Cover -- Contents -- Acronyms and abbreviations -- Preface -- Acknowledgements -- 1 Introduction -- 1.1 Background -- 1.2 Sources of fluoride intake in humans -- 1.3 Fluoride metabolism and excretion -- 1.4 Biomarkers of fluoride exposure -- 1.5 Urinary fluoride assessments in population oral health -- 1.6 Areas of uncertainty -- 2 General design of study -- 2.1 Background -- 2.2 Identification of participants -- 2.3 Sampling -- Location -- Number of subjects -- Age groups -- Frequency -- Time of study and number of days -- 2.4 Methods of monitoring -- 2.4.1 24-hour urine collection -- 2.4.2 Timed collections of urine obtained from defined periods of a day -- 3 Methods for collecting urine, and for handling and evaluating results -- 3.1 Recording of information -- 3.1.1 General information -- 3.1.2 Personal information -- 3.2 Essential preparatory practices -- 3.2.1 Pre-collection planning approaches -- 4 Twenty-four hour urine collection -- 4.1 Procedure -- 4.2 Fluoride and creatinine concentrations -- 4.3 Information to be recorded -- 4.4 Determination of fluoride in urine -- 4.5 General rules for tabulation and processing of data -- 5 Design of the final report for 24-hour urine collection -- 5.1 Introduction -- 5.2 Materials and methods -- 5.3 Results -- 5.4 Discussion and conclusion -- 5.5 Summary -- 5.6 Tables for the 24-hour collection method -- 6 Collections of 8-18 hours (within the 24-hour cycle) -- 6.1 Collection of nocturnal urine and during periods of high excretion -- 6.2 Optional calculations obtained from time-controlled urine collection - Use of a standardized format -- 6.2.1 Coded recordings of personal data and individual fluoride exposure -- 6.2.2 Standard table for surveys with 24-hour collections -- 6.2.3 Standard table for surveys with two collections totalling 14-16 hours, using MS Excel.

6.2.4 Standard table for surveys with three collections totalling 14-16 hours using MS Excel: complete series -- 6.2.5 Standard table for surveys with collections made in four periods totalling the 24-cycle -- 6.2.6 Cleaning of data -- 6.3 Extrapolations -- 7 Design of the final report for time-controlled urinary collections -- 7.1 Tables for time-controlled urinary collections lasting 8-18 hours -- 8 Urine spot samples -- 8.1 Creatinine -- 9 Provision of technical advice -- Annex A: Apparatus and materials -- Annex B: Steps for verifying function of apparatus -- Annex C: Calibration procedure -- References -- Tables -- Table 5.1 Urinary fluoride excretion data from 24-hour urine collections -- Table 5.2 Criteria for cleaning data from children aged 2-6 years, from 24-hour collections -- Table 5.3 Standards for urinary fluoride excretion (mg/24-hour cycle): lower and upper margins -- Table 5.4 Calculated daily urinary fluoride excretion associated with low, optimal and high fluoride intake for ages 1-14 years -- Table 5.5 Calculated daily urinary fluoride excretion associated with low, optimal and high fluoride intake for broader age groups -- Table 7.1 Urinary fluoride data for time-controlled urine collections -- Table 7.2 Criteria for cleaning data from childen aged 2-6 years, from time-controlled urine collections[sup(a)] -- Table 7.3 Range of optimal urinary fluoride excretion (μg/hour) at different times, for time-controlled urine collections: lower and upper margins -- Table 7.4 Standards for urinary fluoride concentration (mg/L -- ppm) for all ages, for time-controlled urine collections -- lower and upper margins -- Table 7.5 Calculation of parameters using simple numerical operations -- Table 7.6 Data and computing table using MS Excel for surveys for 24-hour collections (example with six cases).

Table 7.7 Dataset example and MS Excel computing table showing calculations of fluoride excretion of children providing nocturnal and noon urine collections -- Table 7.8 Dataset example and MS Excel computing table showing calculations of fluoride excretion of children providing morning, afternoon and nocturnal collections -- Table 7.9 Ideal format of a dataset to be transferred to an evaluation centre -- Figures -- Figure 3.1 Example of daytime label used in time-controlled collections, to be attached to the urine collecting jar (WHO Form No. 96392, modified) -- Figure 3.2 Overnight urine collection label used in time-controlled collections (WHO Form No. 96393) -- Figure 3.3 Summary record form of urine collection from a group of children in time-controlled collections (WHO Form No. 96391) -- Figure 3.4 Sample invitation -- Figure 3.5 Questionnaire on use of fluoride supplements and toothpaste.