Feasibility and costs of water fluoridation in remote Australian Aboriginal communities

J EHSANI, Ross Stewart Bailie

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background. Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. Methods. Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. Results. The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit. Conclusion. Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries. � 2007 Ehsani and Bailie; licensee BioMed Central Ltd.
Original languageEnglish
Pages (from-to)100-
JournalBMC Public Health
Volume7
Publication statusPublished - 2007

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Fluoridation
Costs and Cost Analysis
Water Supply
Fluorides
Dental Caries
Northern Territory
Health Priorities
Water Purification
Documentation
Economics
Research Personnel
Interviews
Equipment and Supplies

Cite this

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title = "Feasibility and costs of water fluoridation in remote Australian Aboriginal communities",
abstract = "Background. Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. Methods. Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. Results. The fluoridation plants were operational for about 80{\%} of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit. Conclusion. Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries. � 2007 Ehsani and Bailie; licensee BioMed Central Ltd.",
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Feasibility and costs of water fluoridation in remote Australian Aboriginal communities. / EHSANI, J; Bailie, Ross Stewart.

In: BMC Public Health, Vol. 7, 2007, p. 100-.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Feasibility and costs of water fluoridation in remote Australian Aboriginal communities

AU - EHSANI, J

AU - Bailie, Ross Stewart

PY - 2007

Y1 - 2007

N2 - Background. Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. Methods. Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. Results. The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit. Conclusion. Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries. � 2007 Ehsani and Bailie; licensee BioMed Central Ltd.

AB - Background. Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. Methods. Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. Results. The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit. Conclusion. Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries. � 2007 Ehsani and Bailie; licensee BioMed Central Ltd.

KW - fluoride

KW - water

KW - Aborigine

KW - attitude

KW - Australia

KW - community

KW - cost

KW - dental caries

KW - documentation

KW - electronics

KW - equipment

KW - feasibility study

KW - fluoridation

KW - funding

KW - health

KW - human

KW - indigenous people

KW - interview

KW - management

KW - monitoring

KW - policy

KW - rating scale

KW - responsibility

KW - review

KW - staff

KW - system analysis

KW - water supply

KW - article

KW - cost benefit analysis

KW - economics

KW - environmental monitoring

KW - ethnology

KW - health care planning

KW - health service

KW - hospital service

KW - instrumentation

KW - organization and management

KW - public health service

KW - standard

KW - Cost-Benefit Analysis

KW - Dental Caries

KW - Environmental Monitoring

KW - Feasibility Studies

KW - Fluoridation

KW - Fluorides

KW - Health Services, Indigenous

KW - Humans

KW - Interviews

KW - Maintenance

KW - Medically Underserved Area

KW - Northern Territory

KW - Oceanic Ancestry Group

KW - Public Health Administration

KW - Public Policy

M3 - Article

VL - 7

SP - 100-

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

ER -