Serum fluoride in relation to the prevalence of skeletal fluorosis was
investigated in two villages in Jiangsu Province, China. In the high-fluoride village
of Wamiao, 132 adults (average age 52.36 years; water fluoride 2.18±0.86mg/L;
range 0.85–4.50mg/L) were surveyed. In the low-fluoride village of Xinhuai, 35 adults
(average age 48.11 years; water fluoride 0.37±0.09 mg/L; range 0.21–0.55mg/L) were
surveyed. Subjects were recruited by sampling according to the fluoride content of
the drinking water in their household wells. When the subjects were divided into five
subgroups according to their serum fluoride concentration, higher serum fluoride
concentration was strongly associated with a higher prevalence of skeletal
fluorosis in the form of a significant positive dose-response relationship
(regression equation: Y = –27.29+890.42X–223.20X2). In Wamiao village a significant
difference was also found between serum fluoride concentrations in 41 subjects
with X-ray detectable skeletal fluorosis and in 91 subjects without X-ray detectable
skeletal fluorosis. Gender related differences in serum fluoride concentration,
household well water fluoride, and the prevalence of skeletal fluorosis were not
found in the subjects in Wamiao village. These findings indicate that serum fluoride
concentrations have a significant positive dose-response relationship with the
prevalence of skeletal fluorosis in an endemic fluorosis area associated with highfluoride
drinking water.