A long-standing and polarizing debate over community water fluoridation was brought to the U.S. District Court last year when several organizations including Food & Water Watch, Inc. filed a lawsuit against the Environmental Protection Agency (EPA) to remove fluoride from tap water under the Toxic Substances Control Act (TSCA).1 The court case, which began in June of 2020, has been in abeyance since last fall, with the court waiting for publication of additional studies and reports before proceeding with the trial.2
One of those reports was a pooled benchmark dose (BMD) analysis from the National Institutes of Health (NIH). This peer-reviewed analysis confirmed the plaintiff’s stance that fluoride was a neurotoxicant and its effects “may be even greater than for other toxic elements like lead, mercury, and arsenic.”3 The case was set to begin again on Sept. 14, 2021 but was further delayed as U.S. Court District Judge Edward Chen awaits results of a systematic review of fluoride neurotoxicity from the National Toxicology Program.
Research Finds Fluoride is a Neurotoxin Associated with Decreases in IQ
After dozens of studies continued to emerge demonstrating that water fluoridation is associated with neurotoxic harms in both human and animal studies, several organizations petitioned for removal from U.S. tap water under Section 21 of the TSCA. This section allows for citizen petitions to the EPA to repeal or amend harmful substances that pose an unreasonable risk. The petition was the first ever to be dismissed by the EPA which led to the organization’s decision to file the lawsuit in 2017.4
One of the more well-recognized studies, which was published by JAMA Pediatrics in 2019, found that children whose mothers were exposed to fluoridated water during pregnancy had significantly lower IQ levels.5 The journal’s editor-in chief- stated that these drops in IQ were “sizable” and “on par” with IQ drops seen in children who were exposed to lead.6 An article from JAMA Pediatrics entitled “Translating Best Evidence into Best Care,” issued in July 2020, stated that fluoride should be avoided for pregnant mothers and infants due to significant findings of lower measures of intelligence and behavior.7
During trial, federal judge Edward Chen stated that it is “undisputed” that fluoride can be a neurological hazard that the EPA does not dispute. The remaining question which was discussed heavily by experts is at what level this occurs.
EPA Hired Consultation Company Known for Defending Chemicals
Closing arguments from the plaintiff’s attorney Michael Connett pointed out that the EPA’s witness testimonies included experts hired by the consulting company Exponent, Inc., rather than the organization’s own experts on fluoride.8 Exponent, Inc. is a consulting firm known for its “hired white coat experts” who in the past have defended nicotine and Agent Orange. Former OSHA administrator David Michaels has said about Exponent: “You don’t hire Exponent to give you fresh eyes and an independent view to protect public health. You hire Exponent to defend a chemical.”9
Approximately 75 percent of Americans who use tap water are exposed to fluoride.10 The practice of community water fluoridation began in 1945 and was declared one of the “The Top Ten Public Health Achievements of the 20th Century” by the CDC, despite 94% of Americans over 18 having experienced dental cavities.11vThe type of fluoride that is currently in drinking water is hydrofluorosilicic acid (HSA) which is a byproduct of the phosphate fertilizer industry and has never been studied. 12
Fluoride Presents an “Unreasonable Risk”
Regarding fluoride’s risk, Dr. Kathleen Thiessen, a senior scientist at SENES Oak Ridge, Inc.’s Center for Risks Analysis stated:
Fluoridation chemicals present an ‘unreasonable risk’ of neurotoxic effects, including IQ loss, if assessed under the same risk characterization and risk determination framework that the EPA uses in its evaluations of other chemicals under the TSCA.13
Dr. Thiessen also served as a panelist for the National Research Council’s (NRC) Review of fluoride. Findings from this 450-page fluoride review led to the NRC recommending that the fluoride safety standard be reduced. This review identified several health affects including damage to the brain, endocrine disruption, bone cancer, and tooth and bone damage.14
The fluoridation trial is expected to resume in January 2022.
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1 Carignan S. New health data puts EPA’s fluoride toxicity trial on ice. Bloomberg Law June 17, 2020.
2 Bradford T. Legal battle over water fluoridation continues. Gloucester Daily Times Aug. 10, 2020.
3 Food & Water Watch, et al. Notice of the publication of the pooled benchmark dose anlaysis of the ELEMENT and COHORT studies. June 10, 2021.
4 Pujari D, Benbow C. Insight: fluoridation case challenges EPA chemical evaluation. Bloomberg Law Aug. 7, 2020.
5 Green R. Lanphear B, Hornung R. Association between maternal fluoride exposure during pregnancy and IQ stores in offspring in Canada. Journal of the American Medical Association Aug. 19, 2019.
6 Children’s Health Defense Team. More evidence that fluoride lowers IQ: Will the CDC keep ignoring it? Aug. 27, 2019.
7 Bashash M. Translating best evidence into best care. The Journal of Pediatrics July 2020.
8 McGreevy, T. Landmark trial on water fluoridation & EPA on pause until August 6. River Cities Reader July 8, 2020.
9 Wittenberg A. EPA hired consultants to counter staff experts on fluoride. E&E News Oct. 13, 2020.
10 Chuck E. Science says fluoride in water is good for kids. So why are these towns banning it? NBC News Oct. 17, 2018.
11 U.S. Centers for Disease Control and Prevention. Achievements in public health, 1990-1991: Fluoridation of drinking water to prevent dental caries. MMRW Oct. 22, 1999.
12 Edwards C. I’m a dentist and oppose fluoride in our drinking water. Florida Today Dec. 2, 2019.
13 Fluoride and human health: an interview with Dr. Kathleen Thiessen. Fluoride Action Network Apr. 16, 2021.
14 National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. The National Academies Press 2006.