# Fluoride and Human Health: Assessing Novel Biomarkers in Detecting Bone Disorder

> **NIH NIH R00** · TULANE UNIVERSITY OF LOUISIANA · 2020 · $243,453

## Abstract

Fluorosis is endemic in at least 25 countries globally; more than 200 million people are exposed to 
high concentrations of naturally occurring fluoride (F─). Risk areas are mostly located in arid and 
semi-arid tropical and volcanic regions such as in the Main Ethiopian Rift Valley (MER), where a 
large fraction of groundwater sources have elevated concentrations of F─, affecting the health of 
nearly 8.5 million people. Drinking groundwater has traditionally been considered the major route 
for F─ exposure in this population; however, our preliminary measures of urinary F─ and other 
recent studies suggest that dietary sources may contribute to exposure. We expect that total F─ 
exposure from these sources can be more reliably estimated through nail F─ analysis, which will 
also enhance prediction of health outcomes. In addition, while many epidemiological and clinical 
studies have shown a strong correlation between F─ exposure and dental fluorosis (DF), skeletal 
fluorosis (SF) is more complex and variable, and remains poorly understood. Fluoride exposure  in  
the presence of sufficient calcium (Ca) leads to an osteosclerotic form of SF, whereas in 
nutrition-deficient individuals, SF manifests as bone resorption, particularly among children. This 
novel and highly innovative project will employ clinical/radiographic fluorosis examinations and, 
for the first time, apply Ca isotope techniques developed in the field of geochemistry to detect 
F─-induced metabolic bone disorder. During the mentored phase, under the combined mentorship of 
highly qualified experts in environmental geochemistry and health (primary mentors), skeletal 
fluorosis, F─ metabolism and toxicity (co-mentors), and bone biology, toxicology, biostatistics, 
epidemiology and nutrition (collaborators), Dr. Tewodros R. Godebo, the candidate, will accomplish 
two key goals. First, he will improve understanding of all sources of F─ exposure through 
measurement of F─ in individuals’ fingernails and link this to DF outcomes (Aim 1). Second, he will 
obtain training in clinical diagnostic skills on SF and laboratory analytical methods, and 
additional didactic courses in biostatistics, epidemiology and nutrition, which will lay the 
foundation for research to be undertaken in the independent phase of this award (Aims 2-3). In this 
second phase, the candidate will build on his postdoctoral work to explore the effect of F─ 
exposure on SF using clinical and radiographic methods (Aim 2). He will also explore the effect of 
over-exposure to F─ on natural (biologically-induced) Ca isotope variations in urine (Aim 3). At 
the completion of the K99/R00 project, the project will have: 1) offered new insights on the effect 
of F─ exposure in the pathogenesis of SF (and DF); 2) for the first time, revealed the role of a 
novel Ca isotope biomarker application in urine for monitoring the pathogenesis of SF; 3) helped 
the candidate to achieve his long-term career goal of becoming an establ...

## Key facts

- **NIH application ID:** 9891065
- **Project number:** 5R00ES023472-05
- **Recipient organization:** TULANE UNIVERSITY OF LOUISIANA
- **Principal Investigator:** Tewodros R Godebo
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $243,453
- **Award type:** 5
- **Project period:** 2018-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9891065

## Citation

> US National Institutes of Health, RePORTER application 9891065, Fluoride and Human Health: Assessing Novel Biomarkers in Detecting Bone Disorder (5R00ES023472-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9891065. Licensed CC0.

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