Consultant in Dental Public Health, San Antonio, TX, USA.
Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.
J Dent Res. 2020 Sep;99(10):1157-1164. doi: 10.1177/0022034520919385. Epub 2020 May 11.
Public health policy decisions in the United States have resulted in 62.4% of the population having access to fluoridated water. The purpose of this study was to examine the association between community water fluoridation and osteosarcoma. A secondary data analysis was performed with data collected from 2 separate but linked studies. Patients for phase 1 and phase 2 were selected from US hospitals via a matched case-control study design. For both phases, cases included patients diagnosed with osteosarcoma, and controls were patients diagnosed with other bone tumors or nonneoplastic conditions. In phase 1, cases ( = 209) and controls ( = 440) were patients of record in the participating orthopedic departments from 1989 to 1993. In phase 2, cases ( = 108) and controls ( = 296) were incident patients who were identified and treated by orthopedic physicians from 1994 to 2000. This analysis included all patients who met eligibility criteria on whom we had complete data on covariates, exposures, and outcome. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs for the association of community water fluoridation with osteosarcoma. A modestly significant interaction existed between fluoridation living status and bottled water use ( = 0.047). The adjusted OR for osteosarcoma and ever having lived in a fluoridated area for nonbottled water drinkers was 0.51 (95% CI, 0.31 to 0.84; = 0.008). In the same comparison, the adjusted OR for bottled water drinkers was 1.86 (95% CI, 0.54 to 6.41; = 0.326). Findings from this study demonstrated that community water fluoridation is not associated with an increased risk for osteosarcoma.
美国的公共卫生政策决策使得 62.4%的人口能够获得氟化水。本研究的目的是检验社区水氟化与骨肉瘤之间的关联。对来自两个独立但相关研究的数据进行了二次数据分析。第一阶段和第二阶段的患者通过匹配病例对照研究设计从美国医院中选择。在两个阶段中，病例包括被诊断患有骨肉瘤的患者，而对照包括被诊断患有其他骨肿瘤或非肿瘤性疾病的患者。在第一阶段，病例（n=209）和对照（n=440）是 1989 年至 1993 年参与骨科部门的患者记录。在第二阶段，病例（n=108）和对照（n=296）是由骨科医生于 1994 年至 2000 年发现并治疗的新发病例。该分析包括所有符合纳入标准且具有完整协变量、暴露和结局数据的患者。使用条件逻辑回归估计社区水氟化与骨肉瘤之间关联的比值比（OR）和 95%置信区间（CI）。氟化生活状态和瓶装水使用之间存在适度显著的交互作用（=0.047）。对于从未饮用瓶装水的氟化地区居民，调整后的骨肉瘤与曾经生活在氟化地区的 OR 为 0.51（95%CI，0.31 至 0.84；=0.008）。在同一比较中，对于饮用瓶装水的人，调整后的 OR 为 1.86（95%CI，0.54 至 6.41；=0.326）。本研究的结果表明，社区水氟化与骨肉瘤风险增加无关。
