From: Association of Down's syndrome and water fluoride level: a systematic review of the evidence
Study Details | Outcome and exposure | Inclusion/Exclusion | Group | Water | Number of | Results |
---|---|---|---|---|---|---|
 | details | Criteria |  | fluoride level | live births* | (crude risk) |
 |  |  |  | (parts per |  | per 100 000* |
 |  |  |  | million) |  |  |
Author (year) | Method of outcome | Inclusion criteria | Group 1: | 0.7–1.1 | 20760 | 159.0 |
Berry (1958) | assessment: | Children born in study | Group 2: | 1.9–2.0 | 14710 | 122.4 |
Region of study | Institutions, death | areas during study | Group 3: | 0.9 | 9492 | 137.0 |
Essex, England | certificates, records of | period, mothers living | Group 4: | <0.2 | 12620 | 190.2 |
Year study started | medical officers of | in study area at time of | Group 5: | <0.2 | 11587 | 164.0 |
1945 | health authorities, | birth | Group 6: | 0.2 | 22452 | 164.8 |
Study Length | personal knowledge of | Â | Group 7: | 0.2 | 14873 | 107.6 |
9 years | health visitors | Â | Control: | 0.2 | 6870 | 131.0 |
Author (year) | Method of outcome | Inclusion criteria | Â | Â | Metropolitan | Â |
Erickson(1976) | assessment: | Birth of white children | Â | Â | area | Â |
Region of study | Cases identified through | only, areas in which | Group 1: | High | 95254 | 99 |
Georgia, USA | surveillance | mothers' usual place | Group 2: | Low | 25373 | 85 |
Year study started | programmes, data was | of residence at birth of | Â | Â | NIS | p>0.05 |
1960–1973 | supplemented by a | child permitted |  |  | surveillance |  |
Study Length | retrospective | determination of | Â | Â | areas | Â |
13 years | ascertainment (using | exposure to fluoridated | Group 1: | Â | 234300 | 49 |
 | multiple sources) of | water | Group 2: |  | 1032100 | 51 |
 | children born between |  |  |  |  | p>0.05 |
 | 1960 and 1967. |  |  |  |  |  |
Author (year) | Method of outcome | Inclusion criteria | Â | Â | Â | Â |
Erickson(1980) | assessment: | Cities with 1970 | Â | Â | Â | Â |
Region of study | Data from birth | populations >= 250 | Â | Â | Â | Â |
USA | certificates obtained | 000, Cities fluoridated | Group 1: | >= 0.7 | 432580 | 41.1 |
Year study started | from US Nation Center | for >= 5 years by 1973 | Group 2: | 0.7 | 204185 | 44.1 |
1973 | for Health Statistics, | Exclusion criteria | Â | Â | Â | Â |
Study Length | denominator number of | Cities with mixed | Â | Â | Â | Indirect age |
2 years | live births in study areas | fluoridation status | Â | Â | Â | standardised |
 |  | States which do not |  |  |  | rates: |
 |  | report birth defects on |  |  |  | 41.0 |
 |  | birth certificates |  |  |  | 44.0 |
 |  | Cities fluoridated for |  |  |  |  |
 |  | <5 years by 1973 |  |  |  |  |
Author (year) | Method of outcome | Inclusion criteria | Group 1: | 1 | 81017 | 153.1 |
Needleman(1974) | assessment: | Children born with | Group 2: | 0.3 | 1752435 | 133.8 |
Region of study | Cases identified through | Down's's syndrome | Â | Â | Â | Â |
Massachusetts, USA | maternity and paediatric | Â | Â | Â | Â | Â |
Year study started | hospitals, Departments | Â | Â | Â | Â | Â |
1950 | of Public and Mental | Â | Â | Â | Â | Â |
Study Length | Health, private nurseries | Â | Â | Â | Â | Â |
17 years | and school for mentally | Â | Â | Â | Â | Â |
 | retarded children, |  |  |  |  |  |
 | karyotyping laboratories |  |  |  |  |  |
 | and several |  |  |  |  |  |
 | miscellaneous sources |  |  |  |  |  |
Author (year) | Method of outcome | Inclusion criteria | Group 1: | 1.0–2.6 | 67053 | 71.6 |
Rapaport (1963) | assessment: | All cases children with | Group 2: | 0.3–0.7 | 70111 | 47.1 |
Region of study | Cases identified from | Down's's syndrome | Group 3: | 0.1–0.2 | 132665 | 39.2 |
Illinois, USA | birth and death | born during study | Group 4 | 0.0 | 63521 | 23.6 |
Year study started | certificates, registers of | period | Â | Â | Â | Â |
1950 | specialist medical | Town (of mother's | Â | Â | Â | Â |
Study Length | educational state | residence) size 10 000 | Â | Â | Â | Â |
6 years | institutions | -100 000 | Â | Â | Â | Â |
Author (year) | Method of outcome | Inclusion criteria | Dakota | Â | Â | Â |
Rapaport (1957) | assessment: | Not stated | Group 1: | >3 | 31575 | 34.8 |
Region of study | Alive subjects with | Exclusion criteria | Group 2: | <3 | 467685 | 15.2 |
USA | Down's's syndrome | Not stated | Illinois | Â | Â | Â |
Year study started | identified through |  | Group 1: | 1.6–2.6 | 41618 | 14.4 |
Not stated | institutions (cases living |  | Group 2: | 1.0–1.2 | 210628 | 11.4 |
Study Length | in the community not |  | Group 3: | 0.4–0.7 | 196258 | 12.2 |
Not stated | identified) | Â | Group 4 | 0.3 | 151167 | 6.6 |
 |  |  | Group 5: | 0.1–0.2 | 670120 | 6.0 |
 |  |  | Group 6: | 0.0 | 7049 | 3.9 |
 |  |  | Wisconsin |  |  |  |
 |  |  | Group 1: | 2.8 | 52735 | 30.3 |
 |  |  | Group 2: | 1.4 | 21538 | 32.5 |
 |  |  | Group 3: | 0.5 | 51189 | 25.4 |
 |  |  | Group 4 | 0.1 | 1076876 | 13.5 |