{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T05:30:10Z","timestamp":1773898210903,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bundesinstitut f\u00fcr Risikobewertung (BfR)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Toxicol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Using the methodological approach of systematic review several regulatory bodies and associations have performed an assessment of existing evidence on the adverse effects of fluoride. The most recent review by EFSA published in 2025 recommended a fluoride level in drinking water of below 1.5\u00a0mg\/L and a maximum total daily intake of 3.3\u00a0mg of fluoride as safe level with particular respect to pregnant women and the exposed unborn child. Our work focusses on individual exposure aspects, evaluating the contribution of major sources, specifically those which can be influenced by personal behaviour. We demonstrate that black or green tea and fluoridated household salt\u2014even at salt intake levels below the population 25th percentile\u2014are main contributors of the daily fluoride exposure in the population. Using the safe level proposed by EFSA, we have calculated different exposure scenarios that may be used by individuals to estimate their specific exposure to fluoride from known sources. Considering that the safe level proposed by EFSA can be exceeded e.g. by drinking more than two cups (300\u00a0mL) of black or green tea daily and using even low amounts of fluoridated salt, our findings highlight the need for clear labelling of the fluoride content of products to allow informed consumer choices.<\/jats:p>","DOI":"10.1007\/s00204-025-04143-8","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T08:21:35Z","timestamp":1756628495000},"page":"4931-4940","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fluoride intake during pregnancy: calculation of realistic exposure scenarios for individual risk assessment"],"prefix":"10.1007","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6524-6456","authenticated-orcid":false,"given":"A.","family":"Sonnenburg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Batke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Damm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Foth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Freyberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. G.","family":"Hengstler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Mangerich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Partosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Th.","family":"Schupp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K-M.","family":"Wollin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Vom Brocke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Gundert-Remy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"4143_CR1","unstructured":"Afssa (2003) Rapport du comit\u00e9 d\u2019experts sp\u00e9cialis\u00e9 \u201ceaux\u201d concernant les criteres de qualite des eaux minerales naturelles et des eaux de source embouteillees permettant une consommation sans risque sanitaire pour les nourrissons et les enfants en bas age. https:\/\/www.anses.fr\/en\/system\/files\/EAUX2001sa0257Ra.pdf, checked on 3\/5\/2025."},{"issue":"8","key":"4143_CR2","doi-asserted-by":"publisher","first-page":"3332","DOI":"10.2903\/j.efsa.2013.3332","volume":"11","author":"C Agostoni","year":"2013","unstructured":"Agostoni C, Berni Canani R, Fairweather-Tait S, Heinonen M, Korhonen H et al (2013) Scientific opinion on dietary reference values for fluoride. EFSA J 11(8):3332","journal-title":"EFSA J"},{"key":"4143_CR3","unstructured":"ANSES (2021) Dietary reference values for vitamins and minerals. Edited by French Agency for Food, Environmental and Occupational Health & Safety. https:\/\/www.anses.fr\/en\/content\/dietary-reference-values-vitamins-and-minerals checked on 5\/19\/2025."},{"issue":"3","key":"4143_CR4","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1093\/advances\/nmz134","volume":"11","author":"S Bhat","year":"2020","unstructured":"Bhat S, Marklund M, Henry ME, Appel LJ, Croft KD, Neal B, Wu JHY (2020) A systematic review of the sources of dietary salt around the world. Adv Nutr 11(3):677\u2013686. https:\/\/doi.org\/10.1093\/advances\/nmz134","journal-title":"Adv Nutr"},{"key":"4143_CR5","unstructured":"BMEL (2024) Ergebnisse der DEGS-Studie. Edited by Bundesministerium f\u00fcr Ern\u00e4hrung und Landwirtschaft. https:\/\/www.bmel.de\/SharedDocs\/Downloads\/DE\/_Ernaehrung\/Ergebnisse-DEGS-Salzaufnahme.pdf?__blob=publicationFile&v=2 checked on 3\/21\/2025."},{"issue":"2","key":"4143_CR6","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.foodres.2013.01.025","volume":"51","author":"L Chan","year":"2013","unstructured":"Chan L, Mehra A, Saikat S, Lynch P (2013) Human exposure assessment of fluoride from tea (Camellia sinensis L.): a UK based issue? Food Res Int 51(2):564\u2013570. https:\/\/doi.org\/10.1016\/j.foodres.2013.01.025","journal-title":"Food Res Int"},{"issue":"10","key":"4143_CR7","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1289\/ehp.1104912","volume":"120","author":"AL Choi","year":"2012","unstructured":"Choi AL, Sun G, Zhang Y, Grandjean P (2012) Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environ Health Perspect 120(10):1362\u20131368. https:\/\/doi.org\/10.1289\/ehp.1104912","journal-title":"Environ Health Perspect"},{"key":"4143_CR9","unstructured":"Daz (2010) Entwicklung der Marktanteile von jodiertem und fluoridiertem Speisesalz am gesamten Speisesalzabsatz in Deutschland. Edited by Deutscher Arbeitskreis f\u00fcr Zahnheilkunde. https:\/\/www.kariesvorbeugung.de\/fuer-besucher-aus-fachkreisen\/, checked on 3\/6\/2025."},{"key":"4143_CR32","unstructured":"Della Bucher Torre, Sophie; Jotterand Chaparro, Corinne (2021) Project \u201cNutritional Reference Values (NRVs) for Switzerland\u201d. Edited by Nutrition and Dietetics Department, School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva. https:\/\/www.blv.admin.ch\/dam\/blv\/de\/dokumente\/lebensmittel-und-ernaehrung\/ernaehrung\/nutri-score\/bericht-naehrwertreferenzwerte-schweiz.pdf.download.pdf\/Full%20report_NRV_HEdS_final.pdf."},{"key":"4143_CR10","unstructured":"DGE (2022): Reference values fluoride. Edited by Deutsche Gesellschaft f\u00fcr Ern\u00e4hrung e.V. (German Nutrition Society). https:\/\/www.dge.de\/wissenschaft\/referenzwerte\/fluorid\/, checked on 5\/15\/2025."},{"key":"4143_CR11","unstructured":"DGE (2024) FAQ Fluoride. Edited by Deutsche Gesellschaft f\u00fcr Ern\u00e4hrung e.V. (German Nutrition Society). https:\/\/www.dge.de\/gesunde-ernaehrung\/faq\/fluorid\/#c6645, updated on 3\/11\/2024, checked on 5\/15\/2025."},{"key":"4143_CR12","doi-asserted-by":"publisher","unstructured":"EFSA Scientific Committee (2025) Updated consumer risk assessment of fluoride in food and drinking water including the contribution from other sources of exposure. Edited by European Food Safety Authority. Available online at https:\/\/efsa.onlinelibrary.wiley.com\/doi\/https:\/\/doi.org\/10.2903\/j.efsa.2025.9478 checked on 7\/25\/2025.","DOI":"10.2903\/j.efsa.2025.9478"},{"key":"4143_CR8","unstructured":"European Commission (2013) Survey on Member States\u2019 implementation of the EU salt reduction framework: Publications Office."},{"key":"4143_CR13","unstructured":"European Commission (2003) COMMISSION DIRECTIVE 2003\/40\/EC of 16 May 2003 establishing the list, concentration limits and labelling requirements for the constituents of natural mineral waters and the conditions for using ozone-enriched air for the treatment of natural mineral waters and spring waters. Directive 2003\/40\/EC, revised 5\/22\/2003. https:\/\/eur-lex.europa.eu\/eli\/dir\/2003\/40\/oj\/eng."},{"key":"4143_CR14","unstructured":"European Commission (2023) Health Promotion Knowledge Gateway: Dietary Salt\/Sodium. Defining dietary salt and sodium - overview of salt intake in adults across European countries. Edited by European Commission, checked on 3\/5\/2025."},{"key":"4143_CR15","unstructured":"GMBl (2014) Bek. v. 14.8.14, Ausnahmegenehmigung gem\u00e4\u00df \u00a7 68 Abs. 1 und 2 Nr. 1 LFGB f\u00fcr das Herstellen und Inverkehrbringen von jodiertem Speisesalz mit Zusatz von Kaliumflorid oder Natriumflorid. In : Gemeinsames Ministerialblatt. https:\/\/www.gmbl-online.de\/browse\/document\/b22895e5-a703-3b77-a9b0-07370bd6f154 checked on 3\/7\/2025."},{"issue":"5","key":"4143_CR16","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1007\/s00204-020-02725-2","volume":"94","author":"S Guth","year":"2020","unstructured":"Guth S, H\u00fcser S, Roth A, Degen G, Diel P, Edlund K et al (2020) Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses. Arch Toxicol 94(5):1375\u20131415. https:\/\/doi.org\/10.1007\/s00204-020-02725-2","journal-title":"Arch Toxicol"},{"issue":"7","key":"4143_CR17","doi-asserted-by":"publisher","first-page":"2571","DOI":"10.1007\/s00204-021-03072-6","volume":"95","author":"S Guth","year":"2021","unstructured":"Guth S, H\u00fcser S, Roth A, Degen G, Diel P, Edlund K et al (2021) Contribution to the ongoing discussion on fluoride toxicity. Arch Toxicol 95(7):2571\u20132587. https:\/\/doi.org\/10.1007\/s00204-021-03072-6","journal-title":"Arch Toxicol"},{"key":"4143_CR18","unstructured":"IfK (2021) Kariesvorbeugung mit Fluoriden etabliert und erfolgreich \u2013 30 Jahre IfK. Die Informationsstelle f\u00fcr Kariesprophylaxe (IfK) zieht ein erfolgreiches Res\u00fcmee \u2013 und hat noch Einiges vor. Edited by Informationsstelle f\u00fcr Kariesprophylaxe. https:\/\/www.quintessence-publishing.com\/deu\/de\/news\/zahnmedizin\/praevention-und-prophylaxe\/kariesvorbeugung-mit-fluoriden-etabliert-und-erfolgreich-30-jahre-ifk, checked on 3\/6\/2025."},{"key":"4143_CR19","unstructured":"Institute for Health Metrics and Evaluation (2025): GBD Results. Edited by University of Washington IHME. Seattle, WA. https:\/\/vizhub.healthdata.org\/gbd-results\/ checked on 2\/28\/2025."},{"key":"4143_CR20","unstructured":"ISO 3103:2019, 2019: Tea \u2014 Preparation of liquor for use in sensory tests. https:\/\/www.iso.org\/standard\/73224.html."},{"key":"4143_CR21","doi-asserted-by":"publisher","DOI":"10.3390\/nu14122550","author":"K Jakubczyk","year":"2022","unstructured":"Jakubczyk K, Ligenza A, Gutowska I, Janda-Milczarek K (2022) Fluoride content of Matcha tea depending on leaf harvest time and brewing conditions. Nutrients. https:\/\/doi.org\/10.3390\/nu14122550","journal-title":"Nutrients"},{"issue":"7","key":"4143_CR22","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1007\/s00394-014-0787-8","volume":"54","author":"SA Johner","year":"2015","unstructured":"Johner SA, Thamm M, Schmitz R, Remer T (2015) Current daily salt intake in Germany: biomarker-based analysis of the representative DEGS study. European J Nutr 54(7):1109\u20131115. https:\/\/doi.org\/10.1007\/s00394-014-0787-8","journal-title":"European J Nutr"},{"issue":"2","key":"4143_CR23","doi-asserted-by":"publisher","first-page":"29","DOI":"10.17886\/RKI-GBE-2016-041","volume":"1","author":"S Klenow","year":"2016","unstructured":"Klenow S, Mensink GBM (2016) Sodium intake in Germany. J Health Monit 1(2):29\u201333. https:\/\/doi.org\/10.17886\/RKI-GBE-2016-041","journal-title":"J Health Monit"},{"issue":"3","key":"4143_CR24","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1177\/1403494821990284","volume":"50","author":"N Krishnankutty","year":"2022","unstructured":"Krishnankutty N, Storgaard Jensen T, Kj\u00e6r J, J\u00f8rgensen JS, Nielsen F, Grandjean P (2022) Public-health risks from tea drinking: fluoride exposure. Scand J Public Health 50(3):355\u2013361. https:\/\/doi.org\/10.1177\/1403494821990284","journal-title":"Scand J Public Health"},{"issue":"3","key":"4143_CR25","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1016\/j.fct.2007.10.039","volume":"46","author":"E Malinowska","year":"2008","unstructured":"Malinowska E, Inkielewicz I, Czarnowski W, Szefer P (2008) Assessment of fluoride concentration and daily intake by human from tea and herbal infusions. Food Chem Toxicol 46(3):1055\u20131061. https:\/\/doi.org\/10.1016\/j.fct.2007.10.039","journal-title":"Food Chem Toxicol"},{"key":"4143_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/molecules28176396","author":"A Pavlovi\u010d","year":"2023","unstructured":"Pavlovi\u010d A, Tav\u010dar G, Ponikvar-Svet M (2023) Fluoride and aluminium in tea (Camellia sinensis L.)-tea quality indicators and risk factors for consumers. Molecules. https:\/\/doi.org\/10.3390\/molecules28176396","journal-title":"Molecules"},{"issue":"1","key":"4143_CR27","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s12903-019-0908-0","volume":"19","author":"VY Reshetnyak","year":"2019","unstructured":"Reshetnyak VY, Nesterova OV, Admakin OI, Dobrokhotov DA, Avertseva IN, Dostdar SA, Khakimova DF (2019) Evaluation of free and total fluoride concentration in mouthwashes via measurement with ion-selective electrode. BMC Oral Health 19(1):251. https:\/\/doi.org\/10.1186\/s12903-019-0908-0","journal-title":"BMC Oral Health"},{"issue":"4","key":"4143_CR28","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/nbu.12171","volume":"40","author":"CHS Ruxton","year":"2015","unstructured":"Ruxton CHS, Bond TJ (2015) Fluoride content of retail tea bags and estimates of daily fluoride consumption from typical tea drinking in UK adults and children. In Nutrition Bullet 40(4):268\u2013278. https:\/\/doi.org\/10.1111\/nbu.12171","journal-title":"In Nutrition Bullet"},{"issue":"2","key":"4143_CR29","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s40201-022-00811-4","volume":"20","author":"A Szmagara","year":"2022","unstructured":"Szmagara A, Krzyszczak A, Stefaniak EA (2022) Determination of fluoride content in teas and herbal products popular in Poland. J Environ Health Sci Eng 20(2):717\u2013727. https:\/\/doi.org\/10.1007\/s40201-022-00811-4","journal-title":"J Environ Health Sci Eng"},{"issue":"1","key":"4143_CR30","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1080\/10408444.2023.2295338","volume":"54","author":"MK Taher","year":"2024","unstructured":"Taher MK, Momoli F, Go J, Hagiwara S, Ramoju S, Hu X et al (2024) Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water. Crit Rev Toxicol 54(1):2\u201334. https:\/\/doi.org\/10.1080\/10408444.2023.2295338","journal-title":"Crit Rev Toxicol"},{"key":"4143_CR31","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.5542","author":"KW Taylor","year":"2025","unstructured":"Taylor KW, Eftim SE, Sibrizzi CA, Blain RB, Magnuson K, Hartman PA et al (2025) Fluoride exposure and children\u2019s IQ scores: a systematic review and meta-analysis. JAMA Pediatr. https:\/\/doi.org\/10.1001\/jamapediatrics.2024.5542","journal-title":"JAMA Pediatr"},{"issue":"9","key":"4143_CR33","first-page":"e05778","volume":"17","author":"D Turck","year":"2019","unstructured":"Turck D, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK et al (2019) Dietary reference values for sodium. In EFSA J Eur Food Safety Authority 17(9):e05778","journal-title":"In EFSA J Eur Food Safety Authority"},{"key":"4143_CR34","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13030259","author":"DT Waugh","year":"2016","unstructured":"Waugh DT, Potter W, Limeback H, Godfrey M (2016) Risk assessment of fluoride intake from tea in the Republic of Ireland and its implications for public health and water fluoridation. Int J Environ Res Public Health. https:\/\/doi.org\/10.3390\/ijerph13030259","journal-title":"Int J Environ Res Public Health"},{"key":"4143_CR35","volume-title":"global oral health status report towards universal health coverage for oral health by 2030","author":"World Health Organization","year":"2022","unstructured":"World Health Organization (2022) global oral health status report towards universal health coverage for oral health by 2030. World Health Organization, Geneva"}],"container-title":["Archives of Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00204-025-04143-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00204-025-04143-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00204-025-04143-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:40:08Z","timestamp":1760712008000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00204-025-04143-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,31]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["4143"],"URL":"https:\/\/doi.org\/10.1007\/s00204-025-04143-8","relation":{},"ISSN":["0340-5761","1432-0738"],"issn-type":[{"value":"0340-5761","type":"print"},{"value":"1432-0738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,31]]},"assertion":[{"value":"10 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This publication has been compiled by the Advisory Committee (AC) of the German Society of Toxicology. The AC is elected by the members of the German Society of Toxicology and consists of representatives from academia, industry, and administration to guarantee a broad range of toxicological competence. Opinions expressed are that of the AC and do not represent official statements of members\u2019 affiliations. The AC presents and justifies its activities to the members of the German Society of Toxicology, for example at the yearly plenary meeting. The authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}