High fluoride concentration in groundwater is a critical toxicological issue in Krishnagiri and Dharumapuri in the State Government of Tamil Nadu, India. In 2008, the Japan International Cooperation Agency started conducting a study entitled “Hogenakkal Water Supply and Fluorosis Mitigation Project”. This survey was performed to assess the fluoride and trace element levels in drinking water in the areas at the mid term of this project. Seven water samples were collected and analyzed. Only one water sample exceeded the WHO guideline for fluoride concentration. No trace element exceeded the WHO guideline values. However, it is necessary to assess the effect of trace elements, for which WHO does not provide guideline values. Under the Hogenakkal Water Supply and Fluorosis Mitigation Project, the equipment needed to measure fluoride, such as fluoride ion meters, is now available and currently in operation. However, quality control, in general, must be improved in order to increase data accuracy. Also, accurate diagnosis of fluorosis is necessary to assess the effectiveness of this project.

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1. Mid-term Overview of Japan International Cooperation Agency (JICA) Fluorosis Mitigation Project Phase 2 (2011) in Southern India             2. The survey and proposal for skeletal fluorosis
2. Mid-term Overview of Japan International Cooperation Agency (JICA) Fluorosis Mitigation Project Phase 2 (2011) in Southern India            3. Dental Approach
3. Risk of fluoride compounds in the workforce: reports of three occupational exposure cases