To study the relationship between chemical elements in soil and whole blood, and fluorosis induced by coal-fired pollution, ecological and case-control studies were carried out. We determined the concentrations of 11 chemical elements and pH values in soil in two fluorosis-affected counties in Chongqing, China, and analyzed the correlation between these values and prevalence of dental fluorosis. Ni, I, F, Hg, and pH values positively correlated with fluorosis prevalence (P < 0.05); these soil parameters may be related to coal-fired pollution fluorosis. Cu, Zn, Ca, Mg, and Fe concentrations in whole blood, and fluoride levels in urine of residents in epidemic and non-epidemic areas were determined. Cu, Zn, Mg, and Fe levels of the children in the case group were lower than those of the children in the external control group; urine fluoride level in the children in the case group was higher than that of the children in the internal and external control groups (P < 0.05). The levels of Mg, Fe, and urine fluoride were higher in the case adult group than in the internal adult control group (P < 0.05). Anti-fluoride elements were deficient in endemic areas.
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