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Table 2 Individual study details and results

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

 

Group 7:

0.2

14873

107.6

9 years

health visitors

 

Control:

0.2

6870

131.0

Author (year)

Method of outcome

Inclusion criteria

  

Metropolitan

 

Erickson(1976)

assessment:

Birth of white children

  

area

 

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

  

NIS

p>0.05

1960–1973

supplemented by a

child permitted

  

surveillance

 

Study Length

retrospective

determination of

  

areas

 

13 years

ascertainment (using

exposure to fluoridated

Group 1:

 

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

    

Erickson(1980)

assessment:

Cities with 1970

    

Region of study

Data from birth

populations >= 250

    

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

    

Study Length

denominator number of

Cities with mixed

   

Indirect age

2 years

live births in study areas

fluoridation status

   

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

    

Massachusetts, USA

maternity and paediatric

     

Year study started

hospitals, Departments

     

1950

of Public and Mental

     

Study Length

Health, private nurseries

     

17 years

and school for mentally

     
 

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

    

1950

specialist medical

Town (of mother's

    

Study Length

educational state

residence) size 10 000

    

6 years

institutions

-100 000

    

Author (year)

Method of outcome

Inclusion criteria

Dakota

   

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

   

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)

 

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

  1. * Rapaport (1957) did not report the total number of births, for this study the population figures are provided and the crude risk is the risk per 100 000 population