Environmental Assessment of Fluoride in Drinking Water and Its Health Effects on Communities in Western Libya
DOI:
https://doi.org/10.65405/kh30hv04Keywords:
Fluoride, Drinking Water, Health Risk, Western Libya, Environmental Assessment, Community SurveyAbstract
Background: Fluoride is a naturally occurring element in drinking water that has both beneficial and adverse effects on human health. While optimal levels prevent dental caries, excessive fluoride intake can lead to dental and skeletal fluorosis. In western Libya, few studies have evaluated fluoride concentrations and their associated health outcomes.
Objectives: This study aims to assess the levels of fluoride in drinking water across three locations—Al-Jmail, Raqdalin, and Zuwara—in the western region of Libya. Additionally, it examines the prevalence of health effects associated with fluoride exposure among local residents through a structured community survey.
Methods: A total of 200 water samples were collected from municipal networks, bore wells, and household wells. Fluoride concentrations were determined using an ion-selective electrode method, calibrated with standard solutions. A community survey was conducted with 300 participants to gather data on water consumption, source usage, and health outcomes such as dental staining and joint complaints. Statistical analysis included descriptive statistics, correlation analysis, and risk assessment using the Hazard Quotient (HQ) for different age groups.
Results: Fluoride concentrations varied significantly across the three locations, with Al-Jmail recording the highest mean level (1.82 mg/L), followed by Raqdalin (1.42 mg/L) and Zuwara (0.91 mg/L). Approximately 42% of samples from Al-Jmail exceeded WHO recommended limits. Survey findings indicated a higher prevalence of dental fluorosis among children (38%) and skeletal complaints among adults (12%). A positive correlation was observed between higher fluoride concentrations and health outcomes, particularly in Al-Jmail.
Conclusions: The study highlights significant variability in fluoride concentrations in western Libya, with potential health risks in areas exceeding safe levels. Integrating water analysis with community surveys provides a comprehensive assessment of exposure and health impact, emphasizing the need for preventive measures, including water treatment and public health education.
Downloads
References
Aslani, H., Zarei, M., Taghipour, H., Khashabi, E., Ghanbari, H., & Ejlali, A. (2019). Monitoring, mapping and health risk assessment of fluoride in drinking water supplies in rural areas of Maku and Poldasht, Iran. Environmental geochemistry and health, 41(5), 2281-2294.
Assefa, G., Shifera, G., Melaku, Z., & Haimanot, R. T. (2004). Clinical and radiological prevalence of skeletal fluorosis among retired employees of Wonji-Shoa sugar estate in Ethiopia. East African Medical Journal, 81(12), 638-640.
Ayele, B. A., Godebo, T. R., Tekle-Haimanot, R., & Yifru, Y. M. (2022). Neuro-medical manifestations of fluorosis in populations living in the Main Ethiopian Rift Valley. Environmental geochemistry and health, 44(3), 1129-1136.
Brickley, M. B., Ives, R., & Mays, S. (2020). The bioarchaeology of metabolic bone disease. Academic Press.
Choubisa, S. L. (1997). Fluoride distribution and fluorosis in some villages of Banswara district of Rajasthan. Indian Journal of Environmental Health, 39(4), 281-288.
Choubisa, S. L., Choubisa, L., & Choubisa, D. K. (2001). Endemic fluorosis in Rajasthan. Indian journal of environmental health, 43(4), 177-189.
Christie, D. P. (1980). The spectrum of radiographic bone changes in children with fluorosis. Radiology, 136(1), 85-90.
Czerwinski, E., Nowak, J., Dabrowska, D., Skolarczyk, A., Kita, B., & Ksiezyk, M. (1988). Bone and joint pathology in fluoride-exposed workers. Archives of Environmental Health: An International Journal, 43(5), 340-343.
Demelash, H., Beyene, A., Abebe, Z., & Melese, A. (2019). Fluoride concentration in ground water and prevalence of dental fluorosis in Ethiopian Rift Valley: systematic review and meta-analysis. BMC Public Health, 19(1), 1298.
Deshmukh, A. N., Shah, K. C., & Sriram, A. (1995). Coal ash: a source of fluoride pollution, a case study of Koradi Thermal Power Station, District Nagpur, Maharashtra. Gondwana Geol Mag, 9, 21-29.
Dhar, V., Jain, A., Van Dyke, T. E., & Kohli, A. (2007). Prevalence of dental caries and treatment needs in the school-going children of rural areas in Udaipur district. Journal of Indian society of Pedodontics and Preventive dentistry, 25(3), 119-121.
Elías-Boneta, A. R., Psoter, W., Elias-Viera, A. E., Jiménez, P., & Toro, C. (2006). Relationship between dental caries experience (DMFS) and dental fluorosis in 12-year-old Puerto Ricans. Community dental health, 23(4), 244.
Farooqi, A., Masuda, H., & Firdous, N. (2007). Toxic fluoride and arsenic contaminated groundwater in the Lahore and Kasur districts, Punjab, Pakistan and possible contaminant sources. Environmental pollution, 145(3), 839-849.
Garrab, K., Hellara, I., Douki, W., Younes, M., Ben Amor, M., Bergaoui, N., & Najjar, M. F. (2007, September). Skeletal fluorosis: a case report. In Annales de Biologie Clinique (Vol. 65, No. 5, pp. 574-576).
Güner, Ş., Uyar-Bozkurt, S., Haznedaroğlu, E., & Menteş, A. (2016). Dental fluorosis and catalase immunoreactivity of the brain tissues in rats exposed to high fluoride pre-and postnatally. Biological trace element research, 174(1), 150-157.
Helte, E., Vargas, C. D., Kippler, M., Wolk, A., Michaëlsson, K., & Åkesson, A. (2021). Fluoride in drinking water, diet, and urine in relation to bone mineral density and fracture incidence in postmenopausal women. Environmental health perspectives, 129(4), 047005.
Holloway, P. J., & Ellwood, R. P. (1997). The prevalence, causes and cosmetic importance of dental fluorosis in the United Kingdom: a review. Community Dental Health, 14(3), 148-155.
Iheozor-Ejiofor, Z., Walsh, T., Lewis, S. R., Riley, P., Boyers, D., Clarkson, J. E., ... & O'Malley, L. (2024). Water fluoridation for the prevention of dental caries. Cochrane database of systematic reviews, (10).
Joshi, S., Hlaing, T., Whitford, G. M., & Compston, J. E. (2011). Skeletal fluorosis due to excessive tea and toothpaste consumption. Osteoporosis international, 22(9), 2557-2560.
Lian, Z. C., & Wu, E. H. (1986). Osteoporosis--an early radiographic sign of endemic fluorosis. Skeletal Radiology, 15(5), 350-353.
Majumdar, K. K. (2011). Health impact of supplying safe drinking water containing fluoride below permissible level on flourosis patients in a fluoride-endemic rural area of West Bengal. Indian journal of public health, 55(4), 303-308.
Malde, M. K., Zerihun, L., Julshamn, K., & Bjorvatn, K. (2003). Fluoride intake in children living in a high‐fluoride area in Ethiopia–intake through beverages. International Journal of Paediatric Dentistry, 13(1), 27-34.
Meena, L., & Gupta, R. (2021). Skeletal fluorosis. New England Journal of Medicine, 385(16), 1510-1510.
Mrabet, A., Fredj, M., Ammou, S. B., Tounsi, H., & Haddad, A. (1995). Compressions médullaires au cours de la fluorose osseuse. À propos de quatre cas. La Revue de médecine interne, 16(7), 533-535.
Nelson, E. A., Halling, C. L., & Buikstra, J. E. (2019). Evidence of skeletal fluorosis at the Ray Site, Illinois, USA: a pathological assessment and discussion of environmental factors. International Journal of Paleopathology, 26, 48-60.
O'mullane, D. M., Baez, R. J., Jones, S., Lennon, M. A., Petersen, P. E., Rugg-Gunn, A. J., ... & Whitford, G. M. (2016). Fluoride and oral health. Community dental health, 33(02), 69-99.
Peicher, K., & Maalouf, N. M. (2017). Skeletal fluorosis due to fluorocarbon inhalation from an air dust cleaner. Calcified Tissue International, 101(5), 545-548.
Qiao, L., Liu, X., He, Y., Zhang, J., Huang, H., Bian, W., ... & Han, J. (2021). Progress of signaling pathways, stress pathways and epigenetics in the pathogenesis of skeletal fluorosis. International journal of molecular sciences, 22(21), 11932.
Rao, N. S. (2009). Fluoride in groundwater, varaha river basin, visakhapatnam district, Andhra Pradesh, India. Environmental Monitoring and Assessment, 152(1), 47-60.
Rhomberg, W., Böhler, F., Vith, A., & Breitfellner, G. (1995). Generalized osteopathy with pathological fractures in a patient with long-term exposure to fluorine-containing plastics. Schweizerische Medizinische Wochenschrift, 125(48), 2330-2337.
Sezgin, B. I., Onur, Ş. G., Menteş, A., Okutan, A. E., Haznedaroğlu, E., & Vieira, A. R. (2018). Two-fold excess of fluoride in the drinking water has no obvious health effects other than dental fluorosis. Journal of Trace Elements in Medicine and Biology, 50, 216-222.
Singh, S., Saha, S., Singh, S., Shukla, N., & Reddy, V. K. (2018). Oral health-related quality of life among 12–15-year children suffering from dental fluorosis residing at endemic fluoride belt of Uttar Pradesh, India. Journal of Indian Association of Public Health Dentistry, 16(1), 54-57.
Tailor, G. S., & Chandel, C. S. (2010). To assess the quality of ground water in Malpura Tehsil (Tonk, Rajasthan, India) with emphasis to fluoride concentration. Nature and science, 8(11), 20-26.
Villholth, K. G., & Rajasooriyar, L. D. (2010). Groundwater resources and management challenges in Sri Lanka–An overview. Water resources management, 24(8), 1489-1513.
WHO Expert Committee on Oral Health Status and Fluoride Use, & World Health Organization. (1994). Fluorides and oral health: report of a WHO Expert Committee on Oral Health Status and Fluoride Use [meeting held in Geneva from 22 to 28 November 1993].
Williams, D. M., Chestnutt, I. G., Bennett, P. D., Hood, K., Lowe, R., & Heard, P. (2006). Attitudes to fluorosis and dental caries by a response latency method. Community Dentistry and Oral Epidemiology, 34(2), 153-159.
Xiang, Q. Y., Liang, Y. X., Chen, B. H., Wang, C. S., Zhen, S. Q., Chen, X. D., & Chen, L. S. (2004). Serum fluoride and dental fluorosis in two villages in China. FLUORIDE., 37, 28-37.
Xiao, Y., Hao, Q., Zhang, Y., Zhu, Y., Yin, S., Qin, L., & Li, X. (2022). Investigating sources, driving forces and potential health risks of nitrate and fluoride in groundwater of a typical alluvial fan plain. Science of the Total Environment, 802, 149909.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Comprehensive Journal of Science
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
