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Contribution to the ongoing discussion on fluoride toxicity

Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Guth, Sabine;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Hüser, Stephanie;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Roth, Angelika;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Degen, Gisela;
Affiliation
Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
Diel, Patrick;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Edlund, Karolina; Eisenbrand, Gerhard;
Affiliation
Department of General Food Technology, School of Life Sciences, TU Munich, Freising, Germany
Engel, Karl-Heinz;
Affiliation
Institute of Pharmacy and Biochemistry, University of Mainz, Mainz, Germany
Epe, Bernd;
Affiliation
Department of Molecular Toxicology, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
Grune, Tilman;
Affiliation
German Institute of Food Technologies (DIL), Quakenbrück, Germany
Heinz, Volker;
Affiliation
Department of Food Chemistry, TU Dresden, Dresden, Germany
Henle, Thomas;
Affiliation
Institute of Food Chemistry, Westfälische Wilhelms-Universität Münster, Münster, Germany
Humpf, Hans-Ulrich;
Affiliation
Institute of Food Technology, University of Natural Resources and Life Sciences (BOKU), Vienna, Austria
Jäger, Henry;
Affiliation
Department of Molecular Toxicology, German Institute of Human Nutrition (DIfE), Nuthetal, Germany
Joost, Hans-Georg;
GND
124606687
Affiliation
Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
Kulling, Sabine E.;
Affiliation
Department of Food Safety, Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
Lampen, Alfonso;
Affiliation
Department of Toxicology, University of Würzburg, Würzburg, Germany
Mally, Angela;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Marchan, Rosemarie;
Affiliation
Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
Marko, Doris;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Mühle, Eva;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Nitsche, Michael A.;
Affiliation
Department of Experimental Pharmacology and Toxicology, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
Röhrdanz, Elke;
Affiliation
Institute of Food Safety and Analytic Sciences, Nestlé Research Centre, Lausanne, Switzerland
Stadler, Richard;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
van Thriel, Christoph;
Affiliation
Paul-Ehrlich-Institut, Langen, Germany
Vieths, Stefan;
Affiliation
Lehrstuhl für Technische Mikrobiologie, TU Munich, Freising, Germany
Vogel, Rudi F.;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Wascher, Edmund;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Watzl, Carsten;
Affiliation
Department of Nutrition and Food Sciences, Nutritional Epidemiology, Rheinische Friedrich-Wilhelms University Bonn, Bonn, Germany
Nöthlings, Ute;
Affiliation
Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
Hengstler, Jan G.

Since the addition of fluoride to drinking water in the 1940s, there have been frequent and sometimes heated discussions regarding its benefits and risks. In a recently published review, we addressed the question if current exposure levels in Europe represent a risk to human health. This review was discussed in an editorial asking why we did not calculate benchmark doses (BMD) of fluoride neurotoxicity for humans. Here, we address the question, why it is problematic to calculate BMDs based on the currently available data. Briefly, the conclusions of the available studies are not homogeneous, reporting negative as well as positive results; moreover, the positive studies lack control of confounding factors such as the influence of well-known neurotoxicants. We also discuss the limitations of several further epidemiological studies that did not meet the inclusion criteria of our review. Finally, it is important to not only focus on epidemiological studies. Rather, risk analysis should consider all available data, including epidemiological, animal, as well as in vitro studies. Despite remaining uncertainties, the totality of evidence does not support the notion that fluoride should be considered a human developmental neurotoxicant at current exposure levels in European countries.

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