The Questions of Fluoridegate
Scandal Widens, Calls for Hearings Grow as New Revelations Highlight Science in Conflict with Officials’ Statements on Water Fluoridation Safety
Part 1 of a Series, By Daniel G. Stockin, MPH
Following the Hurricane Katrina formaldehyde trailers fiasco and the Washington D.C. lead-in-drinking water disclosures, now yet another scandal provides evidence that what is said and done by public health experts may not be as important as the reasons behind what is left unsaid and undone.
Enter Fluoridegate, a multi-faceted scandal unfolding while simultaneously a growing number of cities and water utilities have halted water fluoridation or are considering legislation to end it.
City officials in Milwaukee, New York City and Phoenix have recently discussed ending water fluoridation. Quebec and Calgary in Canada, College Station in Texas, and Pinellas County in Florida have ended it, along with numerous smaller cities and agencies.
“I think there are safety concerns and fiscal concerns causing people to rethink fluoridation,” says Wally Babb, a former Georgia water plant operator reveling in the cities’ actions, since he was fired in 2008 for his stance against fluoridation.
“But I also think prosecutors and investigative bodies are going to be very interested to ask why certain groups and individuals did not share key information about fluoridation risks,” he says.
“If any scandal ever deserved a series of investigative hearings, this is it. This is going to call some very high level people on the carpet.”
Prominent Washington D.C. product safety attorney James S. Turner concurs.
“The evidence is shocking,” he says. “It’s time to put some of the key players under oath in Fluoridegate hearings.”
The developments point to a central question: Did a group of vested interest federal and private sector officials collude to use the public health infrastructure to control what the public hears about fluoridation and divert attention from increasingly bad news about harm from fluorides?
For those still unfamiliar with the developments, here are some of the deeply troubling questions of Fluoridegate.
Controlling the Discussion and Talking Points
Water fluoridation is the long-standing practice of adding fluoride chemicals to drinking water to help prevent cavities. For decades, Americans have been told that the practice is entirely safe, though controversy about fluoridation safety has never completely disappeared.
In 2011 a Freedom of Information Act request asked for the names, titles, and job descriptions of all persons past and present inside the U.S. Centers for Disease Control and Prevention (CDC) that had input into CDC’s decision to support fluoridation. The request turned up a disturbing fact: CDC’s Oral Health Directors, acting alone within CDC for more than 35 years, had sole input and control in deciding to support fluoridation.
The revelation raised obvious questions. How were CDC’s dental professionals, with expertise in oral health, competent to assess new research and make statements about possible harmful outside-the-mouth effects from fluorides? Why did CDC not seek assistance and input from its own cancer, diabetes, and minority health professionals, and from toxicologists in its sister organization, the Agency for Toxic Substances and Disease Registry?
Were improper influence and the Oral Health Division’s close ties to the American Dental Association with its long history of denying harm from fluoridation the reasons CDC continued to deny any outside-the-mouth harm?
Interestingly, a letter from ADA had protested that it was “very disturbed” about a proposed reorganization in CDC that would downgrade the status of the Oral Health Division, folding it inside another unit. In explaining that ADA had “come to value its relationship with the (Division of Oral Health)” and describing the two organizations’ “close collaborative relationship,” ADA listed water fluoridation as its number one example of collaborative efforts with the Division.
Was it collaboration…or collusion?
With the information disclosed by the Freedom of Information request, actions by CDC were now seen in a new light. CDC had continued to offer stout assurances that more than 60 years of “extensive research” had proven fluoridation to be safe. But in 2006 the prestigious National Research Council (NRC) of the National Academies of Science issued a 507 page report on fluorides that documented a long list of fundamental, basic-in-nature whole-body research that had never been performed.
Had CDC officials been lying in saying that extensive fluoridation safety research had been performed?
CDC had also issued a widely-circulated statement that fluoridation was one of the 10 great public health achievements in the 20th century. But in a 2008 article in Scientific American, John Doull, chairman of the NRC fluoride committee, stated, “…when the U.S. surgeon general comes out and says this is one of the 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on.” He also stated, “The thyroid changes do worry me.”
Cleverly calling fluoridation one of 10 great public health achievements had worked public relations wonders. It had preemptively diverted many from a deeper investigation of fluorides. But the NRC report and other developments would bring fluorides back under the microscope.
Unnerving Information for HIV, Organ Transplant, Diabetes and Kidney Patients
In addition to dismaying information about thyroid concerns, buried within the voluminous NRC report were other unnerving admissions such as this statement: “More research is needed to clarify fluoride’s biochemical effects on the brain.”
The technical jargon and size of the report are daunting, but readers willing to wade through it learn that consumers are ingesting uncontrolled amounts of fluorides through their water supply without our scientists knowing what this does to our brains.
Because fluorides deposit cumulatively in the bones over time, the report also says it is “paramount” that research be conducted because bone marrow is where immune cells have their genesis. It points out that research could be conducted to determine “what percentage of immunocompromised subjects have adverse reactions” at various levels of fluoride in water.
News of this is understandably alarming to organ transplant patients and persons with HIV/AIDS or congenital immune diseases, but there has been little or no communication of the concerns about fluoride immune system impacts to these groups.
The NRC report also listed diabetics, kidney patients, seniors, children, outdoor workers and other groups as “susceptible subpopulations” that are especially vulnerable to harm from ingested fluorides.
What was done with these startling statements in the report? Had they been quickly acted on and formally distributed by federal officials to affected stakeholder groups such as the National Kidney Foundation, the American Diabetes Association, thyroid health advocates, HIV support groups, child health groups, etc? If so, the groups were uniformly and strangely quiet about receiving it. And why did the Environmental Protection Agency (EPA) and CDC’s parent health agency take nearly five years, and until EPA was threatened by a fluoride fumigant lawsuit, to issue a tepid recommendation to slightly lower the level of fluorides in drinking water?
Was the fix in because the dental industry, water agencies, and other groups would face tremendous legal liability if fluorides were now admitted to be potentially harmful? And were CDC and other groups working to “spin” the NRC report, to do damage control?
Fluoridation advocates cited statements within the report that its purpose was not a specific assessment of water fluoridation, implying that the process of studying fluorides produced no information useful in assessing fluoridation safety. This tactic backfired because it is akin to saying that efforts to put a man on the moon did not produce information useful for other spaceflight programs. Plus, the report designated certain groups as “susceptible subpopulations” without respect to what concentration of fluoride was in their water.
Again, the question: Did a group of vested interest federal and private sector officials collude to use the public health infrastructure to control what the public hears about fluoridation and divert attention from increasingly bad news about harm from fluorides? This is where Fluoridegate hearings will come in. Both federal and state agencies and attorneys general will find numerous avenues of fertile investigation.
Harm to Minorities: the Issue that “Has the Potential to Gain Traction”
One of the key areas for investigation will focus on fluoridation promoters’ actions concerning disproportionate fluoridation risks and harm for minority groups.
For example, why did CDC fail to openly inform the black community of news that blacks are disproportionately harmed by “dental fluorosis,” a permanent and in many cases disfiguring staining of teeth that indicates childhood overexposure to fluorides? CDC continued to not openly share the information with minority advocacy groups even after The Lillie Center in Georgia presented a detailed fluoridation ethics complaint to CDC citing the omission in 2007.
And the issue of harm to black citizens continues to grow. In an April 2011 letter, leaders of the American Dental Association requested assistance from U.S. Assistant Secretary for Health Dr. Howard Koh to help deal with concerns raised by civil rights leaders Ambassador Andrew Young and Rev. Gerald Durley. The two courageous black community leaders had publicly issued letters calling for a halt to fluoridation. In the ADA leaders’ letter to Dr. Koh they explained why they were seeking his assistance to address the concerns Young and Durley had raised about fluoridation safety for minorities.
The letter from ADA leaders stated: “We believe that this issue has the potential to gain traction.”
Gain traction? Fluoridation advocates had long scoffed that fluoridation opponents’ arguments were unfounded. In fact, they said, fluoridation was especially helpful for minority and low income populations, helping eliminate oral health disparities. So what was there about the issue of minorities being harmed by fluoridation that could possibly gain traction?
Could it be that there is substance to the concerns? Does fluoridation in fact disproportionately harm minority populations?
Here we find more grist for Fluoridegate hearings. Studies and other information on fluoride exposure levels and harm had never effectively or formally been presented to minority leaders until recently, by fluoridation opponents.
For example, a fall 2009 study published in the Journal of Public Health Dentistry documented that black children are ingesting significantly more fluorides in water than white children. And CDC released information in 2005 documenting that blacks and hispanics have disproportionately more dental fluorosis than whites. CDC’s statistics were found deeply buried in the very last of 23 dizzying data tables in an article in CDC’s August 26, 2005 “MMWR” publication.
The news spread. Martin Luther King Jr.’s daughter Bernice King spoke out against fluoridation on a radio program. Her cousin, Alveda King, spoke out against fluoridation on her blog. And in the summer of 2011, the League of United Latin American Citizens passed a resolution opposing fluoridation.
Let the Litigation Begin
As part of its efforts to support community water fluoridation programs, the American Dental Association had published a long list, a compendium of organizations that had lent their names as endorsing fluoridation. Dozens of national and international health advocacy, government, and professional organizations were on the seemingly impressive list.
But now it appears that organizations on the list may be named in legal actions. Citizens and decision makers relied on the organizations’ listed names in deciding to buy-in to fluoridation. Very telling will be the groups’ responses to a simple question: Did your group do its own research into potential fluoridation risks prior to allowing your name to be used on ADA’s list, or did you provide a courtesy endorsement of fluoridation without doing your own research?
The list of persons, groups, companies, and agencies that may be sued extends beyond the organizations in ADA’s compendium list. It includes almost anyone that should have warned users of fluoride products of various concerns related to fluorides. Water utilities, bottled water providers, toothpaste sellers, government agencies, nonprofits and industry trade groups, and numerous other individuals and groups may find themselves in the lawsuit cross hairs.
Washington DC toxic tort attorney Chris Nidel said this: “I think when we look back we’ll ask why Fluoridegate didn’t surface earlier. There are serious concerns about possible conflict of interest and heavy editing of information being fed to the public about fluoride risks and impacts.”
Two fluoride-related legal cases were filed in 2011 in Maryland and California courts. Both cases encountered significant, but not unexpected challenges. It’s still early in the process of developing various types of fluoride litigation, but given the now-strongly growing interest in pursuing legal actions, the future looks to hold many fluoridation and fluoride-product-related cases. The sheer number of potentially harmed citizens — persons with dental fluorosis, kidney patients tipped into needing dialysis, diabetics, thyroid patients, etc — numbers in the millions.
Concerning upcoming legal cases and hearings, perhaps most delicious to long-time fluoridation opponents is the prospect that for the first time, key officials in government and private sector agencies can be put on the witness stand and directly questioned about harm from fluorides.
A few interesting questions may be: Why are we warned to spit out pea-sized amounts of fluoridated toothpaste, but we were told we can ingest the same amount of fluoride when it comes in a large glass of fluoridated drinking water? How can it be safe to drink as much fluoridated water as we’d like? And why haven’t Americans been told that fluorides accumulate in the pineal glands in our brains?
In 2008, the National Kidney Foundation’s board of directors quietly issued a new position statement on fluoridation, causing NKF’s name to be removed from the ADA’s compendium list of fluoridation endorsers. But why did NKF not openly announce its new statement? Was it because NKF had been a recipient of grant monies from the CDC and did not wish to risk the ire of CDC officials? Did NKF risk the health of its own constituents, most of who today do not know that the National Research Council has designated kidney patients and diabetics as especially susceptible to harm from ingested fluorides?
Affecting Our Babies and Even Our Pets
Many Americans do not know that for one-time, acute exposures, fluorides are known to be slightly less toxic than arsenic and slightly more toxic than lead. But even with longer-term, lower level chronic exposures, the risks are real, especially for babies and other groups that are particularly vulnerable to harm from fluorides. The NRC report stated that on a body weight basis, infants and young children are ingesting 3-4 times the amount of fluorides as are adults.
On another front, what is fluoridated water doing to our pets and horses? This issue has received little attention until recently, but given Americans’ deep protective instincts for their pets and horses, the issue threatens to become an enormous one in its own right. News of the deaths of the fluoridated water-poisoned horses of Colorado resident Cathy Justus is quickly spreading. A growing number of stunned pet and horse owners are educating themselves further about fluorides before they continue to provide fluoridated water for Fido, the family feline, or a beloved horse.
There are so many facets to the Fluoridegate scandal that it will not be surprising if a number of attorney generals, district attorneys, politicians, investigative journalists, philanthropists, and others make their mark uncovering the harm done and the names of those responsible. Fluorides are an equal opportunity offender, so it is also not surprising that both Democrats and Republicans are joining the calls for Fluoridegate hearings or for a halt to fluoridation.
What are the other key issues? Will there be sacrificial lambs among those subpoenaed for Fluoridegate hearings and court cases? Who will point fingers at each other to try to escape blame?
Part 2 of The Questions of Fluoridegate will delve further into the numerous swirling questions.
Daniel G. Stockin, MPH, is the former manager of the EPA Western Regional Lead Training Center. He is a career public health professional with a background in toxics assessment and hazardous materials management. He is known internationally for his work at The Lillie Center Inc., a Georgia-based firm working to end water fluoridation. He may be reached at: firstname.lastname@example.org
© 2012 The Lillie Center Inc. This article may be reproduced and distributed in its entirety without modification.