Association of lifetime exposure to fluoride and cognitive functions in Chinese children: a pilot study

Neurotoxicol Teratol. Jan-Feb 2015;47:96-101. doi: 10.1016/j.ntt.2014.11.001. Epub 2014 Nov 8.

Abstract

Background: A systematic review and meta-analysis of published studies on developmental fluoride neurotoxicity support the hypothesis that exposure to elevated concentrations of fluoride in water is neurotoxic during development.

Methods: We carried out a pilot study of 51 first-grade children in southern Sichuan, China, using the fluoride concentration in morning urine after an exposure-free night; fluoride in well-water source; and dental fluorosis status as indices of past fluoride exposure. We administered a battery of age-appropriate, relatively culture-independent tests that reflect different functional domains: the Wide Range Assessment of Memory and Learning (WRAML), Wechsler Intelligence Scale for Children-Revised (WISC-IV) digit span and block design; finger tapping and grooved pegboard. Confounder-adjusted associations between exposure indicators and test scores were assessed using multiple regression models.

Results: Dental fluorosis score was the exposure indicator that had the strongest association with the outcome deficits, and the WISC-IV digit span subtest appeared to be the most sensitive outcome, where moderate and severe fluorosis was associated with a digit span total score difference of -4.28 (95% CI -8.22, -0.33) and backward score with -2.13 (95% CI -4.24, -0.02).

Conclusions: This pilot study in a community with stable lifetime fluoride exposures supports the notion that fluoride in drinking water may produce developmental neurotoxicity, and that the dose-dependence underlying this relationship needs to be characterized in detail.

Keywords: Children; Confounding; Fluoride; Fluorosis; Neuropsychological measures; Prenatal exposure delayed effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • China / epidemiology
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology*
  • Female
  • Fluoride Poisoning / complications*
  • Fluoride Poisoning / epidemiology*
  • Humans
  • Male
  • Neuropsychological Tests
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Regression Analysis
  • Retrospective Studies