Abstract: Objective To detect serum oxidative stress products among residents living in endemic areas of coal-burning fluorosis and to explore the mechanism of fluorosis related injury for screening early diagnostic indicators of endemic fluorosis.Methods Totally 165 permanent residents (65 adults and 100 children aged 8-12 years) living in a coal-burning fluorosis endemic area at least 5 years were selected from Douqing town of Liupanshui municipality of Guizhou province and 90 control residents (40 adults and 50 children) were selected from a non-endemic area (Huaga town of the same municipality as the endemic town) in September 2013.Questionnaire survey and physical examination were conducted and morning urine and fasting blood samples were collected among the participants.Urinary fluoride,serum malondialdehyde (MDA),8-hydroxy-2'-deoxyguanosine (8-oHdG),8-iso-prostaglandin F2 alpha (8-iso-PGF2α) and advanced oxidation protein products(AOPPs)were measured for all the participants.Results The contents of 8-oHdG (1.73±0.62 ng/mL),8-iso-PGF2α (256.29±105.95 pg/mL),and AOPPs (61.10±27.33 μmol/L)in the adults of endemic ara were significant higher than those in the adults of non-endemic area (all P<0.05); while only 8-iso-PGF2α (181.22±77.24 pg/mL)was significantly higher in the children of endemic area than that in the children of non-endemic area (P<0.05).The children with minor dental fluorosis showed a significantly higher serum 8-iso-PGF2α (184.87±73.14 pg/mL)than that of the children in the non-endemic area (P<0.05).Conclusion Abnormalities in lipids,protein,and DNA could occur among populations with fluorosis and the abnormality in lipids metabolism could occur much earlier.Serum 8-iso-PGF2α could demonstrate early oxidative stress and may be used as a predictor for the early diagnosis of fluorosis.