Aylward L L, Hays S M, Vezina A, Deveau M, St-Amand A, Nong A
Summit Toxicology, LLP, Falls Church, VA, USA.
Summit Toxicology, LLP, Lyons, CO, USA.
Regul Toxicol Pharmacol. 2015 Jun;72(1):158-67. doi: 10.1016/j.yrtph.2015.04.005. Epub 2015 Apr 8.
Exposure to fluoride is widespread due to its natural occurrence in the environment and addition to drinking water and dental products for the prevention of dental caries. The potential health risks of excess fluoride exposure include aesthetically unacceptable dental fluorosis (tooth mottling) and increased skeletal fragility. Numerous organizations have conducted risk assessments and set guidance values to represent maximum recommended exposure levels as well as recommended adequate intake levels based on potential public health benefits of fluoride exposure. Biomonitoring Equivalents (BEs) are estimates of the average biomarker concentrations corresponding to such exposure guidance values. The literature on daily urinary fluoride excretion rates as a function of daily fluoride exposure was reviewed and BE values corresponding to the available US and Canadian exposure guidance values were derived for fluoride in urine. The derived BE values range from 1.1 to 2.1mg/L (1.2-2.5μg/g creatinine). Concentrations of fluoride in single urinary spot samples from individuals, even under exposure conditions consistent with the exposure guidance values, may vary from the predicted average concentrations by several-fold due to within- and across-individual variation in urinary flow and creatinine excretion rates and due to the rapid elimination kinetics of fluoride. Thus, the BE values are most appropriately applied to screen population central tendency estimates for biomarker concentrations rather than interpretation of individual spot sample concentrations.
由于氟化物在环境中天然存在，以及被添加到饮用水和牙科产品中用于预防龋齿，氟化物暴露十分普遍。过量接触氟化物对健康的潜在风险包括美学上不可接受的氟斑牙（牙齿斑纹）和骨骼脆性增加。许多组织已进行风险评估并设定指导值，以代表最大推荐暴露水平以及基于氟化物暴露对公众健康的潜在益处而推荐的充足摄入量水平。生物监测当量（BEs）是对应于此类暴露指导值的平均生物标志物浓度的估计值。回顾了作为每日氟化物暴露函数的每日尿氟排泄率的文献，并得出了与美国和加拿大现有暴露指导值相对应的尿中氟化物的BE值。得出的BE值范围为1.1至2.1mg/L（1.2 - 2.5μg/g肌酐）。即使在与暴露指导值一致的暴露条件下，个体单次尿样中的氟化物浓度也可能因个体间和个体内尿流和肌酐排泄率的变化以及氟化物的快速消除动力学而与预测的平均浓度相差数倍。因此，BE值最适用于筛查人群生物标志物浓度的中心趋势估计值，而不是解释个体单次样本浓度。
