Janessa M. Stream Graves

Project title: Employing a Simple Research Protocol to Investigate a Children's Environmental Health Concern: Fluoride and Fluorosis among San Juan Island Children

Degree: MPH | Program: Environmental and Occupational Health (EOH) | Project type: Thesis/Dissertation
Completed in: 2008


Residents of San Juan Island (population 15,700) in Washington State obtain drinking water from municipal systems and public and private wells. Mandated testing of public water systems and new building sites, revealed naturally occuring fluoride levels up to several times the EPA's limit of 4.0 mg/L (0.51-12.45 mg/L).

This research developed simple, replicable, and cost-effective methods that allowed for rapid assessment of the potential health effects associated with the observed fluoride levels. A cross-sectional study design was employed to examine exposure to fluoride through drinking water and the prevalence of dental fluorosis among children with recently erupted permanent teeth. This study determined children's exposure to fluoride from home water sources and other sources (e.g. oral dentrifrice, prescribed fluoride) and dental fluorosis prevalence through examinations.

The project revealed a low prevalence of dental fluorosis and low fluoride levels in the sampled water. Additionally, it illustrated effective use of simple protocols to respond to community concerns regarding environmental health risks that might be costly and time-consuming to investigate otherwise. These methods can be applied to other environmental and children's health concerns by kicak health departments and practitioners.