The Effect of High Fluoride in Groundwater on Human Health: Initial Findings and Recommendations of a Case Study From Sanliurfa, Turkey Mehmet Irfan Yesilnacar

, Tuba Rastgeldi Dogan

, Mustafa Kumral

Department of Environmental Engineering, Harran University, Turkey; [email protected]

Department of Soil Science and Plant Nutrition, Harran University, Turkey;

Department of Geological Engineering, Istanbul Technical University, Turkey;

INTRODUCTION MATERIALS and METHODS CONCLUSIONS ABSTRACT

Fluoride in the natural drinking water is the most important source of the fluorine taken in the body.

Endemic fluorosis seen on the individuals living in geographic areas which have the high optimal daily dose of fluorine in the natural drinking water sources is a major public health problem today. Many high-fluoride groundwater provinces have been recognized in various parts of the world.

In Turkey, endemic fluorosis is found in some areas which have the high level drinking of fluoride in water sources.

This geological structure is composed of the volcanic rocks in general. Those cases have been identified yet in the study area which is located in the villages of Sarım and Karatas of northwestern Şanlıurfa, Turkey.

Initial findings recommendations and of the present study are given in the conclusion section.

REFERENCES

-World Health Organisation, 1984a.

Guidelines for drinking water, second ed., vol.

1, Reccomendations Geneva, pp. 77 –77.

-U.,Deliba şı T.

Medical and Geology Fluorsis Problem Within the Context of Medical Geology Turkey,Medical in Geology Newsletter (17): pp.27-29 and 36,2010.

-Selinus, Essentials Medical O., of Geology: Impacts of the Natural Environment on Public Elsevier Health, Academic Pres, (2005).

Acknowledgement

This study was funded by the Scientific & Technological Council of Turkey Research (TÜBİTAK) Poster Design & Printing by under grant no. 110Y234 .

Fluorine is electronegative of the all most chemical elements and is therefore never found in nature in elemental form.

Combined chemically in the form of fluorides, it ranks 17th in abundance of elements in the earth’s crust representing about 0.06

–0.09% of the earth’s crust (World Health Organisation (WHO), 1994). It occurs in a combined formin rocks and soil in a wide variety of minerals such as fluorspar (fluorite) (CaF2), cryolite (Na3AlF6), apatite (Ca5- (PO4)3F) and topaz Al2SiO4(F,OH)2 (Buxton and Shernoff, 1999;WHO, 1994; Hamilton et al., 1982). Therefore, high F− concentrations in groundwater are expected in areas where are fluorine-bearing abundant in the substrate [14,15].Fig 1 minerals geologic

Health effects

Fluoride concentrations mg/l in drinking water of <0.5

leads to dental carries while fluoride content of between 0.5

and 1.5

mg/l promotes dental health (WHO, 1984). A fluoride content of 1.5

–4 mg/l in drinking water leads to dental fluorosis while concentrations of >4 mg/l leads to dental, skeletal and crippling fluorosis.

dental fluorosis while concentrations of >4 mg/l leads to dental, skeletal and crippling fluorosis (Table1).Thus, the fluoride concentration in drinking water is a like two-edged knife, both its higher and lower concentration is not safe (Hussain et al. 2002, 2004a).

More than some 200 million people are adversely affected due to consume of over the WHO’s recommended concentrations of fluoride in the drinking and usage water in the world.

Endemic fluorosis is observed that caused by consumption of a high concentration of fluoride in drinking water, in parts of Anatolia. Volcanic formations are found in areas with high fluoride concentrations in groundwater. According to certain documents to the United Nations Development Program (UNDP) and the World Health Organization (WHO), fluorosis is still an endemic public health problem in Turkey and 24 other nations. According to a recent scientific review, 12 main regions have been identified as hav-ing a fluorosis problem (21, 22) (Figure 2). According to this figure, different type of fluorosis problem appear in different parts of Turkey due to a variety of factors.

Interestingly, these 12 regions are quite far away from each other.

However problem our studies.

number of fluorosis interested 13 regions in These incidents have just been determined in in the villages of Sarım and Karatas of northwestern Şanlıurfa, Turkey.

which comprises the field of this study (Fig 3, 4). Initial findings and recommendations of the present study are given below.

During the first field study, it was observed that people of the region provide the water they need from the wells of 100-150 meters deep which they dug within the last 10-15 years with their own chemical effort.

analyses Necessary were conducted on the water samples taken from 4 different spots of the study field. The results of the analyses are shown on Table 2.

During the second phase of the study, as a result of the high fluoride concentrations obtained, 7 nearby villages such as Geçitköy, Hurmalı, Çevreli and Yukarıaybastı were included in the study, and thus expanding the field, to evaluate all dimensions of the problem.

Water samples from the 13 wells in villages of the region where the study was conducted were taken and their major ion and heavy metal analyses were done.

During the field study to which a dentist appointed by Şanlıurfa Local Health Directory attended, it was revelaed that primary school students in Sarım and Karataş villages have weak or medium level dental fluorosis. Figure 5 shows the children of Sarım and Karataş villages who have fluorosis.

In previous studies, natural fluorosis in regions which have volcanic field structure and its effects on health were examined and revealed.

When the geological formation of Şanlıurfa region is examined, volcanic and sedimentary rocks are seen as two main formations.

Basalts around Karacadağ which is a volcanic formation 132 km away from the region selected as the study field are used as sources for drinking water; however, no dental fluorosis complaints have been filed before.

High fluoride levels were observed in the water samples taken from the wells in the region. However, it is interesting to note that while high fluoride levels were observed in the drinking water wells of these two villages, no fluoride was obtained from the water samples of the wells of nearby villages which are very close to eachother.

SUGGESTIONS

Figure 1. Hydrogeochemical cycle of fluoride (Selinus, 2005) Figure 3. Geological Map of the area Concentration of fluoride in drinking water a) d) Impact on health b) e) Figure 2. Regions in Turkey with fluorosis problems (Demirel,2010) Figure 3. Geological Map of the area parameter (location) Blur (NTU) 0,50 c) f) Figure 5. T he children of Sarım and Karataş villages who have fluorosis.

Karataş 1 Karataş 2 0,90 0,50 The use of the wells dug by the people of the region with their effort for their needs should be banned and they should be provided with the proper water resources appropriate with the norms of the drinking water.

If drinking provided for water the cannot region be from different resources, defluoridation of drinking water resources which have high level fluoride concentrations should be done.

The number of dental check-ups for the primary school students of the region should be increased and done regularly.

The source of the high fluoride level obtained should be determined by examining the hydro-chemical formation of the region.

The authors of the study submitted a project proposal to TÜBİTAK titled “An examination of formation of high underground level fluoride waters, in its distribution, its effects on human health and defluoridation, KB Şanlıurfa” (1001) to investigate the present problem. The project was approved in April 2011.

A hydro-geologist, environmental engineer, GIS specialist, and a dentist work at this project and thus the problem will be examined from a multidisciplinary perspective.

As the results are obtained from the study, they will be shared with the scientific community.

Karataş 3 Sarım 1,10 0.0-0.5 mg/L Limited growth and fertility, Dental caries pH 8,15 8,25 8,24 8,43 0.5-1.5 mg/L 1.5-4.0 mg/L 4.0-10.0 mg/L Promotes dental health resulting in healthy teeth Prevents tooth decay Dental fluorosis (mottling of teeth) Dental fluorosis, Skeletal fluorosis EC (micro S/cm) Sıcaklık C Florür (mg/L) 275 17,60 2,84 300 17,10 2,01 224 18,20 1,32 275 17,30 3,48 >10.0 mg/L (pain in back and neck bones) Crippling fluorosis Table 1. Impact of fluoride on heallth (WHO,1971) Nitrat (mg/L) 0,00 0,00 0,00 0,05 Table 2. Karatas and Sarım villages drinking water analysis results