Toxicological profiles - Fluorine, hydrogen fluoride, and fluorides

TOXICOLOGICAL PROFILE FOR FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES......Page 1
DISCLAIMER......Page 2
UPDATE STATEMENT......Page 3
FOREWORD......Page 4
QUICK REFERENCE FOR HEALTH CARE PROVIDERS......Page 6
CONTRIBUTORS......Page 8
PEER REVIEW......Page 9
CONTENTS......Page 10
LIST OF FIGURES......Page 13
LIST OF TABLES......Page 14
1. PUBLIC HEALTH STATEMENT......Page 15
1.1 WHAT ARE FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES?......Page 16
1.2 WHAT HAPPENS TO FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES WHEN THEY ENTER THE ENVIRONMENT?......Page 17
1.3 HOW MIGHT I BE EXPOSED TO FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES?......Page 18
1.4 HOW CAN FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES ENTER AND LEAVE MY BODY?......Page 20
1.5 HOW CAN FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES AFFECT MY HEALTH?......Page 21
1.6 HOW CAN FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES AFFECT CHILDREN?......Page 23
1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES?......Page 24
1.8 IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN EXPOSED TO FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES?......Page 25
1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO PROTECT HUMAN HEALTH?......Page 26
1.10 WHERE CAN I GET MORE INFORMATION?......Page 27
2.1 BACKGROUND AND ENVIRONMENTAL EXPOSURES TO FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES IN THE UNITED STATES......Page 29
2.2 SUMMARY OF HEALTH EFFECTS......Page 30
Hydrogen Fluoride.......Page 35
Fluoride......Page 37
3.1 INTRODUCTION......Page 39
3.2 DISCUSSION OF HEALTH EFFECTS BY ROUTE OF EXPOSURE......Page 41
3.2.1 Inhalation Exposure......Page 42
3.2.1.1 Death......Page 43
3.2.1.2 Systemic Effects......Page 45
Cardiovascular Effects.......Page 65
Hematological Effects.......Page 66
Hepatic Effects.......Page 69
Renal Effects.......Page 70
3.2.1.4 Neurological Effects......Page 72
3.2.1.5 Reproductive Effects......Page 73
3.2.1.7 Cancer......Page 74
3.2.2 Oral Exposure......Page 75
3.2.2.1 Death......Page 76
3.2.2.2 Systemic Effects......Page 78
3.2.2.3 Immunological and Lymphoreticular Effects......Page 107
3.2.2.5 Reproductive Effects......Page 108
3.2.2.6 Developmental Effects......Page 111
3.2.2.7 Cancer......Page 113
3.2.3.1 Death......Page 119
Respiratory Effects.......Page 120
Dermal Effects.......Page 121
Ocular Effects.......Page 123
3.3 GENOTOXICITY......Page 131
3.4.1.1 Inhalation Exposure......Page 135
3.4.1.2 Oral Exposure......Page 136
3.4.1.3 Dermal Exposure......Page 139
3.4.2.1 Inhalation Exposure......Page 140
3.4.2.2 Oral Exposure......Page 141
3.4.3 Metabolism......Page 144
3.4.4.1 Inhalation Exposure......Page 145
3.4.4.2 Oral Exposure......Page 146
3.4.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models......Page 148
3.5 MECHANISMS OF ACTION......Page 152
3.6 TOXICITIES MEDIATED THROUGH THE NEUROENDOCRINE AXIS......Page 155
3.7 CHILDREN’S SUSCEPTIBILITY......Page 156
3.8 BIOMARKERS OF EXPOSURE AND EFFECT......Page 158
3.8.1 Biomarkers Used to Identify or Quantify Exposure to Fluorine, Hydrogen Fluoride, and Fluorides......Page 159
3.8.2 Biomarkers Used to Characterize Effects Caused by Fluorine, Hydrogen Fluoride, and Fluorides......Page 161
3.10 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE......Page 162
3.11 METHODS FOR REDUCING TOXIC EFFECTS......Page 163
3.11.1 Reducing Peak Absorption Following Exposure......Page 164
3.11.2 Reducing Body Burden......Page 165
3.11.3 Interfering with the Mechanism of Action for Toxic Effects......Page 166
3.12 ADEQUACY OF THE DATABASE......Page 167
3.12.1 Existing Information on Health Effects of Fluorine, Hydrogen Fluoride, and Fluorides......Page 168
3.12.2 Identification of Data Needs......Page 172
3.12.3 Ongoing Studies......Page 181
4.2 PHYSICAL AND CHEMICAL PROPERTIES......Page 183
5.1 PRODUCTION......Page 187
5.3 USE......Page 188
5.4 DISPOSAL......Page 194
6.1 OVERVIEW......Page 196
6.2.1 Air......Page 199
6.2.3 Soil......Page 206
6.3.1 Transport and Partitioning......Page 207
6.3.2.2 Water......Page 209
6.4.1 Air......Page 210
6.4.2 Water......Page 211
6.4.3 Sediment and Soil......Page 213
6.4.4 Other Environmental Media......Page 214
6.5 GENERAL POPULATION AND OCCUPATIONAL EXPOSURE......Page 216
6.6 EXPOSURES OF CHILDREN......Page 220
6.7 POPULATIONS WITH POTENTIALLY HIGH EXPOSURES......Page 224
6.8 ADEQUACY OF THE DATABASE......Page 228
6.8.1 Identification of Data Needs......Page 229
6.8.2 Ongoing Studies......Page 232
7.1 BIOLOGICAL MATERIALS......Page 233
7.2 ENVIRONMENTAL SAMPLES......Page 236
Methods for Determining Biomarkers of Exposure and Effect.......Page 242
7.3.2 Ongoing Studies......Page 243
8. REGULATIONS AND ADVISORIES......Page 244
9. REFERENCES......Page 254
Ceiling Value......Page 326
Immunologic Toxicity......Page 327
Neurotoxicity......Page 328
Prospective Study......Page 329
Standard cubic meter (scm)......Page 330
Xenobiotic......Page 331
ATSDR MINIMAL RISK LEVEL AND WORKSHEETS......Page 332
MINIMAL RISK LEVEL (MRL) WORKSHEET......Page 334
USER'S GUIDE......Page 342
ACRONYMS, ABBREVIATIONS, AND SYMBOLS......Page 349