Water fluoridation controversy: Difference between revisions
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A STATEMENT OF CONCERN ON FLUORIDATION |
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'''Water fluoridation controversy''' refers to moral, ethical, and safety concerns regarding the [[water fluoridation|fluoridation]] of public [[Water supply|water supplies]]. The controversy occurs mainly in English-speaking countries, as [[Continental Europe]] does not practice water fluoridation.<ref name=Martin1989/> |
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Those opposed argue that water fluoridation imposes ethical issues,<ref name=Cross2003/> may cause serious health problems,<ref>With Legislature considering fluoride mandate, health questions linger http://www.fluoridealert.org/media/2005j.html</ref><ref name=SciAm/><ref name=Colquhoun1998>{{cite journal | journal = Fluoride | volume = 31 | issue = 2 | year = 1998 | pages = 103–118 | author = John Colquhoun | title = Why I changed my mind about water fluoridation | url = http://www.fluoride-journal.com/98-31-2/312103.htm | format = reprinted from ''[[Perspectives in Biology and Medicine]]''}}</ref><ref>Second Look. [http://www.slweb.org/bibliography.html A Bibliography of Scientific Literature on Fluoride]</ref> is not effective enough to justify the costs, and has a dosage that cannot be precisely controlled.<ref>American Public Health Association Community Water Fluoridation in the United States 10-28-’08 http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1373</ref><ref>Recommendations for using Fluoride to Prevent and Control Dental Caries in the United States, Centers for Disease Control 8-17-’01 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm</ref><ref>Autio-Gold, Jaana; Courts, Frank, Assesing the effect of fluoride varnish on early enamel carious lesions in the primary dentition, J. Amer. Dent. Assn. http://www.jada.info/cgi/content/full/132/9/1247</ref> Compared with their healthier counterparts, senior citizens, people with calcium and magnesium deficiencies, and people with impaired renal clearance are more susceptible to the negative effects of fluoride.<ref>Review of Fluoride: Benefits and Risks, U. S. Public Health Service,pp. F1-F7 (1991)</ref><ref>Messenger Online, Fluoride Still in the News: Risks Noted for Kidney Patients, Children, Seniors http://www.topangamessenger.com/articles.asp?SectionID=1&ArticleID=3114</ref> |
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Understanding and appreciating the historical reasons for advocating fluoridation, the undersigned professionals now recognize valid concerns about its safety and about its impact on the environment. This Statement serves as a vehicle for expressing these concerns. However, it is not a position statement on fluoridation, nor does it commit the undersigned to any point of view other than what is stated clearly in this document. A brief summary of recent events, reports, and research underlying our concerns, as well as a list of references, are supplementary to this document. (Link to footnotes in this article.) |
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Opposition to fluoridation has existed since its initiation in the 1940s.<ref name=Martin1989>[[Brian Martin (professor)|Martin B.]] (1989) [http://www.uow.edu.au/arts/sts/bmartin/pubs/89sq.html The sociology of the fluoridation controversy: a reexamination]. ''Sociological Quarterly''.</ref> During the 1950s and 1960s, some opponents of water fluoridation suggested that fluoridation was a [[communist]] plot to undermine public health.<ref name="Johnston">{{cite book | last = Johnston | first = Robert D | title = The Politics of Healing | publisher = Routledge | year = 2004 | isbn = 0415933390| page = 136}}</ref> [[Sociologist]] Brian Martin states that sociologists have typically viewed opposition to water fluoridation as irrational, although critics of this position have argued that this rests on an uncritical attitude toward scientific knowledge.<ref name=Martin1989/> |
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OUR MAJOR CONCERNS: |
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==Ethics== |
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Many who oppose water fluoridation consider it to be a form of compulsory mass [[medication]].<ref name="greenparty.org.uk">UK Green Party. (2003). [http://www.greenparty.org.uk/files/reports/2003/F%20illegality.htm Water fluoridation contravenes UK law, EU directives and the European Convention on Human Rights and Biomedicine]. Press office briefing. accessdate 2008-08-03</ref> They argue that consent by all water consumers cannot be achieved, nor can water suppliers accurately control the exact levels of fluoride that individuals receive, nor monitor their response. |
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I. Environmental Concerns |
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In the [[United Kingdom]] the [[Green Party of England and Wales|Green Party]] refers to fluoride as a poison, claims that water fluoridation violates Article 35 of the [[European Charter of Fundamental Rights]], is banned by the UK poisons act of 1972, violates Articles 3 and 8 of the [[Human Rights Act]] and raises issues under the [[United Nations Convention on the Rights of the Child]].<ref name="greenparty.org.uk"/> |
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Silicofluorides: unrefined industrial waste |
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Water fluoridation has also been criticized by Cross and Carton for violating the [[Nuremberg Code]] and the Council of Europe's Biomedical Convention of 1999.<ref name=Cross2003>{{cite journal |author=Cross DW, Carton RJ |title=Fluoridation: a violation of medical ethics and human rights |journal=Int J Occup Environ Health |volume=9 |issue=1 |pages=24–9 |year=2003 |pmid=12749628 |doi= |url=}}</ref> Dentistry professor David Locker and philosopher Howard Cohen argued that the moral status for advocating water fluoridation is "at best indeterminate" and could even be considered immoral because it infringes upon autonomy based on uncertain evidence, with possible negative effects.<ref name=LockerCohen2001>Cohen H, Locker D. (2002). [http://www.cda-adc.ca/jcda/vol-67/issue-10/578.html The Science and Ethics of Water Fluoridation]. J Can Dent Assoc 2001; 67(10):578-80.</ref> |
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91% of Americans ingesting artificially fluoridated water are consuming silicofluorides1. This is a class of fluoridation chemicals that includes hydrofluosilicic acid and its salt form, sodium fluorosilicate. These chemicals are collected from the pollution scrubbers of the phosphate fertilizer industry. The scrubber liquors contain contaminants such as arsenic, lead, cadmium, mercury, and radioactive particles2, are legally regulated as toxic waste, and are prohibited from direct dispersal into the environment. Upon being sold (unrefined) to municipalities as fluoridating agents, these same substances are then considered a "product", allowing them to be dispensed through fluoridated municipal water systems to the very same ecosystems to which they could not be released directly. Sodium fluoride, used in the remaining municipalities, is also an industrial waste product that contains hazardous contaminants. |
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A research article suggested applying the [[precautionary principle]] to this controversy, which calls for [[public policy]] to reflect a conservative approach to minimize risk in the setting where harm is possible (but not necessarily confirmed) and where the science is not settled.<ref name="Tickner">{{cite journal |author=Tickner J, Coffin M |title=What does the precautionary principle mean for evidence-based dentistry? |journal=J Evid Based Dent Pract |volume=6 |issue=1 |pages=6–15 |year=2006 |month=March |pmid=17138389 |doi=10.1016/j.jebdp.2005.12.006 |url=}}</ref> |
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Scarcity of environmental impact studies |
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== Safety == |
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{{Main|Water fluoridation#Safety}} |
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{{Bad summary}} |
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Fluoride's adverse effects depend on total fluoride dosage from all sources.{{Citation needed|date=October 2010}} At the commonly recommended dosage, the only clear adverse effect is [[dental fluorosis]], which can alter the appearance of children's teeth during [[tooth development]]; this is mostly mild and is unlikely to represent any real effect on public health.<ref name=NHMRC>{{cite web |url=http://www.nhmrc.gov.au/publications/synopses/eh41syn.htm |accessdate=November 25, 2010 |year=2007 |title=A systematic review of the efficacy and safety of fluoridation |publisher=National Health and Medical Research Council (Australia)}} Summary: {{cite journal |author=Yeung CA |title= A systematic review of the efficacy and safety of fluoridation |journal=Evid Based Dent |volume=9 |issue=2 |pages=39–43 |year=2008 |pmid=18584000 |doi=10.1038/sj.ebd.6400578 |laysummary=http://www.nhmrc.gov.au/media/media/rel07/_files/Fluoride_Flyer.pdf |laydate=2007 |laysource=NHMRC}}</ref> Fluoridation has little effect on risk of [[bone fracture]] (broken bones); it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation.<ref name=NHMRC/> A major Australian study found no clear association between fluoridation and [[cancer]] or deaths due to cancer, both for cancer in general and also specifically for [[bone cancer]] and [[osteosarcoma]],<ref name=NHMRC/> and other adverse effects lack sufficient evidence to reach a confident conclusion.<ref name=YorkReview2000/> Several studies cited by opponents of community fluoridation have found associations, consistently finding that osteosarcoma rates are significantly higher in male children with raised fluoride levels.<ref>{{cite news |url=http://www.reuters.com/article/pressRelease/idUS145903+29-Apr-2009+PRN20090429 |title=Another Study Links Fluoride to Bone Cancer |agency=[[Reuters]] |date=29 April 2009}}</ref> |
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This is of deep concern to us. Studies that do exist indicate damage to salmon and to plant ecosystems.3a It is significant that Canada's water quality guideline to protect freshwater life is 0.12 ppm (parts per million). 3b |
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The WHO set a general guideline of 1.5 mg/L concentration of fluoride in drinking water to avoid adverse effects of higher concentrations including severe dental fluorosis and [[skeletal fluorosis]], as these effects were minimal at this concentration or lower.<ref>{{cite book |chapter= Human health effects |title=Fluoride in Drinking-water |author=Fawell J, Bailey K, Chilton J, Dahi E, Fewtrell L, Magara Y |publisher=World Health Organization |isbn=92-4-156319-2 |year=2006 |url=http://www.who.int/water_sanitation_health/publications/fluoride_drinking_water_full.pdf |format=PDF |accessdate=February 28, 2009 |pages=29–36}}</ref> In 2006, a 12-person [[U.S. National Research Council]] (NRC) committee reviewed the health risks associated with fluoride in the water<ref name=NRC2006>{{cite book |title= Fluoride in Drinking Water: A Scientific Review of EPA's Standards |author= National Research Council |location= Washington, DC |publisher= National Academies Press |isbn=0-309-10128-X |year=2006 |url=http://books.nap.edu/catalog.php?record_id=11571#toc |laysummary=http://dels.nas.edu/dels/rpt_briefs/fluoride_brief_final.pdf |laysource=NRC |laydate=September 24, 2008}}. See also [http://www.cdc.gov/fluoridation/safety/nrc_report.htm the CDC statement on the NRC report].</ref> and unanimously concluded that the [[maximum contaminant level]] of 4 mg/L should be lowered. Although it did not comment on water fluoridation's safety, three of the panel members, namely Robert Isaacson, Kathleen Thiessen and Hardy Limeback, expressed {{citation needed|date=December 2010}} their opposition to water fluoridation after the study<ref name=Thiessen2006>{{cite web |author=Thiessen KM |date=2 May 2006 |url=http://fluoridealert.org/health/epa/nrc/thiessen-2006.pdf |title=Correspondence}}</ref><ref>{{cite news |author=Budnick N |year=2006 |url=http://www.portlandtribune.com/news/print_story.php?story_id=34527 |title=Fluoride foes get validation |work=[[Portland Tribune]] }}</ref><ref name=LimebackStandardTimes>{{cite news |author=Limeback H |date=14 May 2006 |url=http://archive.southcoasttoday.com/daily/05-06/05-14-06/02opinion.htm |title=GUEST VIEW: The evidence that fluoride is harmful is overwhelming |work=The Standard Times |location=South Coast, MA }}</ref> and the chair, John Doull, suggested that the issue should be reexamined.<ref name=SciAm>{{cite journal |author=Fagin D |title=Second thoughts about fluoride |journal=[[Scientific American]] |volume=298 |issue=1 |pages=74–81 |year=2008 |month=January |pmid=18225698 |doi=10.1038/scientificamerican0108-74 }}</ref> Because the report recommended lowering the MCL, opponents argue that fluoridation has a lower margin of safety than previously realized.<ref name=FluorideAlertOnNRC2006>{{cite web |author=Connett, Paul |url=http://fluoridealert.org/health/epa/nrc/fluoridation.html |title=The relevance of the NRC Report to fluoridation |publisher=Fluoride Action Network}}</ref> |
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99.97% of fluoridated water is released directly into the environment at around 1ppm |
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Because water fluoridation provided is not individually controlled, opponents express concern for vulnerable populations such as children, nutritionally deficient individuals, and [[renal]]ly impaired individuals. The National Research Council states that children have a higher daily average intake than adults per kg of bodyweight.<ref name=NRC2006/>{{rp|23}} Those who perspire heavily or have kidney problems consume more water and thus also have a greater intake. A 2006 study reported an association between fluoride in drinking water and osteosarcoma, a rare bone disease affecting male children.<ref>{{cite journal |author=Bassin EB, Wypij D, Davis RB, Mittleman MA |title=Age-specific fluoride exposure in drinking water and osteosarcoma (United States) |journal=[[Cancer Causes and Control]] |year=2006 |volume=17 |pages=421–8 |pmid=16596294}}</ref> A 2009 analysis by the United States [[Centers for Disease Control]] (CDC) stated that upon reviewing this and other similar studies, the weight of the evidence does not support a relationship. However, the CDC also calls for further research into this potential association to help support or refute the observation.<ref name=CDCosteosarcoma>{{cite web |url=http://www.cdc.gov/fluoridation/fact_sheets/osteosarcoma.htm |title=CDC Statement on Water Fluoridation and Osteosarcoma |publisher=[[U.S. Centers for Disease Control]] |date=24 August 2009 |accessdate=8 December 2010}}</ref> A study performed as a doctoral thesis, which is described as the most rigorous yet by the Washington Post, found a relationship among young boys,<ref>{{cite news |work=[[The Washington Post]] |author=Juliet Eilperin |url=http://www.washingtonpost.com/wp-dyn/content/article/2005/07/12/AR2005071201277.html |title=Professor at Harvard Is Being Investigated |date=12 July 2005 }}</ref> but then the Harvard professor who advised the doctoral students determined that the results were not highly correlative enough to have evidentiary value; the professor then was investigated but exonerated by the federal government's [[Office of Research Integrity]] (ORI).<ref>{{cite news |url=http://www.thecrimson.com/article.aspx?ref=514514 |author=A. Haven Thompson |date=27 September 2006 |title=At the Harvard School of Dental Medicine, One Professor’s Flouride Scandal Stinks |work=[[The Harvard Crimson]] }}</ref> |
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This water is NOT used for drinking or cooking.4 |
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An epidemiological connection between silicofluorides, an industrial byproduct which is used to fluoridate much of the U.S. water, and lead uptake in children was observed in a 2000 study.<ref name=Masters2000>{{Cite journal | author = Masters, R. D.; Coplan, M. J.; Hone, B. T.; Dykes, J. E. | year = 2000 | journal = Neurotoxicology | volume = 21 | issue = 6 | pages = 1091–100 | url = http://www.ncbi.nlm.nih.gov/pubmed/11233755 | pmid = 11233755 | title = Association of silicofluoride treated water with elevated blood lead.}} [http://www.dartmouth.edu/~news/releases/2001/mar01/flouride.html Dartmouth press release]</ref> A 2006 U.S. CDC-funded study was unable to replicate the results,<ref>{{cite journal |author= Macek MD, Matte TD, Sinks T, Malvitz DM |title= Blood lead concentrations in children and method of water fluoridation in the United States, 1988–1994 |journal= Environ Health Perspect |volume=114 |issue=1 |pages=130–4 |year=2006 |pmid=16393670 |pmc=1332668 |doi=10.1289/ehp.8319 |url=http://www.ehponline.org/members/2005/8319/8319.html}}</ref> which the original researchers responded to in a 2007 rebuttal.<ref name=Coplan2007>{{Cite journal | author = Coplan, M. J.; Patch, S. C.; Masters, R. D.; Bachman, M. S. | year = 2007 | title = Confirmation of and explanations for elevated blood lead and other disorders in children exposed to water disinfection and fluoridation chemicals | journal = Neurotoxicology | volume = 28 | issue = 5 | pages = 1032–1042 | doi = 10.1016/j.neuro.2007.02.012 | pmid = 17420053}}</ref> Aside from the lead connection, concerns are raised as to whether silicofluorides might have different effects on the body than sodium fluorides, and silicofluorides have not been rigorously tested for safety.<ref name=Coplan2007/> |
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==Efficacy== |
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{{Main|Water fluoridation#Effectiveness}} |
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{{Bad summary}} |
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The available evidence shows that water fluoridation is effective in reducing cavities (see [[water fluoridation#Effectiveness|effectiveness section of the main article]]). The most comprehensive [[systematic review]] found that fluoridation was [[Association (statistics)|statistically associated]] with a decreased proportion of children with cavities (the [[median]] of [[mean]] decreases was 14.6%, the [[Range (statistics)|range]] −5 to 64%), and with a decrease in decayed, [[Tooth loss|missing]], and [[Dental restoration|filled]] [[primary teeth]] (the median of mean decreases was 2.25 teeth, the range 0.5 to 4.4 teeth),<ref name=YorkReview2000/> which is roughly equivalent to preventing 40% of cavities.<ref name=Yeung-adults>{{cite journal |author= Yeung CA |title=Fluoride prevents caries among adults of all ages |journal=Evid Based Dent|volume=8 |issue=3 |pages=72–3 |year=2007 |pmid=17891121 |doi=10.1038/sj.ebd.6400506 }}</ref> The review found that the evidence was of moderate quality: many studies did not attempt to reduce [[observer bias]], control for [[confounding factor]]s, report variance measures, or use appropriate analysis.<ref name=YorkReview2000>{{cite journal |author=McDonagh MS, Whiting PF, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, Misso K, Bradley M, Treasure E, Kleijnen J |title=Systematic review of water fluoridation |journal=BMJ |volume=321 |issue=7265 |pages=855–9 |date=7 October 2000 |doi=10.1136/bmj.321.7265.855 |pmid=11021861 |pmc=27492 |url=http://www.bmj.com/cgi/reprint/321/7265/855.pdf |format=PDF}} Full report: {{cite book |author=McDonagh MS, Whiting PF, Bradley M, Cooper J, Sutton AJ, Chestnutt I, Misso K, Paul Wilson P, Treasure E, Kleijnen J |title=A Systematic Review of Public Water Fluoridation |publisher=NHS Centre for Reviews and Dissemination |date=September 2000 |url=http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport18.pdf |isbn=1900640163 }} Authors' commentary: {{cite journal |author=Treasure ET, Chestnutt IG, Whiting P, McDonagh M, Wilson P, Kleijnen J |title=The York review—a systematic review of public water fluoridation: a commentary |journal=[[Br Dent J]] |volume=192 |issue=9 |pages=495–7 |year=2002 |pmid=12047121 |doi=10.1038/sj.bdj.4801410a |url=http://www.nature.com/bdj/journal/v192/n9/full/4801410a.html }}</ref> The effect is largely due to the topical effect of fluoride ions in the mouth rather than the systemic effect of ingestion.<ref name=Pizzo>{{cite journal |author=Pizzo G, Piscopo MR, Pizzo I, Giuliana G |title=Community water fluoridation and caries prevention: a critical review |journal=Clin Oral Investig |volume=11 |issue=3 |pages=189–93 |year=2007 |pmid=17333303 |doi=10.1007/s00784-007-0111-6 }}</ref> |
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II. Health Concerns |
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Fluoridation opponents have challenged the efficacy of fluoridation,<ref name=Colquhoun1998/> although their arguments have been accused of bias.<ref name=Spencer1998>{{cite journal |author=Spencer AJ |year=1998 |title=New, or biased, evidence on water fluoridation? |journal=Australian and New Zealand Journal of Public Health |volume=22 |issue=1 |pages=149–154 |doi=10.1111/j.1467-842X.1998.tb01161.x |pmid=9599869}}</ref> A large study of water fluoridation's efficacy was conducted by the National Institute of Dental Research in 1988, which officially found "20 percent fewer decayed tooth surfaces" corresponding to "less than one cavity per child".<ref name=Colquhoun1998/> Arguing that the study had errors, the data was reanalyzed by fluoridation opponent John A. Yiamouyiannis, whose results indicated no statistically significant difference in [[tooth decay]] rates among children in fluoridated and nonfluoridated communities.<ref name=Colquhoun1998/><ref>[http://www.icnr.com/NIDRStudy.html NIDR Study on Fluoridation]</ref> Conversely, fluoridation proponents argued that Yiamouyiannis' work had errors.<ref>{{cite journal |author=Horowitz HS |title=Why I continue to support community water fluoridation |journal=J Public Health Dent |volume=60 |issue=2 |pages=67–71 |year=2000 |pmid=10929563 |doi= 10.1111/j.1752-7325.2000.tb03297.x|url=}}</ref> |
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Absence of safety studies on silicofluorides |
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When asked by the U.S. House Committee on Science for chronic toxicity test data on sodium fluorosilicate and hydrofluorosilicic acid, Charles Fox of the EPA answered on June 23, 1999, "EPA was not able to identify chronic toxicity data on these chemicals". 5 Further, EPA's National Risk Management Research Laboratory stated, on April 25, 2002, that the chemistry of silicofluorides is "not well understood" and studies are needed. |
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In 1986 fluoridation opponent [[Mark Diesendorf]] pointed out the substantial declines in tooth decay in nonfluoridated European countries.<ref>{{cite journal |author=Diesendorf M |title=The mystery of declining tooth decay |journal=Nature |volume=322 |issue=6075 |pages=125–9 |year=1986 |pmid=3523258 |doi=10.1038/322125a0 |url=}}</ref> Although fluoridation may still be a relevant public health measure among the poor and disadvantaged, it may be unnecessary for preventing tooth decay, particularly in industrialized countries where tooth decay is rare.<ref name=Pizzo/> |
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EPA health goals ignored |
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== Statements against == |
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Since 1985, the [[United States Environmental Protection Agency]] (EPA) headquarters' union has expressed concerns about fluoride. In 2005, eleven EPA employee unions, representing over 7000 environmental and public health professionals of the Civil Service, called for a halt on drinking water fluoridation programs across the USA and asked EPA management to recognize fluoride as posing a serious risk of causing cancer in people.<ref>[http://nteu280.org/Issues/Fluoride/fluoridesummary.htm Fluoride Summary<!-- Bot generated title -->]</ref> |
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The EPA defines the Maximum Contaminant Level Goal (MCLG) for toxic elements in drinking water thus: "the level below which there are no known or anticipated effects to health." The MCLG for arsenic, lead, and radioactive particles, all contaminants of the scrubber liquors used for fluoridation, is 0.0 ppb (zero parts per billion). Therefore, any addition of fluorine-bearing substances to drinking water that include these contaminants is contrary to the intent of EPA's established health goals. |
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In 1992, speaking on the Canadian television program ''[[Marketplace (TV series)|Marketplace]]'', former [[EPA]] scientist Robert Carton claimed that "fluoridation is the greatest case of scientific [[fraud]] of this century." The practice was described as the "longest running public health controversy in North America" in the broadcast.<ref>"Looking back at 40 years of fluoride" (''Marketplace'', Canadian Broadcasting Company, ''11-24-92'') http://archives.cbc.ca/programs/481-1844/page/1/</ref> |
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Increased blood lead levels in children |
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In addition, over 3,038 health industry professionals, including one Nobel prize winner in medicine ([[Arvid Carlsson]]), doctors, dentists, scientists and researchers from a variety of disciplines are calling for an end to water fluoridation in an online petition to Congress.<ref name="FlorideAlertAugust2007">[http://www.fluoridealert.org/statement.august.2007.html Professionals' Statement Calling For An End To Water Fluoridation<!-- Bot generated title -->]</ref> The petition signers express concern for [[Vulnerability|vulnerable]] groups like "small children, above average water drinkers, [[diabetics]], and people with poor [[kidney]] function," who they believe may already be [[overdosing]] on fluoride.<ref name="FlorideAlertAugust2007" /> Another concern that the petition signers share is, "The admission by federal agencies, in response to questions from a Congressional subcommittee in 1999-2000, that the industrial grade waste products used to fluoridate over 90% of America's drinking water supplies (fluorosilicate compounds) have never been subjected to [[toxicological]] testing nor received FDA approval for human ingestion."<ref name="FlorideAlertAugust2007" /> The petition was sponsored by the [[Fluoride Action Network]].<ref>http://www.fluoridealert.org/about-fan.htm</ref><ref>Dominion Post, Kapiti Council Keeps Fluoride, 11-6-2010 http://www.stuff.co.nz/dominion-post/local/3799506/Kapiti-council-keeps-fluoride</ref><ref>Dominion Post, Fluoride levels 'too high' for bottle-fed babies, 19-6-2010 http://www.stuff.co.nz/life-style/3830341/Fluoride-levels-too-high-for-bottle-fed-babies</ref><ref>Toronto Star, End water fluoridation, professor says |
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People get enough from toothpaste, he argues, 11-18-'08 http://www.thestar.com/article/538700</ref> |
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Two recent studies with a combined sampling of over 400,000 children found significantly increased levels of lead in children's blood when silicofluorides from the phosphate fertilizer industry were used as the fluoridating agent.6 This shows that there is a significant difference in health effects even between different fluoridation compounds. |
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[[Hardy Limeback]], PhD, [[Doctor of Dental Surgery|DDS]] was one of the 12 scientists who served on the [[United States National Academy of Sciences|National Academy of Sciences]] panel that issued the aforementioned report, ''Fluoride in Drinking Water: A Scientific Review of the EPA's Standards.'' Dr. Limeback is an associate professor of dentistry and head of the preventive dentistry program at the [[University of Toronto]]. He detailed his concerns in an April 2000 letter titled, "Why I am now officially opposed to adding fluoride to drinking water".<ref name=Limeback2000>[[Hardy Limeback|Limeback, Hardy]]. (2000). [http://www.fluoridealert.org/limeback.htm Why I am now officially opposed to adding fluoride to drinking water]. Fluoride Alert.</ref> |
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Ingestion of fluoride linked to many health effects |
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In a presentation to the [[California Assembly]] Committee of Environmental Safety and Toxic Materials, Richard Foulkes, M.D., former special consultant to the Minister of Health of [[British Columbia]], revealed: |
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Contrary to assertions that the health effects of fluoride ingestion already have been scientifically proven to be safe and that there is no credible scientific concern, over the last fifteen years the ingestion of fluoride has been linked in scientific peer-reviewed literature to neurotoxicity7, bone pathology8, reproductive effects9, interference with the pineal gland 10, gene mutations11, thyroid pathology12, and the increasing incidence and severity of dental fluorosis13. This has caused professionals who once championed the uses of fluoride in preventing tooth decay, to reverse their position and call for a halt in further exposures.14 It is of significance that 14 Nobel Prize winning scientists, including the 2000 Nobel Laureate in Medicine, Arvid Carlsson, have expressed reservations on, or outright opposition to, fluoridation.15 |
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<blockquote>The [water fluoridation] studies that were presented to me were selected and showed only positive results. Studies that were in existence at that time that did not fit the concept that they were "selling," were either omitted or declared to be "bad science." The endorsements had been won by coercion and the self-interest of professional elites. Some of the basic "facts" presented to me were, I found out later, of dubious validity. We are brought up to respect these persons in whom we have placed our trust to safeguard the public interest. It is difficult for each of us to accept that these may be misplaced.<ref>http://www.sonic.net/kryptox/politics/lead20s.htm</ref></blockquote> |
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FDA has never approved systemic use of fluoride |
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A 2001 study found that "fluoride, particularly in toothpastes, is a very important preventive agent against dental caries," but added that "additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people."<ref name=Sheiham>{{vcite journal |author=Sheiham A |title=Dietary effects on dental diseases |journal=Public Health Nutr |volume=4 |issue=2B |pages=569–91 |year=2001 |pmid=11683551 |doi=10.1079/PHN2001142 |url=http://journals.cambridge.org/action/displayFulltext?type=1&fid=1357436&aid=1357428 |format=PDF }}</ref> |
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The U.S. Food and Drug Administration in December 2000 stated to the U.S. House Committee on Science they have never provided any specific approval for safety or effectiveness for any fluoride substance intended to be ingested for the purpose of reducing tooth decay.16 |
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On April 15, 2008, the United States [[National Kidney Foundation]] (NKF) updated their position on fluoridation for the first time since 1981.<ref>{{cite web|url=http://www.organicconsumers.org/articles/article_12710.cfm|title=Kidney Patients Should be Notified of Potential Risk from Fluorides and Fluoridated Drinking Water|publisher=Organic Consumers Association|date=2008-06-03|accessdate=2008-06-16}}</ref> Formerly an endorser of water fluoridation, the group is now neutral on the practice. The report states, ''“Individuals with CKD should be notified of the potential risk of fluoride exposure by providing information on the NKF website including a link to the report in brief of the NRC'' <ref name="NRC2006"/> ''and the Kidney Health Australia position paper."'' <ref>Kidney Health Australia Fluoride Position Statement,” http://www.kidney.org.au/HealthProfessionals/PositionStatements/tabid/725/Default.aspx</ref> Calling for additional research, the foundation's current position paper states, however, that there is insufficient evidence to recommend fluoride-free drinking water for patients with renal disease.<ref>National Kidney Foundation. [http://www.kidney.org/atoz/pdf/Fluoride_Intake_in_CKD.pdf Fluoride Intake in Chronic Kidney Disease]. April 15, 2008.</ref> |
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Total fluoride exposure of growing concern |
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The [[International Chiropractor's Association]] opposes mass water fluoridation, considering it "possibly harmful and deprivation of the rights of citizens to be free from unwelcome mass medication."<ref name='ICA_position'>{{cite web|url=http://www.chiropractic.org/index.php?p=ica/policies |title=ICA Policy Position Statements |accessdate=2008-08-28 |publisher=International Chiropractors Association }}</ref> |
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Total fluoride exposure from all sources, including food, water, and air, is of growing concern within the scientific community.17 As evidenced in the U.S. Public Health Service ATSDR 1993 report which was referenced in correspondence between the U.S. House Committee on Science and Charles Fox of the U.S. EPA, large subsets of the population, including the elderly, children, and pregnant women, may be unusually susceptible to the toxic effects of fluoride.18 |
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In the United States, the Sierra Club opposes mandatory water fluoridation. Some reasons cited include possible adverse health effects, harm to the environment, and risks involving sensitive populations.<ref>Sierra Club Policy on Fluoride in Drinking Water, Board of Directors, June 19, 2008 http://www.sierraclub.org/policy/conservation/water_fluoridation.aspx</ref> In 2006, the Massachusetts legislature decided not to consider a bill that would have mandated water fluoridation throughout the state, because of concerns about health effects.<ref>Mandatory fluoride bill loses its bite http://www2.fluoridealert.org/Alert/United-States/Massachusetts/Mandatory-fluoride-bill-loses-its-bite</ref> |
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Centers for Disease Control concession |
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Citing impacts on the environment, the economy and on health, the [[Green Party of Canada]] seeks a ban on artificial fluoridation products. The Canadian Green Party considers water fluoridation to be unsustainable.<ref>Rodriguez-Larrain, Claudia, Ban on artificial water fluoridation, a new policy, Green Party of Canada http://greenparty.ca/blogs/15909/2010-08-26/engage-elizabeth-may-new-policy-ban-fluoridation</ref> |
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The CDC now concedes that the systemic value of ingesting fluoride is minimal, as fluoride's oral health benefits are predominantly topical19, and that there has been a generalized increase in dental fluorosis20. |
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==Use throughout the world== |
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{{Main|Fluoridation by country}} |
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Water fluoridation is used in the [[United States]], United Kingdom, [[Ireland]], [[Canada]], and [[Australia]], and a handful of other countries. The following nations previously fluoridated their water, but stopped the practice, with the years when water fluoridation started and stopped in parentheses: |
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*Federal Republic of Germany (1952–1971) |
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*Sweden (1952–1971) |
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*Netherlands (1953–1976) |
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*Czechoslovakia (1955–1990) |
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*German Democratic Republic (1959–1990) |
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*Soviet Union (1960–1990) |
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*Finland (1959–1993) |
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*Japan (1952–1972){{Citation needed|date=November 2008}} |
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III. In Consideration of the concerns raised above, we urge fluoridated cities, states with mandatory fluoridation, health care professionals, and public health authorities, to review ALL current information available, and use this information to re-evaluate current practices. |
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In 1986 the journal [[Nature (journal)|''Nature'']] had a commentary, "Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries."<ref>[http://www.nature.com/nature/journal/v322/n6075/abs/322125a0.html Nature 322, 125 - 129. 10 July 1986. The mystery of declining tooth decay. Mark Diesendorf]</ref> |
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In areas with complex water sources, water fluoridation is more difficult and more costly. Alternative fluoridation methods have been proposed, and implemented in some parts of the world. The [[World Health Organization]] (WHO) is currently assessing the effects of fluoridated toothpaste, milk fluoridation and salt fluoridation in [[Africa]], [[Asia]], and [[Europe]]. The WHO supports fluoridation of water in some areas, and encourages removal of fluoride where fluoride content in water is too high.<ref>[http://www.who.int/entity/oral_health/media/en/orh_report03_en.pdf WHO World Oral Health Report] (in pdf format), from the [http://www.who.int World Health Organization] website, accessed on 4 March 2006.</ref> |
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IV. Congressional Investigation is Appropriate |
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== History == |
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This Statement of Concern (same substance, slightly different content and form), along with a significant list of signatures, was unveiled at the May 6, 2003 EPA Science Forum session on fluoridation in support of the National Treasury Employees Union Chapter 280 (EPA union of professionals) renewed call for a Congressional investigation. No authorities from government agencies or non-governmental organizations responded to widespread EPA invitations over a six-week period, to attend this session to explain/defend the practice of fluoridation. In view of this fact, and also that some serious questions of propriety have been posed but not addressed, about the formulation of the EPA's drinking water standards for fluoride21, as well as the downgrading of cancer bioassay data by the EPA in 199022, it now seems especially valid to ask Congress to hold hearings that will compel promoters to answer many unanswered questions. |
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{{Main|History of water fluoridation}} |
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It is appropriate that the U.S. Congress undertake an in-depth investigation of this public policy that is endorsed by major U.S. government agencies, but has never been adequately reviewed in its long history. Considering that there is an absence of research on silicofluorides, and that the latest scientific research on toxicity of fluorides has never been included in any government policy-making, and considering the many unanswered questions and concerns, we join the USEPA Union of professional employees in calling for a full-scale Congressional investigation into the public policy of fluoridation. |
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The first large fluoridation controversy occurred in Wisconsin in 1950. Fluoridation opponents questioned the ethics, safety, and efficacy of fluoridation.<ref name=Musto>{{cite journal |author=Musto RJ |title=Fluoridation: why is it not more widely adopted? |journal=CMAJ |volume=137 |issue=8 |pages=705–8 |year=1987 |month=October |pmid=3651941 |pmc=1267306 |doi= |url=}}</ref> New Zealand was the second country to fluoridate, and similar controversies arose there.<ref name=Wrapson>{{cite journal | doi = 10.2307/40111610 | year = 2005 | title = Fluoridation of Public Water Supplies in New Zealand:‘Magic Bullet,’Rat Poison, or Communist Plot? | journal = Health and History | volume = 7 | issue = 2 | pages = 17–29 | url = http://www.historycooperative.org/journals/hah/7.2/wrapson.html | author = Wrapson J | jstor = 40111610}}</ref> Fears about fluoride were likely exacerbated by the reputation of fluoride compounds as insect poisons and by early literature which tended to use terms such as "toxic" and "low grade chronic [[fluoride poisoning]]" to describe mottling from consumption of 6 mg/L of fluoride prior to tooth eruption, a level of consumption not expected to occur under controlled fluoridation.<ref>{{cite journal |author=Richmond VL |title=Thirty years of fluoridation: a review |journal=Am. J. Clin. Nutr. |volume=41 |issue=1 |pages=129–38 |year=1985 |month=January |pmid=3917599 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=3917599}}</ref> When voted upon, the outcomes tend to be negative, and thus fluoridation has had a history of gaining through administrative orders in North America.<ref name=Musto/> Theories for why the public tends to reject fluoridation include "alienation from mainstream" society, but evidence for that is weak. Another interpretation is confusion introduced during the referendum.<ref name=Musto/> Some studies of the sociology of opposition to water fluoridation have been criticized for having an uncritical attitude toward scientific knowledge.<ref name=Martin1989/> |
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Footnotes in Statement of Concern on Fluoridation |
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Outside of [[North America]], water fluoridation was adopted in European countries, but in the late 1970s and early 1980s, [[Denmark]] and [[Sweden]] banned fluoridation when government panels found insufficient evidence of safety, and the [[Netherlands]] banned water fluoridation when "a group of medical practitioners presented evidence" that it caused negative effects in a percentage of the population.<ref name=Colquhoun1998/> |
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(For a more comprehensive list of scientific literature, see Bibliography section at www.SLweb.org ) |
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1 CDC (1993). Fluoridation Census 1992. |
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=== Conspiracy theories === |
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[[Image:Unholy three.png|right|thumb|200px|Flier issued in May 1955 by the Keep America Committee, alleging a [[conspiracy theory]] that water fluoridation is a communist plot.]] |
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Water fluoridation has frequently been the subject of conspiracy theories. During the "[[Red Scare]]" in the United States during the late 1940s and 1950s, and to a lesser extent in the 1960s, activists on the [[far right]] of American politics routinely asserted that fluoridation was part of a far-reaching plot to impose a [[socialist]] or communist regime. They also opposed other public health programs, notably mass [[vaccination]] and [[mental health]] services.<ref name="Henig">{{cite book | last = Henig | first = Robin Marantz | title = The People's Health | publisher = Joseph Henry Press| year = 1997 | isbn = 0309054923 | page = 85 }}</ref> Their views were influenced by opposition to a number of major social and political changes that had happened in recent years: the growth of internationalism, particularly the UN and its programs; the introduction of [[social welfare provision]]s, particularly the various programs established by the [[New Deal]]; and government efforts to reduce perceived inequalities in the [[social structure of the United States]].<ref name="Rovere">{{cite book | last = Rovere | first = Richard H. | title = Senator Joe McCarthy | publisher = University of California Press | year = 1959 | pages = 21–22| isbn = 0-520-20472-7 }}</ref> |
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2 National Sanitation Foundation International. (2000) Letter from Stan Hazan, General Manager, NSF Drinking Water Additives Certification Program, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Representatives. July 7. http://www.keepersofthewell.org/product_pdfs/NSF_response.pdf |
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Some took the view that fluoridation was only the first stage of a plan to control the American people. Fluoridation, it was claimed, was merely a stepping-stone on the way to implementing more ambitious programs. Others asserted the existence of a plot by communists and the [[United Nations]] to "deplete the brainpower and sap the strength of a generation of American children". Dr. Charles Bett, a prominent anti-fluoridationist, charged that fluoridation was "better THAN USING THE ATOM BOMB because the atom bomb has to be made, has to be transported to the place it is to be set off while POISONOUS FLUORINE has been placed right beside the water supplies by the Americans themselves ready to be dumped into the water mains whenever a Communist desires!" Similarly, a right-wing newsletter, the ''American Capsule News'', claimed that "the Soviet General Staff is very happy about it. Anytime they get ready to strike, and their [[fifth column|5th column]] takes over, there are tons and tons of this poison "standing by" municipal and military water systems ready to be poured in within 15 minutes."<ref name="Johnston" /> |
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3a -- Damkaer DM, and Dey DB 1989. Evidence for fluoride effects on salmon passage at John Day Dam, Columbia River, 1982-1986. N. Am. J. Fish. Manage.9:154-162. |
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This viewpoint led to major controversies over public health programs in the US, most notably in the case of the [[Alaska Mental Health Enabling Act]] controversy of 1956.<ref>{{Cite book | surname= Marmor | given= Judd | chapter=Psychodynamics of Group Opposition to Mental Health Programs | title=Psychiatry in Transition | publisher=Brunner/Mazel | year=1974 | isbn = 0876300700}}</ref> In the case of fluoridation, the controversy had a direct impact on local programs. During the 1950s and 1960s, referendums on introducing fluoridation were defeated in over a thousand [[Florida]] communities. Although the opposition was overcome in time, it was not until as late as the 1990s that fluoridated water was drunk by the majority of the population of the United States.<ref name="Henig" /> |
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-- Davison A. and Weinstein L. The effects of fluorides on plants. (1998) Fluorides and the Environment. Earth Island Institute. www.earthisland.org . |
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The communist conspiracy argument declined in influence by the mid-1960s, becoming associated in the public mind with irrational fear and paranoia. It was lampooned in [[Stanley Kubrick]]'s 1964 film ''[[Dr. Strangelove]]'', in which the character General Jack D. Ripper initiates a nuclear war in the hope of thwarting a communist plot to "sap and impurify" the "precious bodily fluids" of the American people with fluoridated water. Similar satires appeared in other movies, such as 1967's ''[[In Like Flint]]'', in which a character's fear of fluoridation is used to indicate that he is insane. Even some anti-fluoridationists recognized the damage that the conspiracy theorists were causing; Dr. Frederick Exner, an anti-fluoridation campaigner in the early 1960s, told a conference: "most people are not prepared to believe that fluoridation is a communist plot, and if you say it is, you are successfully ridiculed by the promoters. It is being done, effectively, every day ... some of the people on our side are the fluoridators' 'fifth column'."<ref name="Johnston" /> |
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3b Canadian Environmental Quality Guidelines, http://www.ec.gc.ca/ceqg-rcqe/English/Html/GAAG_Fluoride.cfm |
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In 2004 on the television program ''Democracy Now'', investigative journalist and author of the book ''The Fluoride Deception'', Christopher Bryson stated that, “the post-war campaign to fluoridate drinking water was less a public health innovation than a public relations ploy sponsored by industrial users of fluoride–including the government’s nuclear weapons program.”<ref>Bryson, Christopher. [http://www.democracynow.org/2004/6/17/the_fluoride_deception_how_a_nuclear "The Fluoride Deception: How a Nuclear Waste Made its Way Into the Nation’s Drinking Water"], ''Democracy Now'', June 17, 2004</ref> |
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4 Personal communication with Dave Paris, Manchester Water Works, NH. (January 2001) Calculation based on estimated two-liters/ person/day used for drinking and cooking. |
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==Court cases== |
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===European Union=== |
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Water was fluoridated in large parts of the Netherlands from 1960 to 1973, when the [[Hoge Raad der Nederlanden|High Council of the Netherlands]] declared fluoridation of drinking water unauthorized.<ref>[http://books.google.com/books?id=3UoZAAAAIAAJ&pg=PA487&lpg=PA487&dq=fluoridering+nederland&source=web&ots=gBeB1umWcI&sig=w-iamuX7EZ4PBcwWbRPObOnTQHM&hl=nl&sa=X&oi=book_result&resnum=6&ct=result#PPA488,M1 -Bram van der Lek, "De strijd tegen fluoridering", in De Gids, v.139, 1976]</ref> Dutch authorities had no legal basis adding chemicals to drinking water if they will not improve the safety as such. The simple reason is that consumers cannot choose for a different tap water.<ref>L.J.A. Damen, P. Nicolaï, J.L. Boxum, K.J. de Graaf, J.H. Jans, A.P. Klap, A.T. Marseille, A.R. Neerhof, B.K. Olivier, B.J. Schueler, F.R. Vermeer, R.L. Vucsán (2005) [http://www.boomuitgeversdenhaag.nl/cache/ab/aba2a7206d9b151808b5c433455b63f8/9054545372_hoofdstuk.pdf Bestuursrecht 1, 2de druk]; Boom Uitgevers, Den Haag; 54-55 (ISBN 978-90-5454-537-8)</ref> Drinking water has not been fluoridated in any part of the Netherlands since 1973. |
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5 EPA. (1999) Letter from Charles Fox, Assistant Administrator, Office of Water, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Comm. on Science, US House of Representatives. June 23, 1999 http://www.keepersofthewell.org/gov_resp_pdfs/EPAresponse1.pdf |
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In ''Ryan v. Attorney General'' (1965), the [[Supreme Court of Ireland]] held that water fluoridation did not infringe the plaintiff's right to bodily integrity.<ref>[http://www.bailii.org/ie/cases/IESC/1965/1.html Ryan v. A.G. IESC 1; IR 294 (3 July, 1965)] — ''text of the Irish Supreme Court's judgement''</ref> However, the court found that such a right to bodily integrity did exist, despite the fact that it was not explicitly mentioned in the [[Constitution of Ireland]], thus establishing the doctrine of [[unenumerated rights]] in Irish constitutional law. |
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6 -- Masters RD, et al. (2000). Association of silicofluoride treated water with elevated blood lead. Neurotoxicology. 21:6, 1091 1099. |
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===United States=== |
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{{See also|Water fluoridation in the United States}} |
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Fluoridation has been the subject of many [[Legal case|court cases]] wherein activists have sued municipalities, asserting that their rights to consent to medical treatment and [[due process]] are infringed by mandatory water fluoridation.<ref name=Cross2003/> Individuals have sued municipalities for a number of illnesses that they believe were caused by fluoridation of the city's water supply. In most of these cases, the courts have held in favor of cities, finding no or only a tenuous connection between health problems and widespread water fluoridation.<ref name="beck">Beck v. City Council of Beverly Hills, 30 Cal. App. 3d 112, 115 (Cal. App. 2d Dist. 1973) ("Courts through the United States have uniformly held that fluoridation of water is a reasonable and proper exercise of the police power in the interest of public health. The matter is no longer an open question." (citations omitted)).</ref> To date, no federal appellate court or state court of last resort (i.e., state supreme court) has found water fluoridation to be unlawful.<ref>Pratt, Edwin, Raymond D. Rawson & Mark Rubin, ''Fluoridation at Fifty: What Have We Learned'', 30 J.L. Med. & Ethics 117, 119 (Fall 2002)</ref> |
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-- Masters RD, and Coplan M. (1999). Water treatment with silicofluorides and lead toxicity. International Journal of Environmental Studies. September. |
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In Marcus v. United States Environmental Protection Agency [[William Marcus]] successfully sued the Environmental Protection Agency. <ref> http://www.kkc.com/files/92tsc05c.htm </ref> EPA fired him for blowing the whistle on the reported carcinogenicity of a fluoride cancer bioassay mandated by Congress. <ref> http://www.kkc.com/files/92tsc05c.htm </ref> <ref> http://nteu280.org/Issues/Fluoride/629FINAL.htm </ref><ref> http://www.whistleblowers.org/index.php?option=com_content&task=view&id=860&Itemid=108 </ref> |
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== See also == |
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* [[Fluoride therapy]] |
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* [[Hexafluorosilicic acid]] |
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* [[Sodium monofluorophosphate]] |
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==References== |
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{{Reflist|2}} |
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7 Neurotoxicity |
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== Further reading == |
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* {{cite book |author=Connett, Paul, PhD; Beck, James, PhD, MD; Micklem, H. Spedding, DPhil |title=The Case Against Fluoride; How Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep It There |publisher=Chelsea Green Publishing |location=Vermont |year=2010 |pages=384 |isbn=9781603582872 }} |
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* {{cite book |author=Fawell, John Wesley |title=Fluoride in drinking-water |publisher=World Health Organization |location=Geneva |year=2006 |pages= |isbn=92-4-156319-2 |oclc= |doi= |accessdate=}} |
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* {{cite book |author=Freeze RA, Lehr JH |title=The Fluoride Wars: How a Modest Public Health Measure Became America's Longest-Running Political Melodrama |publisher=Wiley |year=2009 |isbn=0-470-44833-4 }} |
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-- Varner, J.A. et al (1998). Chronic administration of aluminum-fluoride and sodium-fluoride to rats in drinking water: Alterations in neuronal and cerebrovascular integrity. Brain Research, 784, 284-298. |
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==External links== |
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*[http://nteu280.org/ NTEU CHAPTER 280 - U.S. ENVIRONMENTAL PROTECTION AGENCY, NATIONAL HEADQUARTERS] |
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* {{DMOZ|Society/Issues/Health/Water_Treatment/Fluoridation/|Water fluoridation}} |
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-- Mullenix, P. et al (1995). Neurotoxicity of sodium fluoride in rats. Neurotoxicology &Teratology, 17, 169-77. |
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{{DEFAULTSORT:Water Fluoridation Controversy}} |
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[[Category:Dentistry]] |
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[[Category:Fluorine]] |
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[[Category:Water treatment]] |
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[[Category:Environmental controversies]] |
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[[Category:Medical controversies]] |
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[[Category:Political controversies in the United States]] |
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[[Category:Criticisms|Opposition to water fluoridation]] |
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-- Lu, Y. et al (2000). Effect of high-fluoride water on intelligence of children. Fluoride, 33, 74-78. |
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[[ja:水道水フッ化物添加についての議論]] |
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-- Li, X.S., (1995). Effect of fluoride exposure on intelligence in children. Fluoride, 28:4, 189-192 |
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-- Zhao, L.B. et al (1996). Effect of high-fluoride water supply on children's intelligence. Fluoride, 29, 190-192. |
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8 Bone Pathology |
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-- Riggs, B.L. et al (1990). Effect of fluoride treatment on the fracture rates in postmenopausal women with osteoporosis. N. Eng. J. Med., 322, 802-809. |
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-- Li Y, et al.(2001). Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Miner Res.16(5):932-9. |
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-- Kurttio, P., N. Gustavsson, et al. (1999). Exposure to natural fluoride in well water and hip fracture: A cohort analysis in Finland. American Journal of Epidemiology 150(8): 817-824. |
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-- Jacobsen, S., J. Goldberg, et al. (1992). The association between water fluoridation and hip fracture among white women and men aged 65 years and older; a national ecologic study. Annals of Epidemiology 2: 617-626. |
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-- Danielson, C., J. L. Lyon, et al. (1992). Hip fractures and fluoridation in Utah's elderly population. Journal of the American Medical Association 268(6): 746-748. |
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-- Sowers, M., M. Clark, et al. (1991). A prospective study of bone mineral content and fracture in communities with differential fluoride exposure. American Journal of Epidemiology 133: 649-660. |
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It should be noted that there are studies that found no relation between fluoridation and fractures. |
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9 Reproductive Effects: |
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-- Freni SC. (1994). Exposure to high fluoride concentrations in drinking water is associated with decreased birth rates. J Toxicology and Environmental Health 1994;42:109-121. |
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-- Susheela AK, Jethanandani P (1996). Circulating testosterone levels in skeletal fluorosis patients. J Toxicol Clin Toxicol 34(2):183-9. |
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-- Kumar A, Susheela AK (1994). Ultrastructural studies of spermiogenesis in rabbit exposed to chronic fluoride toxicity. Int J Fertil Menopausal Stud 39(3):164-71. |
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10 Impact on Pineal Gland |
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-- Luke, J. (1997). The Effect of Fluoride on the Physiology of the Pineal Gland. Ph.D. Thesis. University of Surrey. |
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-- Luke, J. (2001). Fluoride deposition in the aged human pineal gland. Caries Res. 35:125-128. |
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11 Genetic Damage |
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-- Department of Health & Human Services (1991). Review of fluoride benefits and risks. App. H. H1-H6. |
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-- Mihashi M, & Tsutsui T. Clastogenic activity of sodium fluoride to rat vertebral body-derived cells in culture. Mutation Research May 368(1):7-13. |
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-- Aardema MJ, et al (1989). Sodium fluoride-induced chromosome aberrations in different stages of the cell cycle: a proposed mechanism. Mutation Research 223 191-203. |
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-- Caspary WJ, et al (1987). Mutagenic activity of fluorides in mouse lymphoma cells. Mutation Research. 187(3):165-80. |
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-- Tsutsui T, et al. (1984). Cytotoxicity, chromosome aberrations and unscheduled DNA synthesis in cultured human diploid fibroblasts induced by sodium fluoride. Mutation Research 139:193-198. |
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12 Thyroid Pathology |
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-- Bachinskii PP, et al. (1985). Action of the body fluorine of healthy persons and thyroidopathy patients on the function of hypophyseal-thyroid system. Probl Endokrinol (Mosk) 31(6):25-9. |
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-- Zhao, W. (1998). Long-term effects of various iodine and fluorine doses on the thyroid and fluorosis in mice. Endocr Regul 32(2):63-70. |
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-- Jooste PL, et al. (1999). Endemic goitre in the absence of iodine deficiency in schoolchildren of the Northern Cape Province of South Africa. Eur J Clin Nutr 53(1):8-12. |
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-- Lin Fa-Fu; et al (1991). The relationship of a low-iodine and high-fluoride environment to subclinical cretinism in Xinjiang. Iodine Deficiency Disorder Newsletter. Vol. 7. No. 3. |
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-- Galletti, P. & Joyet, G. (1958). Effect of fluorine on thyroidal iodine metabolism in hyperthyroidism. J. Clinical Endocrinology. 18:1102-1110 |
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13 Dental Fluorosis |
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Heller KE et al (1997). Dental caries and dental fluorosis at varying water fluoride concentrations. J Pub Health Dent, 57;No. 3, 136-143. |
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14 -- Colquhoun, J. (1997). Why I changed my mind about water fluoridation. Perspectives in Biology and Medicine 41 29-44 1997. |
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-- Limeback, H. (2000). Why I am now officially opposed to adding fluoride to drinking water. Open Letter. http://www.fluoridealert.org/limeback.htm |
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15 See: Connett, P. (2000). Fluoride: A Statement of Concern. Waste Not #414. http://www.fluoridealert.org/fluoride-statement.htm |
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16 FDA. (2000) Letter from Melinda K. Plaisier, Associate Commissioner for Legislation, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Reps. Dec. 21. http://www.keepersofthewell.org/gov_resp_pdfs/fda_response.pdf |
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17 -- Stannard JG. (1991). Fluoride levels and fluoride contamination of fruit juices. Journal of Clinical Pediatric Dentistry. 16 (1): 38-40. 1991 |
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-- UNICEF. Fluoride in water: An overview. Accessed Online May 2001. http://www.unicef.org/programme/wes/info/fluor.htm |
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-- U.S. Public Health Service, Agency for Toxic Substances & Disease Registry (ATSDR), April, 1993: Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine. ATSDR/TP-91/17, 4/93, pp. 155-6. |
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18 -- Letter 9/5/2000 of Charles Fox, Asst. Administrator EPA, Office of Water, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Representatives. http://www.keepersofthewell.org/gov_resp_pdfs/EPA_response2.pdf |
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-- U.S. Public Health Service, Agency for Toxic Substances & Disease Registry (ATSDR), April, 1993: Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine. ATSDR/TP-91/17, 4/93, pp. 155-6. |
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19 CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. Mortality and Morbidity Weekly Review (MMWR), 48(41);933-940 October 22, 1999. |
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20 CDC (2001). Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Mortality and Morbidity Weekly Review. August 17, 50(RR14):1-42. |
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21 Carton, RJ and Hirzy, JW (1998). Applying the NAEP Code of Ethics to the Environmental Protection Agency |
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and the fluoride in drinking water standard. Proceedings of the 23rd Annual Conference of the National Association of Environmental Professionals, 20-24 June 1998, San Diego, CA. |
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22 Hirzy, JW (2000). Statement before Environment and Public Works Subcommittee on Wildlife, Fisheries and Drinking Water. US Senate. June 29, 2000. |
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Revision as of 04:27, 13 December 2010
A STATEMENT OF CONCERN ON FLUORIDATION
Understanding and appreciating the historical reasons for advocating fluoridation, the undersigned professionals now recognize valid concerns about its safety and about its impact on the environment. This Statement serves as a vehicle for expressing these concerns. However, it is not a position statement on fluoridation, nor does it commit the undersigned to any point of view other than what is stated clearly in this document. A brief summary of recent events, reports, and research underlying our concerns, as well as a list of references, are supplementary to this document. (Link to footnotes in this article.)
OUR MAJOR CONCERNS:
I. Environmental Concerns
Silicofluorides: unrefined industrial waste
91% of Americans ingesting artificially fluoridated water are consuming silicofluorides1. This is a class of fluoridation chemicals that includes hydrofluosilicic acid and its salt form, sodium fluorosilicate. These chemicals are collected from the pollution scrubbers of the phosphate fertilizer industry. The scrubber liquors contain contaminants such as arsenic, lead, cadmium, mercury, and radioactive particles2, are legally regulated as toxic waste, and are prohibited from direct dispersal into the environment. Upon being sold (unrefined) to municipalities as fluoridating agents, these same substances are then considered a "product", allowing them to be dispensed through fluoridated municipal water systems to the very same ecosystems to which they could not be released directly. Sodium fluoride, used in the remaining municipalities, is also an industrial waste product that contains hazardous contaminants.
Scarcity of environmental impact studies
This is of deep concern to us. Studies that do exist indicate damage to salmon and to plant ecosystems.3a It is significant that Canada's water quality guideline to protect freshwater life is 0.12 ppm (parts per million). 3b
99.97% of fluoridated water is released directly into the environment at around 1ppm
This water is NOT used for drinking or cooking.4
II. Health Concerns
Absence of safety studies on silicofluorides
When asked by the U.S. House Committee on Science for chronic toxicity test data on sodium fluorosilicate and hydrofluorosilicic acid, Charles Fox of the EPA answered on June 23, 1999, "EPA was not able to identify chronic toxicity data on these chemicals". 5 Further, EPA's National Risk Management Research Laboratory stated, on April 25, 2002, that the chemistry of silicofluorides is "not well understood" and studies are needed.
EPA health goals ignored
The EPA defines the Maximum Contaminant Level Goal (MCLG) for toxic elements in drinking water thus: "the level below which there are no known or anticipated effects to health." The MCLG for arsenic, lead, and radioactive particles, all contaminants of the scrubber liquors used for fluoridation, is 0.0 ppb (zero parts per billion). Therefore, any addition of fluorine-bearing substances to drinking water that include these contaminants is contrary to the intent of EPA's established health goals.
Increased blood lead levels in children
Two recent studies with a combined sampling of over 400,000 children found significantly increased levels of lead in children's blood when silicofluorides from the phosphate fertilizer industry were used as the fluoridating agent.6 This shows that there is a significant difference in health effects even between different fluoridation compounds.
Ingestion of fluoride linked to many health effects
Contrary to assertions that the health effects of fluoride ingestion already have been scientifically proven to be safe and that there is no credible scientific concern, over the last fifteen years the ingestion of fluoride has been linked in scientific peer-reviewed literature to neurotoxicity7, bone pathology8, reproductive effects9, interference with the pineal gland 10, gene mutations11, thyroid pathology12, and the increasing incidence and severity of dental fluorosis13. This has caused professionals who once championed the uses of fluoride in preventing tooth decay, to reverse their position and call for a halt in further exposures.14 It is of significance that 14 Nobel Prize winning scientists, including the 2000 Nobel Laureate in Medicine, Arvid Carlsson, have expressed reservations on, or outright opposition to, fluoridation.15
FDA has never approved systemic use of fluoride
The U.S. Food and Drug Administration in December 2000 stated to the U.S. House Committee on Science they have never provided any specific approval for safety or effectiveness for any fluoride substance intended to be ingested for the purpose of reducing tooth decay.16
Total fluoride exposure of growing concern
Total fluoride exposure from all sources, including food, water, and air, is of growing concern within the scientific community.17 As evidenced in the U.S. Public Health Service ATSDR 1993 report which was referenced in correspondence between the U.S. House Committee on Science and Charles Fox of the U.S. EPA, large subsets of the population, including the elderly, children, and pregnant women, may be unusually susceptible to the toxic effects of fluoride.18
Centers for Disease Control concession
The CDC now concedes that the systemic value of ingesting fluoride is minimal, as fluoride's oral health benefits are predominantly topical19, and that there has been a generalized increase in dental fluorosis20.
III. In Consideration of the concerns raised above, we urge fluoridated cities, states with mandatory fluoridation, health care professionals, and public health authorities, to review ALL current information available, and use this information to re-evaluate current practices.
IV. Congressional Investigation is Appropriate
This Statement of Concern (same substance, slightly different content and form), along with a significant list of signatures, was unveiled at the May 6, 2003 EPA Science Forum session on fluoridation in support of the National Treasury Employees Union Chapter 280 (EPA union of professionals) renewed call for a Congressional investigation. No authorities from government agencies or non-governmental organizations responded to widespread EPA invitations over a six-week period, to attend this session to explain/defend the practice of fluoridation. In view of this fact, and also that some serious questions of propriety have been posed but not addressed, about the formulation of the EPA's drinking water standards for fluoride21, as well as the downgrading of cancer bioassay data by the EPA in 199022, it now seems especially valid to ask Congress to hold hearings that will compel promoters to answer many unanswered questions.
It is appropriate that the U.S. Congress undertake an in-depth investigation of this public policy that is endorsed by major U.S. government agencies, but has never been adequately reviewed in its long history. Considering that there is an absence of research on silicofluorides, and that the latest scientific research on toxicity of fluorides has never been included in any government policy-making, and considering the many unanswered questions and concerns, we join the USEPA Union of professional employees in calling for a full-scale Congressional investigation into the public policy of fluoridation.
Footnotes in Statement of Concern on Fluoridation (For a more comprehensive list of scientific literature, see Bibliography section at www.SLweb.org )
1 CDC (1993). Fluoridation Census 1992.
2 National Sanitation Foundation International. (2000) Letter from Stan Hazan, General Manager, NSF Drinking Water Additives Certification Program, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Representatives. July 7. http://www.keepersofthewell.org/product_pdfs/NSF_response.pdf
3a -- Damkaer DM, and Dey DB 1989. Evidence for fluoride effects on salmon passage at John Day Dam, Columbia River, 1982-1986. N. Am. J. Fish. Manage.9:154-162.
-- Davison A. and Weinstein L. The effects of fluorides on plants. (1998) Fluorides and the Environment. Earth Island Institute. www.earthisland.org .
3b Canadian Environmental Quality Guidelines, http://www.ec.gc.ca/ceqg-rcqe/English/Html/GAAG_Fluoride.cfm
4 Personal communication with Dave Paris, Manchester Water Works, NH. (January 2001) Calculation based on estimated two-liters/ person/day used for drinking and cooking.
5 EPA. (1999) Letter from Charles Fox, Assistant Administrator, Office of Water, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Comm. on Science, US House of Representatives. June 23, 1999 http://www.keepersofthewell.org/gov_resp_pdfs/EPAresponse1.pdf
6 -- Masters RD, et al. (2000). Association of silicofluoride treated water with elevated blood lead. Neurotoxicology. 21:6, 1091 1099.
-- Masters RD, and Coplan M. (1999). Water treatment with silicofluorides and lead toxicity. International Journal of Environmental Studies. September.
7 Neurotoxicity
-- Varner, J.A. et al (1998). Chronic administration of aluminum-fluoride and sodium-fluoride to rats in drinking water: Alterations in neuronal and cerebrovascular integrity. Brain Research, 784, 284-298.
-- Mullenix, P. et al (1995). Neurotoxicity of sodium fluoride in rats. Neurotoxicology &Teratology, 17, 169-77.
-- Lu, Y. et al (2000). Effect of high-fluoride water on intelligence of children. Fluoride, 33, 74-78.
-- Li, X.S., (1995). Effect of fluoride exposure on intelligence in children. Fluoride, 28:4, 189-192
-- Zhao, L.B. et al (1996). Effect of high-fluoride water supply on children's intelligence. Fluoride, 29, 190-192.
8 Bone Pathology
-- Riggs, B.L. et al (1990). Effect of fluoride treatment on the fracture rates in postmenopausal women with osteoporosis. N. Eng. J. Med., 322, 802-809.
-- Li Y, et al.(2001). Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Miner Res.16(5):932-9.
-- Kurttio, P., N. Gustavsson, et al. (1999). Exposure to natural fluoride in well water and hip fracture: A cohort analysis in Finland. American Journal of Epidemiology 150(8): 817-824.
-- Jacobsen, S., J. Goldberg, et al. (1992). The association between water fluoridation and hip fracture among white women and men aged 65 years and older; a national ecologic study. Annals of Epidemiology 2: 617-626.
-- Danielson, C., J. L. Lyon, et al. (1992). Hip fractures and fluoridation in Utah's elderly population. Journal of the American Medical Association 268(6): 746-748.
-- Sowers, M., M. Clark, et al. (1991). A prospective study of bone mineral content and fracture in communities with differential fluoride exposure. American Journal of Epidemiology 133: 649-660.
It should be noted that there are studies that found no relation between fluoridation and fractures.
9 Reproductive Effects:
-- Freni SC. (1994). Exposure to high fluoride concentrations in drinking water is associated with decreased birth rates. J Toxicology and Environmental Health 1994;42:109-121.
-- Susheela AK, Jethanandani P (1996). Circulating testosterone levels in skeletal fluorosis patients. J Toxicol Clin Toxicol 34(2):183-9.
-- Kumar A, Susheela AK (1994). Ultrastructural studies of spermiogenesis in rabbit exposed to chronic fluoride toxicity. Int J Fertil Menopausal Stud 39(3):164-71.
10 Impact on Pineal Gland
-- Luke, J. (1997). The Effect of Fluoride on the Physiology of the Pineal Gland. Ph.D. Thesis. University of Surrey.
-- Luke, J. (2001). Fluoride deposition in the aged human pineal gland. Caries Res. 35:125-128.
11 Genetic Damage
-- Department of Health & Human Services (1991). Review of fluoride benefits and risks. App. H. H1-H6.
-- Mihashi M, & Tsutsui T. Clastogenic activity of sodium fluoride to rat vertebral body-derived cells in culture. Mutation Research May 368(1):7-13.
-- Aardema MJ, et al (1989). Sodium fluoride-induced chromosome aberrations in different stages of the cell cycle: a proposed mechanism. Mutation Research 223 191-203.
-- Caspary WJ, et al (1987). Mutagenic activity of fluorides in mouse lymphoma cells. Mutation Research. 187(3):165-80.
-- Tsutsui T, et al. (1984). Cytotoxicity, chromosome aberrations and unscheduled DNA synthesis in cultured human diploid fibroblasts induced by sodium fluoride. Mutation Research 139:193-198.
12 Thyroid Pathology
-- Bachinskii PP, et al. (1985). Action of the body fluorine of healthy persons and thyroidopathy patients on the function of hypophyseal-thyroid system. Probl Endokrinol (Mosk) 31(6):25-9.
-- Zhao, W. (1998). Long-term effects of various iodine and fluorine doses on the thyroid and fluorosis in mice. Endocr Regul 32(2):63-70.
-- Jooste PL, et al. (1999). Endemic goitre in the absence of iodine deficiency in schoolchildren of the Northern Cape Province of South Africa. Eur J Clin Nutr 53(1):8-12.
-- Lin Fa-Fu; et al (1991). The relationship of a low-iodine and high-fluoride environment to subclinical cretinism in Xinjiang. Iodine Deficiency Disorder Newsletter. Vol. 7. No. 3.
-- Galletti, P. & Joyet, G. (1958). Effect of fluorine on thyroidal iodine metabolism in hyperthyroidism. J. Clinical Endocrinology. 18:1102-1110
13 Dental Fluorosis
Heller KE et al (1997). Dental caries and dental fluorosis at varying water fluoride concentrations. J Pub Health Dent, 57;No. 3, 136-143.
14 -- Colquhoun, J. (1997). Why I changed my mind about water fluoridation. Perspectives in Biology and Medicine 41 29-44 1997.
-- Limeback, H. (2000). Why I am now officially opposed to adding fluoride to drinking water. Open Letter. http://www.fluoridealert.org/limeback.htm
15 See: Connett, P. (2000). Fluoride: A Statement of Concern. Waste Not #414. http://www.fluoridealert.org/fluoride-statement.htm
16 FDA. (2000) Letter from Melinda K. Plaisier, Associate Commissioner for Legislation, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Reps. Dec. 21. http://www.keepersofthewell.org/gov_resp_pdfs/fda_response.pdf
17 -- Stannard JG. (1991). Fluoride levels and fluoride contamination of fruit juices. Journal of Clinical Pediatric Dentistry. 16 (1): 38-40. 1991
-- UNICEF. Fluoride in water: An overview. Accessed Online May 2001. http://www.unicef.org/programme/wes/info/fluor.htm
-- U.S. Public Health Service, Agency for Toxic Substances & Disease Registry (ATSDR), April, 1993: Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine. ATSDR/TP-91/17, 4/93, pp. 155-6.
18 -- Letter 9/5/2000 of Charles Fox, Asst. Administrator EPA, Office of Water, to Ken Calvert, Chairman, Subcommittee on Energy and the Environment, Committee on Science, US House of Representatives. http://www.keepersofthewell.org/gov_resp_pdfs/EPA_response2.pdf
-- U.S. Public Health Service, Agency for Toxic Substances & Disease Registry (ATSDR), April, 1993: Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine. ATSDR/TP-91/17, 4/93, pp. 155-6.
19 CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. Mortality and Morbidity Weekly Review (MMWR), 48(41);933-940 October 22, 1999.
20 CDC (2001). Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Mortality and Morbidity Weekly Review. August 17, 50(RR14):1-42.
21 Carton, RJ and Hirzy, JW (1998). Applying the NAEP Code of Ethics to the Environmental Protection Agency and the fluoride in drinking water standard. Proceedings of the 23rd Annual Conference of the National Association of Environmental Professionals, 20-24 June 1998, San Diego, CA.
22 Hirzy, JW (2000). Statement before Environment and Public Works Subcommittee on Wildlife, Fisheries and Drinking Water. US Senate. June 29, 2000.