Fluoride Concentration in Public Water Supply in a City in the Amazon Region
Keywords:
Fluoridation, Fluorides, Oral Health, Public Health, Dental CariesAbstract
Objective: To analyze the fluoride concentration in the public water supply in Manaus, Brazil. Material and Methods: Water samples were collected in 50 mL polyethylene bottles, identified, and labeled. The collection was performed from September 2016 to August 2018. For the selection of collection points, all neighborhoods of the city of Manaus, divided into four health districts (North, South, East, and West), were mapped. From each district, 30 samples were collected, totaling 120 monthly samples. Water samples were analyzed using an ion analyzer, ORION 720-A, and a specific electrode, ORION 96-09. The ion analyzer and electrode were calibrated in standard solutions. The levels were classified in intervals based on technical consensus to guide the health surveillance agencies. Results: Of the 2,874 water samples, 50.3% were within the recommended range, and 49.7% were inadequate, with 31.6% considered above the parameters and 18.1% below. Among the districts, the North had the highest percentages of unsatisfactory samples, resulting in limited action to prevent tooth decay. During the 24 months of analysis, there were large oscillations in the values in all four districts of Manaus. Conclusion: Results reinforce the importance of heterocontrol for the city to guarantee the effectiveness of this public health measure.References
Giatti LL, Cutolo SA. Acesso à água para consumo humano e aspectos de saúde pública na Amazônia Legal. Ambient soc 2012; 15(1):93-109. https://doi.org/10.1590/S1414-753X2012000100007 [In Portuguese].
Aragão JS, Borges JT. The search for the universalization of water supply and sewage system: evolution, challenges and perspective. A case study in Manaus-AM. Novos Cadernos NAEA 2018; 21(3):232-51. https://doi.org/10.5801/ncn.v13i3.4974
Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; 2015(6):CD010856. https://doi.org/10.1002/14651858.CD010856.pub2
Narvai PC. Dental caries and fluorine: a twentieth century relation. Cien Saude Colet 2000; 5(2):381-92. https://doi.org/10.1590/S1413-81232000000200011
McDonagh M, Whiting P, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, et al. Systematic review of water fluoridation. BMJ 2000 Oct; 321(7265):855-9. https://doi.org/10.1136/bmj.321.7265.855
Cruz MGB, Narvai PC. Caries and fluoridated water in two Brazilian municipalities with low prevalence of the disease. Rev Saude Publica 2018; 52:28. https://doi.org/10.11606/S1518-8787.2018052016330
Rossi TRA, Moreira LGP, Barros SG. History of fluoridation policies as a strategy by the Brazilian Legislative Branch to fight dental caries, 1963 to 2019. Cad Saúde Pública 2020; 36(4):e00208418. https://doi.org/10.1590/0102-311X00208418
Brasil. Lei n. 6050 de 24 de Maio de 1974. Dispõe sobre a fluoretação da água em sistemas de abastecimento público quando existir estação de tratamento. Diário Oficial da União, Brasília (1974 may 27); Sec.1:6021. Available from: https://www.planalto.gov.br/ccivil_03/leis/L6050.htm. [Accessed on August 12, 2019]. [In Portuguese].
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância em Saúde Ambiental e Saúde do Trabalhador. Diretriz Nacional do Plano de Amostragem da Vigilância da Qualidade da Água para Consumo Humano; 2016. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/ diretriznacionalaguaconsumohumano.pdf. [Accessed on August 12, 2019]. [In Portuguese].
Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal. Consenso técnico sobre classificação de águas de abastecimento público segundo o teor de flúor. São Paulo: Faculdade de Saúde Pública da Universidade de São Paulo; 2011. [In Portuguese].
Moimaz SAS, Santos LFP, Saliba TA, Saliba NA, Saliba O. Health surveillance: public water supply fluoridation in 40 municipalities of São Paulo, Brazil. Ciênc Saúde Colet 2020; 25(7):2653-62. https://doi.org/10.1590/1413-81232020257.03972018.
Lacerda APAG, Oliveira NA, Pinheiro HHC, Assis KML, Cury JA. Water fluoridation in the ten largest Municipalities of Tocantins State, Brazil. Ciênc Saúde Colet 2020; 25(4):1507-18. https://doi.org/10.1590/1413-81232020254.17722018
Brasil. Instituto Brasileiro de Geografia e Estatística. Brasília (DF): IBGE. Available from: https://www.ibge.gov.br/cidades-e-estados/am/manaus.html [Accessed on 19, 2019]. [In Portuguese].
Programa das Nações Unidas para o Desenvolvimento – PNUD. Atlas de Desenvolvimento Humano no Brasil 2013. Available from: https://atlasbrasil.org.br/2013/pt/perfil_m/manaus_am. [Accessed on August 12, 2019]. [In Portuguese].
Brasil. Ministério da Saúde. SB Brasil 2010: Pesquisa Nacional de Saúde Bucal, resultados principais. Brasília: Ministério da Saúde; 2012. 117 p. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/pesquisa_nacional_saude _bucal.pdf. [Accessed on August 10, 2019]. [In Portuguese].
Pinheiro HHC, Rebelo MAB, Rebelo Vieira JM, Castro PHDF, Lacerda APAG, Souza MS, et al. Cobertura e vigilância da fluoretação das águas nos municípios com mais de 50 mil habitantes da região Norte. In: Frazão P, Narvai PC. Cobertura e vigilância da fluoretação da água no Brasil: municípios com mais de 50 mil habitantes. São Paulo: Faculdade de Saúde Pública da Universidade de São Paulo; 2017. p. 112-130. [In Portuguese].
Cury JA, Tabchoury C, Tenuta L, Narvai PC, Frazão P. Protocolo de coleta e análise da amostra de água. In: Frazão P, Roncalli A, Pinheiro HHC, Ely HC, Cury JA, Noro L, Zilbovicius C, Narvai PC, Souza TC de. Projeto Vigiflúor: cobertura e vigilância da fluoretação da agua de abastecimento público no Brasil. 2014. Available from: https://www.cecol.fsp.usp.br/dcms/uploads/arquivos/1411739391_Manual-Coleta-Analise-Amostra-Agua%20v.1.0.pdf [Accessed on August 10, 2019]. [In Portuguese].
Brasil. Ministério da Saúde. Portaria n. 635, de 26 de dezembro de 1975. Aprova normas e padrões sobre a fluoretação da água, tendo em vista a Lei n. 6050/74. Diário Oficial da União, Brasília (1976 jan 30); Seção 1. Available from: https://central3.to.gov.br/arquivo/349893/ [Accessed on August 10, 2019]. [In Portuguese].
Bergamo ETP, Barbana M, Terada RSS, Cury JA, Fujimaki M. Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis. Braz Oral Res 2015; 29(1):1-6. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0047.
Moimaz SAS, Santos LFP. Longitudinal study of water fluoridation in the municipality with complex distribution network: ten years of study. Arch Health Invest 2015; 4(5):11-16.
Frazão P, Ely HC, Noro LRA, Pinheiro HHC, Cury JA. The surveillance framework of water and the reporting of fluoride concentration indicators. Saude Debate 2018; 42(116):274-86. https://doi.org/10.1590/0103-1104201811622.
Scalize PS, Pinheiro RVN, Ruggeri Junior HC, Albuquerque A, Lobón GS, Arruda PN. External control of fluoridation in public water supply systems in the state of Goiás, Brazil. Cienc Saude Colet 2018; 23(11):3849-60. https://doi.org/10.1590/1413-812320182311.24712016.
McLaren L, Singhal S. Does cessation of community water fluoridation lead to an increase in tooth decay? A systematic review of published studies. J Epidemiol Community Health 2016; 70(9):934-40. https://doi:10.1136/jech-2015-206502
Meyer J, Margaritis V, Mendelsohn A. Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska. BMC Oral Health 2018; 18(1):1-10. https://doi.org/10.1186/s12903-018-0684-2.
Moimaz SAS, Santos LFP, Saliba TA, Saliba NA, Saliba O. External control of fluoride in public water supply: results and experience of 13 years of surveillance. Arch Health Invest 2018; 7(7):262-68. https://doi.org/10.21270/archi.v7i7.3037.
Brito CS, Garbin RR, Mussi A, Rigo L. Monitoring of fluorine concentration of the public water supply in Passo Fundo City-RS. Cad Saude Colet 2016; 24(4):452-9. https://doi.org/10.1590/1414-462x201600040240
Kuhnen M, Gamba B, Narvai PC, Toassi RFC. Quality of treated water: evaluation of fluoride levels in 10 years of heterocontrol in a city of the State of Santa Catarina. Vigil Sanit Debate 2017; 5(1):91-6. https://doi.org/10.3395/2317-269X.00833
Amarante LM, Jitomirski F, Amarante CLF. Fluoride: the benefits and controversies of the fluoridation program. Rev Bras Odontol 1993; 50(4):22-30.
Chaves VR, Silveira OS, Santos RM. Measuring the concentration of fluoride from fluoridated water distributed in the nine health districts of Belo Horizonte - A comparative view of the fluorine content measured by COPASA. Pilot study. Arq Bras Odontol 2012; 8(2):8-15.
Ramires I, Buzalaf MAR. Fifty years of fluoridation of public water supplies in Brazil: benefits for the control of dental caries. Cienc Saude Colet 2007; 12(4):1057-65. https://doi.org/10.1590/S1413-81232007000400027
Sandim, JFI, Sousa KO, Lacerda APAG, Araújo RO, Turibio TO, Gosch CS. Heterocontrole da fluoretação água de fornecimento público de Palmas-TO. In: Nascimento-Rocha JM, Aires RS, Rocha AM, Neves ACD, Araújo RO, Rocha TM. Coletânea Cientifica Presidente Antônio Carlos: informação cientifica baseada em evidências. Tocantins: Faculdade Presidente Antônio Carlos 2016; 1(1):89-98. [In Portuguese].
Roncalli AG, Noro LRA, Cury JA, Zilbovicius C, Pinheiro HHC, Ely HC, et al. Water fluoridation in Brazil: regional distribution and accuracy of information on surveillance in municipalities with more than 50,000 inhabitants. Cad Saude Publica 2019; 35(6):e00250118. https://doi.org/10.1590/0102-311X00250118
Brasil. Ministério da Saúde. Diretrizes da Política Nacional de Saúde Bucal. Coordenação Nacional de Saúde Bucal; 2004. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_brasil_sorridente.pdf. [Accessed on August 12, 2019]. [In Portuguese].
Brasil. Conselho Nacional de Saúde. Resolução 588 de 12 de julho de 2018. Institui a Política Nacional de Vigilância em Saúde (PNVS). Diário Oficial da União, Brasília (2018 jul 12); Seção 1. Available from: https://conselho.saude.gov.br/resolucoes/2018/Reso588.pdf. [Accessed on August 01, 2019]. [In Portuguese].
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pesquisa Brasileira em Odontopediatria e Clínica Integrada
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
