{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:38:11Z","timestamp":1791513491656,"version":"4.3.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T00:00:00Z","timestamp":1512950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T00:00:00Z","timestamp":1512950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Skeletal fluorosis resulting from high fluoride level in drinking water is a major public health problem. The present study evaluated the association between exposures to drinking water fluoride and skeletal fluorosis in 5 villages of Poldasht County, Iran. All the data and information on the prevalence of bone diseases were obtained from the Health Record Department, Poldasht Health Centre. To obtain the odds ratio of bone disease problem in different risk factors, when considering the cluster effect of rural area, logistic regression in a multilevel model was used. Results showed that skeletal fluorosis of people who live in areas with high fluoride concentration is 18.1% higher than that of individuals who live in areas with low fluoride concentration. Skeletal fluorosis (54.5%) was observed in the age group of 71 years and above, and was more commonly found in females than males. According to Unadjusted, individuals who consume \u22643 unit milk and dairy products per week have almost the same level of bone diseases as compared to those that consume more than 3 units. This study indicated that, skeletal fluorosis is a general health problem in these rural areas because the results revealed that high percentage of the studied population had symptoms of skeletal fluorosis.<\/jats:p>","DOI":"10.1038\/s41598-017-17328-8","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T10:52:43Z","timestamp":1512471163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":163,"title":["Skeletal fluorosis in relation to drinking water in rural areas of West Azerbaijan, Iran"],"prefix":"10.1038","volume":"7","author":[{"given":"Ali Akbar","family":"Mohammadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood","family":"Yousefi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Yaseri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Jalilzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Hossein","family":"Mahvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,12,11]]},"reference":[{"key":"17328_CR1","unstructured":"Edmunds, M & Smedley, P. L. Fluoride in natural waters Essentials of medical geology. Elsevier Academic Press, Burlington, 2005; 301\u201329."},{"key":"17328_CR2","unstructured":"WHO. Fluoride in drinking-water: background document for development of WHO Guidelines for drinking-water quality. WHO\/SDE\/WSH\/03.04.96, English only. Geneva.Availablefrom: http:\/\/www.who.int\/water_sanitation_health\/dwq\/chemicals\/fluoride.pdf. (2004)."},{"key":"17328_CR3","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1007\/s00128-010-9950-y","volume":"84","author":"AR Mesdaghinia","year":"2010","unstructured":"Mesdaghinia, A. R., Vaghefi, K. A., Montazeri, A., Mohebbi, M. R. & Saeedi, R. Monitoring of Fluoride in Groundwater Resources of Iran. Bull Environ Contam Toxicol. \n                           84, 432\u20137 (2010).","journal-title":"Bull Environ Contam Toxicol."},{"key":"17328_CR4","first-page":"1664","volume":"43","author":"H Faraji","year":"2014","unstructured":"Faraji, H. et al. Correlation between fluoride in drinking Water and its levels in breast milk in Golestan Province, Northern Iran. Iran J Public Health. \n                           43, 1664\u201368 (2014).","journal-title":"Iran J Public Health."},{"key":"17328_CR5","first-page":"37","volume":"48","author":"A Maleki","year":"2015","unstructured":"Maleki, A. et al. Influence of selected anions on fluoride removal electrocoagulation\/electroflotation. Fluoride. \n                           48, 37\u201347 (2015).","journal-title":"Fluoride."},{"key":"17328_CR6","doi-asserted-by":"publisher","first-page":"170","DOI":"10.5004\/dwt.2017.20341","volume":"68","author":"AA Mohammadi","year":"2017","unstructured":"Mohammadi, A. A. et al. Temporal and spatial variation of chemical parameter concentration in drinking water resources of Bandar-e Gaz City using Geographic Information System. Desalination and Water Treatment. \n                           68, 170\u2013176 (2017).","journal-title":"Desalination and Water Treatment."},{"key":"17328_CR7","doi-asserted-by":"publisher","first-page":"133","DOI":"10.5455\/msm.2016.28.133-137","volume":"28","author":"D Kanduti","year":"2016","unstructured":"Kanduti, D., Sterbenk, P. & Artnik, B. fluoride: a review of use and effects on health. Mater Sociomed. \n                           28, 133\u2013137 (2016).","journal-title":"Mater Sociomed."},{"key":"17328_CR8","first-page":"9","volume":"47","author":"S Karimzade","year":"2014","unstructured":"Karimzade, S., Aghaei, M. & Mahvi, A. H. Investigation of intelligence quotient in 9\u201312-year-old children exposed to high and low-drinking water fluoride in west Azerbaijan province, Iran. Fluoride. \n                           47, 9\u201314 (2014).","journal-title":"Fluoride."},{"key":"17328_CR9","first-page":"1077","volume":"107","author":"AH Mahvi","year":"2012","unstructured":"Mahvi, A. H., Ghanbarian, M., Ghanbarian, M., Khosravi, A. & Ghanbarian, M. Determination of fluoride concentration in powdered milk in Iran 2010. Fluoride Journal. \n                           107, 1077\u20131079 (2012).","journal-title":"Fluoride Journal."},{"key":"17328_CR10","first-page":"252","volume":"48","author":"M Aghaei","year":"2015","unstructured":"Aghaei, M. et al. hypertension and fluoride in drinking water: case study from west Azerbaijan, Iran. Research report Fluoride. \n                           48, 252\u2013258 (2015).","journal-title":"Research report Fluoride."},{"key":"17328_CR11","first-page":"201","volume":"3","author":"AI Amouei","year":"2012","unstructured":"Amouei, A. I. et al. Fluoride concentration in potable groundwater in rural areas of Khaf city, Razavi Khorasan Province, Northeastern Iran. Int J Occup Environ Med \n                           3, 201\u20133 (2012).","journal-title":"Int J Occup Environ Med"},{"key":"17328_CR12","first-page":"338","volume":"48","author":"HR Shamsollahi","year":"2015","unstructured":"Shamsollahi, H. R., Zolghadr, Z., Mahvi, A. H., Hosseini, S. S. & Mossavic, S. N. The Effect of temperature, water hardness, and exposure time on Fluoride toxicity in the Aquatic Environment. Fluoride. \n                           48, 338\u201344 (2015).","journal-title":"Fluoride."},{"key":"17328_CR13","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.dib.2017.05.045","volume":"13","author":"AA Mohammadi","year":"2017","unstructured":"Mohammadi, A. A., Yousefi, M. & Mahvi, A. H. Fluoride concentration level in rural area in poldasht city and daily fluoride intake based on drinking water consumption with temperature. Data in Brief. \n                           13, 312\u2013315 (2017).","journal-title":"Data in Brief."},{"key":"17328_CR14","first-page":"224","volume":"46","author":"HR Poureslami","year":"2013","unstructured":"Poureslami, H. R., Khazaeli, P., Faryabi, A. & Mahvi, A. H. Fluoride levels and dental fluorosis in deciduous teeth of students residing in Koohbanan, Iran, a city with high-fluoride water and food. Fluoride. \n                           46, 224\u20139 (2013).","journal-title":"Fluoride."},{"key":"17328_CR15","first-page":"693","volume":"18","author":"AI Amouei","year":"2012","unstructured":"Amouei, A. I. et al. Physical and Chemical Quality Assessment of Potable Groundwater in Rural Areas of Khaf, Iran. World Appl Sci J. \n                           18, 693\u20137 (2012).","journal-title":"World Appl Sci J."},{"key":"17328_CR16","first-page":"160","volume":"48","author":"M Aghaei","year":"2015","unstructured":"Aghaei, M., Derakhshani, R., Raoof, M., Dehghani, M. & Mahvi, A. H. Effect of Fluoride in Drinking Water on Birth height and weight: An Ecological study in Kerman Province, Zarand County, iran. Fluoride. \n                           48, 160\u20138 (2015).","journal-title":"Fluoride."},{"key":"17328_CR17","first-page":"2","volume":"2","author":"M Shanthi","year":"2014","unstructured":"Shanthi, M., Thimma Reddy, B. V. & Shivani, K. Health Impact to Different Concentrations of Fluoride in Drinking Water of South India. Int J Sci Stud. \n                           2, 2\u20135 (2014).","journal-title":"Int J Sci Stud."},{"key":"17328_CR18","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1177\/00220345980770091001","volume":"77","author":"KR Phipps","year":"1998","unstructured":"Phipps, K. R., Orwoll, E. S. & Bevan, L. The Association Between Water-borne Fluoride and Bone Mineral Density in Older Adults. 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J Clin Endocrinol Metab. \n                           96, 2318\u20132324 (2011).","journal-title":"J Clin Endocrinol Metab."},{"key":"17328_CR21","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1056\/NEJMicm1200995","volume":"368","author":"N Kakumanu","year":"2013","unstructured":"Kakumanu, N. & Rao, S. D. Skeletal Fluorosis due to Excessive tea drinking. New England Journal of Medicine. \n                           368, 1140 (2013).","journal-title":"New England Journal of Medicine."},{"key":"17328_CR22","doi-asserted-by":"publisher","first-page":"48","DOI":"10.2174\/1874210600903010048","volume":"3","author":"SR Grobler","year":"2009","unstructured":"Grobler, S. R., Louw, A. J., Chikte U. M. E, Rossouw, R. J. & Van W Kotze, T. J. The Relationships between Two Different Drinking Water Fluoride Levels, Dental Fluorosis and Bone Mineral Density of Children. The Open Dentistry Journal. \n                           3, 48\u201375 (2009).","journal-title":"The Open Dentistry Journal."},{"key":"17328_CR23","unstructured":"Eaton ADScaEWR. Standard Methods for the Examination of water waster: AWWA; (2005)."},{"key":"17328_CR24","unstructured":"Susheela, A. K. editor. Fluorosis: An easily preventable disease through practice of interventions. In: Doctor\u2019s Handbook. 1st Ed. New Delhi: Ministry of Health and Family Welfare (GOI) and WHO India Country Office; 2005. p. 1\u201321."},{"key":"17328_CR25","unstructured":"World Health Organization. Nitrate and nitrite in drinking-water: Background document for development of WHO Guidelines for Drinking-water Quality. 2011. 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Journal of Clinical and Diagnostic Research. \n                           9, 18\u201321 (2015).","journal-title":"Journal of Clinical and Diagnostic Research."},{"key":"17328_CR32","first-page":"97","volume":"26","author":"AK Susheela","year":"1993","unstructured":"Susheela, A. K., Kumar, A., Bhatnagar, M. & Bahadur, R. Prevalence of Endemic Fluorosis with Gastrointestinal Manifestations in People Living in some North- Indian Villages. Fluoride. \n                           26, 97\u2013104 (1993).","journal-title":"Fluoride."},{"key":"17328_CR33","first-page":"210","volume":"42","author":"SL Choubisa","year":"2009","unstructured":"Choubisa, S. L., Choubisa, L. & Choubisa, D. Osteo-Dental Fluorosis In Relation To Nutritional Status, Living Habits, And Occupation In Rural Tribal Areas Of Rajasthan, India. 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Technical service management, http:\/\/tsm.ncc.org.ir\/HomePage.aspx?TabID=6925&Site=tsm.ncc.org&Lang=fa-IR (accessed 28 June 2017)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-17328-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-17328-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-17328-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T15:49:35Z","timestamp":1671810575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-17328-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,11]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,12]]}},"alternative-id":["17328"],"URL":"https:\/\/doi.org\/10.1038\/s41598-017-17328-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,11]]},"assertion":[{"value":"6 July 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2017","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2017","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"17300"}}