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Narvai PC. Health surveillance of drinking water fluoridation in the City of Sao Paulo, Brazil, in the period 1990-1999. Sao Paulo, 2001 [Thesis – School of Public Health of University of Sao Paulo]. Effectiveness of water fluoridation depends on continuous and adequate levels of fluoride. Water suppliers companies have permanent control of the operational process. However, this is not enough to assure standard procedures and health authorities should establish a surveillance system based on the heterocontrol concept. A heterocontrol-based water fluoridation system was launched in the city of Sao Paulo, Brazil, in 1990. This thesis describes the system and shows the main results for the period 1990-1999. Materials and Method. Data from annual reports published by the local health authority in Sao Paulo were analysed. Water samples were classified as acceptable (from 0.6 to 0.8 ppm F) or unacceptable (less than 0.6 or above 0.8 ppm F). Sites where samples were collected were classified as adequate or inadequate. Results. The percentage of acceptable samples was always 80% or above. However, percentage of adequate sites varied from 56% to 96%. Sites with no information increased from 11% to 43% between 1993 and 1996. Conclusion. Adequate levels of added fluoride in the water supply were reported in Sao Paulo between 1990 and 1999. On the other hand, the high percentage of sites with no available data between 1993 and 1996 and the lack of information on relevant changes in the fluoride surveillance system may affect the system reliability.

Vigilância sanitária da fluoretação das águas de abastecimento público no município de São Paulo, Brasil, no período 1990-1999