Enduring Fluoride Health Hazard for the Vesuvius Area Population: The Case of AD 79 Herculaneum

Abstract

BackgroundThe study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological lesions. Even today its early stages are misdiagnosed in endemic areas.Methodology/Principal FindingsEndemic fluorosis induced by high concentrations of fluoride in water and soils is a major health problem in several countries, particularly in volcanic areas. Here we describe for the first time the features of endemic fluorosis in the Herculaneum victims of the 79 AD eruption, resulting from long-term exposure to high levels of environmental fluoride which still occur today.Conclusions/SignificanceOur observations on morphological, radiological, histological and chemical skeletal and dental features of this ancient population now suggest that in this area fluorosis was already endemic in Roman times. This evidence merged with currently available epidemiologic data reveal for the Vesuvius area population a permanent fluoride health hazard, whose public health and socio-economic impact is currently underestimated. The present guidelines for fluoridated tap water might be reconsidered accordingly, particularly around Mt Vesuvius and in other fluoride hazard areas with high natural fluoride levels.

A hypothesis of sudden body fluid vaporization in the 79 AD victims of Vesuvius

“…The resulting new site evidence combined with those from laboratory bones analysis allowed to obtain new information on the causes of death and the heat-induced effects on people [ 40 – 43 ]. Further bioanthropological and paleopathological studies were also carried out on the same skeletal sample [ 44 – 47 ].…”

Bone quality in prehistoric, cis‐baikal forager femora: A micro‐CT analysis of cortical canal microstructure

“…For example, abnormal bone formation and resorption patterns indicate the presence of various primary and secondary metabolic diseases (e.g., Aaron et al 1992;Brickley et al, 2007;Mays et al, 2007;De Boer et al, 2013), including those induced by dietary stress (e.g., Armelagos 1979, 1985;Martin et al 1987;Stout and Jackson, 1990;Paine and Brenton, 2006a,b;Brickley et al, 2007;Petrone et al, 2011). For example, abnormal bone formation and resorption patterns indicate the presence of various primary and secondary metabolic diseases (e.g., Aaron et al 1992;Brickley et al, 2007;Mays et al, 2007;De Boer et al, 2013), including those induced by dietary stress (e.g., Armelagos 1979, 1985;Martin et al 1987;Stout and Jackson, 1990;Paine and Brenton, 2006a,b;Brickley et al, 2007;Petrone et al, 2011).…”

“…Histological structures have been used to analyse bone quality and health in past populations. For example, abnormal bone formation and resorption patterns indicate the presence of various primary and secondary metabolic diseases (e.g., Aaron et al 1992;Brickley et al, 2007;Mays et al, 2007;De Boer et al, 2013), including those induced by dietary stress (e.g., Armelagos 1979, 1985;Martin et al 1987;Stout and Jackson, 1990;Paine and Brenton, 2006a,b;Brickley et al, 2007;Petrone et al, 2011). Histology has also been used to examine age-related bone loss (e.g., Armelagos 1979, 1985;Burr et al, 1990;De Boers et al 2013), and differences in cortical microstructure between the sexes also underscore the impact of pregnancy and menopause on the female skeleton (e.g., Armelagos 1979, 1985;Cho and Stout, 2011).…”

“…are not analyzed with the method of Cooper (2005) and colleagues (2007), it does hold the promise of proving useful in better understanding bone quality in past populations. More specifically, it offers a 3D view of the pore systems in cortical bone, which are affected by factors such as genetics (e.g., Weinstein and Bell, 1988;Cho et al, 2006;Schnitzler et al, 2009), sex (e.g., Cho et al, 2006;MacDonald et al, 2011;Nishiyama et al 2012;Kazakia et al, 2013), age (e.g., Jowsey, 1966;Cho et al, 2006;Cooper et al, 2007;Burghardt et al, 2010;MacDonald et al, 2011), diet (e.g., Martin et al 1987Stout and Jackson, 1990;Paine and Brenton, 2006a,b), environment (e.g., Cho et al, 2006;Brickley et al, 2007;Petrone et al, 2011), and activity (e.g., Skedros, 1994Skedros, , 1997Skedros, , 2004van Oers et al, 2008a,b). Additionally, mCT has the potential to circumvent problems associated with diagenetically altered bone because it relies on the preservation of Haversian canals, which are less susceptible to damage due to highly mineralized canal walls (Hanson and Buikstra, 1987;Samson and Branigan, 1987).…”

Association of dental and skeletal fluorosis with calcium intake and serum vitamin D concentration in adolescents from a region endemic for fluorosis

“…This has large crystal size due to which the bone becomes brittle and susceptible to fracture risk. [78] Moreover, young bones retain more fluoride than older bones. [5] Clinical manifestations of fluorosis may be aggravated by malnutrition, specifically calcium and vitamin D nutrition status which is evident from the high incidence of crippling deformities in poor residents from endemic fluorosis zones.…”