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. 2021 Jan 4;18(1):317.
doi: 10.3390/ijerph18010317.

Recent Biomarkers for Monitoring the Systemic Fluoride Levels in Exposed Populations: A Systematic Review

Jesús Lavalle-Carrasco  1 , Nelly Molina-Frechero  2 , Martina Nevárez-Rascón  3 , Leonor Sánchez-Pérez  2 , Aida Hamdan-Partida  2 , Rogelio González-González  4 , Diana Cassi  5 , Mario Alberto Isiordia-Espinoza  6 , Ronell Bologna-Molina  4   7
Affiliations

Recent Biomarkers for Monitoring the Systemic Fluoride Levels in Exposed Populations: A Systematic Review

Jesús Lavalle-Carrasco et al. Int J Environ Res Public Health. .

Abstract

Fluorides are compounds that can be found in the minerals of soil with volcanic rocks. Different populations are exposed to high levels of fluorides through drinking water that, due to their chronic intake, cause several types of damage to health. Nails and hair, denominated as recent biomarkers, have been employed for monitoring systemic fluoride from long-term exposure to fluorides. The aim of this study was to perform a systematic review of the use of recent biomarkers for monitoring systemic fluoride levels in exposed populations and verify their validity in the measurement of the fluorine (F-) concentration within the body. A digital search was performed in the databases PubMed/Medline, Springer Link, Cochrane, and Scopus of original articles that employed recent biomarkers for monitoring systemic F-. Seventeen articles were included in this analysis; the recorded variables were the F- amount in each assessed biomarker, source of exposure, and total daily fluoride intake (TDFI). TDFI was associated with F- in nails and hair, as well as the exposure through drinking water. In conclusion, recent biomarkers are adequate for monitoring the systemic fluoride levels by evaluating the chronic/subchronic exposure through different sources, mainly drinking water, considering nails better than hair for this purpose.

Keywords: fluoride biomarkers; hair; nails; recent biomarkers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart for the systematic review. From the 279 articles found in the four databases included in the search, 17 studies were selected in this study for their analysis.
Figure 2
Figure 2
Risk of bias in individual studies. Some concerns of bias predominated in most of the assessed studies, followed by low risk of bias, and finally, high risk of bias.
Figure 3
Figure 3
Risk of bias across studies. Excluding the first domain, some concerns and high risk of bias predominated in the rest of them, indicating an important bias by considering the results of all the studies.
See this image and copyright information in PMC

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