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摘要:
氟是存在于自然环境中的一种人体必需的微量元素，其在环境中的缺乏或过剩可能导致健康问题。本文综述了氟在自然界如大气、岩石、土壤、水体、植物中的来源，分析了其形态及含量受环境影响的因素如地形、雨水淋溶、土壤母质、土壤酸碱度、土壤有机质等。氟的来源广泛，目前全球超过2.6亿人受氟带来的环境问题影响，因此开展健康风险评估具有重要意义。氟的健康风险评估常用的风险评估模型有危害系数（Hazard Quotient）、危害指数（Hazard Index），概率方法也常运用于风险分析中，目前还出现应用多途径暴露评估法对氟进行评估，不确定性和灵敏度的研究对于评估模型尤为关键。本文比较了传统模型的可行性和局限性，认为确定氟富集的途径，完善复合暴露评估的模式，考虑氟摄入的生物有效性，对于氟的健康风险评估十分必要；氟的健康风险评估下一步的研究还可以趋向于使用模型对氟的风险进行预测；对于氟的来源、赋存状态、迁移途径以及含量影响因素等仍然需要深入了解，全面评估其带来的健康风险。
Abstract:BACKGROUND Fluorine is an essential trace element that exists in the natural environment, and its deficiency or excess in the environment can cause health problems.
OBJECTIVES To summarize the research progress of sources of fluorine in the environment and to assess the risk to health.
METHODS The sources of fluorine in the natural atmosphere, rocks, soils, water, and plants, were reviewed, and the factors affecting its form and content by the environment were analyzed, such as topography, rain leaching, soil parent material, soil pH, soil organic matter and geochemical behavior.
RESULTS Fluorine has a wide range of sources. At present, more than 260 million people in the world have been affected by environmental problems caused by fluorine. Therefore, it is of great significance to carry out a health risk assessment. The common health risk assessment models of fluorine include Hazard Quotient and Hazard Index. Probabilistic methods are often used in risk analysis. At present, there are also applications of multi-channel exposure assessment methods to assess fluorine. The feasibility and limitations of traditional models were compared.
CONCLUSIONS It is necessary to consider the uncertainty and sensitivity of the health risk assessment models, determine the fluorine enrichment pathway, improve the combined exposure assessment models, and consider the bioavailability of fluorine intake for health risk assessment of fluorine. The next step of research on health risk assessment of fluorine can use models to predict the risks of fluorine. It is still necessary to have a deep understanding of the source, occurrences, migration path and content influencing factors of fluorine to assess the health risks.
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Key words:
- fluorine /
- atmosphere /
- rock /
- soil /
- water /
- influencing factors /
- health risk assessment
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表 1 不同类型岩石中的氟化物含量
Table 1. Fluoride concentration in different types of rocks
岩石类型 岩石类别 氟化物含量(mg/kg) 文献来源 变质岩 板岩 1873 Singh等(2018)[33]
Kabir(2020)[34]片岩 1703 片麻岩 1563 花岗岩 1043 玄武岩 360 硅石岩 982 沉积岩 砾岩 963 Singh等(2018)[33]Kabir(2020)[34] 磷灰石 31000 石灰石 1200 砂岩 903 页岩 800 Mukherjee等(2018)[6] 海相页岩 1300 Apambire等(1997)[35] 火山岩 - 2000 Apambire等(1997)[35] 碱性火成岩 - 1300 Apambire等(1997)[35] 超镁铁质岩石和石灰岩 - 100 Apambire等(1997)[35] 煤(灰) - 80 Mukherjee等(2018)[6] 注：“-”表示无更小的类别。 
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表 3 不同国家的饮用水中氟化物限值
Table 3. Recommendations for fluoride limits in drinking water in different countries
国家 饮用水中氟化物限值(mg/L) 文献来源 中国 1.0 Wang等(2013)[46] 美国 0.7~1.2 Li等(2001)[47] 加拿大 0.8~1.0 Li等(2001)[47] 马拉维 6.0 Addison等(2020)[48] 墨西哥 ＜1.5 Guzmán等(2016)[49] 印度 1.0~1.5 Kashyap等(2021)[50] 巴基斯坦 ≤1.5 Lacson等(2021)[51] 新加坡 1.0 Lacson等(2021)[51] 澳大利亚 1.5 Lacson等(2021)[51] 意大利 1.5 Lacson等(2021)[51] 蒙古 0.7~1.5 Lacson等(2021)[51] 尼泊尔 0.5~1.5 Lacson等(2021)[51] 波兰 ＜1.5 Lacson等(2021)[51] 越南 1.5 Lacson等(2021)[51]
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表 5 全球五大氟化带的不同国家和地区及其与全球构造带的关系[58-59]
Table 5. The five major fluoride belts in the world and their relationship with the global tectonic belts[58-59]
氟化带 分布国家 相关构造地区 1带 土耳其，叙利亚，约旦，埃及，苏丹，索马里，埃塞俄比亚，坦桑尼亚，肯尼亚，莫桑比克，南非 沿着非洲裂谷带 2带 埃及，利比亚，阿尔及利亚，摩洛哥，西撒哈拉，毛里塔尼亚 沿着西非移动带 3带 土耳其，伊拉克，伊朗，阿富汗，巴基斯坦，印度，泰国北部，中国 古地中海的活动带 4带 洛基山，墨西，中美洲，哥伦比亚，秘鲁，玻利维亚，安第斯山脉 火山带 5带 日本，菲律宾，印度尼西亚 火山带
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表 6 氟的不同风险评估方法优缺点的比较
Table 6. Comparison of different fluoride risk assessment methods
氟健康风险评估方法 优点 缺点 危害系数法、危害指数法 应用广泛，数据及专业要求较低，评估简单高效 不确定性高 概率法 最小化评估中的误差和干扰，更贴近实际结果 数据及专业要求较高 多途径暴露评估法 考虑多种暴露途径，评估结果更全面 未考虑摄入氟化物的有效性，仅单纯累加
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