LOS ANGELES, Feb. 21 — Plans to add fluoride to Southern Californians' tap water this summer are raising concerns that parents may not know of the potential risks of using fluoridated water to mix infant formula.
The Metropolitan Water District (MWD), which supplies 18 million people in six counties throughout the region, in July will begin adding fluoride to the water it delivers to 26 local water districts, some of which already fluoridate. But since MWD made the decision to fluoridate, the American Dental Association (ADA) — the nation's leading authority on dental health — has for the first time acknowledged the dangers of fluoridation to children and issued a warning to the public.
In a Feb. 20 letter to MWD General Manager Jeffrey Kightlinger, the Environmental Working Group (EWG), which has led a national campaign to re-examine the risks and benefits of fluoridation, urged the district to take aggressive action to make sure all its customers are fully informed of the ADA's warning.
"It is deeply troubling that children, including bottle-fed infants, will begin drinking fluoridated water without the benefit of the ADA warning and in spite of the many [other] serious concerns [about fluoridation] raised by the National Academy of Sciences last spring," EWG wrote. "Public water supplies should be safe for all consumers, young and old alike." (The letter is available at www.ewg.org.)
Last November, the ADA — long a strong advocate of fluoridation, said: "Infants less than one year old may be getting more than the optimal amount of fluoride" if they consume formula or food prepared with fluoridated water. ADA added: "If using a product that needs to be reconstituted, parents and caregivers should consider using water that has no or low levels of fluoride."
(www.ada.org/prof/resources/positions/statements/fluoride_infants.asp)
EWG calculated that about 240,000 babies under one year old live in the MWD service area. "Many of these babies will be bottle-fed for at least some portion of their first year, and their parents need to know about the ADA warning and the risks that fluoride may pose to their children's health.," said the letter to Kightlinger. Copies were sent to the MWD board, representatives from local water agencies, and local and state elected officials.
The group urged MWD to provide the ADA warning to every customer it serves, and to make sure information about the warning is provided to the news media, medical and dental offices, schools, day care centers and other facilities.
ADA's warning said babies exposed to fluoridated water may ingest more fluoride than recommended by the National Academy of Sciences' Institute of Medicine, placing them at elevated risk of developing fluorosis, a defect of the permanent teeth resulting in dark staining and, in severe cases, substantial corrosion of the enamel. The Centers for Disease Control estimate that about 30 percent of children drinking fluoridated water have some degree of fluorisis.
Fluorosis, however, is not the only health risk of childhood fluoride exposure. A March 2006 report from the National Academy of Sciences identified fluoride as a potent hormone disruptor that may affect normal thyroid function. A 2006 peer-reviewed study by four Harvard scientists and doctors strongly supports ongoing concerns that fluoridated water is linked to osteosarcoma (an often fatal form of bone cancer) in boys.
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Full text of the EWG letter to MWD:
February 16, 2007
Jeffrey Kightlinger, General Manager
Metropolitan Water District of Southern California
700 N. Alameda St.
Los Angeles, CA 90012
Dear Mr. Kightlinger:
As the Metropolitan Water District proceeds with its plans to fluoridate drinking water supplies serving 18 million residents of Southern California, we write to express our concern that all MWD customers are fully informed about recent guidance from the American Dental Association (ADA) identifying the potential risks of using fluoridated water to reconstitute infant formula. The statement, which is attached, contains the first-ever warning from the ADA about the dangers of fluoridation to children. It is critical public health information that must not be ignored as the MWD proceeds with its fluoridation plans.
The ADA is the nation's leading authority on dental health and a strong and consistent advocate of water fluoridation. Yet on November 9, 2006, ADA issued a warning: "Infants less than one year old may be getting more than the optimal amount of fluoride" if they receive formulas and food prepared with fluoridated water. ADA added: "If using a product that needs to be reconstituted, parents and caregivers should consider using water that has no or low levels of fluoride."
According to the ADA, babies exposed to fluoridated water can ingest more fluoride than the Tolerable Upper Intake recommended by the National Academy of Sciences' Institute of Medicine, placing them at elevated risk of developing dental fluorosis, a defect of the permanent teeth resulting in dark staining and, in severe but not uncommon cases, substantial corrosion of the enamel. The Centers for Disease Control estimate that about 30 percent of children drinking fluoridated water have some degree of fluorosis, and that two to four percent have moderate to severe cases.
MWD's fluoridation project will make it the largest fluoridated water provider in the nation, serving some 18 million people, including about 240,000 babies under one year old. Many of these babies will be bottle-fed for at least some portion of their first year, and their parents need to know about the ADA warning and the risks that fluoride may pose to their children's health.
Dental fluorosis, however, is not the only health risk of childhood fluoride exposure. A March 2006 report from the National Academy of Sciences identified fluoride as a potent hormone mimic that may affect normal thyroid function. Fluoride was identified in December 2006 as an "emerging" neurotoxin in the prestigious peer-reviewed journal Lancet.
Perhaps of greatest concern is a 2006 peer-reviewed study by four Harvard scientists and doctors strongly supporting ongoing concerns that fluoridated water is linked to osteosarcoma (an often fatal form of bone cancer) in boys (3). Osteosarcoma, while rare, is the third most common form of cancer in children. The study found a five-fold increase in bone cancer among boys drinking fluoridated water from ages 6 through 8, compared to those drinking non-fluoridated water.
Public water supplies should be safe for all consumers, young and old alike. It is deeply troubling that children, including bottle -ed infants, will begin drinking fluoridated water without the benefit of the ADA warning and in spite of the many serious concerns raised by the National Academy of Sciences last spring.
We strongly urge MWD to take the following steps to protect the health of the children drinking fluoridated water:
1) Provide the ADA guidance to every residential water customer in the district, require other water districts that receive MWD water to inform their customers, and require landlords to inform tenants.
2) Proactively distribute materials that prominently feature the ADA warning to the media, health centers, schools, pediatricians, hospitals, obstetrician's offices, dental clinics, and water departments.
We look forward to your reply and to working together in the future.
Sincerely,
Bill Walker, Vice President/West Coast
Environmental Working Group
cc: Board of Directors, Metropolitan Water District
Los Angeles City Council members
Los Angeles County Board of Supervisors members
State Assembly members, Los Angeles County
State Senate members, Los Angeles County
References:
1) CDC (2005) MMWR Surveillance Summaries; 54(03): 1-44.
http://www.cdc.gov/MMWR/preview/mmwrhtml/ss5403a1.htm
Retrieved February 9, 2007.
2) Grandjean P., Landrigan P. (2006). Developmental neurotoxicity of industrial chemicals. Lancet; 368(9553): 2167-78.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve& dopt=AbstractPlus&list_uids=17174709&query_hl=14&itool=pubmed_docsum
Retrieved February 9, 2007.
3) Bassin E.B., Wypij D., Davis R.B. and Mittleman M.A. (2006). Age-specific fluoride exposure in drinking water and osteosarcoma (United States). Cancer Causes Control; 17(4): 421-8.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve& dopt=AbstractPlus&list_uids=16596294&query_hl=1&itool=pubmed_docsum
Retrieved February 12, 2007.
