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Skeletal fluorosis from the point of view of an occupational exposure to fluorides in former Czechoslovakia

Buchancová J, Poláček H, Hudečková H, Murajda L, Osina O, Valachová J - Interdiscip Toxicol (2008)

Bottom Line: The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry.The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum).Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments.Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers).The last occupational case was registered in the year 2001.

Affiliation: Institute of Public Health, Jessenius Faculty of Medicine Comenius University, Martin, SLOVAKIA.

ABSTRACT

Electrolytic production of aluminium in former Czechoslovakia started in the year 1953 in the Žiar valley in the central Slovakia. However, till 1995 the hygienic conditions for health protection were not met in the factory. It underwent a reconstruction afterwards.The authors demonstrate cases of occupational skeletal fluorosis (currently rare in Europe) in 14 metallurgists which were all disclosed in foundry workers in Žiar nad Hronom as to the year 2005. The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry.The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum). The content of fluorides in urine was increased (254.4±130.95 µmol/l). The average age of patients at the time of recognition of the professional etiology of the disease was 57.93±7.95 years. Eight patients were older than 60 years. Skeletal abnormalities were evaluated by using X-ray skiagraphy, estimating the Stage I-III of the skeletal fluorosis. Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments. Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers).The last occupational case was registered in the year 2001. The authors assume that aluminium production with modern technology of better safety and protection of health of workers is the key which will make the skeletal fluorosis the history in the Czech and Slovak Republic.

Skeletal fluorosis (Stage III). Exostoses in area of foramen obturatorium dx. I (low arrows).
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Figure 0003: Skeletal fluorosis (Stage III). Exostoses in area of foramen obturatorium dx. I (low arrows).

Mentions: Mean values of fluorides in urine give evidence of a 5-time exceeding of the values in non-exposed population. In 3 cases the indicative biological cut-off value was exceeded. Bone fluorosis in the group was assessed after occupational-medical examination, objectivisation of the exposure, according to x-ray findings by radiological specialists as: Stage I in 9 cases, Stage II in 3 cases, Stage II–III in 2 cases. Typical x-ray findings were the calcifications in the area of interosseal membrane between radius and ulna (Figure 1) and between tibia and fibula, tendinous exostoses in the area of foramen obturatorium of the pelvic bones (Figure 3), ossifications in area of spina iliaca anterior et superior, coarsening of compacta of the long bones of limbs with narrowing of the bone marrow cavity (Figure 2) and pseudoperiostoses of lower margines of ribs (Figure 4). In some cases it was augmentation of a density of the skelet in lumbosacral and pelvic areas and different osteophytic periostoses. Four patients had dense flebolites on x-ray of the pelvic area.

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Skeletal fluorosis from the point of view of an occupational exposure to fluorides in former Czechoslovakia

Buchancová J, Poláček H, Hudečková H, Murajda L, Osina O, Valachová J - Interdiscip Toxicol (2008)

Skeletal fluorosis (Stage III). Exostoses in area of foramen obturatorium dx. I (low arrows).
© Copyright Policy - open-access
Figure 0003: Skeletal fluorosis (Stage III). Exostoses in area of foramen obturatorium dx. I (low arrows).
Mentions: Mean values of fluorides in urine give evidence of a 5-time exceeding of the values in non-exposed population. In 3 cases the indicative biological cut-off value was exceeded. Bone fluorosis in the group was assessed after occupational-medical examination, objectivisation of the exposure, according to x-ray findings by radiological specialists as: Stage I in 9 cases, Stage II in 3 cases, Stage II–III in 2 cases. Typical x-ray findings were the calcifications in the area of interosseal membrane between radius and ulna (Figure 1) and between tibia and fibula, tendinous exostoses in the area of foramen obturatorium of the pelvic bones (Figure 3), ossifications in area of spina iliaca anterior et superior, coarsening of compacta of the long bones of limbs with narrowing of the bone marrow cavity (Figure 2) and pseudoperiostoses of lower margines of ribs (Figure 4). In some cases it was augmentation of a density of the skelet in lumbosacral and pelvic areas and different osteophytic periostoses. Four patients had dense flebolites on x-ray of the pelvic area.

Bottom Line: The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry.The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum).Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments.Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers).The last occupational case was registered in the year 2001.

Affiliation: Institute of Public Health, Jessenius Faculty of Medicine Comenius University, Martin, SLOVAKIA.

ABSTRACT

Electrolytic production of aluminium in former Czechoslovakia started in the year 1953 in the Žiar valley in the central Slovakia. However, till 1995 the hygienic conditions for health protection were not met in the factory. It underwent a reconstruction afterwards.The authors demonstrate cases of occupational skeletal fluorosis (currently rare in Europe) in 14 metallurgists which were all disclosed in foundry workers in Žiar nad Hronom as to the year 2005. The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry.The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum). The content of fluorides in urine was increased (254.4±130.95 µmol/l). The average age of patients at the time of recognition of the professional etiology of the disease was 57.93±7.95 years. Eight patients were older than 60 years. Skeletal abnormalities were evaluated by using X-ray skiagraphy, estimating the Stage I-III of the skeletal fluorosis. Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments. Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers).The last occupational case was registered in the year 2001. The authors assume that aluminium production with modern technology of better safety and protection of health of workers is the key which will make the skeletal fluorosis the history in the Czech and Slovak Republic.

View Similar Images In: Results  - Collection
View Article: PubMed Central -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=2993488&rFormat=json&query=null&req=5