Impact of early life fluoride exposure on cognitive and behavioural outcomes in children

项目总结/摘要 水氟化是加拿大和美国用于控制牙齿的人群健康干预措施 腐烂通过公共饮用水施用氟化物的安全性尚不确定。最近的人类研究 表明饮用水中氟暴露可能会改变甲状腺功能，增加血铅水平， 降低智商，增加患多动症的风险。尽管如此，许多人类研究包括一些群体， 暴露于更高水平的氟化物，他们往往缺乏一个比较组或敏感的措施， 行为或学习。鉴于人们广泛接触到氟化水，美国国家研究理事会 在2007年的一份报告中得出结论，迫切需要进行严格的流行病学研究，以解决 关于这种公共卫生干预的安全性的争议。 本研究的目的是确定产前和儿童期接触氟化物是否会影响学习能力 和行为问题，特别强调弱势群体。 目前的建议将建立在一个特殊的国家怀孕队列研究：“母婴 环境化学品研究（MIREC）。MIREC队列非常适合解决 研究目的，因为必要的信息（妊娠期间的尿液和儿童结局）是 收集了大量的样本，这些样本随着城市水氟化的功能而变化。氟化物浓度 将使用储存的尿液样本进行测量，这些样本来自1960名生活在10个国家的孕妇。 加拿大大城市-其中一半在市政用水中添加氟化物。在1207名参与者中， 方法，标准化问卷评估行为结果，可用于898名儿童 (74%的样本）居住在加拿大的一些城市。此外，标准化认知评估，或 出生队列中有610名儿童的智商得分。该研究还将探讨 在摄入婴儿配方奶粉的儿童中， 无氟水。最后，我们将检查孕妇尿氟浓度是否连续变化， 生活在城市饮用水加氟社区的妇女比例更高。 这项研究的结果将告知公共卫生官员和决策者有关“实时”氟化物 生活在加氟和不加氟社区的孕妇的水平。它还将提供重要的 有关氟暴露是否对儿童的行为或学习能力产生不利影响的信息。 这一信息将直接影响有关水氟化安全的决策， 易受伤害的人口，因此是一个高

Project Summary / Abstract Water fluoridation is a population health intervention used in Canada and the United States to control tooth decay. The safety of administering fluoride via public drinking water is uncertain. Recent human studies suggest that exposure to fluoride in drinking water may alter thyroid function, increase blood lead levels, lower IQ, and increase the risk of developing ADHD. Still, many of the human studies included groups who were exposed to higher levels of fluoride and they often lacked a comparison group or sensitive measures of behavior or learning. Given widespread exposure to fluoridated water, the US National Research Council concluded in a 2007 report that rigorous epidemiological research is urgently needed to address the controversy about the safety of this public health intervention. The aim of this study is to determine if prenatal and childhood exposure to fluoride impacts learning abilities and behavioral problems in young Canadian children, with particular emphasis on vulnerable populations. The present proposal will build upon an exceptional national pregnancy cohort study: “Maternal-Infant Research on Environmental Chemicals” (MIREC). The MIREC cohort is ideally suited to address the research objectives because the requisite information (urine during pregnancy and child outcomes) was collected in a large sample that varied as a function of municipal water fluoridation. Fluoride concentrations will be measured using stored urine samples obtained from a sample of 1960 pregnant women living in ten large Canadian cities – half of which add fluoride to municipal water. Out of 1207 participants who were approached, standardized questionnaires assessing behavioral outcomes are available for 898 children (74% of sample) living in select cities across Canada. In addition, standardized cognitive assessments, or IQ scores, are available for 610 of the children in the birth cohort. The study will also examine whether neurodevelopmental outcomes differ among children who ingested infant formula using fluoridated versus non-fluoridated water. Finally, we will examine whether serial urinary fluoride concentrations in pregnant women are higher in women who live in communities that fluoridate their municipal drinking water. The results of this study will inform public health officials and decision makers about “real-time” fluoride levels of pregnant women living in fluoridated and non-fluoridated communities. It will also provide important information about whether fluoride exposure adversely impacts children’s behaviors or learning abilities. This information will direclty impact decision making concerning the safety of water fluoridation among vulnerable populations and is therefore an area of high