Journal of Public Health Dentistry 2003; 63(Suppl 1): S36

Water Fluoridation and Blood Lead Levels in US Children

Mark Macek, DDS, DrPH, University of Maryland Dental School, Baltimore, MD; Thomas Matte, MD, PhD and Thomas Sinks, PhD, National Center for Environmental Health, CDC; Dolores Malvitz, DrPH, Division of Oral Health, CDC, Atlanta, GA

Objective: The purpose was to use national data to determine whether an association exists between type of water fluoridation (WF) and blood lead levels (BLL) among children aged 1-16 years. Methods: Data on BLL and known demographic correlates of BLL came from the Third National Health and Nutrition Examination Survey. The 1992 Water Fluoridation Census was used to determine WF for the water systems serving each jurisdiction. The dependent variable was BLL (micrograms/dL), and independent variables were WF, age, gender, race/ethnicity, poverty status, and age of dwelling (before 1946, 1946-1973, 1974-present). SUDAAN was used to account for the complex sample design. Results: Multivariate linear regression showed that the WF/BLL association was part of a significant interaction with age of dwelling. Using [age of dwelling=1974-present plus WF=no fluoride] as the reference, BLLs for [WF=all types plus age of dwelling=before 1946], as well as [WF=unknown, natural, and none plus age of dwelling=1946-73] were significantly higher than the reference. Conclusions: Any WF/BLL association appears to be dependent on, and strongly influenced by, age of dwelling. Findings should be viewed in the context of other biological and environmental findings.

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