SPATIAL DISTRIBUTION OF RISK FACTORS AND FLUORIDE LEVELS IN PUBLIC WATER SUPPLIES ON A MUNICIPAL SCALE

Authors

DOI:

https://doi.org/10.4215/rm2022.e21021

Keywords:

Fluoride, Water Fluoridation, Environmental Health Surveillance, Health Geography

Abstract

Fluoridation of public water supplies is an important measure to prevent dental caries and is linked to Sustainable Development Objective 6. This study aimed to evaluate the fluoride content of Ceará's municipalities. The research used secondary data from SISAGUA (municipality; year, date, source and point of collection; form of supply; supply system; chlorine and fluoride concentrations) and the IBGE (HDI, population, FIRJAN Municipal Development Index, and estimated population) for spatial distribution and the analysis of fluoride risk factors. Of the 26,390 samples collected, only 17.8% had ideal fluoride content, with a higher prevalence in samples collected in 2016, in isolated urban areas, in water supply systems, and in chlorine levels above the ideal. Of the 182 municipalities evaluated, 16.7% had most of the samples with ideal fluoride content. In a multivariate analysis, municipalities with a population below 30 thousand inhabitants had a prevalence of inadequate fluoride content (below or above the ideal) 2.12 (95% CI = 1.92-4.88) times higher than municipalities with large populations. It is concluded that less than a fifth of Ceará's population is exposed to adequate public water fluoride levels, and cities with fewer than 30,000 inhabitants are the most affected.

Keywords: Fluoride. Water Fluoridation. Environmental Health Surveillance. Health Geography.

Author Biographies

  • Edenilo Baltazar Barreira Filho, Federal University of Ceará, Fortaleza (CE), Brazil

    Sanitarian, Epidemiologist, Currently Resident Advsor in São Tomé and Príncipe by the Brazilian Association of Field Epidemiology Professionals. Graduated in Degree in Geography (1996) and Bachelor in Geography (1999) from the Federal University of Ceará, Bachelor in Law (2009) from the University of Fortaleza. Master in Development and Environment from the Federal University of Ceará (2002) and PhD in Public Health from the Faculty of Medicine, Department of Community Health of the Federal University of Ceará (2014). In the period 1997-1999, he worked in areas of agrarian reform through the LUMIAR project, providing technical assistance to rural settlements, having the opportunity to carry out a specialization in Cooperative Administration (1999), at the University of Brasília (UnB), in partnership with the Movement of Landless Rural Workers (MST). In 2002-2003, he joined the Ceará School of Public Health to structure the Specialization in Surveillance in Environmental Health. In the period 2003-2005 he was a substitute professor at the Department of Geography at the Federal University of Ceará, in the Teaching Practices studies sector. From 2002-2005 he was a consultant for the Ministry of Health in Basic Courses on Environmental Health Surveillance, having participated in the process of structuring Environmental Surveillance in some states of Brazil. In 2005-2008, he assumed the Coordination of Environmental Health Surveillance at the Municipal Health Secretariat of Fortaleza-CE, having participated in the implementation of the Reference Center for Worker's Health (CEREST) in Fortaleza. In 2007-2008, he coordinated the Specialization Course in Surveillance in Environmental Health at the School of Public Health of Ceará, having left to assume, in the period of 2008-2009, the Adviser of the General Coordination of Surveillance in Environmental Health of the Ministry of Health, and in this period assuming the General Coordination of Environmental Health Surveillance (CGVAM), for 2 months. In the period 2010-2012 he coordinated the Sanitary Surveillance of the Municipality of Fortaleza, participating in the structuring of the team to act in mass events. In the year 2012-2018 he coordinated the Law Course at the Faculty of Education and Culture of Ceará, also responsible for the disciplines of Environmental Law, Sustainable Development and Constitutional Law. In 2012 he joined the Community of Practice on the Ecosystem Approach to Human Health in Latin America and the Caribbean-COPEH-LAC, representing Node Brazil. In 2015-2018, he was Supervisor of the Center for Environmental and Worker Surveillance in the State of Ceará, where, in partnership with the Osvaldo Cruz Foundation, he has been structuring at the Ceará Health Department, the Health Impact Assessment resulting from large undertakings, studying the case of the Industrial and Port Complex of Pecém (CIPP) in Ceará. from 2020 to 2021 he was Technical Advisor to the Secretariat for Health Surveillance and Regulation of the Ceará State Health Secretariat.

  • Sharmênia de Araújo Soares Nuto, University of Fortaleza, Fortaleza (CE), Brazil

    PhD in Health Sciences from the Federal University of Rio Grande do Norte (2007). She is currently Researcher in Public Health at the Oswaldo Cruz Foundation (Family Health area) and Full Professor at the University of Fortaleza (UNIFOR). She has experience in Public Health, with an emphasis on Primary Health Care, working mainly on the following topics: teaching, evaluation of services, epidemiology in dentistry, medical anthropology and oral health.

  • Maria Vieira de Lima Saintrain, Federal University of Pernambuco, Recife (PE), Brazil

    PhD in Dentistry in Collective Health from the University of Pernambuco (2003). Post doctorate in Public Health - UNICAMP. Titular Professor T1 at the University of Fortaleza, Researcher at the National Council for Scientific and Technological Development. Specialist in Gerontology from the Federal University of Ceará, certified by the SBGG. Member of the International Epidemiological Association - IEA. He has experience in Public Health, with an emphasis on Public Health, working mainly on the following topics: Public Health, Elderly, Oral Health, Geriatric Dentistry and Epidemiology.

  • Paulo Goberlânio de Barros Silva, Christus University Center, Fortaleza (CE), Brazil

    PhD in Dentistry, by the Graduate Program in Dentistry, at the same university (UFC-2016). Currently, at the Centro Universitário Christus, he teaches the undergraduate courses in Dentistry and Medicine and the Graduate Program in Dental Sciences. At the Instituto do Câncer do Ceará, at Hospital Haroldo Juaçaba, he performs the functions of Biostatistics and Hospital Dentistry, and at Faculdade Rodolfo Teófilo, he performs the functions of professor of the undergraduate course in Nursing and of the Postgraduate Program in Oncology and coordinator of the General Directory Research Center of CNPq (Group of Studies in Oncology). He also collaborates with the Histopathology sector of the Núcleo de Pesquisa e Desenvolvimento de Medicamentos (NPDM-UFC) and provides consultancy in biostatistics.

  • Anya Pimentel Gomes Fernandes Vieira-Meyer, Christus University Center, Fortaleza (CE), Brazil

    PhD in Dentistry at the University of Toronto-Canada (2005) and postdoctoral fellow in Public Health at the University of California Berkeley (2015-2016). She is currently a Specialist Researcher at the Oswaldo Cruz Foundation / FIOCRUZ-CE and Executive Secretary of the Northeast Family Health Training Network-RENASF, in addition to teaching the Dentistry course and the Master's Degree in Dental Sciences at Unichristus. His current lines of research refer to the evaluation of health services; access to health services and violence suffered by vulnerable populations (HIV, children, the elderly, patients with special needs, Bolsa Família beneficiaries, etc.); Family Health; and the impact of the Bolsa Família Program and the Family Health Strategy on the population's health. These focus on the assessment of knowledge, practices, care and health conditions in people in risk groups; evaluate health services in the area of primary care - from the perspective of users, health professionals and managers; as well as the impact of public policies on the health of the population.

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Published

2023-02-04

Issue

Vol. 21 (2022)

Section

Artigos

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