The occurrence of fluorosis, a medical condition that affects both the growth of healthy teeth and in extreme conditions can cause deformation of skeletal structure leading to crippling, is one manifestation that attests to the intersections between two environmental issues: safe water supply and energy consumption. UNICEF has reported that China is one of countries with the greatest number of dental and skeletal fluorosis cases in the world. The World Health Organization estimates that 2.7 million people in China have skeletal fluorosis and Chinese sources’ estimates range from 2 million to 2.8 million cases of skeletal fluorosis while 38 million people suffer from the dental form.

While fluorine is essential for the healthy development of teeth, over-exposure of fluorine—either by ingestion, skin contact, or inhalation—can cause yellow, brown and eventually black staining of the teeth, and in extreme cases, deformation and pain of bones and joints.

Reports on fluorosis in China usually either focus on cases from impoverished regions in the south, or cases from the northeast. In actuality, the causes for the prevalence in these two regions are different; in northeastern China, the source of excess fluorine is groundwater that does not meet national drinking water standards, while in southern China, the mining and consumption of sub-standard coal is the main source of over-exposure. The difference in the exposure sources represents an overall picture of natural geography and environmental safety of China.

China, especially northern China relies heavily on groundwater, which can contain metals and other pollutants in high concentrations, for domestic usage. Fluorine is one of such elements. Although Fluorine is nationally regulated to 1 mg/L in drinking water, it is often found in amounts far above that. In a recent study on the geological background and source of fluorine in drinking water in China found that fluorine in groundwater ranges from 1-22mg/L in Shandong Province, 1-22mg/L in Shanxi Province and 1-12mg/L in Shaanxi Province. In some rural areas, drinking water may not be properly treated, resulting in residents’ exposure to fluorine. Northern China is rich in coal deposits, which can lead to higher concentrations of fluorine in groundwater.

The reports that focus on skeletal fluorosis in southern China however do not draw as much attention to ingestion of sub-standard drinking water, but rather to coal mining and consumption. However, compared to northern China, the south is poor in coal deposits. Why then, is most coverage on fluorosis in the south focused on the inhalation of coal fumes? There are two reasons. One, precisely because coal deposits are more scarce in the south, a powdery form of coal is mined out and mixed with clay to make into coal bricks. The additional clay content contains an amount of fluorine ten times the amount in the coal itself and when the coal bricks are burned, poor ventilation causes high exposure to residents. Secondly, because of the wet local climate, vegetables that are customarily dried for winter storage must be smoked in order to be effectively preserved. The smoke, which comes from burning high-fluorine coal bricks, is absorbed into drying corn and peppers, and ingested orally, adding to rural residents’ already high fluorine exposure.

For the past twenty years the Chinese government has been cooperating with international organizations to decrease risk from the slow poisoning effect of fluorine. In the south the central government even allocated funds to change and upgrade furnaces to reduce coal fumes. In the north, water treatment methods are constantly being upgraded. In at least the last three Five-Year Plans, the issue of fluorosis was addressed, with goals for decreasing the prevalence of the disease, whose effects range from social discrimination because of stained teeth to citizens who are completely crippled by the age of 40. Because coal and water in themselves are considered scarce commodities in some areas however, the battle to decrease fluorosis in China will continue to be an issue in coming years.

The occurrence of fluorosis, a medical condition that at affects both the growth of healthy teeth and in extreme conditions can cause deformation of skeletal structure leading to crippling, is one manifestation that attests to the intersections between two environmental issues: safe water supply and energy consumption. UNICEF has reported that China is one of countries with the greatest number of dental and skeletal fluorosis cases in the world. The World Health Organization estimates that 2.7 million people in China have skeletal fluorosis and Chinese sources’ estimates range from 2 million to 2.8 million cases of skeletal fluorosis while 38 million people suffer from the dental form.

While fluorine is essential for the healthy development of teeth, over-exposure of fluorine—either by ingestion, skin contact, or inhalation—can cause yellow, brown and eventually black staining of the teeth, and in extreme cases, deformation and pain of bones and joints.

Reports on fluorosis in China usually either focus on cases from impoverished regions in the south, or cases from the northeast. In actuality, the causes for the prevalence in these two regions are different; in northeastern China, the source of excess fluorine is groundwater that does not meet national drinking water standards, while in southern China, the mining and consumption of sub-standard coal is the main source of over-exposure. The difference in the exposure sources represents an overall picture of natural geography and environmental safety of China.

China, especially northern China relies heavily on groundwater, which can contain metals and other pollutants in high concentrations, for domestic usage. Fluorine is one of such elements. Although Fluorine is nationally regulated to 1 mg/L in drinking water, it is often found in amounts far above that. In a recent study on the geological background and source of fluorine in drinking water in China found that fluorine in groundwater ranges from 1-22mg/L in Shandong Province, 1-22mg/L in Shanxi Province and 1-12mg/L in Shaanxi Province. In some rural areas, drinking water may not be properly treated, resulting in residents’ exposure to fluorine. Northern China is rich in coal deposits, which can lead to higher concentrations of fluorine in groundwater.

The reports that focus on skeletal fluorosis in southern China however do not draw as much attention to ingestion of sub-standard drinking water, but rather to coal mining and consumption. However, compared to northern China, the south is poor in coal deposits. Why then, is most coverage on fluorosis in the south focused on the inhalation of coal fumes? There are two reasons. One, precisely because coal deposits are more scarce in the south, a powdery form of coal is mined out and mixed with clay to make into coal bricks. The additional clay content contains an amount of fluorine times the amount in the coal itself and when the coal bricks are burned, poor ventilation causes high exposure to residents. Secondly, because of the wet local climate, vegetables that are customarily dried for winter storage must be smoked in order to be effectively preserved. The smoke, which comes from burning high-fluorine coal bricks, is absorbed into drying corn and peppers, and ingested orally, adding to rural residents’ already high fluorine exposure.

For the past twenty years the Chinese government has been cooperating with international organizations to decrease risk from the slow poisoning effect of fluorine. In the south the central government even allocated funds to change and upgrade furnaces to reduce coal fumes. In the north, water treatment methods are constantly being upgraded. In at least the last three Five-Year Plans, the issue of fluorosis was addressed, with goals for decreasing the prevalence of the disease, whose effects range from social discrimination because of stained teeth to citizens who are completely crippled by the age of 40. Because coal and water in themselves are considered scarce commodities in some areas however, the battle to decrease fluorosis in China will continue to be an issue in coming years.

Posted in China, Energy, Water Resources | No Comments »