuphuza angaphoqeleleki wamazinga aphakeme angcolile (ama-SMCL) .141 I-EPA icacisa ukuthi i-MCLG “yizinga eliphezulu lokungcola emanzini okuphuza okungekho mthelela omubi owaziwayo noma olindelekile empilweni yabantu ongaba khona, okuvumela ukuphepha okwanele.” 142 Ngaphezu kwalokho, i-EPA ikufanelekela ukuthi amasistimu wamanzi angaphezu kwe-MCL ye-fluoride “kumele azise abantu abasebenziswa yileso simiso ngokushesha, kodwa kungakadluli izinsuku ezingama-30 uhlelo lutholile ukwephula.” 143
Ngo-1975, i-EPA yabeka izinga lokungcola elingaphezulu (i-MCL) le-fluoride emanzini okuphuza ngo-1.4 kuya ku-2.4 milligram ngelitha. 144 Basungula lo mkhawulo ukuvimbela amacala we-dental fluorosis. Ngo-1981, iSouth Carolina yaphikisa ngokuthi i-dental fluorosis imane nje iyisimonyo, futhi umbuso wanxusa i-EPA ukuthi iqede i-MCL ye-fluoride. Njengomphumela, ngo-145, i-EPA yasungula umgomo wezinga lokungcola (i-MCLG) omkhulu we-fluoride kuma-1985 milligram ngelitha. 4 Esikhundleni samazinyo i-fluorosis esebenza njengendawo yokugcina evikelayo (obekungadinga amazinga aphansi okuphepha), leli zinga eliphakeme lasungulwa njengezindlela zokuvikela ukulwa nesifo samathambo, isifo samathambo esibangelwa i-fluoride eyeqile. Ukusebenzisa i-skeletal fluorosis njengesiphetho ekugcineni kwaholela ekushintsheni kwe-MCL ye-fluoride, eyakhuphukela kuma-milligram ama-146 ngelitha ngalinye ngo-4. 1986 Nokho, i-fluorosis yamazinyo yasetshenziswa njengendawo yokugcina ye-SMCL ye-fluoride yama-milligram ama-147 ngelitha, nayo yasethwa ngo-2. 1986
Impikiswano yalandelwa ngalezi zimiso ezintsha futhi yaholela nasekuthatheni izinyathelo zomthetho ngokumelene ne-EPA. ISouth Carolina yaphikisana nokuthi asikho isidingo sanoma iyiphi i-MCLG (umgomo ophakeme wokungcola) we-fluoride, kuyilapho uMkhandlu Wezokuvikelwa Kwemithombo Yemvelo uphikise ukuthi i-MCLG kufanele yehliswe ngokuya nge-dental fluorosis. 149 Inkantolo yakhipha isinqumo esivuna i-EPA, kepha lapho ibuyekeza amazinga e-fluoride, i-EPA yafaka isicelo kuMkhandlu Kazwelonke Wokucwaninga (i-NRC) weNational Academy of Sciences ukuze iphinde ihlole ubungozi bezempilo be-fluoride. 150 151
Umbiko ovela kuMkhandlu Kazwelonke Wokucwaninga, owakhishwa ngo-2006, waphetha ngokuthi i-MCLG ye-EPA (umgomo ophakeme wokungcola) we-fluoride kufanele yehliswe. 152 Ngaphezu kokubona ukuthi kungenzeka kube nengozi ye-fluoride ne-osteosarcoma (umdlavuza wamathambo), u-2006 Umbiko woMkhandlu Kazwelonke Wokucwaninga ubalule ukukhathazeka ngemiphumela yemisipha, ukuzala kanye nemiphumela yokuthuthuka, i-neurotoxicity nemiphumela ye-neurobehavioral, i-genotoxicity ne-carcinogenicity, kanye nemiphumela kwezinye izinhlelo zezitho zomzimba.153
I-NRC yaphetha ngokuthi i-MCLG ye-fluoride kufanele yehliswe ngo-2006, kodwa i-EPA kusafanele yehlise izinga. 154 Ngo-2016, iFluoride Action Network, i-IAOMT, namanye amaqembu kanye nabantu abathile banxusa i-EPA ukuthi ivikele umphakathi, ikakhulukazi ukuthinteka okuthe ngqo, okuvela ezingcupheni ze-neurotoxic ze-fluoride ngokuvimbela ukwengeza okunenjongo kwe-fluoride emanzini okuphuza. 155 Isicelo sinqatshiwe yi-EPA ngoFebhuwari 2017.156
Isigaba 5.2: Amanzi Amabhodlela
Njengomuthi wokuxubha kanye nemikhiqizo eminingi yamazinyo, amanzi asemabhodleleni nawo angaqukatha i-fluoride.
I-United States Food and Drug Administration (FDA) inesibopho sokuqinisekisa ukuthi izindinganiso zamanzi asemabhodleleni ziyahambisana nezindinganiso zamanzi ompompi asethwe yi-EPA 157 namazinga anconywayo asethwe yi-US Public Health Service (PHS). 158 I-FDA ivumela amanzi asemabhodleleni ahlangabezana nezindinganiso zawo 159 ukufaka ulimi oluthi ukuphuza amanzi ane-fluorid kunganciphisa ingozi yokubola kwamazinyo.
Isigaba 5.3: Ukudla
I-FDA yanquma ukukhawulela ukwengezwa kwamakhemikhali e-fluorine ekudleni ngenzalo yezempilo yomphakathi ngo-1977. 161 Kodwa-ke, i-fluoride isekhona ekudleni ngenxa yokulungiswa emanzini apholile, ukutholakala kwemithi yokubulala izinambuzane kanye nomanyolo, nezinye izinto. Ngo-2004, uMnyango wezoLimo wase-United States (USDA) wethula imininingwane yamazinga e-fluoride eziphuzweni nasekudleni, kanti umbiko onemibhalo eningiliziwe washicilelwa ngo-2005.162 Yize lo mbiko usabalulekile, amazinga e-fluoride ekudleni naseziphuzweni kungenzeka lenyuke eminyakeni eyishumi eyedlule ngenxa yokusebenzisa i-fluoride emithini yokubulala izinambuzane esanda kuvunywa.163 Ezinye izithasiselo zokudla ezingaqondile ezisetshenzisiwe njengamanje nazo ziqukethe i-fluoride.
Ngaphezu kwalokho, ngo-2006, uMkhandlu Kazwelonke Wokucwaninga wancoma ukuthi “ukusiza ekulinganiseni ukuvezwa komuntu nge-fluoride ekungenisweni, abakhiqizi nabakhiqizi kufanele banikeze imininingwane ngokuqukethwe kwe-fluoride yokudla neziphuzo ezentengiselwano.” 165 Kodwa-ke, lokhu ngeke kwenzeke noma nini maduzane. Ngo-2016, i-FDA yabuyekeza imfuneko yokufakwa kwelebuli kokudla kwamalebula we-Nutrition and Supplement Facts futhi yakhipha isinqumo sokuthi ukumenyezelwa kwamazinga e-fluoride kungokuzithandela kokubili kwemikhiqizo ene-fluoride engeziwe ngenhloso nemikhiqizo ene-fluoride eyenzeka ngokwemvelo. 166 Ngaleso sikhathi, i-FDA nayo ayizange isungule Inani Lezithenjwa Zansuku zonke (i-DRV) le-fluoride
Ngokuphambene nalokho, ngo-2016, i-FDA yenqabela i-perfluoroalkyl ethyl equkethe izinto zokuthinta ukudla (PFCSs), ezisetshenziswa njengeziphindiseli zika-oyela namanzi ngephepha nephepha. 168 Lesi senzo sithathwe ngenxa yedatha enobuthi kanye nesikhalazo esifakwe nguMkhandlu Wezokuvikela Wezemvelo kanye namanye amaqembu.
Ngaphandle kwalokhu kucatshangelwa nge-fluoride ekudleni, ukusungula amazinga aphephile e-fluoride ekudleni ngenxa yezibulala-zinambuzane kwabiwa yi-FDA, i-EPA, kanye ne-Food Safety and Inspection Service yomnyango Wezolimo wase-US. 169
Isigaba 5.4: Izibulala-zinambuzane
Ama-pesticides athengiswa noma asatshalaliswa e-US kumele abhaliswe ne-EPA, kanti i-EPA ingasungula ukubekezelela izinsalela zemithi yokubulala izinambuzane uma ukutholakala kokudla kuthathwa ngokuthi "kuphephile." 170
Mayelana nalokhu, imishanguzo yokubulala izinambuzane emibili equkethe i-fluoride ibe yisihloko sengxabano:
1) I-Sulfuryl fluoride yaqala ukubhaliswa ngo-1959 ukuze ilawulwe umuhlwa ezakhiweni zezinkuni 171 nango-2004/2005 ukulawula izinambuzane ekudleni okusetshenzisiwe, njengokusanhlamvu okusanhlamvu, izithelo ezomisiwe, amantongomane ezihlahla, ubhontshisi we-cocoa, ubhontshisi wekhofi, kanye nokudla izindawo zokuphatha kanye nezokulungisa ukudla.172 Amacala obuthi bomuntu ngisho nokufa, yize kuyivelakancane, ahlotshaniswa nokuvezwa kwe-sulfuryl fluoride okuhlobene namakhaya aphethwe isibulala-zinambuzane.173 Ngo-2011, ngenxa yocwaningo olusha kanye nokukhathazeka okwaphakanyiswa yiFluoride Action Network FAN), i-EPA iphakamise ukuthi i-sulfuryl fluoride ayisakwazi ukuhlangabezana nezindinganiso zokuphepha nokuthi ukubekezelelwa kwalesi sibulala-zinambuzane kufanele kuhoxiswe. 174 Ngo-2013, imboni yezibulala-zinambuzane yenza umzamo omkhulu wokunxenxa isiphakamiso se-EPA sokuqeda i-sulfuryl fluoride, kanye Isiphakamiso se-EPA sihlehlisiwe ngesimiso esifakwe kuMthethosivivinywa Wezolimo wase-2014
2) I-Cryolite, equkethe i-sodium aluminium fluoride, isibulala-zinambuzane esaqala ukubhaliswa ne-EPA ngo-1957.176. 177 I-Cryolite yisibulala-zinambuzane esikhulu se-fluoride esisetshenziselwa ukukhulisa ukudla e-US (kanti i-sulfuryl fluoride isetshenziswa njenge-fumigant ekudleni kwangemva kokuvuna) . I-Cryolite isetshenziswa ezitsheni ezisawolintshi namatshe, imifino, amajikijolo, namagilebhisi, i-178 futhi abantu bangadalulwa kuyo ngokudla kwabo, njengoba i-cryolite ingashiya izinsalela ze-fluoride ekudleni ebisetshenziselwe kona. i-sulfuryl fluoride, i-EPA iphinde yaphakamisa ukuthi kuhoxiswe konke ukubekezelela ama-fluoride emithini yokubulala izinambuzane. 2011 Lokhu-ke bekungafaka i-cryolite; kodwa-ke, njengoba kuphawuliwe ngenhla, lesi siphakamiso sichithwe.
Isigaba 5.5: Imikhiqizo Yamazinyo Eyosetshenziswa Ekhaya
I-FDA idinga ukufakwa ilebula “kwemikhiqizo elwa nezidakamizwa” elithengiswa ekhawunta, njengethambo lokuxubha nokugeza umlomo. Amagama athile welebula akhethwa yifomu le-
umkhiqizo (isb. ijeli noma unamathisela bese ugeza), kanye nokuhlushwa kwe-fluoride (ie 850-1,150 ppm, 0.02% sodium fluoride, njll.). Izexwayiso eziyi-180 nazo zihlukaniswe ngamaqembu eminyaka yobudala (okusho ukuthi iminyaka emibili nangaphezulu, ngaphansi kweminyaka eyisithupha , Iminyaka eyi-12 nangaphezulu, njll.). Ezinye izexwayiso zisebenza kuyo yonke imikhiqizo, efana nale elandelayo:
(1) Kuyo yonke imikhiqizo ye-fluoride dentifrice (ijeli, unamathisela, ne-powder). “Gcina lapho izingane ezingaphansi kweminyaka eyisithupha zifinyelele khona. [kugqanyiswe ngokugqamile] Uma okungaphezu kwalokho okusetshenziselwe ukuxubha kugwinywe ngephutha, thola usizo lwezokwelapha noma uthinte i-Poison Control Center ngokushesha. ”6
(2) Kuwo wonke ama-fluoride hlambulula futhi uvikele imikhiqizo yejel yokwelashwa. “Gcina kude nezingane. [kugqanyiswe ngesinhlamvu esibhalwe ngokugqamile] Uma kusetshenziswe okungaphezulu kune ”(khetha igama elifanele:“ ukuxubha ”noma“ ukuhlanza ”)“ kugwinywe ngephutha, thola usizo lwezokwelapha noma uthinte i-Poison Control Center khona manjalo. ”182
I-athikili yocwaningo eshicilelwe ngo-2014 iveze ukukhathazeka okuphawulekayo ngalelilebula. Ngokuqondile, ababhali basungule ukuthi ngaphezulu kwemikhiqizo engama-90% abayihlolile babala isexwayiso se-FDA sokuthi sisetshenziswe kuphela ngabantwana abaneminyaka engaphezu kwemibili emuva kwepayipi lokuxubha kanye nefonti encane.183 Izimo ezifanayo zabikwa ngezixwayiso ezivela ku I-American Dental Association (ADA), okuyiqembu lokuhweba hhayi inhlangano kahulumeni. Abaphenyi babhala ukuthi konke okokuxubha kwamazinyo ngokuvunywa noma ukwamukelwa yi-ADA kubeka isexwayiso se-ADA (ukuthi izingane kufanele zisebenzise inani elilingana nepea lomuthi wokuxubha futhi zigadwe ngumuntu omdala ukunciphisa ukugwinya) ngemuva kwephubhu kufonti encane Amasu wokumaketha ayi-184 abe
okunye okukhonjwe njengokukhuthaza umuthi wokuxubha njengokungathi kungumkhiqizo wokudla, abacwaningi abakuvumile ukuthi iyiqhinga elingadala ukuthi izingane zigwinye lo mkhiqizo.
Yize i-dental floss ihlukaniswe yi-FDA njengedivayisi yeClass I, i-186 dental floss equkethe i-fluoride (imvamisa i-stannous fluoride) ibhekwa njengomkhiqizo ohlanganisiwe187 futhi idinga
izicelo ze-premarket.188 I-Dental floss nayo ingaqukatha i-fluoride ngesimo samakhemikhali ane-perfluorinated; Kodwa-ke, akukho lwazi lokulawula ngalolu hlobo lwe-fluoride ku-floss yamazinyo
ingatholwa ngababhali baleli phepha lesikhundla.
Isigaba 5.6: Imikhiqizo Yamazinyo Esetshenziswa Ehhovisi Lamazinyo
Iningi lezinto ezisetshenziswa ehhovisi lamazinyo ezingakhipha i-fluoride zilawulwa njengezinto zokwelashwa / zamazinyo, njengezinto ezithile zokugcwalisa i-resin, i-190 191 ezinye izinti zamazinyo, i-192 nezinye izinto zokwenziwa kwe-resin. 193 Ngokuqondile, iningi lalawa izinto zamazinyo zihlukaniswa yi-FDA njengamadivayisi we-Class II Medical Devices, ngo-194 okusho ukuthi i-FDA inikeza “isiqinisekiso esizwakalayo sokuphepha nokusebenza kwedivayisi” ngaphandle kokubeka umkhiqizo ezingeni eliphakeme lokulawulwa kokulawula.195 Okubalulekile, njengengxenye yokuhlukaniswa kwe-FDA inqubo, amadivayisi wamazinyo ane-fluoride abhekwa njengemikhiqizo ehlanganisiwe, ama-196 namaphrofayili wamazinga wokukhishwa kwe-fluoride kulindeleke ukuthi anikezwe njengengxenye yesaziso sangaphambi kokuthengiswa komkhiqizo.197 I-FDA iyaqhubeka ithi: “Izimangalo zokuvimbela umgodi noma ezinye izinzuzo zokwelapha kuvunyelwe uma kusekelwa ngemininingwane yomtholampilo eyenziwe ngophenyo lwe-IDE [Investigational Device Exemption]. ” 198 Ngaphezu kwalokho, ngenkathi i-FDA isho esidlangalaleni indlela ekhipha i-fluoride yamanye amadivayisi okubuyisela amazinyo, i-FDA ayibakhangisi esidlangalaleni kuwebhusayithi yabo ukuze isetshenziswe ekuvinjelweni kwe-caries.199
Ngokufanayo, ngenkathi ama-varnishes e-fluoride evunywa njengama-Class II Medical Devices ukuthi asetshenziswe njenge-liner cavity kanye / noma i-desensitizer yamazinyo, awavunyelwe ukuthi asetshenziswe ekuvinjelweni kwe-caries. 200 Ngakho-ke, lapho kwenziwa izicelo zokuvinjelwa kwe-caries ngomkhiqizo obenziwe kungcoliswe nge-fluoride eyengeziwe, lokhu kubhekwa yi-FDA njengesidakamizwa esingavunyiwe, esingcolile. Ngaphezu kwalokho, imithethonqubo ye-FDA yenza ukuthi udokotela / udokotela wamazinyo abhekane mathupha nokusetshenziswa kwelebula kwezidakamizwa ezigunyaziwe. 201
Ngokwengeziwe, ngo-2014, i-FDA yavumela ukusetshenziswa kwe-silver diamine fluoride ekwehliseni ukuzwela kwamazinyo. 202 Ku-athikili eyashicilelwa ngo-2016, ikomidi e-University of California, San Francisco, School of Dentistry, lakubona lokho, ngenkathi i-off-label ukusetshenziswa kwe-silver diamine fluoride (njengokulawulwa kwe-caries) sekuvumelekile ngokomthetho, kunesidingo somhlahlandlela ofanelwe, umthetho olandelwayo kanye nemvume.
Okunye futhi okumele sikuqaphele ukuthi unamathisela oqukethe i-fluoride osetshenziswe ngesikhathi sokuvikela amazinyo (ukuhlanza) uqukethe amazinga aphakeme kakhulu e-fluoride kunamazinyo athengiswa ngokuthengisa (okusho ukuthi 850-1,500 ppm kumuthi wokuxubha ojwayelekile204 kuqhathaniswa no-4,000-20,000 ppm fluoride ku-prophy paste205). Ukunamathisela kwe-fluoride akwamukelwa yi-FDA noma i-ADA njengendlela ephumelelayo yokuvimbela ukubola kwamazinyo. 206
Isigaba 5.7: Izidakamizwa Ezenza Imithi (Kubandakanya Izithasiselo)
I-fluoride yengezwa ngamabomu emithini yokwelapha (amaconsi, amaphilisi, namalogwe avame ukubizwa ngokuthi “ama-supplements” noma “amavithamini”) ajwayele ukunikwa izingane, okusolwa ukuthi zivimbela izimbotshana. Ngo-1975, i-FDA yabhekana nokusetshenziswa kwezithako ze-fluoride ngokuhoxisa isicelo esisha semithi ye-Ernziflur fluoride. Ngemuva kwezenzo ze-FDA ku-Ernziflur lozenges kwaba
esishicilelwe kwiFederal Register, kwavela isihloko kuDrapy Therapy esisho ukuthi imvume ye-FDA yahoxiswa “ngoba abukho ubufakazi obubambekayo bokusebenza kwezidakamizwa njengoba kunqunyiwe, kunconyiwe, noma kuphakanyisiwe ekubhaleni kwayo.” 207 208 Lo mbhalo uphinde wathi: “I Ngakho-ke i-FDA yeluleke abenzi bezinhlanganisela zamalungiselelo e-fluoride namavithamini ukuthi abo
ukuqhubeka nokumaketha kwephula imibandela emisha yezidakamizwa zeFederal Food, Drug, and Cosmetic Act; ngakho-ke bacele ukuthi kumiswe ukukhangiswa kwale mikhiqizo. ”209 210
Ngo-2016, i-FDA yathumela enye futhi incwadi eyisixwayiso mayelana nodaba olufanayo lwemithi emisha engagunyaziwe ngezindlela eziningi kubandakanya izithasiselo ze-fluoride okwakhulunywa ngazo ngo-1975.
Januwari 13, 2016, yathunyelwa eKirkman Laboratories maqondana nezinhlobo ezine ezahlukahlukene zemixube yabantwana ye-fluoride ebhalwe njengezinsiza ekuvikeleni amazinyo wamazinyo. 211 Incwadi yesixwayiso se-FDA yanikeza inkampani izinsuku eziyi-15 zokuhambisana nomthetho212 futhi isebenza njengamanje esinye isibonelo sezingane ezithola kabi amalungiselelo e-fluoride angavumelekile, manje osekuyinkinga e-US iminyaka engaphezu kwengu-40.
Okwamanje, i-fluorine nayo yengezwa ngokuvumelekile kweminye imithi yokwelapha. Ezinye izizathu eziye zahlonzwa ngokungezelelwa kwazo emithini zifaka phakathi izimangalo zokuthi “ingayinyusa imithi
ukukhetha, ukuwenza ukwazi ukuncibilika emafutheni, futhi kwehlise ijubane lapho umuthi uhlanganiswa khona, ngaleyo ndlela ulinike isikhathi esengeziwe sokusebenza. ” I-213 20-30% yamakhemikhali ezemithi kulinganiselwa ukuthi aqukethe i-fluorine.214 Eminye yemithi edume kakhulu ifaka iProzac, iLipitor, neCiprobay (ciprofloxacin), 215 kanye nawo wonke umndeni we-fluoroquinolone (gemifloxacin [emakethwa njenge-Factive], i-levofloxacin [imakethwa njenge-Levaquin], i-moxifloxacin [imakethwa njenge-Avelox], i-norfloxacin [imakethwa njenge-Noroxin], ne-ofloxacin [imakethwa njenge-Floxin ne-generic ofloxacin]).
216
Mayelana ne-fluoroquinolones, i-FDA yakhipha isexwayiso esisha mayelana nokukhubaza imiphumela emibi ngo-2016, ngemuva kweminyaka le mithi yethulwa okokuqala emakethe. Esimemezelweni sabo sikaJulayi 2016, i-FDA yathi:
Le mithi ihlotshaniswa nemiphumela emibi ekhubaza futhi engahle ibe khona unomphela yamathambo, imisipha, amalunga, izinzwa nohlelo oluphakathi lwezinzwa olungaba khona ndawonye esigulini esifanayo. Ngenxa yalokho, sibuyekeze iBoxed Warning, isexwayiso esiqine kakhulu se-FDA, ukubhekana nalezi zinkinga ezibucayi zokuphepha. Siphinde sangeza isexwayiso esisha futhi sabuyekeza ezinye izingxenye zelebula lezidakamizwa, kufaka phakathi ne-Patient Medication Guide
Ngenxa yale miphumela engemihle, i-FDA yeluleke ukuthi le mithi kufanele isetshenziswe kuphela uma ingekho enye indlela yokwelashwa etholakala ezigulini ngoba izingozi zingaphezu
izinzuzo.218 Ngesikhathi samemezelo se-FDA se-2016, kulinganiselwa ukuthi abantu baseMelika abangaphezu kwezigidi ezingama-26 babephuza le mithi minyaka yonke. 219
Isigaba 5.8: Izinhlanganisela ezenziwe ngopende
Izinto ze-Per- ne-polyfluoroalkyl (PFASs), ezibizwa nangokuthi izakhi ezenziwe ngopende noma amakhemikhali ane-perfluorinated (PFCs), yizinto ezisetshenziswa kukhaphethi, ezokuhlanza, ezokugqoka, ezokupheka,
ukupakisha ukudla, upende, iphepha neminye imikhiqizo ngoba kunikeza ukumelana nomlilo nowoyela, ibala, amafutha, nokuxosha amanzi. 220 221 Isibonelo, i-perfluorooctanoic acid (PFOA) isetshenziselwa ukwenza i-polytetrafluoroethylene (PTFE), esetshenziswa eTefon , Gore-tex, iScotchguard, neStainmaster. 222
Kodwa-ke, lapho ososayensi abangaphezu kwama-200 abavela emazweni angama-38 besayina ku- "Isitatimende SaseMadrid" ngo-2015, ukukhathazeka okungama-223 ngalezo zinto nokuxhumeka kwazo okungenzeka kube yimpilo engeyinhle kwamenyezelwa.
Ngokwengeziwe, ngo-2016, i-EPA yathi ngama-PFSA:
Ucwaningo lukhombisa ukuthi ukuvezwa kwe-PFOA ne-PFOS ngaphezu kwamazinga athile kungahle kube nemiphumela emibi yezempilo, kufaka phakathi imiphumela yokuthuthuka emibungu ngesikhathi sokukhulelwa noma ezinsaneni ezincelisiwe (isb., Isisindo sokuzalwa esiphansi, ukuthomba okusheshayo, ukuhluka kwamathambo), umdlavuza (isb. , izinso), imiphumela yesibindi (isib. ukulimala kwezicubu), imiphumela yokuzivikela komzimba (isb. ukukhiqizwa kwama-antibody kanye nokuzivikela komzimba), neminye imiphumela (isb, ushintsho lwe-cholesterol) .225
Ngakho-ke, e-US, imizamo isanda kuqala nje ukunciphisa ukusetshenziswa kwala makhemikhali. Isibonelo, ngo-2016, i-EPA yakhipha izeluleko zezempilo ze-PFOA ne-PFOS emanzini okuphuza, okukhomba izinga noma ngaphansi kwemiphumela emibi yezempilo engalindelekile ukuthi yenzeke esikhathini sonke sokuvezwa njengezingxenye ze-0.07 ngezigidigidi (izingxenye ezingama-70 nge-trillion) ye-PFOA ne-PFOS. 226 Njengesinye isibonelo, ngo-2006, i-EPA yahlangana nezinkampani eziyisishiyagalombili ngohlelo lokuphatha lezi zinkampani eziyisishiyagalombili ukunciphisa nokuqeda i-PFOA ngo-2015.227 Nokho, i-EPA
futhi kubhaliwe ukuthi "bahlala bekhathazekile" ngezinkampani ezikhiqiza le mikhiqizo ezingazange zibambe iqhaza kulolu hlelo.228
Isigaba 5.9: Emsebenzini
Ukuvezwa kwama-fluoride (i-fluoride, i-perfluoride) emsebenzini kulawulwa yi-Occupational Safety & Health Administration (OSHA). Isici sempilo esithathelwa phezulu kakhulu ngalezi zindinganiso yi-skeletal fluorosis, futhi amanani wemikhawulo wokuchayeka emsebenzini kuma-fluoride ahlelwe njalo njengo-2.5 mg / m3.229
Ku-athikili ka-2005 eyashicilelwa kwi-International Journal of Occupational and Environmental Health futhi yanikezwa ngokwengxenye e-American College of Toxicology Symposium, umbhali uPhyllis J. Mullenix, PhD, wakhomba isidingo sokuvikelwa okungcono endaweni yokusebenza kuma-fluoride. 230 Ngokukhethekile, uDkt Mullenix ubhale ukuthi ngenkathi amazinga e-fluoride ehlala ehambelana:
Muva nje sekutholakale imininingwane ephakamisa hhayi kuphela ukuthi lawa mazinga ahlinzekele ngokuvikelwa okunganele kubasebenzi abachayeke ku-fluorine nama-fluoride, kepha ukuthi amashumi eminyaka imboni ibinolwazi oludingekayo lokukhomba ukungalingani kwamazinga kanye nokubeka amazinga wokuvikelwa okuthe xaxa. 231
Embikweni wango-2006 woMkhandlu Kazwelonke Wokucwaninga (NRC) weNational Academy of Sciences lapho kwahlolwa khona ubungozi bezempilo be-fluoride, kwaphakanyiswa ukukhathazeka mayelana nezinhlangano ezingaba khona phakathi kwe-fluoride ne-osteosarcoma (umdlavuza wamathambo), ukuqhekeka kwamathambo, imiphumela yemisipha, imiphumela yokuzala nentuthuko, i-neurotoxicity nemiphumela ye-neurobehavioral, i-genotoxicity ne-carcinogenicity, nemiphumela kwezinye izinhlelo zomzimba. 232
Kusukela umbiko we-NRC ukhishwe ngo-2006, kuye kwashicilelwa ezinye izifundo eziningi ezifanele. Eqinisweni, esicelweni sesakhamuzi sango-2016 ku-EPA esivela ku-Fluoride Action Network (FAN), i-IAOMT, namanye amaqembu, uMichael Connett, u-Esq., Umqondisi Wezomthetho we-FAN, unikeze uhlu locwaningo olusha olubonisa ukulimala kwe-fluoride, efanele kakhulu, ikakhulukazi ngenxa yenani lezifundo zabantu ezingeziwe: 233
Sekukonke, Abafaka izicelo bakhombe futhi banamathisela izifundo ezishicilelwe ze-196 ezibhekane nemiphumela ye-neurotoxic yokuvezwa kwe-fluoride ngemuva kokubuyekezwa kwe-NRC, kufaka phakathi izifundo zabantu ezingama-61, izifundo zezilwane eziyi-115, izifundo zamaseli ayi-17, kanye nokubuyekezwa okuhlelekile oku-3.
Izifundo zabantu ze-post-NRC zifaka:
• Izifundo ezingama-54 eziphenya ngemiphumela ye-fluoride ekusebenzeni kwengqondo, kufaka phakathi kepha kungagcini ku-IQ, ngazo zonke lezi zifundo ngaphandle kwezingu-8 ezithola ukuthi zibalulekile ngokwezibalo
izinhlangano phakathi kokuchayeka kwe-fluoride nokushoda kwengqondo. 234
• Izifundo ezi-3 eziphenya ngemiphumela ye-fluoride ebuchosheni bombungu, isifundo ngasinye kwezi-3 zibika imiphumela engemihle. 235
• Ucwaningo olungu-4 oluphenya ukuzihlanganisa kwe-fluoride nezinye izinhlobo zokulimala kwe-neurotoxic, kufaka phakathi i-ADHD, indlela yokuziphatha kwezingane ezisanda kuzalwa, nezimpawu ezahlukahlukene zezinzwa.236
Izifundo zezilwane ze-post-NRC zifaka:
• Izifundo eziyi-105 eziphenya ngamandla we-fluoride wokukhiqiza ushintsho lwe-neuroanatomical kanye ne-neurochemical, ngazo zonke izifundo ngaphandle kwezingu-2 ezithola okungenani umphumela owodwa olimazayo okungenani kwelinye lamazinga esilinganiso esihloliwe.
• Izifundo ezingama-31 eziphenya ngemiphumela ye-fluoride ekufundeni nasenkumbulweni, lapho konke kwenziwa isifundo esisodwa kodwa esisodwa ukuthola okungenani umphumela omubi emaqenjini aphethwe i-fluoride.
• Ucwaningo lwe-18 oluphenya ngomthelela we-fluoride kwamanye amapharamitha we-neurobehavior ngaphandle kokufunda nenkumbulo, ngazo zonke izifundo kodwa kube nemiphumela etholakele.
Izifundo zeseli ze-post-NRC zifaka:
• Izifundo eziyi-17, ezibandakanya izifundo ezi-2 ezaphenya zathola imiphumela emazingeni e-fluoride eyenzeka njalo egazini labantu baseMelika abahlala emiphakathini ene-fluoridated.240
Ngaphezu kwezifundo ezingenhla, Abafakizicelo bahambisa ukubuyekezwa okuhlelekile kwezincwadi okwenziwe ngemuva kwe-NRC, kufaka phakathi okubili okubhekiswe ezincwadini zomuntu / ze-IQ, kanye nesinye
ikhuluma ngemibhalo yezilwane / yokuqonda. 241
Kuyacaca ukuthi izindatshana zocwaningo eziningi sezivele ziveze ukulimala okungaba khona kubantu kusuka ku-fluoride emazingeni ehlukene okuchayeka, kufaka phakathi amazinga njengamanje athathwa njengaphephile. Yize ngasinye salezi zihloko sidinga ukunakwa nokuxoxwa, uhlu olufushanisiwe lufakiwe ngezansi ngesimo sencazelo ejwayelekile yemiphumela yezempilo ehlobene nokuvezwa kwe-fluoride, okufaka okuvelele kwemibiko nezifundo ezihambisanayo.
Isigaba 6.1: Uhlelo Lwamathambo
I-fluoride engeniswe emzimbeni womuntu ingena egazini ngomgudu wokugaya ukudla.242 Iningi le-fluoride engakhishwa ngomchamo ligcinwa emzimbeni. Kuvame ukuthiwa ukuthi i-99% yale fluoride ihlala ethanjeni, i-243 lapho ifakwe esakhiweni se-crystalline futhi ihlangana ngokuhamba kwesikhathi. 244 Ngakho-ke, akunakuphikwa ukuthi amazinyo namathambo yizicubu zomzimba ezigxilisa i-fluoride esidalulwayo.
Empeleni, embikweni wayo wango-2006, ingxoxo yoMkhandlu Kazwelonke Wocwaningo (NRC) ngengozi yokwephuka kwamathambo ngenxa ye-fluoride eyeqile yaxhaswa ngocwaningo olubalulekile. Ngokuqondile,
lo mbiko uthe: “Kukonke, kube nokuvumelana phakathi kwekomidi ukuthi kunobufakazi besayensi bokuthi ngaphansi kwezimo ezithile i-fluoride ingenza ithambo linyuke futhi kwandise namathuba okuqhekeka.” 245
Isigaba 6.1.1: I-Dental Fluorosis
Ukuvezwa kwe-fluoride eyeqile ezinganeni kuyaziwa ukuthi kungaholela ekutheni i-dental fluorosis, isimo lapho amazinyo koqweqwe lwawo alimala ngokungenakuphikiswa futhi amazinyo aguquke unomphela, akhombise iphethini elimhlophe noma elinsundu futhi enze amazinyo aqhephukayo aphuka futhi angcolise kalula. kuye kwaqashelwa ngokwesayensi kusukela ngawo-246 ukuthi ukuvezwa ngokweqile kwe-fluoride kubanga lesi simo, esingahle sisuke ekubeni mnene kakhulu siye kwesinzima. Ngokusho kwedatha evela kuCenters for Disease Control and Prevention (CDC) ekhishwe ngo-1940, ama-2010% aseMelika aneminyaka engu-23-6 no-49% wezingane ezineminyaka engu-41-12 akhombisa i-fluorosis ngezinga elithile. 15 Lokhu kukhuphuka okukhulu kwamazinga we-Fental fluorosis zibe yinto ebalulekile esinqumweni seNkonzo Yezempilo Yomphakathi yokwehlisa izincomo zayo ezingeni lamanzi oketshezi lwamanzi ngo-247
Umdwebo 1: I-Dental Fluorosis Isukela Kophansi Kakhulu Iya Kakhulu
(Izithombe ezisuka kuDkt David Kennedy futhi zisetshenziswa ngemvume yezisulu ze-dental fluorosis.)
Izithombe ze-Dental Fluorosis, uphawu lokuqala lobuthi be-fluoride, kusuka kobumnene kuya kokubi kakhulu; Isithombe nguDkt David Kennedy futhi sisetshenziswe ngemvume yezisulu ze-dental fluorosis
Isigaba 6.1.2: I-Skeletal Fluorosis ne-Arthritis
Njenge-dental fluorosis, i-skeletal fluorosis ingumphumela ongenakuphikwa wokuchayeka ngokweqile ku-fluoride. I-Skeletal fluorosis ibangela amathambo aqine, ubuhlungu obuhlangene, uhla olulinganiselwe lokuhamba ngokuhlanganyela, naku-
amacala abucayi, umgogodla oqinile ngokuphelele. 249 Noma kubhekwa njengokungajwayelekile e-US, lesi simo siyenzeka, ama-250 futhi kusanda kuphakanyiswa ukuthi uhlaka lwamathambo lungaba yinkinga enkulu yezempilo yomphakathi kunalokho obekuqashelwa ngaphambili.251
Njengoba ucwaningo olushicilelwe ngo-2016 luphawulile, akukakabi bikho ukuvumelana okungokwesayensi kokuthi malini i-fluoride kanye / noma ukuthi kufanele athathwe ama-fluoride angakanani ngaphambi kokuba kuvele uhlaka lwamathambo. 252
Ngenkathi ezinye iziphathimandla ziphakamise ukuthi uhlaka lwamathambo luvele kuphela ngemuva kweminyaka eyishumi noma ngaphezulu yokuvezwa, ucwaningo lukhombisile ukuthi izingane zingasithola lesi sifo ezinyangeni eziyisithupha, 10
futhi abanye abantu abadala bakwakhe eminyakeni emibili kuya kwengu-254 kuphela.10 Ngokufanayo, ngenkathi ezinye iziphathimandla ziphakamise ukuthi i-2 mg / usuku lwe-fluoride luyadingeka ukwakha i-skeletal fluorosis, ucwaningo lubike ukuthi amazinga aphansi kakhulu okuchayeka ku-fluoride (ku ezinye izimo ezingaphansi kuka-255ppm) nazo zingasibangela lesi sifo. 2010 Ngaphezu kwalokho, ucwaningo olushicilelwe ngo-256 luqinisekisile ukuthi ukuphendula kwezicubu zamathambo ku-fluoride kuyahlukahluka kumuntu ngamunye.
Ezigulini ezine-skeletal fluorosis, i-fluoride nayo kusolwa ukuthi ibanga i-hyperparathyroidism yesibili kanye / noma idale ukulimala kwethambo okufana ne-hyperparathyroidism yesibili. Isimo, esivame ukubangelwa yisifo sezinso, sibangelwa lapho amazinga e-calcium ne-phosphorus egazini esephansi kakhulu.257 Izifundo eziningi eziqoqwe yi-Fluoride Action Network (FAN) zihlola ukuthi kungenzeka yini ukuthi i-fluoride yinye okunikela kulo mphumela wezempilo. 258
Ngenxa yokuthi izimpawu ze-arthritic zihlotshaniswa ne-skeletal fluorosis, i-arthritis enye indawo yokukhathazeka maqondana nokuchayeka kwe-fluoride. Ngokuphawulekayo kulokhu, ucwaningo luxhumanise i-fluoride ne-osteoarthritis, kokubili nge-fluorosis noma ngaphandle kwamathambo.259 Ukwengeza, i-temporomandibular joint disorder (TMJ) ihlotshaniswa ne-dental and skeletal fluorosis.
Isigaba 6.1.3: Umdlavuza Wethambo, Osteosarcoma
Ku-2006, i-NRC yaxoxa ngesixhumanisi esikhona phakathi kokuvezwa kwe-fluoride ne-osteosarcoma. Lolu hlobo lomdlavuza wamathambo luye lwamukelwa “njengeqembu lesithupha elivame kakhulu lezicubu ezibulalayo ezinganeni kanye nesigaxa sesithathu esivame kakhulu ukubulala ezinganeni.” 261 I-NRC yathi ngenkathi ubufakazi bungasasebenzi, i-fluoride ibonakala inamandla okukhuthaza umdlavuza .262
Bacacisile ukuthi i-osteosarcoma ibikhathaza kakhulu, ikakhulukazi ngenxa yokufakwa kwe-fluoride ethanjeni kanye nomphumela we-mitogenic we-fluoride kumaseli wethambo.263
Ngenkathi ezinye izifundo zehlulekile ukuthola ukuhlangana phakathi kwe-fluoride ne-osteosarcoma, ngokocwaningo olwenziwe nguDkt Elise Bassin ngenkathi eseHarvard School of Dental Medicine, ukuvezwa kwe-fluoride emazingeni anconyiwe ahambisana nokwanda okuphindwe kasikhombisa kwe-osteosarcoma lapho abafana okuvezwe phakathi kweminyaka emihlanu kuya kweyisikhombisa. Ucwaningo lukaBassin, olushicilelwe ngo-264, yilona kuphela ucwaningo mayelana ne-osteosarcoma oluthathe izingozi eziqondene nobudala.
Isigaba 6.2: Uhlelo Oluphakathi Lwezinzwa
Ithuba lokuthi ama-fluoride abe nomthelela ebuchosheni lisungulwe kahle. Embikweni wabo wango-2006, i-NRC yachaza: “Ngokwesisekelo solwazi olususelwa ikakhulu ezifundweni zakhe zomlando, zamakhemikhali nezamangqamuzana, kusobala ukuthi ama-fluoride anamandla okuphazamisa imisebenzi yobuchopho nomzimba ngezindlela eziqondile nezingaqondile . ”266 Kokubili ukuwohloka komqondo kanye ne-Alzheimer's
Izifo nazo ziyabikwa embikweni we-NRC ukuze zibhekwe njengezingaxhunyaniswa ne-fluoride
Lokhu kukhathazeka kufakazelwe. Ucwaningo olumayelana nokuguqulelwa kwamanzi kanye nemiphumela ye-IQ luhlolisiswe kakhulu ocwaningweni olushicilelwe ngo-Okthoba ka-2012 ku-Environmental Health Perspectives. 268 Kulokhu kubuyekezwa kwe-meta, izifundo eziyi-12 zikhombisile ukuthi imiphakathi enamazinga amanzi ahlanzekile angaphansi kuka-4 mg / L (isilinganiso esingu-2.4 mg / L ) ibinama-IQ aphansi kunamaqembu alawulayo. 269 Selokhu kwashicilelwa ukubuyekezwa kuka-2012, izifundo eziningi ezengeziwe ezithola ama-IQ ancishisiwe emiphakathini ene-fluoride engaphansi kuka-4 mg / L emanzini sezitholakele. 270 esicelweni sesakhamuzi ku-EPA ngo-2016, uMichael Connett, u-Esq., Umqondisi Wezomthetho we-FAN, wakhomba izifundo ezingama-23 zokubika ezinciphise i-IQ ezindaweni ezinamazinga e-fluoride njengamanje amukelwa ephephile yi-EPA.
Ngaphezu kwalokho, ngo-2014, kwabuye kwashicilelwa isibuyekezo ku-The Lancet esihloko sithi "Imiphumela ye-Neurobehavioral yobuthi obuthuthukisayo." Kulesi sibuyekezo, i-fluoride ibalwe njengenye yamakhemikhali ezimboni ayi-12
eyaziwa ngokudala i-neurotoxicity yentuthuko kubantu.272 Abaphenyi baxwayisa: “Ukukhubazeka kwe-Neurodevelopmental, okubandakanya i-autism, i-disorder-deficit hyperactivity disorder, i-dyslexia, nokunye ukukhubazeka kwengqondo, kuthinta izigidi zezingane emhlabeni wonke, kanti okunye ukuxilongwa kubonakala kwanda kaningi. Amakhemikhali ezimboni alimaza ubuchopho obukhulayo ngezinye zezimbangela ezaziwayo zalokhu kwanda kwesilinganiso. ”273
Isigaba 6.3: Isistimu Yezinhliziyo
Ngokwezibalo ezishicilelwe ngo-2016, isifo senhliziyo siyimbangela ehamba phambili yokufa kwabesilisa nabesifazane e-US, futhi sibiza izwe ama- $ 207 billion minyaka yonke.
ubudlelwano obukhona phakathi kwezinkinga ze-fluoride nezenhliziyo abudingi nje kuphela izindlela eziphephile ezingasungulelwa i-fluoride kodwa futhi nezindlela zokuvimbela ezenzelwe isifo senhliziyo.
Ukuhlangana phakathi kwezinkinga ze-fluoride nezenhliziyo kuye kwasolwa amashumi eminyaka. Umbiko we-2006 NRC uchaze ucwaningo lwango-1981 olwenziwa nguHanhijärvi noPenttää olwabika ukuthi i-serum fluoride ephakeme ezigulini ezinokwehluleka kwenhliziyo.275 I-Fluoride ibuye ihlobene nokubalwa kwemithambo yegazi, i-276 arteriosclerosis, ukungakwazi ukusebenza kwenhliziyo okungama-277, i-278 i-electrocardiogram abnormalities, i-279 ye-hypertension, i-280 ne- umonakalo we-myocardial.281 Ngaphezu kwalokho, abacwaningi besifundo esivela eChina esashicilelwa ngo-2015 baphetha ngokuthi: “Imiphumela ikhombise ukuthi, i-NaF [i-sodium fluoride], ngendlela yokuncika kokuhlushwa futhi nasezingeni eliphansi elingu-2 mg / L, iguqule i-morphology yama-cardiomyocyte, anciphisa ukusebenza kwamaseli, kukhuphule izinga lokuboshwa kwenhliziyo, futhi kukhuphule amazinga we-apoptosis. ”282
Isigaba 6.4: Uhlelo lwe-Endocrine
Imiphumela yeFluoride ohlelweni lwe-endocrine, oluqukethe izindlala ezilawula ama-hormone, nayo iye yafundwa. Embikweni we-2006 NRC, kwathiwa: “Ngokufingqa, ubufakazi bezinhlobo eziningana bukhombisa ukuthi i-fluoride ithinta ukusebenza okuvamile kwe-endocrine noma impendulo; imiphumela yezinguquko ezibangelwa i-fluoride iyahlukahluka ngezinga nangomusa kubantu abahlukene. ”283 Umbiko we-2006 NRC uphinde wafaka itafula elikhombisa ukuthi imithamo ephansi ngokweqile ye-fluoride itholakale iphazamisa ukusebenza kwe-thyroid, ikakhulukazi lapho kunokuntuleka kwe-iodine samanje.284 Eminyakeni esanda kwedlula, kugcizelelwe kabusha umthelela we-fluoride ohlelweni lwe-endocrine. Ucwaningo olushicilelwe ngo-2012 lubandakanya i-sodium fluoride ohlwini lwamakhemikhali aphazamisa i-endocrine (ama-EDC) anemiphumela ephansi, angama-285 kanti lolu cwaningo lucashunwe embikweni wango-2013 ovela kwi-United Nations Environment Programme naseWorld Health Organization. 286
Okwamanje, ukwanda kwamazinga okukhubazeka kwe-thyroid kuhlotshaniswe ne-fluoride. 287 Ucwaningo olushicilelwe ngo-2015 ngabaphenyi e-University of Kent eCanterbury, eNgilandi, luthi amazinga aphezulu e-fluoride emanzini okuphuza angabikezela amazinga aphezulu we-hypothyroidism. Baqhubeka bachaza: “Ezingxenyeni eziningi zomhlaba, i-hypothyroidism iyinkinga enkulu yezempilo futhi ngaphezu kwezinye izinto — njengokuntuleka kwe-iodine— ukuvezwa kwe-fluoride kufanele kubhekwe njengesici esinomthelela. Okutholakele ocwaningweni kuphakamisa ukukhathazeka okuthile mayelana nokusebenza kwe-fluoridation yomphakathi njengesilinganiso sezempilo somphakathi esiphephile. ”288 Ezinye izifundo zisekele ukuhlangana phakathi kwe-fluoride ne-hypothyroidism, i-289 ukwanda kwe-thyroid stimulating hormone (THS), 290 kanye nokushoda kwe-iodine. 291
Ngokwezibalo ezikhishwe yiCenters for Disease Control and Prevention (CDC) ngonyaka wezi-2014, abantu abayizigidi ezingama-29.1 noma u-9.3% wabantu banesifo sikashukela.293 Nakulokhu, iqhaza elingaba khona le-fluoride kulesi simo kubalulekile ukuthi libhekwe. Umbiko we-2006 NRC uxwayise:
Isiphetho esivela ezifundweni ezitholakalayo ukuthi ukuvezwa okwanele kwe-fluoride kubonakala kukhulisa uketshezi lwegazi noma ukubekezelela ukungasebenzi kahle kwe-glucose kwabanye abantu nokwandisa ubukhali bezinhlobo ezithile zesifo sikashukela. Ngokuvamile, ukungasebenzi kahle kwe-glucose metabolism kubonakala kuhlotshaniswa nokugxila kwe-serum noma i-plasma fluoride cishe okungu-0.1 mg / L noma ngaphezulu kuzo zombili izilwane nabantu (URigalli et al. 1990, 1995; UTrivedi et al. 1993; de al Sota et al. 1997) .294
Ucwaningo luye lwahlobanisa isifo sikashukela nomthamo owehlisiwe wokusula i-fluoride emzimbeni, i-295 kanye ne-syndrome (i-polydispsia-polyurea) okuholela ekwandeni kokudla kwe-fluoride, i-296 ne
ucwaningo luye lwaxhumanisa ukuvinjelwa kwe-insulin nokumelana ne-fluoride.297
Okunye futhi okukhathazayo ukuthi i-fluoride ibonakala iphazamisa ukusebenza kwe-pineal gland, esiza ukulawula isigqi nama-hormone, kufaka phakathi ukulawulwa kwe-melatonin namahomoni okuzala. UJennifer Luke waseRoyal Hospital yaseLondon ukhombe amazinga aphakeme e-fluoride aqoqwe ku-gland pineal298 waphinde wakhombisa ukuthi la mazinga
ingafinyelela ku-21,000 ppm, ibanikeze phezulu kunamazinga we-fluoride ethanjeni noma emazinyweni. 299 Olunye ucwaningo luxhumanise i-fluoride namazinga e-melatonin, ukuqwasha okungama-300, i-301 kanye nokuthomba kokuqala
emantombazaneni, 302 kanye namazinga okuzala aphansi (kufaka phakathi abesilisa) kanye namazinga we-testosterone ancishisiwe.303
Isigaba 6.5: Uhlelo Lwezinso
Umchamo uyindlela enkulu yokukhishwa kwe-fluoride efakwe emzimbeni, futhi uhlelo lwe-renal lubalulekile ekulawuleni amazinga we-fluoride emzimbeni. 304 305 Ukukhishwa kwe-urinary kwe-fluoride
ithonywe yi-pH yomchamo, ukudla, ukuba khona kwezidakamizwa, nezinye izinto.306 Abaphenyi bendatshana yango-2015 eyashicilelwa yiRoyal Society of Chemistry bachaza: “Ngakho-ke, isilinganiso se-plasma kanye nesilinganiso sokukhishwa kwezinso sakha ibhalansi ye-physiologic enqunywa ngokudla kwe-fluoride, ithatha nokususwa emathanjeni nomthamo we-fluoride clearance yizinso. ”307
Umbiko we-2006 NRC ngokufanayo waqaphela indima yezinso ekuvezweni kwe-fluoride. Baphawula ukuthi akumangazi ukuthi iziguli ezinesifo sezinso zikhule ngokwanda kwe-plasma kanye ne-bone fluoride.308 Babuye bathi izinso zabantu “kufanele zigxilise i-fluoride ephindwe ka-50 ukusuka e-plasma kuye emchameni. Izingxenye zesistimu yezinso zingaba sengozini enkulu yobuthi be-fluoride kunezicubu eziningi ezithambile. ”309
Ngokwalolu lwazi, kunengqondo ukuthi abacwaningi baxhumanise ukuvezwa kwe-fluoride nezinkinga zesistimu yezinso. Ngokuqondile, abacwaningi baseToronto, eCanada, bakhombisile ukuthi iziguli ezidaywa nge-renal osteodystrophy zazinamazinga aphezulu e-fluoride ethanjeni futhi zaphetha ngokuthi “ithambo i-fluoride inganciphisa ukuqina kwamathambo ngokuthikameza ukufakwa kwamaminerali.” 310 Ngaphezu kwalokho, ucwaningo ngabasebenzi abachayeke ku-cryolite nguPhilippe Grandjean noJørgen H. Olsen eshicilelwe ngo-2004 basikisela ukuthi i-fluoride ibhekwe njengembangela yomdlavuza wesinye futhi ibe nomthelela omkhulu kumdlavuza wamaphaphu.311
Isigaba 6.6: Uhlelo Lokuphefumula
Imiphumela ye-fluoride ohlelweni lokuphefumula ibhalwe ngokucacile ezincwadini mayelana
ukuvezwa emsebenzini. Ngokusobala, abasebenzi ezimbonini ezibandakanya i-fluoride base kakhulu
ingozi ephezulu yokuhogela i-fluoride kunaleyo engasebenzi embonini; noma kunjalo kwezimboni
ukusetshenziswa kungathinta nezinhlelo zokuphefumula zezakhamizi ezijwayelekile ngokusebenzisa ukuvezwa okuhlukahlukene
imizila.
Ukuhogela i-hydrogen fluoride kusebenza njengesibonelo esihle somsebenzi ofakazelwa kabili
kanye nengozi yezempilo engasebenzi. I-Hydrogen fluoride isetshenziselwa ukwenza iziqandisi, imithi yokubulala ukhula,
okwenziwa kwemithi, uphethiloli o-octane ophakeme, i-aluminium, amapulasitiki, izingxenye zikagesi, i-fluorescent
izibani zokukhanya, nensimbi kanye nengilazi eboshiwe (njengaleyo esetshenziswa kwamanye amadivayisi kagesi),
312 futhi
njengokukhiqizwa kwamakhemikhali e-uranium nokuhlanzwa kwe-quartz.313
Izikhungo Zokulawulwa Kwezifo kanye
I-Prevention (CDC) ichaze ukuthi ngaphezu kokuchayeka emsebenzini, okungeyona eyomsebenzi
Ukuvezwa kwe-hydrogen fluoride nakho kungenzeka ezindaweni zokuthengisa nangezinto zokuzilibazisa ezibandakanya
izinto ezenziwe ngalolu ketshezi, kanye nomcimbi ongajwayelekile wokuchayeka kubushokobezi bamakhemikhali
umenzeli. 314
Imiphumela yezempilo evela ku-hydrogen fluoride ingalimaza izitho eziningi ezahlukahlukene, kufaka phakathi lezo
abathintekayo ohlelweni lokuphefumula. Ukuphefumula ikhemikhali kungalimaza izicubu zamaphaphu futhi kubangele
ukuvuvukala nokuqongelela uketshezi emaphashini (i-pulmonary edema) .315
Izinga eliphakeme lokuchayeka ku-hydrogen fluoride kungadala ukufa kusuka ekwakhiweni kwamaphaphu, 316 kuyilapho okungamahlalakhona, izinga eliphansi
ukuhogela kungadala ukucasuka nokucinana kwekhala, umphimbo, namaphaphu. 317
Ngokuqondile ngokombono womsebenzi, imboni ye-aluminium ibe yisihloko sezinhlu eziningi
yophenyo ngomthelela we-fluoride ezinhlelweni zokuphefumula zabasebenzi. Ubufakazi obuvela ku-
uchungechunge lwezifundo lukhombisa ukuhlangana phakathi kwabasebenzi ezitshalweni ze-aluminium, ukuvezwa kwe
i-fluoride, nemiphumela yokuphefumula, njenge-emphysema, i-bronchitis, namaphaphu anciphile
umsebenzi.318
Isigaba 6.7: Uhlelo Lokugaya ukudla
Lapho kungeniswa, kufaka phakathi ngamanzi aphethwe yi-fluoridated, i-fluoride imuncwa yisisu
system lapho ine-half-life yemizuzu engama-30. 319
Inani le-fluoride elincikisiwe lithembele
emazingeni e-calcium, ngokugxila okuphezulu kwe-calcium okwehlisa isisu
ukumuncwa.
320 321
Futhi, ngokusho kocwaningo olushicilelwe ngo-2015 yi-American Institute of
Ama-Chemical Engineers, ukuxhumana kwe-fluoride ohlelweni lwamathumbu “kubangela ukwakheka
i-hydrofluoric [HF] acid ngokuphendula nge-hydrochloric [HCL] acid ekhona esiswini. Ukuba
idala kakhulu, i-HF acid eyakhiwe kanjalo izobhubhisa ulwelwesi lwesisu nolwamathumbu nge
ukulahleka kwama-microvilli. ”322
Enye indawo yocwaningo ehlobene nomthelela we-fluoride emgudwini wamathumbu ngengozi
ukungenisa umuthi wokuxubha. Ngo-2011, iSikhungo Esilawula Ubuthi sathola izingcingo ezingama-21,513 ezihlobene ne-
ukusetshenziswa ngokweqile komuthi wokuxubha we-fluoridated.323
Izinombolo zabantu abathintekayo kungenzeka
kube phezulu kakhulu, noma kunjalo. Kukhathazekile ukuthi ezinye izimpawu zesisu
kungenzeka kungathathwa kalula njengokuhlobene nokungeniswa kwe-fluoride, njengoba abacwaningi bachaza ngo-1997:
Abazali noma abanakekeli kungenzeka bangaziboni izimpawu ezihambisana nobuthi obuncane be-fluoride
noma ingababiza nge-colic noma i-gastroenteritis, ikakhulukazi uma bengayiboni ingane
faka i-fluoride. Ngokufanayo, ngenxa yemvelo engacacisiwe yobumnene ukuya kokumaphakathi
izimpawu, ukuxilongwa okwahlukile kukadokotela akunakwenzeka ukuthi kufake ubuthi be-fluoride
ngaphandle komlando wokungeniswa kwe-fluoride.324
Ezinye izindawo zohlelo lokugaya ukudla zaziwa futhi ukuthi zithintwe yi-fluoride. Isibonelo, i-
Umbiko we-2006 NRC wacela imininingwane eminingi ngomphumela we-fluoride esibindini: “Kungenzeka
ukuthi ukungenisa impilo ka-5-10 mg / ngosuku kusuka emanzini okuphuza aqukethe i-fluoride ku-4 mg / L kungenzeka
kube nemiphumela yesikhathi eside esibindini, futhi lokhu kufanele kuphenywe ngokuzayo
izifundo ze-epidemiologic. ”325 Njengesinye isibonelo, umuthi wokuxubha we-fluoride ungadala i-stomatitis, njenge
izilonda zomlomo nezomkhuhlane kwabanye abantu. 326
Isigaba 6.8: Amasosha Omzimba
Amasosha omzimba enye ingxenye yomzimba engathinteka yi-fluoride. An
Ukucatshangelwa okubalulekile ukuthi amaseli omzimba akhula emnkantsheni wethambo, ngakho-ke umphumela we-fluoride
emasosheni omzimba kungahle kuhlobene nokudlanga kwe-fluoride ohlelweni lwamathambo. I-2006
Umbiko weNRC uchaze kabanzi ngalesi simo:
Yize kunjalo, iziguli ezihlala emphakathini owenziwe ngoketshezi oketshezi noma i-
umphakathi lapho amanzi okuphuza ngokwemvelo aqukethe i-fluoride ku-4 mg / L anakho konke
i-fluoride enqwabelene ezinhlelweni zazo zamathambo futhi engaba ne-fluoride ephezulu kakhulu
ukugxila emathanjeni abo. Umnkantsha kulapho kukhula khona amaseli omzimba futhi lokho
kungathinta ukungatheleleki komzimba kanye nokukhiqizwa kwama-antibody kumakhemikhali angaphandle.327
Ukungezwani komzimba kanye nokuzwela ngokweqile kwe-fluoride kungenye into enobungozi ehlobene nomzimba
uhlelo. Ucwaningo olwanyatheliswa ngawo-1950, 1960, nango-1970 lwabonisa ukuthi abanye abantu
i-hypersensitive to fluoride.328 Kuyathakazelisa ukuthi ababhali bezocwaningo abashicilelwe ngo-1967 bakhomba
ukuthi ngenkathi abanye besangabaza iqiniso lokuthi i-fluoride kumuthi wokuxubha kanye "namavithamini" angadala
ukuzwela, imibiko yecala eyethulwe kushicilelo lwabo yaveza ukuthi ukungezwani komzimba ne
I-fluoride ikhona.329 Izifundo ezisanda kwenziwa zikuqinisekisile lokhu. 330
Isigaba 6.9: I-Integumentary System
I-fluoride nayo ingathinta uhlelo lwama-integumentary, oluqukethe isikhumba, izindlala ze-exocrine,
izinwele, nezinzipho. Ngokuyinhloko, ukusabela ku-fluoride, kufaka phakathi i-fluoride esetshenziswe kumuthi wokuxubha
kuxhunyaniswe nezinduna nezinye izimo zesikhumba. 331 332 333
Ngaphezu kwalokho, okusongela impilo
Isimo esaziwa njenge-fluoroderma sibangelwa ukusabela okweqile ku-fluorine, 334
futhi lolu hlobo lokuqhuma kwesikhumba (i-halogenoderma) luye lwahlotshaniswa neziguli ezisebenzisa
imikhiqizo yamazinyo e-fluoridated.335
Ngokwengeziwe, izinwele nezinzipho sekufundwe njengama-biomarker we
ukuchayeka kwe-fluoride.
336
Ukunqunywa kwezipikili kuyakwazi ukukhombisa ukuvezwa okungapheli kwe-fluoride337
nokuvezwa kusuka kumuthi wokuxubha, i-338 nokusebenzisa ukugxila kwe-fluoride kuzipikili ukukhomba izingane
kusengozini yokuhlushwa i-fluorosis yamazinyo.339
Isigaba 6.10: I-fluoride Toxicity
Icala lokuqala elikhulu lokusolwa ngobuthi ezimbonini elivela ku-fluorine lalibandakanya inhlekelele e
IMeuse Valley eBelgium ngawo-1930. Inkungu nezinye izimo kule ndawo enezimboni bezikhona
okuhambisana nokufa kwabantu abangama-60 nabantu abayizinkulungwane eziningana abagulayo. Ubufakazi buye balandisa
lokhu kulimala kokukhishwa kwe-fluorine okuvela emafemini aseduze.340
Elinye icala lokudliswa ushevu ezimbonini lenzeka ngo-1948 eDonora, ePennsylvania, ngenxa yenkungu futhi
ukushintsha kokushisa. Kulesi simo, ukukhishwa kwegesi kusuka ku-zinc, insimbi, ucingo naku-nail
izimboni zokufaka ugesi kusolwa ukuthi zibangele ukufa kwabantu abangama-20 nabantu abayizinkulungwane eziyisithupha
ugule ngenxa yobuthi be-fluoride.341
Ubuthi be-fluoride obuvela kumkhiqizo wamazinyo e-United States kwenzeka ngo-1974 lapho iminyaka emithathu
Umfana omdala waseBrooklyn ushone ngenxa yokweqisa okweqile kwe-fluoride ovela kujel wamazinyo. Intatheli yeNew York
I-Times yabhala ngalesi sehlakalo: “Ngokusho kwesazi sobuthi saseNassau County, uDkt Jesse Bidanset,
UWilliam wafaka ama-cubic centimeter angama-45 wamaphesenti ama-2 we-stannous fluoride solution, okuyisiphindwe kathathu inani
kwanele ukubulala umuntu. ”342
Amacala amaningana amakhulu obuthi be-fluoride e-United States athole ukunakwa muva nje
amashumi eminyaka, njengokuqubuka kwe-1992 eHooper Bay, e-Alaska, ngenxa yamazinga aphezulu e-fluoride ekuphakelweni kwamanzi343 kanye noshevu ka-2015 womndeni eFlorida ngenxa yesulfuryl
i-fluoride esetshenziswa ekwelapheni umuhlwa ekhaya labo. 344
Ngenkathi izibonelo ezinikezwe ngenhla zingamacala we-acute (umthamo omkhulu, isikhathi esifushane) ubuthi, ongalapheki
(umthamo ophansi, isikhathi eside) ubuthi nakho kufanele kubhekwe. Okungenani imininingwane nge-fluoride
ubuthi sebutholakala ukusiza ukwakha ukuqonda okungcono kwenkinga. Emsebenzini
eshicilelwe ngo-2015, abacwaningi babukeza amaqiniso okuthi uphawu lokuqala lobuthi be-fluoride lungamazinyo
i-fluorosis nokuthi i-fluoride iyisiphazamisi esaziwa nge-enzyme.345
Ngokwengeziwe, isibuyekezo esishicilelwe ku-
U-2012 unikeze imininingwane eningiliziwe yezingozi zomphumela wobuthi we-fluoride kumaseli: “Iyasebenza
cishe zonke izindlela zokusayina ezingaphakathi kwamangqamuzana kufaka phakathi izindlela ezincike emaprotheni ze-G,
ama-caspases, kanye nezinqubo ezixhunywe yi-mitochondria- kanye ne-death receptors, kanye nokudala uhla
wezinguquko zomzimba nezokuloba, kufaka phakathi ukubonakaliswa kokuhlobene okuningi kwe-apoptosis
zofuzo, ekugcineni okuholela ekufeni kwamangqamuzana. ”346
Ukuphuthuma kobuthi be-fluoride ukuthi kwaziwe kabanzi kwahlolwa ngonyaka we-2005
Incwadi enesihloko esithi “I-fluoride poisoning: iphazili enezicucu ezifihliwe.” Umbhali uPhyllis J.
I-Mullenix, i-PhD, yaqala lo mbhalo, owethulwa ngokwengxenye e-American College of
I-Toxicology Symposium, ngesexwayiso: “Umlando wezincazelo eziyindida zobuthi be-fluoride
emibhalweni yezokwelapha ikuvumele ukuthi kube ngenye yezinto ezingaqondakali kakhulu, ezingatholakali kahle,
nezinkinga zempilo ezimelwe kabi e-United States namuhla. ”347
Lapho kufundwa iSigaba 7 esandulele mayelana nokuchayeka kwe-fluoride, kuba sobala ngokusobala ukuthi kungakanani ukucwaninga okwengeziwe okudingekayo ngaphambi kokuba noma iliphi izinga “eliphephile” lokuvezwa kwe-fluoride lingasungulwa ngokwanele. Lokhu kushoda kobufakazi kufinyelela kude kakhulu kunalokho okungaziwa njengamanje. Ukushoda kobufakazi nakho kuholele kulokho osekuvele kwaziwa ngokusetshenziswa kwesintu i-fluoride, ikakhulukazi maqondana "nokusizakala" kwaso okushiwo ukuvimbela ukubola.
Isigaba 8.1: Ukuntuleka kokusebenza
I-fluoride ezintweni zokuxubha nakweminye imikhiqizo yabathengi yengezwe ngoba kusolwa ukuthi inciphisa ukubola kwamazinyo. Izinzuzo eziphakanyisiwe zale fomu ye-fluoride zihlobene nomsebenzi wayo emazinyweni wokuvimbela ukuphefumula kwamagciwane we-Streptococcus mutans, ibhaktheriya eliguqula ushukela nesitashi libe yi-asidi enamathelayo encibilika koqweqwe lwawo. 504 Ikakhulukazi, ukuxhumana kwe-fluoride nengxenye yezimbiwa phansi amazinyo akhiqiza i-fluorohydroxyapatite (i-FHAP noma i-FAP), futhi umphumela walesi senzo kuthiwa wenziwa ngcono ukuqinisa kabusha amandla futhi wehlise ukudonswa kwamazinyo ngamazinyo. Yize kukhona ukusekelwa kwesayensi ngale ndlela ye-fluoride, kuphinde kwatholakala ukuthi i-fluoride ngokuyinhloko isebenza ukunciphisa ukubola kwamazinyo ngokwezihloko (okusho ukuyihlikihla iye ngqo emazinyweni ngesixubho samazinyo), ngokungafani nokuhleleka (okusho ukuphuza noma ukufaka i-fluoride ngamanzi noma ezinye izindlela) .505
Yize izinzuzo zezihloko ze-fluoride zivezwe ngokusobala ezincwadini zesayensi, ucwaningo nalo luzibuzile lezi zinzuzo. Isibonelo, abacwaningi abavela eNyuvesi yaseMassachusetts uLowell bachaze izingxabano eziningana ezihambisana nokusetshenziswa kwezinhlayiya kwe-fluoride ku-athikili eyashicilelwa ku-Journal of Evidence-Based Dental Practice ngo-2006. Ngemuva kokucaphuna ucwaningo lwango-1989 lweNational Institute of Dental Research olutholakale luncane umehluko ezinganeni ezithola i-fluoride kanye nalawo angayitholi i-fluoride, abalobi babhekise kwezinye izifundo ezibonisa ukuthi amanani emigodi emazweni athuthukile anciphile ngaphandle kokusetshenziswa kwe-fluoride. 506 Ababhali baqhubekile babuyekeza izifundo ezibonisa ukuthi i-fluoride ayisizi ekuvikeleni ukubola komgodi kanye nokuqhekeka (okuyi uhlobo oluvame kakhulu lokubola kwamazinyo e-US) noma ekuvimbeleni ukubola kwamazinyo ezingane zamabhodlela (okuvame kakhulu emiphakathini empofu) .507
Njengesinye isibonelo, ucwaningo lwakuqala olusetshenziselwe ukuxhasa ukufudumeza kwamanzi njengendlela yokwehlisa ukubola kwamazinyo laphinde lahlolwa futhi, kwatholakala amandla edatha elahlekisayo. Ekuqaleni, ukuncishiswa kwamazinyo abolile futhi agcwalisiwe (DFT) aqoqwe ocwaningweni atolikwa njengobufakazi bokusebenza kahle kwe-fluoridation yamanzi. Kodwa-ke, ucwaningo olulandelayo olwenziwe nguDkt.John A. Yiamouyiannis luye lwaphakamisa ukuthi ukufudumeza amanzi kungaba nomthelela ekuqhamukeni kokuqhuma kwamazinyo. 508 Ukuqhuma okunjalo okubambezelekile kungaholela emazinyweni amancane ngakho-ke, ukungabikho kokubola, okusho ukuthi amanani aphansi e-DFT empeleni kubangelwa ukungabi namazinyo ngokungafani nemiphumela yezinsolo ze-fluoride kuma-caries amazinyo.
Ezinye izibonelo ezincwadini zesayensi ziye zangabaza ukusetshenziswa kwe-fluoride ekuvimbeleni ukubola kwamazinyo. Ukubuyekezwa kwango-2014 kuqinisekisile ukuthi umphumela we-fluoride anti-caries uncike ku-calcium ne-magnesium ku-koqweqwe lwamazinyo kodwa futhi nokuthi inqubo yokuqinisa kabusha ku-koqweqwe lwamazinyo ayixhomekile ku-fluoride.509 Ucwaningo olushicilelwe ngo-2010 luveze ukuthi umqondo "wamazinyo aqinisa i-fluoride" bekungeke kusathathwa njengokubalulekile emtholampilo kunoma ikuphi ukwehla kwama-caries axhumene nokusetshenziswa kwe-fluoride.510 Ngaphezu kwalokho, ucwaningo luphakamise ukuthi ukuvezwa kwe-systemic fluoride kunomphumela omncane (uma kukhona) emazinyweni, i-511 512 nabaphenyi baphinde banikela ngemininingwane yokuthi i-dental fluorosis (uphawu lokuqala lwe-fluoride toxicity513) luphakeme emiphakathini yase-US enamanzi ane-fluoridated uma kuqhathaniswa nalabo abangenawo.
Eminye futhi imibiko ikhombisa ukuthi njengoba amazwe ayethuthuka, amazinga okubola enanini labantu anyukele enanini eliphakeme lamazinyo abolile, alahlekile, noma agcwalisiwe amane (ngawo-1960) abese ekhombisa ukwehla okukhulu (amazinga anamuhla), kungakhathalekile ukuthi i-fluoride iyini. sebenzisa. Kucatshangelwe ukuthi ukwanda kwenhlanzeko yomlomo, ukufinyelela ezinsizakalweni zokuvimbela, kanye nokuqwashisa okwengeziwe ngemiphumela emibi yoshukela yikhona okubangela ukwehla okubonakalayo kokubola kwamazinyo. Noma ngabe izizathu zingaba yini, kufanele kuqashelwe ukuthi le nkambiso yokwehla kokubola kwamazinyo yenzeka ngaphandle nangaphandle kokufakwa kwesistimu kwamanzi aphefumulelwe, i-515 ngakho-ke kuzovela ukuthi ezinye izinto ngaphandle kwe-fluoride zidale lolu shintsho. Umdwebo wesi-2 ngezansi ukhombisa ukuthambekela kokubola kwamazinyo emazweni anama-fluoridated nangaphandle koketshezi kusuka ngo-1955-2005.
Umdwebo 2: Izitayela Zokubola Kwamazinyo Emazweni Ahlanganisiwe Nama-Unfluoridated, 1955-2005
Okunye ukucatshangelwa okuningana kufanelekile kunoma yisiphi isinqumo mayelana nokusebenzisa i-fluoride ukuvimbela ukubola. Okokuqala, kufanele kuphawulwe ukuthi i-fluoride ayiyona into ebalulekile ekukhuleni nasekuthuthukeni kwabantu.516 Okwesibili, i-fluoride iye yamukelwa njengenye yamakhemikhali ezimboni ayi-12 “aziwa ngokudala i-neurotoxicity yentuthuko kubantu.” 517 Futhi ekugcineni, i-American IDental Association (ADA) yacela ukuthi kwenziwe ucwaningo olwengeziwe ngonyaka we-2013 maqondana nendlela yokwenza imiphumela ye-fluoride nemiphumela:
Kudingeka ucwaningo maqondana nama-fluoride ahlukahlukene e-topical ukuthola indlela yokusebenza kwawo kanye nemiphumela yokuvimbela i-caries lapho isetshenziswa ezingeni lamanje lokuvezwa kwe-fluoride yangemuva (okungukuthi, amanzi we-fluoridated ne-fluoride toothpaste) e-United States. Izifundo maqondana namasu wokusebenzisa i-fluoride ukwenza ukuboshwa noma ukuguqulwa kokuqhubeka kwe-caries, kanye nomphumela othile we-topical fluoride ekuqhumeni kwamazinyo, kuyadingeka.
Isigaba 8.2: Ukuntuleka kobufakazi
Izinkomba zokungaqiniseki kwamazinga lapho kutholakala khona imiphumela ye-fluoride ohlelweni lomuntu kuye kwenziwa kulo lonke leli phepha lesikhundla. Kodwa-ke, kubalulekile ukugcizelela ukungabikhona kobufakazi obuhambisana nokusetshenziswa kwe-fluoride, ngakho-ke, iThebula 4 linikeza uhlu olufushanisiwe lwezexwayiso eziqinile ezivela kuhulumeni, ezesayensi, nezinye iziphathimandla eziphathelene nobungozi nokungaqiniseki okuhlobene nokusebenzisa imikhiqizo ene-fluoridated.
Ithebula 4: Izilinganiso ezikhethiwe mayelana Nezixwayiso zeFluoride ezihlukaniswe nguMkhiqizo / Inqubo kanye noMthombo
| UMKHIQIZO / INQUBO EBONISWE | ISICELO / ISIQEPHU | UMTHOMBO WOLWAZI |
|---|---|---|
| I-fluoride yokusetshenziswa kwamazinyo, kufaka phakathi amanzi fluoridation | "Ukwanda kwamazinyo ezinhlungwini zabantu akuhlobene neze nokuhlungwa kwe-fluoride koqweqwe lwawo, futhi inani eliphakeme le-koqweqwe lwawo alusebenzi ngokwengeziwe ekuvikeleni ukubola kwamazinyo." "Zimbalwa izifundo ezibheka ukusebenza ngempumelelo komuthi wokuxubha we-fluoride, i-gel, i-rinse, ne-varnish kubantu abadala." | Izikhungo Zokulawulwa Nokuvikelwa Kwezifo (CDC). UKohn WG, Maas WR, Malvitz DM, Presson SM, Shaddik KK. Izincomo zokusebenzisa i-fluoride ukuvimbela nokulawula ukubola kwamazinyo e-United States. Umbiko Wamasonto Onke Wokugula Nokufa: Izincomo Nemibiko. 2001 Agasti 17: i-42. |
| Ukufakwa Kwezithenjwa Zokudla: Kunconywe Izibonelelo Zezokudla Nokutholwa Okwanele | "Kukonke, kube nokuvumelana phakathi kwekomidi ukuthi kunobufakazi besayensi bokuthi ngaphansi kwezimo ezithile i-fluoride ingenza ithambo linyuke futhi kwandise namathuba okuphuka." | UMkhandlu Kazwelonke Wocwaningo. I-fluoride emanzini okuphuza: Ukubuyekezwa Kwezesayensi Kwamazinga EPA. I-National Academies Press: Washington, DC 2006. |
| I-fluoride emanzini okuphuza | "Inhloso ye-Maximum Contaminant Level Goal (MCLG) ye-fluoride emanzini okuphuza kufanele ingabi zero." | Ibhokisi le-RJ. Ukubuyekezwa kombiko we-2006 United States National Research Council: I-fluoride emanzini okuphuza. I-fluoride. 2006 Julayi 1; 39 (3): 163-72. |
| Ukuguqulwa kwamanzi | "Ukuchayeka kwe-fluoride kunobudlelwano obuyinkimbinkimbi maqondana nokushwabana kwamazinyo futhi kungakhuphula ingozi yamazinyo engcupheni ezinganeni ezingondlekile ngenxa yokwehla kwe-calcium ne-koqweqwe lwe-hypoplasia ..." | I-Peckham S, i-Awofeso N. I-fluoridation yamanzi: ukubuyekezwa okubucayi kwemiphumela yomzimba ye-fluoride engenisiwe njengokungenelela kwezempilo komphakathi. IScientific World Journal. 2014 Feb 26; 2014. |
| I-fluoride kumikhiqizo yamazinyo, ukudla namanzi okuphuza | "Ngenxa yokuthi ukusetshenziswa kwemikhiqizo yamazinyo e-fluoridated nokusetshenziswa kokudla neziphuzo ezenziwe ngamanzi anefluorid kukhuphukile selokhu i-HHS yancoma amazinga afanele we-fluoridation, abantu abaningi manje sebengachayeka ku-fluoride kakhulu kunalokho obekulindelekile." | I-Tiemann M.Fluoride emanzini okuphuza: ukubuyekezwa kwezinkinga ze-fluoridation nezomthetho. IBhiblioGov. 2013 Apr 5. Umbiko Wensizakalo Yocwaningo LweCongress of Congress. |
| Ukudla kwe-fluoride ezinganeni | "Ukutholakala 'okuphelele' kwe-fluoride kwamukelwe kabanzi amashumi eminyaka njengoba phakathi kuka-0.05 no-0.07 mg we-fluoride ngekhilogremu lesisindo somzimba kodwa kusekelwe ebufakazini obulinganiselwe besayensi.” "Lokhu okutholakele kusikisela ukuthi ukufinyelela esimweni sokungabi namakhaza kungenzeka kungahlangene nokudla i-fluoride, kuyilapho i-fluorosis ngokusobala incike kakhulu ekudleni kwe-fluoride." | UWarren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber ‐ Gasparoni K. Ukucatshangelwa kokudla okuphelele kwe-fluoride usebenzisa i-dental fluorosis kanye nemiphumela ye-caries yamazinyo-isifundo se-longitudinal. Ijenali Yezempilo Yomphakathi Amazinyo. 2009 uMar 1; 69 (2): 111-5. |
| Izinto zokubuyisela amazinyo ezibuyiselwa i-fluoride (okusho ukugcwaliswa kwamazinyo) | “Kodwa-ke, akufakazelwa yilabo abazoba yizifundo zokwelashwa ukuthi ngabe izehlakalo zokulimala kwesibili zingancishiswa ngokuphuma kwe-fluoride yezinto zokubuyisela esimweni. ” | I-Wiegand A, i-Buchalla W, i-Attin T. Ukubukeza ngezinto zokukhipha i-fluoride-i-fluoriderelease ne-uptakecharacteristics, i-antibacterialactivity kanye nomthelela ekuguqulweni kwe-cariesformation. Izinto Zamazinyo. 2007 Mar 31; 23 (3): 343-62. |
| Izinto zamazinyo: isiliva diamine fluoride | "Ngenxa yokuthi i-silver diamine fluoride yintsha kwezobudokotela bamazinyo baseMelika nasemfundweni yamazinyo, kunesidingo somhlahlandlela ofanele, inqubo elandelwayo kanye nemvume." "Akukacaci ukuthi kuzokwenzekani uma ukwelashwa kumiswa ngemuva kweminyaka engu-2-3 bese kudingeka ucwaningo." | UHorst JA, u-Ellenikiotis H, uNdunankulu waseMilgrom, iKomidi Lokuboshwa Kwe-UCSF Silver Caries. I-Protocol ye-UCSF Yokubanjwa Kwe-Caries Sebenzisa i-Silver Diamine Fluoride: Isizathu, Izinkomba, Nemvume. Ijenali ye-California Dental Association. 2016 uJan; 44 (1): 16. |
| I-topical fluoride yokusetshenziswa kwamazinyo | “Iphaneli belinezinga eliphansi le- ukuqiniseka maqondana nenzuzo ye- U-0.5% we-fluoride unamathisele noma i-gel emazinyweni angapheli ezingane nasezimpandeni ezinama-caries ngoba bekumbalwa imininingwane ngokusetshenziswa kwasekhaya kwale mikhiqizo. ” “Kudingeka ucwaningo maqondana nokusebenza nobungozi bemikhiqizo ethile kulezi zindawo ezilandelayo: okuzifakelayo, amandla kadokotela, ama-gel asebenzisa amakhaya ama-fluoride, okokuxubha noma okokwehla; Amaphesenti ama-2 asebenzise ngobungcweti i-gel fluoride gel; ezinye izindlela zokulethwa, njengegwebu; amaza wokufaka alungile we-fluoride varnish nama-gel; ukusetshenziswa komzuzu owodwa kwejeli le-APF; kanye nenhlanganisela yemikhiqizo (ukusetshenziswa kwekhaya nokusetshenziswa kahle). ” | I-Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, Hujoel PP, Iafolla T, Kohn W, Kumar J, Levy SM. I-topical fluoride yokuvimbela i-caries: Isifinyezo esiPhezulu sezincomo zomtholampilo ezibuyekeziwe kanye nokusekelwa kokubuyekezwa okuhlelekile. Ijenali ye-American Dental Association. 2013; 144 (11): 1279-1291. |
| I-fluoride “supplements” (amaphilisi) | "Ukungavumelani okukhona phakathi kwemiphumela kukhombisa ukuthi kunempumelelo elinganiselwe kumaphilisi e-fluoride." | UTomasin L, Pusinanti L, Zerman N. Indima yamaphilisi e-fluoride ku-prophylaxis yamazinyo wamazinyo. Ukubuyekezwa kwezincwadi. I-Annali diStomatologia. 2015 uJan; 6 (1): 1. |
| Imithi, i-fluorine kwezokwelapha | "Akekho ongakwazi ukubikezela ngendlela efanele ukuthi kwenzekani emzimbeni womuntu ngemuva kokufakwa kwama-compounds ane-fluorine." | IStrunecká A, uPatočka J, uConnett P. fluorine kwezokwelapha. Ijenali Ye-Biomedicine Esetshenzisiwe. 2004; 2: 141-50. |
| Amanzi okuphuza anezinto ze-poly- ne-perfluoroalkyl (PFASs) | "Ukungcoliswa kwamanzi okuphuza ngezinto ze-poly- ne-perfluoroalkyl (PFASs) kubeka engcupheni impilo yabathengi ekhulayo, yokuzivikela emzimbeni, ye-metabolic ne-endocrine." "... ulwazi olumayelana namanzi okuphuza ukudalulwa kwePFAS ngakho-ke luyashoda cishe kwengxenye eyodwa kwezintathu zabantu base-US." | UHu XC, Andrews DQ, Lindstrom AB, Bruton TA, Schaider LA, Grandjean P, Lohmann R, Carignan CC, Blum A, Balan SA, Higgins CP. Ukutholwa Kwezinto Eziningi ZePoly-and Perfluoroalkyl (PFASs) e-US Amanzi Okuphuza Axhumene Nezindawo Zezimboni, Izindawo Zokuqeqesha Umlilo, kanye Nezitshalo Zokwelapha Amanzi Angcolile. Izincwadi Zesayensi Yezemvelo Nezobuchwepheshe. 2016 Okthoba 11 |
| Ukuvezwa emsebenzini kwe-fluoride ne-fluoride toxicity | “Ukubuyekezwa kolwazi olungashicilelwe mayelana nemiphumela yokuphefumula okungapheli kwe-fluoride ne-fluorine kwembula ukuthi amazinga okusebenza manje awahlinzeki ngokwanele. ” | UMullenix PJ. I-fluoride poisoning: iphazili enezicucu ezifihliwe. Ijenali Yomhlaba Wonke Yezempilo Emsebenzini Nezemvelo. 2005 Okthoba 1; 11 (4): 404-14 |
| Ukubuyekezwa kwamazinga okuphepha okuchayeka kuma-fluorine nama-fluoride | "Ukube besingacubungula kuphela ukuhlangana kwe-fluoride ne-calcium, besingaqonda ukuthi ikhono elikhulu le-fluoride lokulimaza amaseli, izitho, izindlala, nezicubu." | UPrystupa J. Fluorine -ukubuyekezwa kwamabhuku manje. Ukubuyekezwa kwe-NRC ne-ATSDR kwamazinga okuphepha okuchayeka ku-fluorine nama-fluoride. Izindlela Nezindlela Zokusebenzisa Ubuthi. 2011 Feb 1; 21 (2): 103-70. |
Isigaba 8.3: Ukuntuleka Kwesimilo
Okunye ukukhathazeka okukhulu mayelana nokuchayeka kwe-fluoride emanzini okuphuza nokudla kuhlobene nokukhiqizwa kwama-fluoride asetshenziswa ekuhlinzekelweni kwamanzi emphakathini. Ngokusho kweCenters for Disease Control and Prevention (CDC), izinhlobo ezintathu ze-fluoride zivame ukusetshenziselwa ukufudumeza amanzi emphakathini:
- I-Fluorosilicic acid: isixazululo esisuselwa emanzini esisetshenziswa yizinhlelo eziningi zamanzi e-United States. I-Fluorosilicic acid ibizwa nangokuthi yi-hydrofluorosilicate, FSA, noma i-HFS.
- I-Fluorosilicic acid: isixazululo esisuselwa emanzini esisetshenziswa yizinhlelo eziningi zamanzi e-United States. I-Fluorosilicic acid ibizwa nangokuthi yi-hydrofluorosilicate, FSA, noma i-HFS.
- I-sodium fluorosilicate: isithasiselo esomile, esincibilikiswa sibe yisixazululo ngaphambi kokungezwa emanzini.â € ¢ I-sodium fluoride: isithasiselo esomile, esivame ukusetshenziswa ezinhlelweni zamanzi amancane, sincibilike sibe yisixazululo ngaphambi kokufakwa emanzini.519
Impikiswano isivele ngokuhlangana kwezezimboni nalezi zithako. I-CDC ichaze ukuthi idwala le-phosphorite lifudunyezwa nge-sulfuric acid ukudala i-95% ye-fluorosilicic acid esetshenziswa ekuguquleni amanzi.520 I-CDC iphinde yachaza: “Ngoba ukutholakala kwemikhiqizo ye-fluoride kuhlobene nokukhiqizwa kukamanyolo we-phosphate, umkhiqizo womkhiqizo we-fluoride futhi ziyaguquguquka kuye ngezici ezinjengezinga lokushintshaniswa kwamanye amazwe elingathandeki nokuthengiswa kukamanyolo kwamanye amazwe. ”521 Umbhalo kahulumeni wase-Australia ukubeke ngokusobala ukuthi i-hydrofluosilicic acid, i-sodium silicofluoride ne-sodium fluoride konke“ kutholakala ngokujwayelekile kubakhiqizi bomanyolo we-phosphate. ”522 Ukuphepha abameli bokuchayeka kwe-fluoride babuze ukuthi ngabe lezi zibopho zezimboni zilungile nokuthi ukuxhumana kwezimboni nalawa makhemikhali kungahle kuholele ekufihlweni kwemiphumela yezempilo ebangelwe yi-fluoride exposure.
Udaba oluthile lokuziphatha oluqubuka nokubandakanyeka okunjalo kwemboni ukuthi amaqembu aqhutshwa yinzuzo abonakala echaza izidingo eziguqukayo zalokho okwenza ucwaningo “oluhamba phambili” olusekelwe ebufakazini, futhi okwamanje, isayensi engachemile iba nzima ukuxhasa, ukukhiqiza, ukushicilela, futhi umphakathi. Lokhu kungenxa yokuthi ukuxhasa ngemali isifundo esikhulu kungabiza kakhulu, kepha izinhlangano ezisuselwa ezimbonini zingakwazi ukukhokhela kalula abacwaningi bazo. Bangakwazi futhi ukuchitha isikhathi behlola izindlela ezahlukahlukene zokubika imininingwane (njengokushiya izibalo ezithile ukuthola imiphumela evumelana kangcono), futhi bangakwazi ukukhokhela ngokwengeziwe ukumemezela noma isiphi isici socwaningo esisekela imisebenzi yabo. Ngeshwa, umlando ukhombisile ukuthi amabhizinisi ezinkampani angakwazi ngisho nokuhlukumeza ososayensi abazimele njengendlela yokuqeda umsebenzi wabo uma lowo msebenzi ukhombisa ukulimala okudalwe ukungcola kwezimboni kanye nokungcola.
Ngempela, lesi simo sesayensi engalingani sibonwe ocwaningweni lwe-fluoride. Ababhali bokubukeza okushicilelwe kwi-Scientific World Journal ngo-2014 bachaza kabanzi: “Yize ukufakelwa amanzi okungelona iqiniso bekuyisu eliphikisanayo lezempilo yomphakathi selokhu laqalwa, abacwaningi — okubandakanya ososayensi nezifundiswa ezihlonishwa umhlaba wonke — bakuthole kunzima ukukushicilela izindatshana ze-fluoridation yomphakathi kumaphephabhuku ezazi zamazinyo nezempilo yomphakathi. ”523
Ngokwengeziwe, ukungqubuzana kwezintshisekelo kungaxhunyaniswa ngqo nezifundo mayelana nokuchayeka ekudleni kumakhemikhali ane-perfluorinated (PFCs). Ku-athikili eyashicilelwa ngo-2012, ucwaningo mayelana nokudla okuvela kuma-PFC lwahlolwa yizwe. Umbhali uveze ukuthi idatha evela e-US ibikhawulelwe kakhulu, ebandakanya okushicilelwe kuphela ngo-2010 ngabacwaningi abaningi baseMelika, kanye nocwaningo oluxhaswe nge-3M olusebenze njengocwaningo oluphambili ngaphambi kokushicilelwa kuka-2010 (futhi kusolwa ukuthi amasampula amaningi kokudla kunamazinga angcolile angaphansi kokutholwa.) 524 Noma kunjalo, abacwaningi bezemfundo bakhiqize okutholakele okwehlukile kunombiko we-3M futhi babhala encwadini yabo yango-2010 bathi: "Naphezu kokuvinjelwa kwemikhiqizo, sithole ama-POPs [ukungcola okuphikelelayo okungokwemvelo] ekudleni kwase-US, nemixube yale amakhemikhali asetshenziswa ngumphakathi waseMelika kumazinga ahlukahlukene. Lokhu kuphakamisa isidingo sokwandisa ukuhlolwa kokudla kwamakhemikhali angcolisayo. ”525
Ukungqubuzana kwezintshisekelo nakho kwaziwa ngokungena ezinhlakeni zikahulumeni ezibandakanyeka kumthetho wamakhemikhali onobuthi. I-Newsweek ka-2014 ebhalwe nguZoë Schlanger enesihloko esithi “Ingabe I-EPA Iyayithanda Imboni Lapho Ihlola Izingozi Zamakhemikhali?” kufaka phakathi ukucaphuna kwesazi semvelo uMichelle Boone esithi “'yonke noma iningi lemininingwane esetshenzisiwe ekuhloleni ubungozi ingavela ocwaningweni olunikezwa yimboni, naphezu kokucaca [kokushayisana kwezintshisekelo].'” 526
Kuyabonakala kalula ukuthi imboni yamazinyo inokushayisana okukhulu kwezintshisekelo ne-fluoride ngoba inzuzo yenziwa yizinkampani ezikhiqiza imikhiqizo yamazinyo equkethe i-fluoride. Ngokwengeziwe, izinqubo ezibandakanya i-fluoride elawulwa udokotela wamazinyo nabasebenzi bamazinyo nazo zingathola inzuzo ngamahhovisi amazinyo, ama-527 528 kanye nemibuzo ephathelene nokuziphatha iphakanyisiwe mayelana nokucindezela lezi zinqubo ze-fluoride ezigulini.529
Mayelana nokuziphatha kwemikhuba yezokwelapha neyamazinyo, itshe legumbi lenqubomgomo yezempilo yomphakathi eyaziwa njengezimiso zokuqapha kumele licatshangwe futhi. Isisekelo esiyisisekelo sale nqubomgomo sakhiwe phezu kwesifungo sezokwelapha esesineminyaka eminingi sithi "okokuqala, ungalimazi." Kodwa-ke, ukusetshenziswa kwanamuhla kwesimiso sokuqapha empeleni kusekelwa yisivumelwano samazwe omhlaba.
NgoJanuwari 1998, engqungqutheleni yamazwe omhlaba ebandakanya ososayensi, abameli, abenzi bomgomo, kanye nabezemvelo abavela e-US, Canada nase-Europe, kwasayinwa isitatimende esisemthethweni futhi saziwa ngokuthi “Isitatimende Esisatshalaliswa Esimisweni Sokuqapha.” 530 Kuyo, kunikezwa izeluleko ezilandelayo: “Uma umsebenzi uphakamisa izinsongo zokulimaza impilo yabantu noma imvelo, kufanele kuthathwe izinyathelo zokuqapha noma ngabe ubudlelwano obubangela nemiphumela bungasungulwa ngokuphelele ngokwesayensi. Kulesi simo umxhasi womsebenzi, hhayi owomphakathi, kufanele athwale umthwalo wobufakazi. ”531
Akumangalisi ukuthi isidingo sokusetshenziswa okufanele kwesimiso sokuqapha sihlotshaniswa nokusetshenziswa kwe-fluoride. Ababhali bendatshana yango-2006 enesihloko esithi “Isho Ukuthini Le Migomo Yokuqapha Ezenzweni Ezisuselwa Ebufakazini?” siphakamise isidingo sokubhekelela ukuvezwa okuqoqekayo okuvela kuyo yonke imithombo ye-fluoride nokuhlukahluka kwesibalo sabantu, ngenkathi kushiwo nokuthi abathengi bangafinyelela emazingeni “we-fluoridation” afanele ngaphandle kokuphuza amanzi ane-fluoridated.532 Ngaphezu kwalokho, abacwaningi bokubukeza okushicilelwe ngo-2014 babhekele isibopho sokuqapha Umgomo okumele usetshenziswe ekusetshenzisweni kwe-fluoride, futhi bathatha lo mqondo baya kwelinye igxathu lapho bephakamisa ukuthi ukuqonda kwethu kwanamuhla ngama-caries amazinyo "kunciphisa noma iyiphi indima enkulu ezayo ye-fluoride ekuvikeleni i-caries." 533
I-Fluoride Position Paper Ababhali
UDkt. Jack Kall, i-DMD, i-FAGD, i-MIAOMT, ungomunye we-Academy of General Dentistry kanye noMongameli odlule wesahluko saseKentucky. Uyi-Accredited Master ye-International Academy of Oral Medicine and Toxicology (IAOMT) futhi kusukela ngo-1996 usebenze njengoSihlalo weBhodi Yabaqondisi. Uphinde asebenze ebhodini labacebisi leBioregulatory Medical Institute (BRMI). Uyilungu le-Institute for Functional Medicine kanye ne-American Academy for Oral Systemic Health.
UDkt. Griffin Cole, i-MIAOMT yathola i-Mastership yakhe ku-International Academy of Oral Medicine kanye ne-Toxicology ngo-2013 futhi yabhala Ibhukwana le-Academy's Fluoridation Brochure kanye nokubuyekezwa okusemthethweni kweSayensi mayelana nokusetshenziswa kwe-Ozone ekwelapheni kwezimpande. UnguMongameli wesikhathi esidlule we-IAOMT futhi usebenza Ebhodini Labaqondisi, Ikomidi Lokuqondisa, Ikomidi Le-Fluoride, IKomidi Lenkomfa futhi unguMqondisi Wezifundo Eziyisisekelo.
UDkt. David Kennedy wenza udokotela wamazinyo iminyaka engaphezu kwengu-30 futhi wathatha umhlalaphansi emsebenzini wokwelapha ngo-2000. UnguMongameli Odlule we-IAOMT futhi useke wafundisa odokotela bamazinyo nabanye ochwepheshe bezempilo emhlabeni wonke ngezindaba zempilo yamazinyo, ubungozi be-mercury, kanye ne-fluoride. UDkt. Kennedy waziwa emhlabeni wonke njengommeli wamanzi okuphuza aphephile, udokotela wamazinyo webhayoloji futhi ungumholi owaziwayo emkhakheni wokuvimbela amazinyo. UDkt. Kennedy ungumbhali nomqondisi ophumelele indondo yefilimu i-Fluoridegate.
