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The most appropriate and widely used source of drinking water for the rural populations of South Africa is groundwater. Pilot studies and surveys conducted by the Department of Water Affairs and Forestry (DW AF) indicated that there are a number of boreholes across the country that contain apart from fluoride, levels of nitrate, some heavy metals, total dissolved solids, sulphates and faecal coliform (in isolated regions) that could pose a health risk if the water is used for drinking purposes. Very few boreholes have been tested for heavy metals or toxic organic substances. However considering the levels of fluoride, in general, groundwater is of acceptable quality except for some provinces in which elevated levels of natural groundwater fluoride occurs. Very high levels of fluoride, >4 mg/l occur in some groundwater sources in all nine provinces of South Africa, especially in the Limpopo, North-West, Eastern Cape, Northern Cape, Western Cape and KwaZulu Natal provinces. A superficial inspection reveals that most of the local people in those areas suffer from dental fluorosis at varying degrees. The main aim of this study is to determine the distribution of the fluoride ion concentration levels in South African groundwater and the impacts thereof on dental health. The available data is used to assess the distribution of the various fluoride ion concentration levels in some national groundwater sources. Areas of particularly high or low fluoride levels are identified. Results from an epidemiological survey carried out by the National Department of Health (NDOH) are used concurrently with the fluoride data to determine the percentage morbidity of dental fluorosis in each area The results are compared in order to determine if any relationship exists between the occurrence of fluoride in drinking water and the incidences of dental fluorosis. Vegter's lithostratigraphy and the simplified geology of South Africa are used to interpret the results and assess the role of surface geology in the release and distribution of fluorides in groundwater. The role of other factors such as climate and the interactions of the fluoride ion and other water quality parameters in aqueous media are also assessed. / Dissertation (MSc (Water Utilization))--University of Pretoria, 2006. / Chemical Engineering / unrestricted

Text in Afrikaans / Die tydruimtelike variasie in die fluoriedinhoud vannatuurlike drinkwater en in die voorkoms van tandfluorose, die verband tussen hierdie veranderlikes asook hulle kovariasie is op 'n hoe resolusievlak in geselekteerde endemiese gebiede ondersoek. Die drie studiegebiede verskil grootliks van mekaar wat sommige fisies- en menslik-geografiese kenmerke betref, maar ondergrondse water was oral die belangrikste bron van drinkwater. Ioonspesifieke analise en laboratoriumtegnieke is gebruik om die fluoriedinhoud van die drinkwater uit 517 bronne te bepaal. Die tande van 3 068 kinders is klinies en fotografies ondersoek. Die erkende Tooth Fluorosis Index en die indeks van Dean is gebruik om die voorkoms van fluorose te beskryf. Grafiese tegnieke, beskrywende statistieke en nieparametriese analise van variansietoetse is gebruik om die voorkoms en tydruimtelike variasiepatrone van die sleutelveranderlikes in elke studiegebied, asook die verskillende ruimtelike eenhede binne die studiegebiede, te beskryf. Die verband tussen die sleutelveranderlikes asook hul intra- en interareale kovariasie is ontleed. Daar is gevind dat die fluoriedinhoud van die ondergrondse water in die Pilanesberg- en Hammanskraal-studiegebied relatief hoog tot hoog is en die in die Vrystaat-studiegebied relatief laag. Ruimtelike veranderlikheid met groot verskille oor klein afstande kenmerk die fluoriedinhoud van ondergrondse water ongeag die gesteentes waaruit dit onttrek word. Middelwaardes bied ontoereikende beskrywings van die fluoriedgehalte van die drinkwater. Die skep van nuwe drinkwaterbronne veroorsaak langtermynvariasie in die fluoriedinhoud van die beskikbare drinkwater. Fluoroseprevalensie in die studiegebiede bet van 62% tot 87% gewissel, met meer ernstige aantasting in die Pilanesberg- en Hammanskraal-gebied as in die Suid-Vrystaat. Beduidende intra-areale ruimtelike variasie is 'n wesenlike kenmerk van die voorkoms van fluorose in al drie studiegebiede. In alle gevalle het die variasiepatroon in die fluoriedinhoud van die drinkwater die in die voorkoms van fluorose slegs gedeeltelik verklaar. Sporadiese en/of periodieke kortstondige blootstelling aan hoe fluoriedkonsentrasies lei tot emstige aantasting ten spyte van die gereelde gebruik van water met 'n laefluoriedinhoud. Ligte fluorose ontwikkel geredelik in assosiasie met <0,5 mgF-/l en matige fluorose in assossiasie met 0,5-0,7 mgF-/l, die optimum konsentrasieinterval vir fluoridasie in Suid-Afrika. / The spatiotemporal variation in the fluoride content of natural drinking water and the occurrence of dental fluorosis, the relation between these variables as well as their covariation were investigated at a high resolution level in selected endemic areas. Groundwater was the most important source of drinking water in all three study areas, but they differed markedly in respect of some physical and human geographical characteristics. Ion specific analysis and laboratory techniques were used to determine the fluoride content of the water from 517 sources. The teeth of 3 068 children were examined clinically and photographically. The fluorosis was scored according to the Tooth Fluorosis Index and Dean's classification. Graphical techniques, descriptive statistics and nonparametric analysis of variance were used to describe the occurrence and variation patterns of the key variables in the different spatial units is each study area. The relation between the variables as well as their intra and interareal covariation were analysed. The fluoride content of the groundwater in the Pilanesberg and Hammanskraal areas was relatively high to high; in the southern Free State it was relatively low. Spatial variability and significant differences over small distances typify the fluoride content of the groundwater, irrespective of the aquifer. Central statistics inadequately describe the fluoride quality of the natural drinking water. The development of new water sources causes long term variation in the fluoride content of the available drinking water. Fluorosis prevalence varied form 62% to 87%, with more severe fluorosis in Pilanesberg and Hammanskraal than in the southern Free State. Significant intra-areal spatial variation is an attribute of fluorosis in all three study areas. In all cases the variation pattern in the fluoride content of the drinking water partly explained the spatial pattern in the occurrence of fluorosis. Sporadic and/or periodic brief exposure to high fluoride concentrations leads to severe fluorosis despite regul~ usage of water with a low fluoride content. Mild fluorosis readily develops in association with <0,5 mgF-1~ and medium fluorosis in association with 0,5-0,7 mgF-/l, the optimum concentration interval for fluoridation in South Africa. / Geography / D. Phil. (Geografie)

Text in Afrikaans / Die tydruimtelike variasie in die fluoriedinhoud vannatuurlike drinkwater en in die voorkoms van tandfluorose, die verband tussen hierdie veranderlikes asook hulle kovariasie is op 'n hoe resolusievlak in geselekteerde endemiese gebiede ondersoek. Die drie studiegebiede verskil grootliks van mekaar wat sommige fisies- en menslik-geografiese kenmerke betref, maar ondergrondse water was oral die belangrikste bron van drinkwater. Ioonspesifieke analise en laboratoriumtegnieke is gebruik om die fluoriedinhoud van die drinkwater uit 517 bronne te bepaal. Die tande van 3 068 kinders is klinies en fotografies ondersoek. Die erkende Tooth Fluorosis Index en die indeks van Dean is gebruik om die voorkoms van fluorose te beskryf. Grafiese tegnieke, beskrywende statistieke en nieparametriese analise van variansietoetse is gebruik om die voorkoms en tydruimtelike variasiepatrone van die sleutelveranderlikes in elke studiegebied, asook die verskillende ruimtelike eenhede binne die studiegebiede, te beskryf. Die verband tussen die sleutelveranderlikes asook hul intra- en interareale kovariasie is ontleed. Daar is gevind dat die fluoriedinhoud van die ondergrondse water in die Pilanesberg- en Hammanskraal-studiegebied relatief hoog tot hoog is en die in die Vrystaat-studiegebied relatief laag. Ruimtelike veranderlikheid met groot verskille oor klein afstande kenmerk die fluoriedinhoud van ondergrondse water ongeag die gesteentes waaruit dit onttrek word. Middelwaardes bied ontoereikende beskrywings van die fluoriedgehalte van die drinkwater. Die skep van nuwe drinkwaterbronne veroorsaak langtermynvariasie in die fluoriedinhoud van die beskikbare drinkwater. Fluoroseprevalensie in die studiegebiede bet van 62% tot 87% gewissel, met meer ernstige aantasting in die Pilanesberg- en Hammanskraal-gebied as in die Suid-Vrystaat. Beduidende intra-areale ruimtelike variasie is 'n wesenlike kenmerk van die voorkoms van fluorose in al drie studiegebiede. In alle gevalle het die variasiepatroon in die fluoriedinhoud van die drinkwater die in die voorkoms van fluorose slegs gedeeltelik verklaar. Sporadiese en/of periodieke kortstondige blootstelling aan hoe fluoriedkonsentrasies lei tot emstige aantasting ten spyte van die gereelde gebruik van water met 'n laefluoriedinhoud. Ligte fluorose ontwikkel geredelik in assosiasie met <0,5 mgF-/l en matige fluorose in assossiasie met 0,5-0,7 mgF-/l, die optimum konsentrasieinterval vir fluoridasie in Suid-Afrika. / The spatiotemporal variation in the fluoride content of natural drinking water and the occurrence of dental fluorosis, the relation between these variables as well as their covariation were investigated at a high resolution level in selected endemic areas. Groundwater was the most important source of drinking water in all three study areas, but they differed markedly in respect of some physical and human geographical characteristics. Ion specific analysis and laboratory techniques were used to determine the fluoride content of the water from 517 sources. The teeth of 3 068 children were examined clinically and photographically. The fluorosis was scored according to the Tooth Fluorosis Index and Dean's classification. Graphical techniques, descriptive statistics and nonparametric analysis of variance were used to describe the occurrence and variation patterns of the key variables in the different spatial units is each study area. The relation between the variables as well as their intra and interareal covariation were analysed. The fluoride content of the groundwater in the Pilanesberg and Hammanskraal areas was relatively high to high; in the southern Free State it was relatively low. Spatial variability and significant differences over small distances typify the fluoride content of the groundwater, irrespective of the aquifer. Central statistics inadequately describe the fluoride quality of the natural drinking water. The development of new water sources causes long term variation in the fluoride content of the available drinking water. Fluorosis prevalence varied form 62% to 87%, with more severe fluorosis in Pilanesberg and Hammanskraal than in the southern Free State. Significant intra-areal spatial variation is an attribute of fluorosis in all three study areas. In all cases the variation pattern in the fluoride content of the drinking water partly explained the spatial pattern in the occurrence of fluorosis. Sporadic and/or periodic brief exposure to high fluoride concentrations leads to severe fluorosis despite regul~ usage of water with a low fluoride content. Mild fluorosis readily develops in association with <0,5 mgF-1~ and medium fluorosis in association with 0,5-0,7 mgF-/l, the optimum concentration interval for fluoridation in South Africa. / Geography / D. Phil. (Geografie)