External control of fluoridation in the Metropolitan Region of Curitiba in the years of 2014 and 2015

Abstract Introduction External control is the monitoring of fluoride concentration in the water supply that must be done by state institutions, and has been motivated to ensure the efficacy and safety of fluoridation. This study aimed to analyze the external control of municipalities with more than 50.000 inhabitants in the metropolitan region of Curitiba in the years 2014 and 2015. Methodology Health surveillance services of the studied municipalities provided external control data, which were analyzed according to the technical criterion of the CECOL for fluoride content. Results Collection of water samples failed in some municipalities and months for an adequate number for the fluoride parameter. From the total samples analyzed, only 51.5% were in the best benefit-risk range for the fluoride concentration. Eight percent of the samples presented insignificant benefit and risk and 0.1% showed a high-risk fluoride concentration, without any benefit. Conclusion the analyzed municipalities performed the external control, with periods of inadequate sample collections. Fluoride concentrations in the supply water of the study municipalities presented an unsatisfactory result. The main goal of external control is to maintain fluoride levels at adequate levels.

【摘要】外部管控是指国家机构必须开展的供水氟化物浓度监测工作，其实施目的为保障饮水氟化（water fluoridation）的有效性与安全性。本研究旨在对2014至2015年间库里蒂巴都会区人口超过5万的自治市开展外部管控情况分析。

研究方法：本研究通过各受访自治市的卫生监测服务获取外部管控相关数据，并依据CECOL制定的氟化物含量技术标准进行数据分析。

研究结果：部分自治市及部分月份的水样采集量未达到氟化物参数检测所需的合格样本规模。在全部完成分析的样本中，仅51.5%的氟化物浓度处于最优效益-风险区间内；8%的样本仅表现出极微弱的效益与风险，另有0.1%的样本氟化物浓度处于高风险区间且无任何健康获益。

研究结论：本研究涉及的自治市均开展了外部管控工作，但存在水样采集时段不达标等问题。研究区域内自治市的供水氟化物浓度结果未达理想水平。外部管控的核心目标是将供水氟化物浓度维持在适宜范围内。