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儿童氟暴露后的龋齿预防与神经发育障碍风险

Tooth decay prevention and neurodevelopmental disorder risk following childhood fluoride exposure.

作者信息

Geier David A, Geier Mark R

机构信息

Institute of Chronic Illnesses, Inc, 14 Redgate Ct, Silver Spring, MD, 20905, USA.

出版信息

BMC Pediatr. 2025 Apr 2;25(1):265. doi: 10.1186/s12887-025-05601-z.

DOI:10.1186/s12887-025-05601-z
PMID:40170137
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11963426/
Abstract

BACKGROUND

The Centers for Disease Control and Prevention (CDC) reports that water fluoridation is among the ten greatest public health achievements of the 20Century. Tooth decay (TD) prevention and neurodevelopmental disorder (ND) risk were assessed in relation to childhood water fluoridation exposure.

METHODS

This longitudinal cohort study examined the Independent Healthcare Research Database (IHRD) composed of prospectively collected healthcare data from the Florida Medicaid system for the period 1990-2012, using logistic and frequency statistical modeling (with adjustment for covariates). A cohort of 73,254 children continuously enrolled for their first 10 years of life was examined. The yearly percentage of persons in Florida receiving fluoridated water exposure from community water systems was examined by county. The number of children diagnosed with TD, autism spectrum disorder (ASD), attention deficit-hyperactivity disorder (ADHD), intellectual disability (ID), and specific delays in development (SDD) was evaluated.

RESULTS

Fluoride exposure in the year of birth, statistically significantly and dose-dependently, slightly reduced the risk of TD, and, separately, slightly increased the risk of ASD, ADHD, ID, and SDD. During the first 10 years of life, children who were fluoride-exposed as compared to unexposed were at significantly lower risk for TD, and, separately, at significantly greater risk for ASD, ID, and SDD.

CONCLUSIONS

Findings from the present study, coupled with previous studies, suggest new risk/benefit analyses of water fluoridation should be undertaken.

摘要

背景

美国疾病控制与预防中心(CDC)报告称,水氟化是20世纪十大公共卫生成就之一。针对儿童水氟化暴露情况,对龋齿(TD)预防和神经发育障碍(ND)风险进行了评估。

方法

这项纵向队列研究使用逻辑和频率统计模型(对协变量进行调整),对独立医疗保健研究数据库(IHRD)进行了检查,该数据库由1990 - 2012年期间从佛罗里达州医疗补助系统前瞻性收集的医疗保健数据组成。对73254名在生命最初10年持续登记的儿童队列进行了检查。按县检查了佛罗里达州接受社区供水系统氟化水暴露的人口的年度百分比。评估了被诊断患有TD、自闭症谱系障碍(ASD)、注意力缺陷多动障碍(ADHD)、智力残疾(ID)和特定发育迟缓(SDD)的儿童数量。

结果

出生当年的氟暴露在统计学上具有显著的剂量依赖性,略微降低了TD风险,另外,略微增加了ASD、ADHD、ID和SDD的风险。在生命的前10年中,与未暴露的儿童相比,暴露于氟的儿童患TD的风险显著降低,另外,患ASD、ID和SDD的风险显著增加。

结论

本研究结果与先前研究结果表明,应进行水氟化的新风险/效益分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e70f/11963426/587ff95633ce/12887_2025_5601_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e70f/11963426/587ff95633ce/12887_2025_5601_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e70f/11963426/587ff95633ce/12887_2025_5601_Fig1_HTML.jpg

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本文引用的文献

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Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856. doi: 10.1002/14651858.CD010856.pub3.
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Focus on cognitive impairment induced by excessive fluoride: An update review.关注过量氟化物引起的认知障碍:最新综述。
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Constitutional chromosomal anomalies in children, fetal alcohol syndrome, and maternal toxicant exposures: A longitudinal cohort study.儿童染色体结构异常、胎儿酒精综合征和母体毒物暴露:一项纵向队列研究。
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