Havard T.H.Chan. --- Impact of fluoride on neurological development in children

http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/

"July 25, 2012 — For years health experts have been unable to agree on whether fluoride in the drinking water may be toxic to the developing human brain. Extremely high levels of fluoride are known to cause neurotoxicity in adults, and negative impacts on memory and learning have been reported in rodent studies, but little is known about the substance's impact on children's neurodevelopment. In a meta-analysis, researchers from Harvard School of Public Health (HSPH) and China Medical University in Shenyang for the first time combined 27 studies and found strong indications that fluoride may adversely affect cognitive development in children. Based on the findings, the authors say that this risk should not be ignored, and that more research on fluoride's impact on the developing brain is warranted.

The study was published online in Environmental Health Perspectives on July 20, 2012."

Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis

Anna L. Choi, 1 Guifan Sun, 2 Ying Zhang, 3 and Philippe Grandjean1, 4

PDF: http://ehp.niehs.nih.gov/wp-content/uploads/120/10/ehp.1104912.pdf

"Background: Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on children's neurodevelopment.

Objective: We performed a systematic review and meta-analysis of published studies to investigate the effects of increased fluoride exposure and delayed neurobehavioral development.

Methods: We searched the MEDLINE, EMBASE, Water Resources Abstracts, and TOXNET databases through 2011 for eligible studies. We also searched the China National Knowledge Infrastructure (CNKI) database, because many studies on fluoride neurotoxicity have been published in Chinese journals only. In total, we identified 27 eligible epidemiological studies with high and reference exposures, end points of IQ scores, or related cognitive function measures with means and variances for the two exposure groups. Using random-effects models, we estimated the standardized mean difference between exposed and reference groups across all studies. We conducted sensitivity analyses restricted to studies using the same outcome assessment and having drinking-water fluoride as the only exposure. We performed the Cochran test for heterogeneity between studies, Begg's funnel plot, and Egger test to assess publication bias, and conducted meta-regressions to explore sources of variation in mean differences among the studies.

Results: The standardized weighted mean difference in IQ score between exposed and reference populations was –0.45 (95% confidence interval: –0.56, –0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. Subgroup and sensitivity analyses also indicated inverse associations, although the substantial heterogeneity did not appear to decrease.

Conclusions: The results support the possibility of an adverse effect of high fluoride exposure on children's neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment."