A Brief Review of Endemic Fluorosis in Dromedary Camels (Camelus Dromedarius) and Focus on Their FluorideSusceptibility

Review Article

Austin J Vet Sci & Anim Husb. 2023; 10(1): 1117.

A Brief Review of Endemic Fluorosis in Dromedary Camels (Camelus Dromedarius) and Focus on Their FluorideSusceptibility

Choubisa SL*

Department of Advanced Science and Technology, National Institute of Medical Science and Research, NIMS University Rajasthan, India

*Corresponding author: Shanti Lal Choubisa Department of Advanced Science and Technology, National Institute of Medical Science and Research, NIMS University Rajasthan, Jaipur, & Former Post Graduate Department of Zoology, Government Meera Girls College, Udaipur, Rajasthan 313002, India

Received: January 02, 2023; Accepted: February 10, 2023; Published: February 17, 2023

Abstract

Chronic fluoride poisoning in the form of fluorosis in diverse species of domestic animals, viz. cattle (Bos taurus), water buffaloes (Bubalus bubalis), sheep (Ovis aries), goats (Capra hircus), horses (Equus caballus), donkeys (Equus asinus), and dromedary camels (Camelus dromedarius) is the resultant of prolonged consumption or exposure of high fluoride through drinking water, food, and air. In general, fluorosis can be recognised by the presence of dental mottling (dental fluorosis) and bone deformities (skeletal fluorosis). In animals, skeletal fluorosis often results in reduced mobility as a result of bone damages or changes due to exostosis, osteosclerosis, osteoporosis, and osteophytosis. In addition, fluoride-induced non-skeletal disorders like gastro-intestinal disturbances, neurological disorders, reproductive dysfunctions, apoptosis, excitotoxicity, genotoxicosis, and teratogenic effects have also been observed in fluorosed domestic and experimental animals. The maximum prevalence, 19.4% and 17.9% of dental and skeletal fluorosis at >3.0 ppm fluoride concentration in drinking water has been observed in domesticated dromedary camels in India, respectively. The prevalence and severity of fluorosis varies from one fluoride endemic region to another and depends on a number of determinants or factors. However, the major determinants are fluoride concentration and its frequency and duration of exposure, rate and density of bio-accumulation of fluoride, and food nutrients. Among different species of domestic animals, camels are found to be less susceptible to fluoride or have a relatively higher fluoride tolerance. In present communication, fluorosis in camels, determinants of fluoride toxicity, and fluoride susceptibility in camels are briefly and critically reviewed. Simultaneously, research gapes have also been highlighted for further research work on chronic fluoride intoxication in diverse species of animals. This review is significant for researchers in understanding of chronic fluoride toxicity in grazers (cattle and buffalo) and browsers (equines, flocks, and camels).

Keywords: Chronic fluoride toxicosis; Determinants; Dromedary camels (Camelus dromedarius); Fluoride; Fluorosis; Susceptibility

Introduction

It is well established, chronic exposure to high concentration of fluoride through drinking water, food, and air results in mild to severe fluoride poisoning in the form of dreaded fluorosis disease not only in humans [1-11] but also in diverse species of domestic animals included cattle (Bos taurus), water buffaloes (Bubalus bubalis), sheep (Ovis aries), goats (Capra hircus), horses (Equus caballus), donkeys (Equus asinus), and dromedary camels (Camelus dromedarius) [12-32]. Fluoride poisoning (fluorosis) in animals due to drinking of water having fluoride > 1.0 or 1.5 ppm is, generally, known to as hydrofluorosis, which is more prevalent and endemic in several countries [1]. Both hydrofluorosis and industrial fluorosis (caused by chronic exposure to industrial fluoride pollution) have been extensively studied in bovine (cattle and water buffaloes), equine (horses and donkeys) and flock (sheep and goats) animals throughout the world where there is endemic of fluoridated drinking water. However, studies on chronic fluoride toxicity (fluorosis) in dromedary camels are still very limited and reported only from a few countries [33-39].

Among different species of domestic animals, desert dromedary camels are unique animals and have different morphology, anatomy, and physiology. These dromedaries are well adapted to survive in extreme desert environment or ecosystem with extremely low and high temperatures and low annual rainfall. In fact, it is a wonderful animal of the desert, which has all the qualities that keep it alive in the desert, even without drinking water; it can survive for many days. Their estimated population size in the world is around 20 million which is lower than other domestic ruminants. Therefore, this may also be a reason why studies on fluorosis in dromedaries have not been done extensively. However, few scientific studies on chronic industrial fluoride poisoning (industrial fluorosis) have been well conducted in dromedary camels of Egypt [33,34]. Industrial fluorosis has also been studied in 86 dromedaries living in the industrial areas of Sahara of Morocco but not single dromedary camel was found to be afflicted with chronic industrial fluoride intoxication [35]. Later on hydrofluorosis in camels was first identified and reported from India by Choubisa in 2010 due to drinking of fluoridated water [36]. Subsequently, this form of fluorosis has also been reported in camels living in different geographical provinces of state of Rajasthan (India) where drinking groundwater sources have high level of fluoride [37-39].

Fluorosis in Dromedary Camels

Successive and prolonged exposure of high fluoride in dromedary camels leads to the development of mild to severe fluorosis disease. In fact, more than 50% absorbed fluoride is excreted in the form of stool, urine, and perspiration, while rest is retained in the body where it accumulates gradually in diverse organs of humans and animals. However, its highest accumulation in the body occurs in those organs, where the amount of calcium is found to be relatively high, such as in teeth and bones [40,41]. That is why the symptoms of fluorosis start emerging in these organs at the earliest. Nevertheless, the bio-accumulation of fluoride is also found in various soft tissues or organs of the body and develops various ill effects. Based on occurring of fluoride-induced changes in hard and soft organs, fluorosis has been categorised into three forms, namely dental fluorosis, skeletal fluorosis, and non-skeletal fluorosis. All three forms may occur in the same individual or animal suffering from chronic fluoride intoxication.

Dental fluorosis is a pathologic condition characterised by hypomineralization of the enamel due to excessive exposure to fluoride during enamel mineralization. In fact, dental fluorosis is first visible, irreversible, and diagnostic or clinical sign of chronic fluoride poisoning in man and animals [40,41]. Fluoride poisoning may occur regardless of the source of fluoride, but the appearance of dental fluorosis is nearly identical in humans and animals. In dental fluorosis teeth become mottled characterised with light to deep brownish or yellowish staining on the enamel surface of the teeth. In severe dental fluorosis, irregular wearing of teeth is also found. This staining is generally appeared bilaterally, homogenously, and horizontally striated form and rarely in the form of fine spots/dots in the almost all kind of domestic animals [40,41]. But in desert camels, this staining is appeared vertically and non-striated form (Figures 1 and 2). Due to limited studies in these animals, it is difficult to say that vertical and non-striated staining is found only in these animals. For its confirmation, more survey studied on chronic fluoride intoxication in camels is highly suggestive. Due to industrial fluoride exposure, 55 (48.24%) camels out of 114 were found to be afflicted with dental fluorosis in Egypt [35]. At 1.4- 3.3 ppm fluoride concentration in drinking waters, the highest incidence, 44.4% of dental fluorosis has also been reported in camels from India [36].

Figure a & b: Moderate to severe dental fluorosis in juvenile (Figure a) and adult camels (Figure b) characterised with light to deep brownish staining on anterior teeth, diffused to well marked spots (central incisors), and irregular wearing. Recession of teeth supporting bone with recession and bulging of gingival tissue is also present [36,39].


    


    

    


    


    Figure a & b: Moderate to severe dental fluorosis in juvenile (Figure a) and adult camels (Figure b) characterised with light to deep brownish staining on anterior teeth, diffused to well marked spots (central incisors), and irregular wearing. Recession of teeth supporting bone with recession and bulging of gingival tissue is also present [36,39].

Skeletal fluorosis has been reported in most of the mature or old age camels due to excessive ingestion of high amount of fluoride for long-time (Figures 3 and 4). In the skeletal fluorosis, the mobility of individual is greatly affected and reduced as a result of bone damage due to exostosis, osteosclerosis, osteoporosis, and osteophytosis [42-44]. Symptoms of skeletal fluorosis in camels are similar to those found in other domestic animals, bovines and flocks. No special or different types of skeletal fluorosis symptoms have been found or reported in these camels. However, the periosteal exostoses, intermittent lameness, and hardening of tendons in the legs are as main pathognomonic signs of skeletal fluorosis [41]. Among the mature camels, the maximum prevalence of skeletal fluorosis, 48.24% and 20.0% has been reported due to chronic fluoride exposure through industrial fluoride emissions and fluoridated drinking water, respectively [33,36]. These fluorosed camels are generally found to be weak bodied, lazy, and reluctant to stand.

Figure c: Hind legs of 11-year-old male camel (Figure 4) showing diffused to well mark bony lesions (periosteal exostoses) on the femoral, fibular, tarsal, and metatarsal regions. This camel also had dental fluorosis [36].


    


    

    


    


    Figure c: Hind legs of 11-year-old male camel (Figure 4) showing diffused to well mark bony lesions (periosteal exostoses) on the femoral, fibular, tarsal, and metatarsal regions. This camel also had dental fluorosis [36].

Figure d: Emaciated 11-year-old male camel afflicted with skeletal fluorosis. Note wasted thigh and shoulder muscles and bulging lesions on posterior region of the mandible and lacrimal bones [36].


    


    

    


    


    Figure d: Emaciated 11-year-old male camel afflicted with skeletal fluorosis. Note wasted thigh and shoulder muscles and bulging lesions on posterior region of the mandible and lacrimal bones [36].

In the fl uorosed camels, other signs of chronic fl uoride intoxication as colic, intermittent diarrhoea, excessive urination, irregular reproductive cycles, repeated abortions, sterility, and still birth have also been reported [33-39]. These fluoride-induced health complaints are collectively known as non-skeletal fluorosis and these are reversible and also found in other ruminants living together with these camels [36-39].

Determinants

The magnitude of fluorosis in man and animals living in different geographical provinces having almost similar F concentration in their drinking water sources is greatly varied. Even in the different species of animals living in the same areas, the prevalence and severity of osteo-dental fluorosis are also varied in them. Among the animals of herd living in same area or location, the severity of fluoride toxicosis is also variable in them. This indicates that some determinants or factors have potential role in acceleration of the fluoride toxicity. The most important determinants are fluoride concentration and its frequency and duration of exposure, density or rate of fluoride bio-accumulation, age, sex, habits, nutrition and food constituents, chemical constituents of drinking water, environmental factors as well as individual health, susceptibility, biological response, tolerance, and genetics [45-52].

Fluoride Susceptibility in Camels

Camels are morpho-anatomically and physiologically adapted to arid environment characterized by high temperature and water scarcity. These are known to survive in hostile environmental conditions without having the need to drink water for more than 30 days [53]. They are also adapted physiologically to obtain and retain water from their food resources, which reduces the intake of fluoride-rich drinking water. This is one of the ways by which camels have low level of severity of fluoride poisoning. In general, immature animals are more susceptible to chronic fluoride toxicosis as compared to mature animals [37]. However, bovine calves have maximum susceptibility to fluoride poisoning [54]. Hence these are ideal bio- indicators for endemic of fluoride and fluorosis [55].

In India, few studies were conducted on fluorosis in different species of domestic animals (bovines, flocks, equines, and camels) residing in fluoride endemic areas of Rajasthan state [56-59]. These animals were studied in three different areas having fluoride concentration <1.5 ppp (Table 1), 3.1-6.1 ppm (Table 2), and 2.0-5.7 ppm (Table 3) in drinking groundwater sources. The highest prevalence and severity of osteo-dental fluorosis was found in grass-eater (grazer) bovines and lowest in plant-eater (browser) camels and flocks. This indicates that bovines are relatively more susceptible to F toxicosis compared to camels and flocks. However, immature animals are more susceptible to fluoride compared to adult animals [37]. These findings suggest that some available chemical substances in foods are responsible for making the difference and influence the chronic fluoride toxicity in these animals. In fact, camel and flock animals generally feed on small delicate fresh leaves, pods, and small fruits of trees and shrubs which contain ample amount of calcium (Ca) and ascorbic acid (vitamin C) nutrients [49,50]. Both nutrients may neutralize the effect of excess fluoride content or interfere with the fluoride metabolism and ultimately reduce the fluoride toxicity in these animals [1,49,60,61]. It is evidently cleared that either these nutrients are protective against to fluoride toxicity in humans but whether these are protective or not in camels, more experimental scientific studies are needed.

Table 1: Prevalence of dental and skeletal fluorosis in immature animals of different species living in areas with low fluoride (<1.5ppm) in drinking water [37].










  


    
Animals (spp)


    
No. of animals (age) investigated


    
No. of animals showed


    
Total


  


  


    
DF


    
SF


  


  


    
Buffaloes (B. bubalis)


    
78 (< 3 years)


    
41 (52.56)


    
8 (10.25)


    
49 (62.82)


  


  


    
Cattle (B. taurus ) 


    
89 (< 3 years)


    
44     (49.43)


    
8 (8.98)


    
52 (58.42)


  


  


    
Donkey (E. asinus) 


    
30 (< 3 years)


    
5 (16.66)


    
-(0.00)


    
5 (16.66)


  


  


    
Horses (E.    caballus) 


    
21 (< 3 years)


    
3 (14.28)


    
-(0.00)


    
3 (14.28)


  


  


    
Camels (C.    dromrdarius) 


    
23 (< 6 years)


    
-(0.00)


    
-(0.00)


    
-(0.00)


  


  


    
Goats (C. hircus) 


    
96 (< 1 year)


    
-(0.00)


    
-(0.00)


    
-(0.00)


  


  


    
Sheep (O. aries) 


    
92 (< 1 year)


    
-(0.00)


    
-(0.00)


    
-(0.00)


  


  


    
Total 


    
435


    
93(21.37)


    
16 (3.67)


    
109 (25.05)


  


  


    
Figures in parentheses indicate percentage. DF: Dental    Fluorosis; SK: Skeletal Fluorosis 


  


















Table 1: Prevalence of dental and skeletal fluorosis in immature animals of different species living in areas with low fluoride (<1.5ppm) in drinking water [37].

Table 2: Prevalence of dental and skeletal fl uorosis in domestic animals living in areas with high fl uoride content (>3.0 ppm) in drinking water [38].










  


    
Animal (species)


    
Immature animals


    
Mature animals


    
Lameness


  


  


    
DF


    
SF


    
DF


    
SF


  


  


    
Cattle (B. taurus)


    
63/78 (80.7)


    
21/78 (26.9)


    
328/518 (63.3)


    
267/518 (51.5)


    
+++


  


  


    
Buffaloes (B. bubalis)


    
62/64 (96.8)


    
22/64 (34.3)


    
209/312 (66.9)


    
188/312 (60.2)


    
+++


  


  


    
Donkeys (E. asinus) 


    
16/33 (48.4)


    
6/33 (18.1)


    
39/106 (36.7)


    
28/106 (26.4)


    
++


  


  


    
Horses (E. caballus)


    
7/16 (43.7)


    
3/16 (18.7)


    
23/70 (32.8)


    
17/70 (24.2)


    
++


  


  


    
Camels (C. dromedarius)


    
4/18 (22.2)


    
2/18 (11.1)


    
13/67 (19.4)


    
12/67 (17.9)


    
+


  


  


    
Sheep (O. aries)


    
12/126 (9.5)


    
–/126 (0.0)


    
112/544 (20.5)


    
54/544 (9.9)


    
+


  


  


    
Goats (C. hircus)


    
8/108 (7.4)


    
–/108 (0.0)


    
102/538 (18.9)


    
47/538 (8.7)


    
+


  


  


    
Total


    
172/443 (38.8)


    
54/443 (12.1)


    
826/2155(38.3)


    
613/2155 (28.4)


    

  


  


    
Figures in parentheses indicate percentage. DF    dental fluorosis, SF skeletal fluorosis +, mild; ++, moderate; +++, severe 


  


















Table 2: Prevalence of dental and skeletal fl uorosis in domestic animals living in areas with high fl uoride content (>3.0 ppm) in drinking water [38].

Table 3: Relative prevalence of dental and skeletal fluorosis in camels, bovines and humans living in desert environment with fluoride in drinking water in the 2.0–5.7 ppm range [39].










  


    

    
Number examined


    
Adults exhibiting


    
Young/juveniles exhibiting


  


  


    
DF (%)


    
SF (%)


    
DF (%)


    
SF (%)


  


  


    
Camels 


    
238


    
27/195 (13.8)


    
20/195 (10.2)


    
4/43 (9.3)


    
1/43 (2.3)


  


  


    
Bovines* 


    
210


    
77/168 (45.8)


    
69/168 (41.0)


    
26/42 (61.9)


    
12/42 (28.5)


  


  


    
Humans 


    
218


    
78/160 (48.7)


    
78/160 (48.7)


    
34/58 (58.6)


    
30/58 (31.0)


  


  


    
Total 


    
666


    
182/523 (34.7)


    
167/523 (31.9)


    
64/143 (44.7)


    
43/143 (29.4)


  


  


    
*Indicates both cattle and buffaloes. DF, Dental    fluorosis; SF, Skeletal fluorosis. 


  


















Table 3: Relative prevalence of dental and skeletal fluorosis in camels, bovines and humans living in desert environment with fluoride in drinking water in the 2.0–5.7 ppm range [39].

Conclusion

Successive exposure to high fluoride for prolonged period through drinking water and industrial fluoride pollution in dromedary camels causes chronic fluoride intoxication in the form of fluorosis. In the world, chronic fluorosis has not been studied extensively in domesticated dromedaries as compared to other domestic animals, bovines, equines, and flocks, though these animals are economically as well as biologically very important. In fact, camels are desert animals and are perfectly adapted to dry environments and they can survive without water for >30 days. In these desert animals, both forms of fluorosis, industrial fluorosis and hydrofluorosis have been reported. Fluoride- induced dental mottling and diverse bony changes (exostosis, osteosclerosis, osteoporosis, and osteophytosis) are the main characteristic of chronic fluoride poisoning in camels. Among different species of domestic bovine and equine animals, dromedary camels are found to be less susceptible to chronic fluoride poisoning due to nutrients such as calcium and vitamin C present in their food. However, for its further confirmation more research survey studies in large number of camels are highly suggestive.

Conflict of Interest

The author declares no conflict of interest.

Acknowledgements

The author thanks to Dr. Darshana Choubisa, Associate Professor, Department of Prosthodontics and Crown and Bridge, Geetanjali Dental and Research Institute, Udaipur, Rajasthan 313002, India for cooperation.

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Citation: Choubisa SL. A Brief Review of Endemic fluorosis in Dromedary Camels (Camelus Dromedarius) and Focus on Their Fluoride Susceptibility. Austin J Vet Sci & Anim Husb. 2023; 10(1): 1117.