Fluoride in drinking water poses enough risk to merit new EPA action, judge says

[serpentdebunker]

Recently, I've come across strange articles concerning fluoride in water supplies this past month.

These articles are written in a way that seems to make readers want to doubt the safety of fluoride that is in the water supply. I'll list some of the quotes here.

U.S. District Judge Edward Chen cautioned that it's not certain that the amount of fluoride typically added to water is causing lower IQ in kids

he concluded that mounting research points to an unreasonable risk that it could be.

What "mounting research" is he talking about, exactly? Beyond the one study the article talks about, I've only ever seen studies debunking the notion that fluoride lowers IQ, as that is one of the most common arguments from conspiracy theorists.

She called it "the most historic ruling in the U.S. fluoridation debate that we've ever seen."

This sentence is strange, as it assumes that fluoride existing in water is subject to debate, even though fluoride is a naturally occurring element. This gives me a similar vibe to how people call vaccines a "debate", as if both sides have equal opportunity for scandal as the other.

The judge's ruling is another striking dissent to a practice that has been hailed as one of the greatest public health achievements of the last century.

Last month, a federal agency determined "with moderate confidence" that there is a link between higher levels of fluoride exposure and lower IQ in kids. The National Toxicology Program based its conclusion on studies involving fluoride levels at about twice the recommended limit for drinking water.

They say "about twice" but they do not say the exact concentration, "about" could be doing some heavy lifting.

The EPA — a defendant in the lawsuit — argued that it wasn't clear what impact fluoride exposure might have at lower levels.

"Simply put, the risk to health at exposure levels in United States drinking water is sufficiently high to trigger regulatory response by the EPA" under federal law, he wrote.

But in the last two decades, studies have suggested a different problem: a link between fluoride and brain development.

I'm also not too sure why the concern is about IQ, as IQ is not a good indicator of intelligence and can be strongly affected by socioeconomic factors.

Some more odd statements in a closing statement towards the end of the article:

"In our view, the only effective way to eliminate the risk from adding fluoride chemicals to water is to stop adding them," said Michael Connett, the plaintiffs' lead attorney, in an email Wednesday.

This seems too close to common conspiracy arguments about fluoride for comfort. I had not heard anything about fluoride lowering IQs besides from conspiracy theorists, and then all of a sudden, there are many articles about it that read from their playbook. Is there something weird going on here?

 

[elvenwear]

What "mounting research" is he talking about, exactly?

We would need the court transcripts for this. I am not certain, but it appears to be this case.

Food and Water Watch et al. v. United States Environmental Protection Agency et al.

17-cv-02162-EMC

Due to the level of interest in this case, this web page has been created to notify attorneys, journalists and interested members of the public of important news and information about access to proceedings and to case information.[/H2}

Ordinarily you would have to pay for the documents. In this case, it appears the documents will be put on the internet as this is a case of interest. Nothing has been added as yet.

 

[Mendel]

The National Toxicology Program based its conclusion on studies involving fluoride levels at about twice the recommended limit for drinking water.

They say "about twice" but they do not say the exact concentration, "about" could be doing some heavy lifting.

I'd suspect the work is done by "recommended limit", as most people's intake of fluoride via tap water is likely to be substantially less than the legal limit.

Edit: the US recommended level is 0.7 mg/L , and the study considered a fluoride intake exceeding 1.5 mg/L , the WHO limit.The EPA limit is 4 mg/L .

I'm also not too sure why the concern is about IQ, as IQ is not a good indicator of intelligence and can be strongly affected by socioeconomic factors.

Is there a better indicator?
If you do a longitudinal study, socioeconomic factors cancel out.

 

[Mendel]

What "mounting research" is he talking about, exactly? Beyond the one study the article talks about,

That should really have been in the OP, as it's the evidence underlying the claim. All you need to do is chase down the links you already have.

Article:

August 22, 2024

The long-awaited report released Wednesday comes from the National Toxicology Program, part of the Department of Health and Human Services. It summarizes a review of studies, conducted in Canada, China, India, Iran, Pakistan, and Mexico, that concludes that drinking water containing more than 1.5 milligrams of fluoride per liter is consistently associated with lower IQs in kids.

The report did not try to quantify exactly how many IQ points might be lost at different levels of fluoride exposure. But some of the studies reviewed in the report suggested IQ was 2 to 5 points lower in children who'd had higher exposures.

Since 2015, federal health officials have recommended a fluoridation level of 0.7 milligrams per liter of water, and for five decades before the recommended upper range was 1.2. The World Health Organization has set a safe limit for fluoride in drinking water of 1.5.

The report said that about 0.6% of the U.S. population — about 1.9 million people — are on water systems with naturally occurring fluoride levels of 1.5 milligrams or higher.

The 324-page report did not reach a conclusion about the risks of lower levels of fluoride, saying more study is needed. It also did not answer what high levels of fluoride might do to adults.

Officials lowered their recommendation for drinking water fluoride levels in 2015 to address a tooth condition called fluorosis, that can cause splotches on teeth and was becoming more common in U.S. kids.

Separately, the Environmental Protection Agency has maintained a longstanding requirement that water systems cannot have more than 4 milligrams of fluoride per liter. That standard is designed to prevent skeletal fluorosis, a potentially crippling disorder which causes weaker bones, stiffness and pain.

In 2006, the National Research Council, a private nonprofit organization in Washington, D.C., said limited evidence from China pointed to neurological effects in people exposed to high levels of fluoride. It called for more research into the effect of fluoride on intelligence.

After more research continued to raise questions, the National Toxicology Program in 2016 started working on a review of the available studies that could provide guidance on whether new fluoride-limiting measures were needed.

Source: https://apnews.com/article/fluoride-water-brain-neurology-iq-0a671d2de3b386947e2bd5a661f437a5

Article:

Fluoride Exposure: Neurodevelopment and Cognition

Therefore, the National Toxicology Program (NTP) conducted a systematic review of the published scientific literature on the association between fluoride exposure and neurodevelopment and cognition. The NTP released their findings in a State of the Science Monograph (available below under Documents). A corresponding meta-analysis on children's IQ has been accepted by a scientific journal for publication later in 2024.

Findings

The NTP monograph concluded that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note, however, that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children's IQ.

The NTP uses 4 confidence levels - high, moderate, low, or very low - to characterize the strength of scientific evidence that associates a particular health outcome with an exposure. After evaluating studies published through October 2023, the NTP Monograph concluded there is moderate confidence in the scientific evidence that showed an association between higher levels of fluoride and lower IQ in children.

The determination about lower IQs in children was based primarily on epidemiology studies in non-U.S. countries such as Canada, China, India, Iran, Pakistan, and Mexico where some pregnant women, infants, and children received total fluoride exposure amounts higher than 1.5 mg fluoride/L of drinking water. The U.S. Public Health Service currently recommends 0.7 mg/L, and the World Health Organization has set a safe limit for fluoride in drinking water of 1.5 mg/L. The NTP found no evidence that fluoride exposure had adverse effects on adult cognition.

Aug 21, 2024

NTP Monograph - Final (Abstract) Preferred Citation: National Toxicology Program (NTP). 2024. NTP monograph on the state of the science concerning fluoride exposure and neurodevelopment and cognition: a systematic review. Research Triangle Park, NC: National Toxicology Program. NTP Monograph 08. https://doi.org/10.22427/NTP-MGRAPH-8

Source: https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/completed/fluoride

 

[Mendel]

Article:

The NTP uses 4 confidence levels - high, moderate, low, or very low - to characterize the strength of scientific evidence that associates a particular health outcome with an exposure.

Source: https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/completed/fluoride

From the abstract of the NTP monograph (emphasis mine):

Article:

Existing animal studies provide little insight into the question of whether fluoride exposure affects IQ. In addition, studies that evaluated fluoride exposure and mechanistic data in humans were too heterogenous and limited in number to make any determination on biological plausibility. The body of evidence from studies in adults is also limited and provides low confidence that fluoride exposure is associated with adverse effects on adult cognition. There is, however, a large body of evidence on associations between fluoride exposure and IQ in children. There is also some evidence that fluoride exposure is associated with other neurodevelopmental and cognitive effects in children; although, because of the heterogeneity of the outcomes, there is low confidence in the literature for these other effects. This review finds, with moderate confidence, that higher estimated fluoride exposures (e.g., as in approximations of exposure such as drinking water fluoride concentrations that exceed the World Health Organization Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride) are consistently associated with lower IQ in children. More studies are needed to fully understand the potential for lower fluoride exposure to affect children's IQ.

Source: https://ntp.niehs.nih.gov/publications/monographs/mgraph08

The tl;dr is that studies find a correlation between fluoride and lower IQ, but it's currently unclear what causes this: nobody knows for certain what fluoride could do in people's brains to reduce their intelligence.

The EPA is between a rock and a hard place here: given this uncertainty, consumers would want to limit their fluoride intake, but is the evidence sufficient to set a lower limit than 4 mg/L? The water providers who'd need to start filtering fluoride from their supply are liable to go to court over this, too.

 

[Ann K]

The issue is complicated by the fact that many people nowadays (at least in the USA) drink bottled water, so the measure of fluoride in the water supply doesn't necessarily agree with the level of fluoride ingested.

 

[Mendel]

The issue is complicated by the fact that many people nowadays (at least in the USA) drink bottled water, so the measure of fluoride in the water supply doesn't necessarily agree with the level of fluoride ingested.

2007 data:

Article:

Based on the present study, distilled bottled waters have an average fluoride content of less than 0.01 ppm, while drinking/purified bottled waters all (except for one sample) had an average fluoride content of less than 0.03 ppm. Spring/artesian bottled water had an average fluoride content of 0.08 ppm, compared with 0.32 ppm for mineral water bottled waters, 0.16 ppm for flavor-added bottled waters, and 0.63 ppm for fluoride-added bottled water.

Source: https://pubmed.ncbi.nlm.nih.gov/19146140/

ppm should equate to mg/L.