Transcript Adding Fluoride to Water is a Bad Idea

Adding Fluoride to Water is a Bad
Idea – The Short Version
Presentation to the Valparaiso City Utilities
Fluoride Committee
By J. William Hirzy, Ph.D.
June 25, 2014
Some Brief History
• First proposed in 1939 by Gerald Cox, funded
by ALCOA. Opposed by ADA.
• Fluoridation endorsed by USPHS in 1950, half
way through a “ten-year” experiment on
safety and efficacy (without evidence of
either, or informed consent of test subjects).
• Editorials in Journal of the American Medical
Association (6) and Journal of the American
Dental Association (7) expressed reservations.
Summarizing the arguments against
fluoridation
• It is unnecessary (Our kids are already
getting more than enough fluoride from
other sources – dental fluorosis rates(1).
• It is inappropriate (if fluoride works at all
to fight tooth decay it works TOPICALLY. It
doesn’t do any good to swallow fluoride,
only harm(2)
Summarizing the arguments against
fluoridation
• It is a bad medical practice to use the public
water supply to deliver medicine because
• A) you can’t control the dose
• B) you can’t control who gets it
• C) it violates the individual’s right to informed
consent to medication –
• It is unethical (because of C)
Summarizing the arguments against
fluoridation
• There is no adequate margin of safety to
protect the whole population from KNOWN
harmful effects – including damage to the
brain, bones and endocrine system
• Fluoridation may actually be killing a few
young men each year with osteosarcoma(5)
• The risks far outweigh the benefits
Summarizing the arguments against
fluoridation
• It is ineffective (the evidence that swallowing
fluoride reduces tooth decay is very weak.
Most countries don’t fluoridate their water
and their children’s teeth are as good if not
better than those that do – WHO figures. (3)
• The fluoridating chemicals are not
pharmaceutical grade and contain human
carcinogens like arsenic(4)
Figure 2: Tooth Decay Trends for 12 Year Olds: Fluoridated Vs. Unfluoridated
Countries. Data from World Health Organization. (Graph by Chris Neurath).
Fluoridation, as supported by U.S. EPA, is not
about dental health, but is about managing
260,000 tons/year of hazardous waste while
profiting the phosphate fertilizer industry.
Taxpayers in communities buying HFSA are
subsidizing this waste management program –
more than 98% goes straight down the drain.
And exposing themselves and their families to
neurotoxicants and carcinogens.
Source: USGS 2011 Fluorspar Report
• In 2011, three companies produced byproduct FSA1 at phosphoric acid
plants (part of phosphate fertilizer operations). J.R. Simplot Co., Mosaic
Fertilizer (a subsidiary of The Mosaic Co.), and PCS Phosphate Co.
• In 2011, FSA sold for water fluoridation was 65,900 t valued at $12.1
million, and 4,230 t valued at $1.33 million was sold or used for other
applications.
• 65,900 tons of 100% assay = 264,000 tons of 24% (commercial grade)
• $12.1 million ÷ 264,000 = $45.83/ton. Value reported to USGS
•
• Water utilities pay from $700 (Washington DC) to $2300 (NYC)/ton. So
annual sales revenue is $185,000,000 to $528,000,000.
•
1. Fluorosilicic acid a.k.a. hydrofluorosilicic acid (HFSA)
Arsenic in HFSA
• By 2010 over 118 million people were getting
HFSA in their water supply (8).
• By the end of this year about 200 of those
people will have developed lung or bladder
cancer caused by the arsenic in typical HFSA.
• Treatment costs for those cases are over $700
million in 2001 dollars.
U. S. Populations exposed to HFSA starting in years since 1965
Population data from CDC Fluoridation Census websites,
some of which have been taken down by CDC.
Annual lung/bladder cancer cases in the U.S.
caused by arsenic contamination of HFSA
compared to cases from arsenic in
pharmaceutical grade NaF. From Hirzy et al. Environ. Sci.
and Policy 38 282-284 (2014)
(0.99 μg/L ÷ 0.078 μg/L) x 30 μg/L = 380 μg/L
Lung/Bladder cancer cases in cohorts exposed staring in years since 1965
and associated treatment costs in constant 2001 U.S. dollars
Cohort sizes from Table 1 reduced by 0.8%/year mortality. Number of
cases and treatment costs based on risk assessment methodology from
EPA Arsenic in Drinking Water Rule. FR 66 (14) 6975-7066 Jan. 22, 2001
• By 2020, if no change in policy is made, 2100
of those people will have developed these
cancers, at cost of over $7 billion, in 2001
dollars.
• But this isn’t the worst of it…………..
Neurotoxicity
• 1 ppm F- in drinking water:
–
–
–
–
•
•
•
•
Al build-up in brain and kidney
damages brain structure
damages the kidney
damages immune system (Varner 1998)
Prenatal dosing: hyperactivity (Mullenix 1995)
Key brain lipids depleted (Guan 1998)
Many more on biochemical impact on brain function
http://SLweb.org/bibliography.html
Recent History- IQ Loss in Kids
• In 2012 a publication by Choi et al.in
Environmental Health Perspectives, a highly
respected, peer reviewed journal presented data
showing an average 7 IQ points lost in children
exposed to fluoride in drinking water (9).
• This Spring two highly respected public health
scientists, Grandjean and Landrigan, added
fluoride to their list of agents causing damage to
the brains of children. (10)
Implications of the Choi et al. Study
Lin et al. 1991
Xu et al. 1994
Hypothetical 3mg/L
Wang SX et al. 2007
Drinking water
fluoride~mg/L
Average daily water
intake ~mL/day
Average daily
dose~mg/day
Uncertainty & Safety
Factors
SELC ~ mg/day
0.88
1.8
3.0
8.3
500
500
500
500
0.44
0.90
1.5
4.2
100a
100
100
100
0.0044
0.0090
0.015
0.042
MCLG ~ mg/L
0.0057
0.012
0.019
0.055
The first row gives drinking water levels at which IQ losses were observed in the
studies which are identified above each column. We assumed water was ingested at
500 mL/day by the children in these studies, based on EPA/NRC data for U.S.
children. The third row gives the estimated daily doses of fluoride that caused the IQ
losses observed. The fourth row shows uncertainty/safety factors used by EPA in risk
assessments like this multiplied together: 10 (to convert to a dose unlikely to cause
the effect) x 10 (to account for intra-human differences in sensitivity. The fifth row
gives the expected Safe Exposure Level. The last row is a calculated “safe” level in
drinking water if no other exposure occurs.
If one assumes only a single factor of 10, instead of
two such uncertainty/safety factors, the following
SELC and MCLG values obtain:
Lin et al. 1991
Xu et al. 1994
Hypothetical 3mg/L
Wang SX et al. 2007
Drinking water
fluoride~mg/L
Average daily water
intake ~mL/day
Average daily
dose~mg/day
Uncertainty & Safety
Factors
SELC ~ mg/day
0.88
1.8
3.0
8.3
500
500
500
500
0.44
0.90
1.5
4.2
10
10
10
10
0.044
0.090
0.15
0.42
MCLG ~ mg/L
0.028
0.056
0.094
0.26
IQ and population
Number of Kids
With a
Specific IQ
Mentally
handicapped
IQ
95 100
Very Bright
TABLE 6
Mean DMFS of U.S. Children with Permanent Teeth By Age and
Water Fluoridation Exposure (11)
Age
Life-Long Water
Fluoridation Exposure
Mean DMFS*
5
0.03
0.10
70
6
0.14
0.14
0
7
0.36
0.53
32
8
0.64
0.79
19
9
1.05
1.33
21
10
1.64
1.85
11
11
2.12
2.63
19
12
2.46
2.97
17
13
3.43
4.41
22
14
4.05
5.18
22
15
5.53
6.03
8
16
6.02
7.41
19
17
7.01
8.59
18
All Ages
2.79
3.39
18
No Water Fluoridation
Exposure: Mean DMFS*
Percent Difference
*All means adjusted to age and gender distribution of total U.S. population ages 5-17.
1.) 3.39 – 2.79 = 0.6 Tooth surface out of 128 = 0.47% Tooth surfaces saved!
2.) Authors: 0.6/3.39 x 100 = 17.7 ~ 18 % Difference
% of Residents with Water Fluoridation
Lo Income with Very Good/Excellent Teeth
Hi Income Very Good/Excellent Teeth
120
100
Percent
80
60
40
20
Ave: 83 S.D. = 2.3
Ave: 54.2 S.D. = 8.2
0
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49
50 USA States and DC
National Survey of Children's Health.
http://mchb.hrsa.gov/oralhealth/portrait/1cct.htm
U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
The National Survey of Children's Health 2003. Rockville, Maryland: U.S. Department of Health and Human Services, 2005
http://www.cdc.gov/oralhealth/waterfluoridation/fact_sheets/states_stats2002.htm
CDC, MMWR, 48(41); 933-940, Oct 22,
1999
• “Fluoride’s caries-preventive properties initially
were attributed to changes in enamel during tooth
development because of the association between
fluoride and cosmetic changes in the enamel and a
belief that fluoride incorporated into enamel during
tooth development would result in a more acidresistant material. However, laboratory and
epidemiologic research suggest that fluoride prevents
dental caries predominantly after eruption of the
tooth into the mouth, and its actions primarily are
topical for both adults and children…”
• KY 100% fluoridated; 38% edentulous (no teeth)(12)
To Better Serve Valparaiso Citizens…..
• Educate kids and parents on brushing and diet
impacts on dental health…...and
• instead of paying thousands to the phosphate
industry for the honor and privilege of using your
drinking water system to dispose of its waste ….
• thinking you are helping poor kids to have better
teeth, in spite of evidence from CDC …
• Worry more about those kids’ intellectual deficits
caused by fluoride and the impact of that on your
community.
Alternative Fluoride Delivery for Valparaiso
Population: 32,000
Assume everyone in town wants the amount of fluoride that would come in
2 liters/day of drinking water that would require adding 0.5 mg of
fluoride/liter.
Everyone in town would receive 1.0 mg/day fluoride supplement.
1mg/day-person x 32,000 people x365 days/year = 11.7 x 106 mg/year
11.7 x 106 mg = 11.7 x 103 g = 11.7 kg
Pharmaceutical grade NaF costs about $7/kg and is 45.2% fluoride
Total annual fluoride cost: (11.7 kg F x $7/kg) ÷ 0.452 = $182/year
References
• 1.Beltran-Aguilar, E.D. et al. 2010. Prevalence and severity of dental
fluorosis in the United States, 1999 – 2004. NCHS Data Brief. United States
Department of Health and Human Services, Centers for Disease Control
•
•
•
•
and Prevention, National Center for Health Statistics. November 2010.
2. Fluoride’s predominant effect is posteruptive and topical. Centers for
Disease Control and Prevention. (2001). Recommendations for Using
Fluoride to Prevent and Control Dental Caries in the United States.
Morbidity and Mortality Weekly Report 50(RR14): 1-42.
3. World Health Organization. Collaborating Center for Education, Training
and Research in Oral Health. http://www/mah.se/CAPPWeb Access June
17, 2014.
4. NSF 2014. NSF/ANSI Standard 60: Drinking Water Treatment Chemicals Health Effects. Available:
http://www.nsf.org/newsroom_pdf/NSF_Fact_Sheet_on_Fluoridation.pdf.
Web Access May 13, 2014.
5. Cancer Causes Control. 2006 May;17(4):421-8. Age-specific fluoride
exposure in drinking water and osteosarcoma (United States). Bassin EB,
et al.
References-con’t
• 6. Chronic fluorine intoxication. (editorial) Journal of the American
Medical Association 123 (1943) 150.
• 7. Effect of fluorine on dental caries. (editorial) Journal of the American
Dental Association 31 (1944) 1360-1363.
• 8. Corrigendum to: Comparison of hydrofluorosilicic acid and
pharmaceutical sodium fluoride as fluoridating agents-A cost-benefit
analysis. Environmental Science and Policy 38 (2014) 282-284.
• 9. Choi, A.L., et al., 2012. Developmental fluoride neurotoxicity: A syematic
review and meta-analysis. Environmental Health Perspectives 120(10):
1362-1368. October 2012
• 10. Grandjean, P. and Landrigan, P.J. 2014. Neurobehavioural effects of
developmental neurotoxicity. Lancet Neurology 2014; 13: 330-38.
• 11. Recent Trends in Dental Caries in U.S. Children and the effect of water
fluoridation.
J.A. Brunelle and J.P. Carlos Epidemiology Branch,
National Institute of Dental Research, National Institutes of Health.
www.slweb.org/NIDR-DMFS.html
• 12.www.statemaster.com/../hea_ora_hea_los_of_nat_tee-health-oralloss-na. Access June 25, 2014
And http://www.childstats.gov/americaschildren/tables.asp
TABLE 1—MeanWeschler IQScores inChildhood and Adulthood by Sources of Fluoride Exposure:
Dunedin Multidisciplinary Health and Development Study; Dunedin, New Zealand; 1972–2012
Variable
IQ at Age 7–13 Years
M ean (SD) No.
P
Area of residence (age 5 y)
CWF area
Never lived in CWF area
Unknown
100.0 (13.5) 891
99.8 (13.0) 99
2
Fluoride toothpaste (age 5 y)
Always
Sometimes
Never
Unknown
100.2 (13.4) 634
98.7 (12.4) 240
100.2 (18.4) 22
101.8 (15.0) 96
Fluoride tablets (age 5 y)
Yes
No
Unknown
IQ at Age 38 Years
Mean (SD)
No.
.92
.184
100.2 (14.2)
98.1 (13.5)
847
93
2
100.0 (14.1)
98.8 (14.2)
101.1 (10.8)
608
21 7
20
97
.52
.996
.849
100.2 (13.5) 139
99.7 (13.2) 763
90
P
.988
100.0 (14.5)
99.7 (14.0)
136
715
91