Craig L, Lutz A, Berry KA, Yang W. Recommendations for fluoride limits in drinking water based on estimated daily fluoride intake in the Upper East Region, Ghana. The Science of the Total Environment. 2015 Jun 6;532:127-137. doi: 10.1016/j.scitotenv.2015.05.126.
Both dental and skeletal fluorosis caused by high fluoride intake are serious public health concerns around the world. Fluorosis is particularly pronounced in developing countries where elevated concentrations of naturally occurring fluoride are present in the drinking water, which is the primary route of exposure. The World Health Organization recommended limit of fluoride in drinking water is 1.5mgF–L-1, which is also the upper limit for fluoride in drinking water for several other countries such as Canada, China, India, Australia, and the European Union. In the United States the enforceable limit is much higher at 4mgF–L-1, which is intended to prevent severe skeletal fluorosis but does not protect against dental fluorosis. Many countries, including the United States, also have notably lower unenforced recommended limits to protect against dental fluorosis. One consideration in determining the optimum fluoride concentration in drinking water is daily water intake, which can be high in hot climates such as in northern Ghana. The results of this study show that average water intake is about two times higher in Ghana than in more temperate climates and, as a result, the fluoride intake is higher. The results also indicate that to protect the Ghanaian population against dental fluorosis, the maximum concentration of fluoride in drinking water for children under 6-8years should be 0.6mgF–L-1 (and lower in the first two years of life), and the limit for older children and adults should be 1.0mgF–L-1. However, when considering that water treatment is not cost-free, the most widely recommended limit of 1.5mgF–L-1 – which is currently the limit in Ghana – may be appropriate for older children and adults since they are not vulnerable to dental fluorosis once the tooth enamel is formed.
Rochelle-Newall E, Nguyen TM, Le TP, Sengtaheuanghoung O, Ribolzi O. A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions. Frontiers in Microbiology. 2015 Apr 17;6:308. doi: 10.3389/fmicb.2015.00308.
Given the high numbers of deaths and the debilitating nature of diseases caused by the use of unclean water it is imperative that we have an understanding of the factors that control the dispersion of water borne pathogens and their respective indicators. This is all the more important in developing countries where significant proportions of the population often have little or no access to clean drinking water supplies. Moreover, and notwithstanding the importance of these bacteria in terms of public health, at present little work exists on the persistence, transfer and proliferation of these pathogens and their respective indicator organisms, e.g., fecal indicator bacteria (FIB) such as Escherichia coli and fecal coliforms in humid tropical systems, such as are found in South East Asia or in the tropical regions of Africa. Both FIB and the waterborne pathogens they are supposed to indicate are particularly susceptible to shifts in water flow and quality and the predicted increases in rainfall and floods due to climate change will only exacerbate the problems of contamination. This will be furthermore compounded by the increasing urbanization and agricultural intensification that developing regions are experiencing. Therefore, recognizing and understanding the link between human activities, natural process and microbial functioning and their ultimate impacts on human health are prerequisites for reducing the risks to the exposed populations. Most of the existing work in tropical systems has been based on the application of temperate indicator organisms, models and mechanisms regardless of their applicability or appropriateness for tropical environments. Here, we present a short review on the factors that control FIB dynamics in temperate systems and discuss their applicability to tropical environments. We then highlight some of the knowledge gaps in order to stimulate future research in this field in the tropics.