Studies in Endemic Genu Valgum — A Manifestation of Fluoride Toxicity in India

Abstract

Fluoride is distributed ubiquitously in nature in several forms and enters the human system by several routes. The most important of these is ingestion of fluoride through drinking water. High levels of fluoride in water have been described from all the continents in the world¹. However, disease in man due to fluoride toxicity in endemic forms has been identified in only some countries of which India stands distinctly. The disease endemic fluorosis is the result of chronic excessive accumulation of environmental fluoride in human organs; the most important of which is the skeletal system. The basic pathology of fluoride toxicity lies in its affinity for bone wherein the former enters as an integral component of the apatite crystal. Extensive epidemiological studies carried out form time to time in the rural parts of India had indicated that endemic fluorosis is characterized by skeletal changes such as kyphosis, exostoses formation, cervical spondylopathy, sclerosis and also calcification of ligaments, tendons, interosseous membranes and muscular attachments^{2, 3, 4}. In a majority of earlier studies the fluoride content of water in endemic areas had been up to 16 ppm.