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Silicofluorides Should Not Be Added to Municipal Water Without Safety Testing Adequate to Protect Children and Other Vulnerable Populations

by Myron Coplan, P.E., & Robert Carton, Ph.D.

Resolution submitted to the American Public Health Association, October 21-25, 2001.


The American Public Health Association,

Recognizing that the APHA has had a consistent and long-standing policy of endorsing water fluoridation as a public health measure in Policy Statements 5005, 5508, 5607, 5904, 6912, 8402, and 7911, and

Recognizing also that said endorsement has traditionally been predicated on the belief that fluoride is a valuable caries preventive whose benefits can be enjoyed without adverse health effects by regular ingestion of water treated to an appropriate level of fluoride ion derived from an appropriate source, and

Recognizing that none of the recited APHA Policy Statements took into account the fact that there had been no health safety testing of specific water fluoridating agents known as the silicofluorides (H2SiF6 and Na2SiF6, henceforth “SiFs”) when their use began; and

Recognizing that water systems providing 91 percent of U.S. fluoridated water, and serving 140 million people, 1 dispense 200,000 tons per year of SiFs 2 and these agents have been used since 1947 3 without tests of their health safety 4, 5 and

Recognizing that a 1952 request by a Select Congressional Committee (82nd Cong., 2d Session) for studies “to determine the long-range effects upon the aged and chronically ill of the ingestion of water containing inorganic fluorides” 6 has yet to be addressed regarding health safety of the silicofluorides while animal health studies of fluoridated water, including those conducted by the National Institute of Health's National Toxicology Program, regularly employ sodium fluoride (NaF), the first fluoridating compound used (in 1945), and not SiFs, the principal agents currently added to water; 7,8,9,10,11,12,13,14,15,16 ; and

Further recognizing that, claims to the contrary,17 SiF treated water is not like NaF treated water because [SiF6] 2- (a) is unlikely to dissociate completely under water plant conditions, producing only free fluoride and silicic acid without side reactions;18, 19 (b) is likely to react with Al(OH)3 to produce several derivative compounds; (c) dissociation status depends on pH and concentration so that incompletely dissociated SiF residues may re-associate both at intra-gastric pH around 2.0 20 and during food preparation, producing SiF species including silicon tetrafluoride, (SiF4), a known toxin; 21, 22, 23, 24, 25, 26 and (d) commercial SiFs are likely to be contaminated with fluosiloxanes, 27 arsenic and heavy metals, 28 and radionuclides,29 since they are waste products from fertilizer manufacture and uranium extraction from phosphate rock 30, 31, 32, 33

Recognizing that in 1950,34 the U.S. Public Health Service endorsed Na2SiF6 as a cheaper alternative for NaF, reasoning that equal fluoride uptake by hard tissues demonstrated the biological equivalence of NaF and Na2SiF6, although earlier animal studies 35 had shown that when equal amounts of fluoride were ingested and the total amount of fluoride excreted was also equal, animals exposed to NaF eliminated more fluoride in feces, while animals exposed to Na2SiF6 eliminated three-fold more fluoride in urine, thus indicating circulating blood fluoride levels; and

Recognizing that a 1975 German study found that acetylcholinesterase inhibition, (the intended action of the high-risk organophosphate and carbamate pesticides widely used in agriculture and around residences), is many-fold more severe due to the SiF complex (and other complexes such as with iron) as compared to the simple fluoride ion released by NaF, which is itself an acetylcholinesterase inhibitor;36 and

Noting that dental fluorosis (pre-eruption F-induced tooth enamel malformation) expected in 1945 to be only mild and prevail at 10-12 percent in “optimally” fluoridated areas,37 now averages over 25 percent, and sometimes exceeds 80 percent in said “optimally” fluoridated areas with many moderate to severe cases;38 and

Further noting that a 1983 expert panel appointed by the Surgeon General to review “non-dental health effects” of ingested fluoride was instructed to limit its scope to “death (poisoning), gastrointestinal hemorrhage, gastrointestinal irritation, arthralgias, and crippling fluorosis” thus essentially ignoring many possible effects in children; 39 and

Considering that data on 400,000 children in New York, Massachusetts, and in the NHANES III (National Health and Nutrition Examination Survey III) study, found that where local water is fluoridated with SiFs the prevalence of children with venous blood lead exceeding 10mcg/dL was significantly higher than in non-fluoridated areas with risk ratios of between 2.0 and 4.0 (p<0.001) controlling for race, housing age, poverty, congestion, and parental education);40, 41and

Recognizing that blood lead is believed responsible for adverse effects inflicted in utero such as impaired immune capacity,42 brain damage and developmental problems,43, 44, 45 as well as in early childhood,46, 47, 48, 49, 50, 51and into puberty/adolescence as impaired cognition and impulse control,52, 53and adulthood as nephropathy and hypertension,54, 55and into geriatric life;56 and

Finally, recognizing that dental caries prevalence rates in “optimally fluoridated” areas today is indistinguishable from prevalence rates in non-fluoridated areas 57, 58, 59, 60, 61, 62, 63; and

Noting that the Journal of the American Dental Association has recently published a comprehensive study showing that ingestion of fluoride does not benefit teeth in their pre-eruptive stage, but only via by topical contact after tooth eruption;64 and

Noting also that seven times in the past APHA has in one way or another endorsed fluoridation of public water supplies but none of the relevant POLICY STATEMENTS explicitly endorsed any specific fluoridating agent, whereas POLICY STATEMENT 6912 implicitly did so by identifying fluoridation in Grand Rapids in 1945 which, according to Reference 3, was initially accomplished by adding sodium fluoride to its water supply; and

Noting, moreover, that less than 10% of US fluoridated water today is treated with sodium fluoride while over 90% is treated with one of the SiFs which have never been tested for health safety; and

Further noting that the premise that “fluoride is fluoride” whatever its source is false and dangerously misleading based on evidence that water treated with SiFs is not just like water treated with sodium fluoride as confirmed by (a) epidemiological analyses of several health and behavioral effects comparing communities using SiFs with communities using sodium fluoride or not adding fluoride; (b) biological studies comparing effects of ingested water treated with sodium fluoride with effects of ingested water treated with SiFs; (c) disputed assurances concerning the “virtually total” dissociation of the SiFs under real use conditions; (d) an advisory letter from the Director of the EPA Water Supply and Water Resources Division in a letter67 dated March 15, 2001 summarizing the position of the highest scientific authorities of the EPA reached in January 2001 which notes the following:

“Several fluoride chemistry related research needs were identified including; (1) accurate and precise values for the stability constants of mixed fluorohydroxo complexes [read “silicofluoride dissociation residues”] with aluminum (III), iron (III) and other metal cations likely to be found under drinking water conditions and (2) a kinetic model for the dissociation and hydrolysis of fluosilicates and stepwise equilibrium constants for the partial hydrolysis products.”


thus admitting that EPA scientific leaders are not satisfied with assurances given by their own technical staffs of the health safety of SiFs on two counts: (i) possible formation of toxic complexes with aluminum, iron and other cations commonly present in water plant water and (ii) potential toxic effects from SiF dissociation residues in municipal drinking water that may be present despite predictions made by EPA and others for SiF dissociation.

Citing APHA's explicit endorsement of the precautionary principle as a cornerstone of preventive public health policy, especially in “order to protect the health and well-being of all developing children”;65 and Presidential Executive Order #13045 calling on all federal agencies to ensure that all federal environmental health policies and regulations consider the special sensitivities and vulnerabilities of children;66

The APHA, therefore:

  1. Calls for the establishment of an APHA study committee comprising an equal number of members from the Environment and Oral Health Sections plus a representative of the APHA Directorship to investigate in depth water fluoridation using silicofluorides on the basis that they have never been tested for health safety in humans and may be particularly hazardous to children, the aged and the chronically ill;
  2. Calls for the National Institute of Environmental Health Science/National Toxicology Program to nominate the silicofluorides for priority CCL status to undertake a full battery of chronic health effects testing of silicofluoride treated water; and
  3. Calls for the US. EPA to review its standards for the safe level of fluoride exposure in the light of any NTP results arising under actions requested above.

-------------------------------------

Myron J. Coplan, P.E.* (APHA #9774108)
Intellequity Technology Services
Natick, MA 01760
(ph) 508-653-6147 (fax) 508-655-3677

Robert J. Carton, Ph.D.** (APHA #9774839)
Environmental Coordinator
U.S. Army Medical Research & Materiel Command
Fort Detrick, MD 21702-5012
(ph) 310-610-2004 (fax) 1-301-619-7803
Robert.Carton@det.amedd.army.mil

* Contact author

**The views presented in this resolution are those of its authors (MJC and RJC) and do not necessarily represent the views of the Department of Defense.


Footnotes

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