Water fluoride: No information was provided on how the water samples were tested. It was noted that the exposed area was selected because it had known historic high fluoride levels. It was noted that arsenic levels in the drinking water were measured using a validated method of field testing, but no information was provided on fluoride measurements. It was also noted that this was only used for preselecting the children for biomonitoring. However, they did provide water fluoride concentrations in the two areas and there is no information provided on when the information was obtained or how it was measured.

Dental fluorosis: Fluorosis was measured using the Dean's index. This was used to obtain a community fluorosis index.

Saeed 2021

Risk of bias

Epidemiological study populations

HAWC