Abstract Fluoride (F−) originating from many natural geologic sources and anthropogenic activities has imposed a substantial environmental health risk. More than 200 million people from more than 35 nations are at risk of fluorosis, thus increasing the global attention paid to F− research. The present study reviews the mechanisms of F− ingestion from possible sources and exposures, correlating possible health effects by extensively surveying the literature. The relationship between F− levels in drinking water and dental and skeletal fluorosis has been studied for decades. However, several alternative routes of exposure, such as food and other supplements, influence fluorosis incidence and hinder benchmarking of fluorosis levels with F− concentrations in drinking water. Deposition of F− in developing teeth, accompanied by the loss of matrix protein, leads to deformities in tooth enamel and dentin. Skeletal fluorosis results from the strong and irreversible inclusion of F− in the deeper parts of bone and causes increased bone mass and density along with enlarged joints. This review article also describes extensive in vivo or in vitro studies of F− ingestion in laboratory animals and the correlation of F− exposure with several health effects.

中文翻译：

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氟化物与人类健康：对来源、暴露、代谢和毒性的系统评估

摘要 源自许多自然地质来源和人为活动的氟化物 (F-) 已经造成了巨大的环境健康风险。来自超过 35 个国家的超过 2 亿人面临氟中毒的风险，从而增加了全球对氟研究的关注。本研究回顾了可能来源和暴露的 F− 摄入机制，通过广泛调查文献关联可能的健康影响。几十年来，人们一直在研究饮用水中 F− 水平与氟牙症和氟骨症之间的关系。然而，几种替代的暴露途径，例如食物和其他补充剂，会影响氟中毒的发生率，并阻碍以饮用水中 F− 浓度为基准的氟中毒水平。F− 在发育中的牙齿中沉积，伴随着基质蛋白的损失，导致牙釉质和牙本质畸形。氟骨症是由于 F− 强烈且不可逆地包含在骨骼的较深部分，导致骨量和密度增加以及关节扩大。这篇评论文章还描述了实验室动物摄入氟的广泛体内或体外研究，以及氟暴露与几种健康影响的相关性。