THE REGIONAL MUNICIPALITY OF PEEL

COMMUNITY WATER FLUORIDATION COMMITTEE AGENDA CWFC - 2/2016 DATE: Thursday, March 31, 2016 TIME: 8:30 AM – 9:30 AM LOCATION: Regional Council Chamber, 5th Floor Regional Administrative Headquarters 10 Peel Centre Drive, Suite A Brampton, Ontario MEMBERS: F. Dale; J. Downey; A. Groves; M. Palleschi; C. Parrish; K. Ras;

J. Sprovieri; J. Tovey Chaired by Councillor C. Parrish or Vice-Chair Councillor J. Sprovieri 1.

DECLARATIONS OF CONFLICTS OF INTEREST

2.

APPROVAL OF AGENDA

3.

DELEGATIONS

3.1.

Dr. Raymond Ray, Resident, Town of Oakville, Regarding Community Water Fluoridation

4.

REPORTS

4.1.

Community Water Fluoridation Committee Work Plan

4.2.

Dr. Dick Ito’s Masters of Science Thesis (Oral)

Presentation by Dr. de Villa, Medical Officer of Health, Region of Peel 5.

COMMUNICATIONS

5.1.

Karen Spencer, Resident, Gloucester, MA, Email dated December 29, 2015, Providing Regional Council a Copy of a Communication to National Academy of Science (NAS) and Institute of Medicine (IOM) Food and Nutrition Board Regarding Fluoride Dietary Reference Intake (DRI) dated April 27, 2015 (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

CWFC-2/2016 -2- Thursday, March 31, 2016 5.2. Henry Rodriguez, Founder and Executive Director, League of United Latin

American Citizens (LULAC) Concilio Zapatista 4383, Letter dated January 13, 2016, Regarding Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.3.

Lois Marie Gibbs, Founder and Stephen Lester, Science Director, Center for Health, Environment and Justice (CHEJ), Letters dated January 20, 2016 and September 8, 2015, Regarding Opposition to Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.4.

Dr. Oksana M. Sawiak, Wellness Counsellor, Author, Lecturer, Email dated January 27, 2016, Regarding Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.5.

Edna Toth, Editor, Tough Times, Letter dated February 3, 2016, Regarding Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.6.

Maria Britto, Board Chair, Central West Local Health Integration Network (LHIN), Letter dated February 5, 2016, Regarding Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.7.

Dr. Mike Toth, President, Ontario Medical Association (OMA), Letter dated February 8, 2016, Regarding Drinking Water and the Issue of Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.8.

Bill MacLeod, Chief Executive Officer, Mississauga Halton Local Health Integration Network (LHIN), Letter dated February 9, 2016, Regarding Water Fluoridation (Receipt recommended) (Referred from the February 11, 2016 Regional Council meeting)

5.9.

Ondina Love, Chief Executive Officer, The Canadian Dental Hygienists Association (CDHA), Letter dated February 1, 2016, Regarding Community Water Fluoridation (Receipt recommended)

5.10.

Dr. Victor Kutcher, President, Ontario Dental Association (ODA) and Dr. Sanjukta Mohanta, President, Halton-Peel Dental Association (HPDA), Letter Dated February 18, 2016, Regarding Community Water Fluoridation (Receipt recommended)

5.11.

Anna Louise, Registered Dental Hygienist and Resident, Email dated February 29, 2016, Regarding Community Water Fluoridation (Receipt recommended)

5.12.

Dr. Alyssa Hayes, President, Canadian Association of Public Health Dentistry (CAPHD), Letter dated March 12, 2016, Regarding Community Water Fluoridation (Receipt recommended)

CWFC-2/2016 -3- Thursday, March 31, 2016 6.

IN CAMERA MATTERS

6.1.

Update on Lawsuit Concerning Water Fluoridation (Oral) (Litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board)

7.

OTHER BUSINESS

8.

NEXT MEETING Thursday, April 14, 2016, 8:30 a.m. - 9:30 a.m. Regional Council Chamber, 5th Floor Regional Administrative Headquarters 10 Peel Centre Drive, Suite A Brampton, Ontario

9.

ADJOURNMENT

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REPORT Meeting Date: 2016-03-31

Water Fluoridation Committee

DATE: March 22, 2016

REPORT TITLE: COMMUNITY WATER FLUORIDATION COMMITTEE WORK PLAN

FROM: Janette Smith, Commissioner of Health Services

Eileen de Villa, Medical Officer of Health

RECOMMENDATION That the Work Plan, attached as Appendix I to the report of the Commissioner of Health Services and the Medical Officer of Health, titled “Community Water Fluoridation Committee Work Plan”, be approved.

REPORT HIGHLIGHTS

The Region of Peel Community Water Fluoridation Committee (CWFC) met on February 11, 2016 to discuss the mandate and terms of reference.

On March 10, 2016, Regional Council approved the mandate and Terms of Reference for the CWFC.

Based on Committee discussion and direction from Regional Council through approval of the Committee’s Terms of Reference, staff has put forward a work plan for discussion by CWFC members. The proposed work plan is attached as Appendix I.

DISCUSSION 1. Background

On January 28, 2016, Regional Council requested that a new committee be established to provide Council members with the opportunity to closely examine water fluoridation and the oral health of Peel residents more broadly. The Region of Peel Community Water Fluoridation Committee (CWFC) met on February 11, 2016 to discuss the mandate and Terms of Reference. On March 10, 2016, Regional Council approved the mandate and Terms of Reference for the CWFC.

2. Proposed Work Plan Details

Based on Committee discussion and direction from Regional Council through approval of the Committee’s Terms of Reference, staff has put forward a work plan for discussion by CWFC members. The proposed work plan is attached as Appendix I. The purpose of the work plan is to support and guide the committee’s work. Additional information regarding community water fluoridation and oral health status in Peel will be

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COMMUNITY WATER FLUORIDATION COMMITTEE WORK PLAN

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made available upon request from the Committee. Additional information and changes to the work plan will be at the discretion and approval of the Committee.

CONCLUSION Staff recommends approval of the Committee work plan attached in Appendix I in order to commence the work of the Committee to closely examine water fluoridation and the oral health of Peel residents more broadly.

Janette Smith, Commissioner of Health Services

Eileen de Villa, Medical Officer of Health Approved for Submission:

D. Szwarc, Chief Administrative Officer APPENDICES

1. Appendix I – Community Water Fluoridation Committee (CWFC) Work Plan For further information regarding this report, please contact Eileen de Villa, Medical Officer of Health, at ext. 2856 or Eileen.deVilla@peelregion.ca Authored By: Sharanjeet Kaur

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COMMUNITY WATER FLUORIDATION COMMITTEE WORK PLAN Appendix I

Community Water Fluoridation Committee (CWFC)

Work Plan

Meeting Topic

#1 Updated Terms of Reference

Work plan

Communication items

Dr. Ito’s Master of Science thesis (A Cross-Sectional Study to Compare Caries and Fluorosis in 7-year-old Schoolchildren from a Fluoridated Area with those in a Neighbouring Non-Fluoridated Area in Ontario)

#2 History of fluoridation (including World Health Organization data)

Mechanism of action (ways in which fluoride works in the body)

#3 Legislative framework i. Federal

ii. Provincial (e.g., Safe Drinking Water Act and other regulatory obligations)

#4 Water fluoridation process i. Process (including proximity to source of community water fluoridation)

ii. Current additive analysis iii. Alternative additives analysis (including pharmaceutical grade)

#5 Sources of fluoride (e.g., toothpaste)

#6 Emerging evidence i. Safety

#7 Emerging evidence ii. Effectiveness (including scientific research, jurisdictional evidence)

#8 Alternative approaches to Community Water Fluoridation

#9 Approaches to public engagement

Note: Impact of Discontinuing Community Water Fluoridation in Calgary – date to be determined

when researchers confirm release of all data.

4.1-3

To:

Members of Regional Council

Date: March 24, 2016

From:

Dr. Eileen de Villa Medical Officer of Health

Subject:

SUBJECT: Dr. Dick Ito’s Masters of Science Thesis, “A Cross-Sectional Study to Compare Caries and Fluorosis in 7-year-old Schoolchildren from a Fluoridated Area with those in a Neighbouring Non-Fluoridated Area in Ontario”.

At the September 10, 2015 Region of Peel Council meeting, Council requested staff to review Dr. Dick Ito’s Masters of Science thesis and obtain Dr. Ito’s input on his thesis. The information was requested again by the Community Water Fluoridation Committee at its meeting on February 11, 2016, for further discussion by the Committee. The full thesis can be accessed at: http://www.collectionscanada.gc.ca/obj/thesescanada/vol2/002/MR27307.PDF. 1. Dr. Ito’s Reflection Letter

Dr. Ito’s letter outlining his thoughts on his thesis can be found in Appendix A. 2. Staff Review

Study Objectives The study sought to examine the difference in rates of dental cavities and fluorosis in seven-year-old children from Caledon (non-fluoridated) and Brampton (fluoridated) and investigate the factors associated with these oral health outcomes.

Study Findings Rates of dental cavities and fluorosis Based on the 1,047 children studied (810 Brampton and 237 Caledon), the study found no difference between Brampton and Caledon in the rate of cavity-free children and the rate of decayed, extracted and filled teeth. Dental fluorosis of aesthetic concern was relatively higher in Brampton (52 children) compared to Caledon (6 children). The author notes that examiner bias could have contributed to these outcomes, as one screening team tended to score fluorosis rates higher in Brampton. Oral health factors The study found factors that were associated with the presence of cavities and fluorosis in the children studied.

Memo

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RC-26

Factors associated with the presence of cavities included:

• child or their parents were born outside Canada • child did not take multivitamins • family income was less than $40,000/year

Factors associated with the presence of fluorosis included:

• child began brushing teeth at six to eleven months old • child was exposed to water fluoridation throughout life • child covered three-quarters of the head of the toothbrush with toothpaste when

brushing

Brampton children were more likely than Caledon children to have parents born outside Canada and have a family income less than $40,000/year (increased risk of dental cavities). Caledon children were more likely than Brampton children to have dental treatment such as regular check-ups (decreased risk of dental decay) and to use a pea-sized amount of toothpaste (decreased risk of fluorosis). Study Limitations

1. Approximately one quarter of the Caledon children were drinking optimally fluoridated water at home. However, these children were included in the non-fluoridated population in the study. This means that the results do not reflect a true comparison between fluoridated and non-fluoridated populations. It is unknown if fluoride exposure contributed to the oral health outcomes of the children in Caledon.

2. Low recruitment and survey response rates weaken the statistical strength of the study.

3. The study population is not representative of Peel’s or Ontario’s population given that they have a higher average income and a higher proportion have dental insurance compared to Peel and the province. Most study participants also had strong patterns of preventive oral health behaviours and good access to professional dental care (likely due to the high socioeconomic status of the study population). Conclusions

• Various factors such as income, access to dental care and preventive dental health

practices contributed to the observed oral health outcomes. • Given the study limitations, the findings cannot be taken as a measurement of the

effectiveness of community water fluoridation and are not conclusive enough to alter policy considerations.

• The author also concluded that: o the outcomes of the study are not large enough to be important in either clinical

or public health terms; and o given the affluent population that was studied, the findings are not to be taken as

a measurement of the effectiveness of water fluoridation on a population-wide basis in Peel region.

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DICK H. ITO, D.D.S., M.Sc., RCDC(C) 80 Bradford St., Suite 403 Barrie, Ontario L4N 6S7 705-721-7520 ext. 7205

Fax: 705-734-9369

December 17, 2015

Region of Peel,

10 Peel Centre Drive,

Brampton, Ontario

L6T 4B9

My Thoughts on the 2007 Peel Region Thesis

I understand that councillors are interested in local Peel data to better appreciate the effects of community

water fluoridation. In 2004, Regional Council requested this study be done in an effort to fill the data gap,

however, due to data limitations the results of the study cannot be generalized despite efforts to select similar

populations of children in fluoridated Brampton and non-fluoridated areas of Caledon. Over the years, the

fi di gs fro y Master’s thesis have ee sele tively herry-picked and misused by opponents of

community water fluoridation. New research is based on the scientific evidence base of previously published

studies and I found that the research on the effects of fluoride in drinking water is extensive, and can be

traced as far back as the early 1900s. The results of my literature search as described in my thesis

demonstrated that community water fluoridation is safe, effective and cost-saving from a societal perspective.

Limitations Based on Differences between Two Communities

Overall, the children and parents in non-fluoridated parts of Caledon had better oral hygiene and

dietary practices than those in Brampton.

Children and parents in Caledon had greater access to dental care.

A higher percentage of Caledon children had a family dentist and more importantly tended to visit the

dentist at an earlier age and more often for routine check-up and cleaning, compared to those in

Brampton.

A slightly higher percentage of the parents of Caledon children had private dental insurance compared

to the parents in Brampton.

Limitations Due to Study Design

The following factors affected the results of this study, likely in terms of both the direction and the magnitude

of the findings:

1. The difference in the prevalence of fluorosis between Caledon and Brampton may be the result of

examiner bias.

2. The study focused on non-fluoridated areas of Caledon and a small area of Brampton and the

unexpected lower participation rates resulted in smaller than needed sample sizes, which weakened

the results.

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3. In a non-fluoridated area like Caledon that is surrounded by a large fluoridated area such as the rest of

Peel region, children from Caledon may easily have been exposed to fluoridated water from

neighbouring jurisdictions.

4. The advantages of higher income and higher parental education levels in Caledon compared to

Bra pto hildre ’s fa ilies likely o tri uted to redu i g the aries rates in Caledon children.

5. Conversely, the disadvantages of lower average family income, lower parental education levels, and

ore pare ts ei g or outside Ca ada for hildre ’s fa ilies fro Bra pto likely o tri uted to increasing the caries rates among Brampton children.

For all these limitations, extreme caution should be taken when considering the results of this study and using

selected findings, such as the no apparent difference in rates of caries between high income Grade 2 children

from non-fluoridated areas of Caledon and fluoridated Brampton, to make generalizations on the total

population of children in the two areas.

Reflection

I believe addressing the above noted limitations would require:

Comparing a geographically large fluoridated as well as a large non-fluoridated area, where the cross-over

effects at the borders of the regions on exposure to fluoride would be less significant.

Not placing any restrictions on matching populations by schools but controlling for the factors that affect

caries rates during statistical analyses.

Choosing regions with population sizes (for the age groups of interest) adequate to obtain statistically

significant results for all the factors of interest.

I hope that you find this information helpful in your deliberations.

Respectfully Yours,

Dick Ito DDS, MSc, FRCD(C)

4.2-4

Region of Peel

APPROVED AT REGIONAL COUNCIL February 11, 2016

5.1. Karen Spencer, Resident, Gloucester, Massachusetts, Email dated December 29, 2015, Providing Regional Council a Copy of a Communication to National Academy of Science (NAS) and Institute of Medicine (IOM) Food and Nutrition Board Regarding Fluoride Dietary Reference Intake (DRI) dated April 27, 2015 (Regional Council Agenda Item 8.4)

5.2. Henry Rodriguez, Founder and Executive Director, League of United Latin American Citizens (LULAC) Concilio Zapatista 4383, Letter dated January 13, 2016, Regarding Water Fluoridation (Regional Agenda Council Item 8.2)

5.3. Lois Marie Gibbs, Founder and Stephen Lester, Science Director, Center for

Health, Environment and Justice (CHEJ), Letters dated January 20, 2016 and September 8, 2015, Regarding Opposition to Water Fluoridation (Regional Council Agenda Item 8.3)

5.4. Dr. Oksana M. Sawiak, Wellness Counsellor, Author, Lecturer, Email dated

January 27, 2016, Regarding Water Fluoridation (Regional Council Agenda Item 8.5)

5.5. Edna Toth, Editor, Tough Times, Letter dated February 3, 2016, Regarding

Water Fluoridation (Regional Council Agenda Item 8.8) 5.6. Maria Britto, Board Chair, Central West Local Health Integration Network

(LHIN), Letter dated February 5, 2016, Regarding Water Fluoridation (Regional Council Agenda Item 8.9)

5.7. Dr. Mike Toth, President, Ontario Medical Association (OMA), Letter dated

February 8, 2016, Regarding Drinking Water and the Issue of Water Fluoridation (Regional Council Agenda Item 8.11)

5.8. Bill MacLeod, Chief Executive Officer, Mississauga Halton Local Health

Integration Network (LHIN), Letter dated February 9, 2016, Regarding Water Fluoridation (Regional Council Agenda Item 8.10)

Referred to the Community Water Fluoridation Committee

Regional Council Resolution Numbers: 2016-98 to 2016-101 inclusive and 2016-105 to 2016-108 inclusive

From: Karen Spencer

Subject: Artificial Water Fluoridation & Public Harm: Letter plus Attachment

Date: December 29, 2015 at 4:08:23 PM EST

To: Kathryn Lockyer

Cc:

Attn: City Clerk Ms. Kathryn Lockyer

PLEASE INCLUDE MY LETTER BELOW TOGETHER WITH THE IOM LETTER

ATTACHMENT AS PART OF PUBLIC RECORD:

”Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with

the prior, free and informed consent of the person concerned, based on adequate information.

The consent should, where appropriate, be express and may be withdrawn by the person

concerned at any time and for any reason without disadvantage or prejudice.” - UNESCO on

Bioethics and Human Rights (2005)

“I now realize that what my colleagues and I were doing was what the history of science shows

all professionals do when their pet theory is confronted by disconcerting new evidence: they

bend over backwards to explain away the new evidence. They try very hard to keep their theory

intact — especially so if their own professional reputations depend on maintaining that

theory.” - Dr. John Colquhoun DDS, PhD, former Chief Dental Officer of New Zealand (1998)

29 December 2015

Dear Water Fluoridation Committee Members, Regional Councilors, City Solicitors and City

Staff,

As one of the countless opponents to fluoridation, I have been following the “disproportionate

harm” argument out of Peel Region, Ontario quite closely. I am also the individual who prepared

the April 2015 letter to the Institute of Medicine cc’d to thirty members of the US Congress that

was signed by consumer advocate Erin Brockovich; Wm. Ingram MD, president of the American

Academy of Environmental Medicine on its behalf; David Matthews JD of Matthews &

Associates; Dr. Daniel A. Eyink, MD; Dr. Jean Nordin-Evans, DDS; and Dr. Stephanie Seneff,

PhD. I am attaching a link to that letter, as well as a copy of my personal testimony to my city

council given in December 2014.

My research into fluoridation has not only included reviewing the toxicological science relevant

to fluoride toxicity and fluoridation, but also the psychology and politics behind the avid

promotion of this 1950 mass medication program and polarization of the politicized debate.

Obviously, doctors and dentists do not choose their professions in order to do harm.

Consequently, cognitive dissonance and group think motivates many fluoridation advocates to

vigorously dismiss opposition and deny science that does not fit in their world view. Moreover,

change is hard. It’s hard for individuals who have watched countless commercials promoting

fluoridation as well as corporations who have based their business model on our current use of

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fluoride and policy makers such as yourself. It takes integrity and courage to admit a mistake

and make amends.

The late Chief Dental Officer of Aukland, New Zealand, Dr. John Colquhoun was one such

proponent turned opponent after examining all the data from his country rather than just

considering the cherry picked and massaged reports. Dr. Colquhoun wrote about the science,

the fraudulent studies, and the psychology motivating fluoridationists. Dr. Hardy Limeback, BSc,

PhD, DDS of Canada is another former proponent with the intellectual discipline, personal

courage and professional integrity required to speak out publicly against fluoridation policy. Peel

Canada is fortunate to have this moral man and honest broker of truth as a resident.

Opponents like Dr. Limeback realize that scientific integrity is not the same as the scientific

advocacy that frames fluoridation in distorted dental context. Opponents recognize that

fluoridation decision making should be based on morality, values and cost in a much larger

context of the overall health of the entire population and ethics.

Just as many legislatures and businesses banned public smoking in order to protect the shared

resource of air for those most vulnerable among us to the effects of second hand smoke, and

did so over the objections of the tobacco industry who denied the validity of opposition science,

so should legislators ban the addition of artificial fluorides to our municipal water supplies to

protect those with genetic, racial, or disease specific susceptibilities to adverse impacts of life

long, low dose fluoride ingestion. National Research Council panelist Dr. Thiessen in her

commissioned affidavit for the pending Peel Region lawsuit explains more about the impact of

artificial fluoridation on these susceptible populations.

Councilors, to debate the pros and cons of fluoridation is a false dilemma. It is easy and cheap

to add fluoride drops to your own drinking water, or buy pre-fluoridated drinking water if you do

not believe brushing your teeth with fluoridated toothpastes is sufficient. It is costly and next to

impossible to remove this toxin once its added to the water. It is also far more costly to provide

crowns for the approximately 4% of children, most of whom are non-white or low income, who

suffer from the brown stains and pitted teeth of moderate to severe dental fluorosis than it is to

fill a cavity. It is more costly still to treat thyroid or kidney disease, or fund special needs

education for hyperactive children and those with cognitive deficits due to fluoride poisoning.

Councilors, save your region and your constituents money and misery. Do the moral thing. End

municipal fluoridation.

Respectfully,

Karen Spencer

5.1-2

Attachments:

1. April 2015 letter to IOM: https://www.aaemonline.org/pdf/LetterIOM_2015.04.27.pdf 2. December 2014 Testimony to Gloucester, Massachusetts City Council (below)

Councilors -

This is me with my babies in ’82. I was not well. My illness began summer of ’81. I thought it

was the pregnancy, but I wasn’t getting better. By fall of ’82, my weight plunged into the 90s. I’d

get up okay in the morning, make breakfast, brush my teeth and then lay down on the hall floor

too exhausted and weak to make it to my bed. I was dizzy. I had small itchy bruises that came

and went. My bleeding eczema drove me batty with pain. My kids also had nasty rashes and

gastrointestinal problems. My allergist, who gave me skin tests, told me to only use bottled

spring water, even to brush my teeth and wash my fruit.….. my story continues with my ill-fated

switch to a water filter in ’91. Gloucester began fluoridation summer of ’81 during my pregnancy.

The 14 year Public Health Service controlled dose study on PREGNANT WOMAN and YOUNG

CHILDREN found that 1% of them had allergic reactions, listing eczema and gastrointestinal

problems as common symptoms. The PHS advised water fluoridation was a closed subject.

In the 1950s, allergists were seeing people like me and my children in their clinical practices.

Double blind studies and skin tests by Dr. George Waldbott of Detroit revealed that many had

adverse reactions to fluoride, but only about 1% had the characteristic allergic wheal.

However, 15% of the general US population and at least 25% of Gulf War veterans have

multiple chemical sensitivities, an acquired condition. It is not about “allergies.”

Allergic reactions are consistent with the symptoms of POISONING. Fluoride is not a nutrient. It

is characterized by chemists and the EPA as an inorganic CHEMICAL and a POISON. The

2006 National Research Council found that:

1. Fluoride inhibits enzymes, causing gastrointestinal problems. 2. It is an endocrine disruptor, interfering with the immune system 3. It is stored in organs, like kidneys which are at a “higher risk of fluoride toxicity than most

soft tissues” 4. Fluoride accumulates in bones making them brittle and causing arthritic pain

The NRC states that “water fluoridation studies did not carefully assess changes in renal

function.” About 15% of us have kidney disease and Black Americans have quadruple the risk

of developing kidney disease, as well as twice the incidence of dental fluorosis.

This is like the 2nd hand smoke argument. Fluoride lobbyists, like tobacco lobbyists twenty

years ago, dogmatically insist our exposure level is safe. Legislators stepped in and said

POISONING the shared air is not fair to those with increased susceptibilities.

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In Gloucester, just considering the 15% with chemical sensitivities and an equivalent number of

those with kidney disease, there are 9k residents who should not use fluoridated water.

In closing: I want to speak to my Sicilian cousins. If your grandparents came from Terrasini, -

we share a common genetic heritage. If your great-grandparents were Favazza, Favaloro,

Frontiero, Palazzola, Parisi, Aiello, Ciaramitaro or Ventimiglia - you and I share blood. If you or

your family has allergies, lupus, MS, kidney disease, thyroid disorders, or the rare bone cancer

that killed my father at age 53 and is currently killing one of my cousins… you should not be

drinking fluoridated water.

Councilors - we elected you to serve our best interests. We are being poisoned. Find a way to

stop it!

Karen Favazza Spencer

16 Dec 2014

About Me: Currently a consultant in high tech venues, I am a former analyst and project leader.

I am adept at conducting research, analyzing trends, developing control plans, and validating

results. My special interests include critical thinking, data-driven decision making, and

organizational theory. The course work for my Masters degree from Lesley College included

studies in qualitative evaluation. I currently serve as the Chair of the Gloucester Cable TV

Advisory Committee. Over the years, I have served the city on several working committees. In

2010 I worked with the city of Gloucester’s IT Director in a volunteer analyst capacity that

resulted in the city’s current website. I am a Gloucester native who has lived in Lanesville since

1978.

5.1-4

To: IOM/NAS leadership and Food and Nutrition board members Keck Center 500 Fifth St. NWWashington, DC 20001

From:

April 27, 2015

Dear Ms. Mosley, et al.

This letter serves as a formal notification to the IOM and NAS leadership, you as registered agent for the NAS, and the Food & Nutrition board members personally of two issues:

I. Failure to maintain the ‘DRI: Elements’ table with current and accurate information reflective of the science on fluoride, some of which was provided by Committee on Fluoride in Drinking Water for the 2006 National Research Council.

II. Failure to warn the government and public of the health risks fluoride ingestion poses to the young, elderly, and those with health conditions.

Given that the IOM DRI table that includes fluoride is used by state Departments of Health, local Boards of Health, and medical professionals as justification for the fluoridation of water supplies which results in uncontrollable doses and ubiquitous contamination of drink and food with fluoride, an inorganic chemical characterized by chemists as a poison and labeled as a neurotoxin in 2012, the continued failure of the IOM to fulfill their ‘aim of helping government to make informed health decisions based on evidence’ will make the IOM and its leadership culpable for damage caused by ingestion of fluoride in food or drink.

Moreover, by allowing the fluoride section in the DRI:Elements table to stand in the most recent 2006 DRI when almost every major point in the 1997 NAS document used to justify the DRI has been since scientifically disproved, the IOM fails to fulfill its ‘mission of asking and answering the nation’s most pressing questions about health and health care.’

Ralph J. Cicerone, President NASVictor J. Dzau, President IOMAnn Yaktine, Board Director F&NCutberto Garza, Chair F&NSuzanne Murphy, Chair F&NGeraldine Kennedo, contact F&N

Cheryl AndersonPatsy BrannonSharon DonovanLee-Ann JaykusAlice LichtensteinJoanne Lupton

James Ntambi Rafael Perez-EscamillaA. Catharine RossMary StoryKatherine TuckerConnie Weaver

Audrey Byrd Mosley as Registered Agent, National Academy of Sciences/Institute of Medicine 2101 Constitutional Ave NW Suite NAS210Washington, DC 20418

Erin BrockovichBrockovich Research and Consulting Los Angeles, CA

American Academy of Environmental Medicine6505 E. Central Ave #296Wichita, KS 67206

David P. Matthews, J.D.Matthews & Associates2905 Sackett StreetHouston, TX 77098

Daniel A. Eyink, M.D.171 High Street Newburyport, MA 01950

Jean Nordin-Evans, D.D.S.493-495 Main StreetGroton, MA 01450

Stephanie Seneff, Ph.D. 32 Vassar Street, CSAILCambridge, MA 02139

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "1

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Finally, it is disheartening that a series of 1997-98 letters from scientists to the IOM were dismissed by the IOM/NAS leadership. That dismissal represents a failure on the part of the IOM to ‘facilitate discussion, discovery, and critical, cross-disciplinary thinking.’ The concerns and warnings contained in those letters have been validated by 21st century science and health trends outlined in this communication. Consequently, it is past time for the IOM to correct that failure.

What is required is the immediate removal of ‘safe and adequate’ fluoride recommendations from the DRI: Element list with its age-appropriate suggestions as that artifact is being used in a manner harmful to public health. Furthermore, the notification of state Departments of Health of such removal and concerns on the part of the IOM as to the establishment of any safe level of the neurotoxic fluoride given its significant adverse impact on the health of the public documented by the science of the past twenty years is advisable given the seriousness of those risks.

In taking this action, we suggest you consider the precautionary principle applied by government when no-smoking bans became the order of the day. A shared resource like water and air must be safe for the most vulnerable of the public based on possible health risks and exposure over a lifetime and include an adequate margin of safety. There is no evidence of such a scientifically valid safe exposure level for fluoride.

RESOURCES: see endnotes

1. 2006: Current DRI: http://www.nap.edu/openbook.php?record_id=11537&page=312 2. 1997 Dietary Reference Intakes: Elements: http://www.iom.edu/Global/News%20Announcements/~/media/

48FAAA2FD9E74D95BBDA2236E7387B49.ashx3. 1997 Chapter 8: Dietary Reference Intakes: http://www.ncbi.nlm.nih.gov/books/NBK109832/ 4. 1997-98 Letters protesting fluoride DRI & IOM responses: http://www.fluoridation.com/fraud.htm 5. 2006 NRC Report to EPA: Fluoride in Drinking Water: http://www.nap.edu/openbook.php?record_id=11571 6. 2015 CDC on water fluoridation: http://www.cdc.gov/fluoridation/pdf/statement-cwf.pdf 7. EPA on Safe Water Drinking Act: http://water.epa.gov/lawsregs/rulesregs/sdwa/index.cfm 8. MA Fact Sheet: http://www.mass.gov/eohhs/docs/dph/com-health/oral-health/drinking-tap-water-dental-health.pdf

CHEMICAL TOXICITY Although the dental community that calls fluoride a “naturally occurring mineral” wants to frame the fluoride/fluoridation question completely around dental concerns, that effort is at the very least disingenuous. Chemists characterize fluoride as a poison. Fluoride is included in toxicology compendiums and it has been labeled a neurotoxin. Fluoride is more toxic than lead and only slightly less toxic than arsenic. Harvested from smokestack slurry, most fluoride added to our water supplies originates as waste product in the aluminum and phosphate industries. A 2014 study of fluoride samples predictably reported that 100% of those samples were contaminated with aluminum, while lead, arsenic, cadmium and barium were other common contaminants. The study author, toxicologist Dr. Phyllis Mullenix, wrote, “Aluminum and barium levels approach what EPA finds in electroplating sludge and hazardous soils….”

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "2

In 1998 the IOM wrote that although they did not consider fluoride a nutrient and made no recommendations for infants under 6 months, “During the second six months of life and thereafter, the AI for fluoride from all sources is set at 0.05 mg/kg/day because it confers a high level of protection

against dental caries and is associated with no

known unwanted health effects.” These are the two

faulty assumptions that have established the foundation of all water fluoridation policy.

- See letter from Bruce Alberts & Kenneth Shine of

IOM to Albert W. Burgstahler et al, 20 Nov 1998

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The 2013 study of chemist Dr. Richard Sauerheber examined the differences between naturally occurring Calcium Fluoride and the highly toxic Industrial Fluoride used in water supplies. Dr. Sauerheber confirmed that the calcium in CaF makes the fluoride much less absorbable by the human body and therefore less toxic when ingested in that form, whereas the industrial fluoride is not only highly absorbable but also leaches lead, another neurotoxin, out of water pipes into water supplies. There is also evidence that neurotoxins act synergistically so that when combined their toxicity is greater than the sum of their parts. Large studies conducted in New York (2000) and Massachusetts (1999) published since the IOM 1997 review of fluoride have confirmed that children living in communities using “silly fluorides” have more lead in their blood. Those studies are included in a 2014 letter with substantiating documentation written by Dr. Sauerheber to the FDA protesting water fluoridation as a harmful practice.

The DRI reference to fluoride, similar to dental assertions, naively does not take into account either the toxic nature of fluorine or the contaminated dietary sources of this element.

RESOURCES: see endnotes

9. 2014 Mullenix study in full: http://momsagainstfluoridation.org/sites/default/files/Mullenix%202014-2-2.pdf10. 2014 Sauerheber FDA Ltr: http://sboh.wa.gov/Portals/7/Doc/Meetings/2014/06-11/WSBOH-06-11-14-Tab10c.pdf11. 2013 Sauerheber in J of Env Pub Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690253/ 12. 2011 Dr. Kathleen Thiessen Comments : http://www.fluoridealert.org/wp-content/uploads/thiessen.4-19-11.pdf13. 2007 in Neurotoxicology about Lead, Disinfectants & Fluoridation: http://www.ncbi.nlm.nih.gov/pubmed/1742005314. 2000 in Neurotoxicology about Silicofluoride & Lead: http://www.ncbi.nlm.nih.gov/pubmed/11233755

SYSTEMIC v. TOPICAL Even within the dental framework, there is no actual science proving any systemic ingestion mechanism of fluoride that results in dental benefits. Those claims are based on medical hypothesis and dental studies open to charges of bias and selective sampling, i.e. proxy use of Medicaid codes for cavities in a region with known high incidences of Medicaid fraud as input in a simulation to demonstrate that water fluoridation is beneficial to poor children. The simulation output is contrary to Medicaid data from other regions. It is also in stark contrast to real world data from large fluoridation studies in the US and New Zealand that examined tens of thousands of actual children which demonstrated there is no significant difference between cavity rates in fluoridated and non-fluoridated communities.

The findings of the 2000 UK York Review of all world wide dental literature also denied any proof of SES benefits. That panel, like many other dental panels and the 2006 NRC, commented on the surprising lack of high quality evidence of dental benefit due to fluoridation or any evidence of safety.

The more recent Medicaid simulation also predicts dire consequences in the event of cessation, again in contrast to real world studies that show continued cavity decline after cessation. Additionally, Pew, CDC and ADA marketing materials claim fluoridation benefits are proved by citing very small samples, such as

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "3

1. Whilst there is evidence that water fluoridation is effective at reducing caries, the quality of the studies was generally moderate and the size of the estimated benefit, only of the order of 15%, is far from "massive"

2. The review found water fluoridation to be significantly associated with high levels of dental fluorosis, which was not characterised as "just a cosmetic issue".

3. The review did not show water fluoridation to be safe. The quality of the research was too poor to establish with confidence whether or not there are potentially important adverse effects in addition to the high levels of fluorosis. The report recommended that more research was needed.

4. There was little evidence to show that water fluoridation has reduced social inequalities in dental health....

Professor Trevor Sheldon, chair 2000 York Review

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a 1998 study comparing three towns in NE and IL. Pew failed to note the impact of sealants commented on by the researchers, or that the DMFS difference was very small in absolute terms with more than 80% of dental surfaces cavity free in all three towns. Nor does this current marketing material mention that the incidence of dental fluorosis in all towns was also very similar, having increased in the non-fluoridated towns. In other words, this was a small study with similarly small findings whose most important finding could be said to be that even those living in non-fluoridated towns were ingesting toxic levels of fluoride prior to 1998.

This biased dental practice is a continuation of a pattern begun with the discredited 1940s trials. Although those trials were challenged for statistical manipulation, poor design, bias, selective sampling, and conclusions not supported by the evidence at the time of their publication by dental researchers such as Philip R.N. Sutton, it took decades before the CDC and NIDCR would admit to the inadequacy of those and subsequent 20th century fluoridation studies. The IOM referred to these studies in their 1997 determination, and to CDC endorsements of their own CDC fluoridation policy in 2006.

The only study mentioned in the IOM report that has any small degree of scientific validity is the Brunelle and Carlos study. However, the percentages of 18% and 25% mentioned in that study are disingenuous. In absolute terms, they represent one or two fewer cavities over a lifetime, moreover they represented only a sampling of the data. When the complete data set of the 39k American children examined was calibrated by Dr. John Yiamouyiannis, those results showed no significant differences in decay rates between fluoridated and non-fluoridated communities.

Despite the continued opposition of fluoride industry backed proponents and promotion of biased studies, even the CDC agreed in 1999 and 2001 that the scientific evidence indicated that fluoride provided a ‘predominantly’ topical and post-eruptive benefit, based on studies that concluded the benefit was ‘almost exclusively’ topical and post-eruptive. The CDC also confirmed that fluoridation did not result in anti-cariogenic saliva. Neither the CDC nor studies proffered any scientific proof of any systemic and pre-eruptive benefit. However, the dental hypothesis was that fluoride hardens teeth and remineralizes them both pre and post-eruptively.

In 2011 and 2013, Dr. Muller et al. deflated the post-eruptive remineralization hypothesis and offered the only evidence-based scientific proof of fluoride’s dental benefit. In high concentrations, such as in dentifrices, fluoride makes the cavity producing bacteria “less sticky.” In other words, fluoride, a known enzyme inhibitor, weakens or kills bacteria. 2013 studies on concentrated topical applications in dental offices also provided some weak evidence of topical effectiveness.

Likewise, the concept of fluoride hardening teeth pre-eruptively by virtue of causing mild fluorosis has questionable scientific merit. Dental fluorosis is a poisoning of ameloblast mitochondria that results in a structural change to the composition of the tooth. Fluorosed teeth in the mild and very mild categories may be slightly harder, but tooth structures are changed making them more brittle with age and potentially more difficult to repair. That structural change is more pronounced in moderate and severe fluorosis and includes tooth pitting and flaking enamel in addition to white, yellow or brown staining on 75-100% of teeth. Although dentists, and even the NRC, may argue whether moderate and severe dental fluorosis constitutes a cosmetic v. health effect, there is universal agreement that both moderate and severe dental fluorosis are adverse symptoms of fluoride toxicity due to ingestion, and cost considerable to fix.

Even if ingestion resulted in some reduction of cavities per the marketing material of the fluoride lobby who are actively engaged in manipulating public perception and the media through a

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practice known as Astroturfing, the harm to human health outlined in this communication outweighs that purported benefit. The misery caused by increased autoimmune disease, thyroid disorders, cognitive disabilities, kidney disease, bone disease and moderate to severe dental fluorosis trumps any argument made in favor of fluoride, which is only scientifically validated as having a mild topical anti-cariogenic benefit.

Despite what many dentists and the American Dental Association (ADA) claim, there isn’t consensus within the dental community regarding the need for a fluoride DRI. Even dental researchers with the longitudinal Iowa Fluoride Study (IFS) stated in 2003 that, “Current evidence strongly suggests that fluorides work primarily by topical means through direct action on the teeth and dental plaque. Thus ingestion of fluoride is not essential for caries

prevention,”  and in 2009 suggest that caries status was not dependent on fluoride intake. Those same researchers also recommend the reduction of fluoride ingestion early in life, and the pro-fluoride Dr. Levy, head of the IFS project, questioned the term “optimum fluoride level” in 1999 and 2009, an opinion echoed by many dental professionals and fluoride researchers.

RESOURCES: see endnotes

15. 2015 Cost of Fluoridation: http://www.ncbi.nlm.nih.gov/pubmed/25471729 16. 2014 Review Article in Scientific World Journal:  http://www.hindawi.com/journals/tswj/2014/293019/  17. 2013 Remineralization. http://www.sciencedaily.com/releases/2013/05/130501112855.htm 18. 2013 Topical Applications, an ADA report: http://ebd.ada.org/~/media/EBD/Files/

Topical_fluoride_for_caries_prevention_2013_update.ashx 19. 2013 The Big Chill, manipulation of public: http://www.pipsc.ca/portal/page/portal/website/issues/science/bigchill 20. 2010 Fluorosed Teeth in J of Dental Medical Science: http://lib.tmd.ac.jp/jmd/5701/03_Waidyasekera.pdf21. 2010 Bacteria: http://www.acs.org/content/acs/en/pressroom/presspacs/2011/acs-presspac-march-2-2011/does-

fluoride-really-fight-cavities-by-the-skin-of-the-teeth.html22. 2010 Medicaid codes as proxies in biased ecologic study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000/ 23. 2009 IFS: http://www.ncbi.nlm.nih.gov/pubmed/1905431024. 2008. The Devil’s Poison by Dean Murphy, DDS. 25. 2008 Scientific Controversy. http://globalization.icaap.org/content/v7.1/Martin.html26. 2007 80% of dentists surveyed get it wrong: http://www.ncbi.nlm.nih.gov/pubmed/17899898 27. 2004 Systemic v. Topical in Caries: http://www.ncbi.nlm.nih.gov/pubmed/15153698?dopt=Abstract 28. 2001 CDC MMWR, it’s Topical: http://www.cdc.gov/Mmwr/preview/mmwrhtml/rr5014a1.htm 29. 2003 IFS: http://www.dental.theclinics.com/article/S0011-8532(02)00098-8/abstract 30. 2000 York Review: http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport18.pdf31. 2000 Prof. Sheldon, York Review: http://www.nteu280.org/Issues/Fluoride/flouridelist.htm 32. 1999 New Zealand: http://www.bmartin.cc/pubs/99air/99Colquhoun.pdf 33. 1995 CA Medicaid dental claims higher in fluoridated counties: http://www.nofluoride.com/calhealth.cfm34. 1990 Analysis of 39k US children: http://www.fluorideresearch.org/232/files/FJ1990_v23_n2_p055-067.pdf35. 2001 Canada Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/11153562 36. 2000 North Carolina Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/10728978?dopt=Abstract 37. 2000 Cuba Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/10601780 38. 2000 East Germany Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/1101451539. 1998 Finland Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/975842640. 1992 Netherlands Cessation Study: http://www.ncbi.nlm.nih.gov/pubmed/1184278241. 1998: Pew/CDC bias see NE/IL study,: http://www.ilikemyteeth.org/fluoridation/fluoride-toothpaste/ 42. 1988: Reference to 1972 JADA cost comparison of communities: http://www.slweb.org/hileman.html 43. 1960 Errors & Omissions by Philip Sutton: http://www.scribd.com/doc/212649060/Fluoridation-Errors-and-

Omissions-in-Experimental-Trials-2-Ed-Phillip-Sutton-1960

RACIAL AND ECONOMIC DISPROPORTIONATE HARMAfrican American and Hispanic Civil Rights leaders have officially opposed fluoridation since 2011 based on the disproportionate harm to their communities. Non-white and poor populations not only have a higher rate of dental fluorosis, but also suffer from most of the moderate and severe incidences that require veneers and crowns to fix. The general US rate for dental

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fluorosis among adolescents as of 2004 was 41%, and that rate is higher in fluoridated communities. This is a permanent condition for those afflicted.

Communications among government agencies such as the CDC and HHS with the private organizations such as ADA, NDA and Pew noting the disproportionate harm to minority communities were released under a Freedom of Information Act (FOIA) request made by former UN Ambassador Andrew Young. The FOIA documents were published in the mainstream press in October 2014.

Throughout the decades, those inter-agency communications emphasized protecting the fluoridation policy, rather than addressing health implications. For example, the topic of a 1962 government memo concerned the impact on the fluoridation program if “opponents” learned that “negroes in Grand Rapids had twice as much fluorosis than others.” Emails from government officials in 2011 admit, “Per CDC data, blacks did have higher levels of dental fluorosis than whites (58% vs 36%)” and “CDC data also show that in 1986-1987 blacks had more untreated tooth decay.” Throughout, the government/private industry discussion is restricted to how to neutralize the threat to the fluoridation policy, discussing “strategy” rather than addressing either harm caused by fluoridation or dental decay among minority and poor populations.

These same heavily redacted communications also mention the high incidence of kidney disease and diabetes among the black and Hispanic communities, both of which set up a vicious cycle as sub-optimal kidney fluoride clearance results in higher fluoride retention and possible kidney damage. Diabetics often drink much higher amounts of water, naturally resulting in higher fluoride intake and absorption. Fluoride is also implicated in causing both kidney disease and diabetes, a chicken and egg dilemma.

Although the initial 1940s trials noted that “Negros” naturally had better teeth more resistant to decay than white Americans, within a generation the CDC reported that Black Americans in fluoridated cities had the worst dental health. Hispanics have similarly poor dental health. Native Americans living on fluoridated reservations with free dental care, like Black Americans in inner cities, have high rates of kidney disease, diabetes, endulism, and poor dental health.

A study published by Boston Children’s Hospital with the Harvard School of Dental Medicine in 2013 noted a 42% increase in dental emergencies in hospital ERs between 2000 and 2008. Some of these visits required hospitalization and some resulted in deaths. The study noted that most of the patients were low income and uninsured. Further research revealed that most of them were also living in fluoridated communities.

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "6

Expert in Chemical Research: "Fluoride is an enzyme

poison, in the same class as cyanide, oxalate, or

azide ... it is capable of a very wide variety of harmful

effects, even at low doses. It is a scientific disgrace

that a well organized lobby of the American Dental

Association ever managed to stampede American

legislators into ignoring the highly technical but very

cogent objection to fluoridation." - James B. Patrick,

Ph.D., research scientist at National Institute of Health

Expert in Medical History: “I now realize that what my

colleagues and I were doing was what the history of

science shows all professionals do when their pet

theory is confronted by disconcerting new evidence:

they bend over backwards to explain away the new

evidence. They try very hard to keep their theory intact

— especially so if their own professional reputations

depend on maintaining that theory.” - Dr. John

Colquhoun, former Chief Dental Officer of New Zealand

Expert on Scientific Controversy: "Ironically, the

“antis,” who are usually portrayed as unscientific, often

act more scientifically in the debate.... By contrast, the

political profluoridation stance has evolved in to a

dogmatic, authoritarian, essentially antiscientific

posture, one that discourages open debate of scientific

issues." - Edward Groth, III (1991)

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An example of the disconnect between the harm caused by fluoridation in minority and low income communities and the promotion of fluoridation policy as a panacea for the poor is also reflected in these two 2014 “feel good” news stories out of Key West, Florida.

1. Key West wins an award for 50 years of water fluoridation: http://keysnews.com/node/55964 2. Rotary Club provides dental care to two poor children: http://keysnews.com/node/60713

1. One girl required 10k worth of dental work. 2. One boy with discolored teeth had cosmetic dentistry.

Fluoridation certainly didn’t help the first child, and most assuredly damaged both the teeth and self-esteem of the second.

Although the 2014 release of the heavily redacted FOIA documents gives the impression of this information being hidden, it was hidden in plain sight. In 1952, JADA published an article that stated, “malnourished infants and children, especially if deficient in calcium intake, may suffer from the effects of water containing fluorine (fluorosis) while healthy children would remain unaffected.” In 1972, the Canadian NRC wrote, “It appears possible that chronic exposure to fluoride increases the metabolic requirement for vitamin C.” And in 1965, Dr. George Waldbott referenced reports from the 1940s and 1960s noting double the dental fluorosis among the “Negro” children. Dr. Waldbott also discusses the role of nutrition in good dental health, as well as adverse effects such as gastrointestinal bleeding in infants given fluoride with their vitamin drops. Dr. Waldbott was one of many who wrote that cavities is a disease of poverty due to lack of nutritious food, not due to a lack of fluoride and not curable by fluoride.

Consequently, dental claims that fluoridated water is beneficial to the poor are beyond disingenuous. Current recommendations from the American Dental Association (ADA) and others that mixing infant formula with fluoridated water although safe may cause mild fluorosis ignores the potential for more serious incidences of moderate and severe fluorosis, adverse autoimmune responses, endocrine disruption, and gastrointestinal distress that has increased relevance to the lower social economic status community.

ADA recommendations are also blind to the economic realities beyond malnutrition - an inability to purchase bottled water when money is tight. Moreover, ADA infant formula recommendations ignore similarly weak and under advertised CDC recommendations that in order to avoid dental fluorosis the ingestion of fluoride should be restricted for children under age 3, 5 or 8 dependent on which government webpage you visit. All these recommendations are beyond the ability of the low income to follow, putting their children at a significantly higher risk than children with parents in better economic circumstances who can afford bottled water and a healthy diet for their families. These ‘special considerations’ are not reflected in the IOM DRI on fluoride.

The weak warnings from organizations vested in promoting water fluoridation are based on protecting our national policy of fluoridation above any concern for protecting our children’s health. Our government at federal, state and municipal levels use the IOM Dietary Reference Intake (DRI) to justify the existence of water fluoridation policy.

RESOURCES: see endnotes

44. 2014 FOIA: http://www.thenewamerican.com/usnews/health-care/item/19317-feds-blacks-suffer-most-from-fluoride-fluoridate-anyway#

45. 2014 Wm. Maas on kidneys: http://benswann.com/do-newly-released-emails-reveal-conflict-of-interest-between-the-cdc-and-the-ada/

46. 2014 About Dental Emergencies study: http://now.tufts.edu/articles/preventing-needless-dental-emergencies47. 2012 Kidney by race: http://www.kidneyfund.org/about-us/assets/pdfs/akf-kidneydiseasestatistics-2012.pdf

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48. 2011 FOIA docs: http://www.nidellaw.com/wp-content/uploads/2014/09/FOIA-3-Civil-Rights.pdf49. 2011 Civil Right Leaders Statements Opposing Fluoridation: http://fluoridealert.org/issues/ej/statements/50. 2010 age 3, infant formula and fluorosis: http://www.ncbi.nlm.nih.gov/pubmed/2088492151. 2007 Mexican study: http://www.ncbi.nlm.nih.gov/pubmed/17436973 52. CDC age 5: http://www.cdc.gov/fluoridation/faqs/ 53. CDC age 8: http://www.cdc.gov/fluoridation/safety/dental_fluorosis.htm 54. EPA age 8: http://water.epa.gov/drink/contaminants/basicinformation/fluoride.cfm#three 55. 2007 FOIA: http://iaomt.org/blacks-disproportionately-harmed-fluoridated-water/ 56. 2005 CDC Table 23 on fluorosis by race: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5403a1.htm#tab23 57. 2004 CDC: http://www.cdc.gov/nchs/data/databriefs/db53.htm 58. 2002: Dental Crisis in Harlem, NYC: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447387/ 59. 2002 Kidney disease in Native Americans: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594281/ 60. 2001 dietary fluoride & kidneys: http://ir.cmu.edu.tw/ir/bitstream/310903500/1332/1/2001067481.pdf 61. 1980 JAMA: http://archinte.jamanetwork.com/article.aspx?articleid=60034262. 1978 The Great Dilemma by George Waldbott: http://www.whale.to/b/Waldbott_DILEMMA_ocr.pdf 63. 1960 Fluoridation E&O by Philip Sutton: http://www.scribd.com/doc/212649060/Fluoridation-Errors-and-

Omissions-in-Experimental-Trials-2-Ed-Phillip-Sutton-1960 64. 1952 Relation of endemic dental fluorosis to malnutrition. JADA: http://www.slweb.org/massler-schour.html

ENDOCRINE DISRUPTION There is no question that fluoride is an endocrine disruptor. The 2006 Report to the EPA on Fluoride in Drinking Water confirmed this fact. The only thing not confirmed is how little fluoride ingestion is required to adversely impact individual health.

The 2006 NRC noted in their report that there were no studies on susceptible populations, among whom it was reasonable to anticipate harm at lower doses. In the chapter devoted to endocrine disruption the committee was particularly concerned with the teeter-totter hormonal impact for those with thyroid and parathyroid diseases, as well as diabetes:

• PARATHYROID DISEASE: “…fluoride induces a net increase in bone formation and also decreases calcium absorption from the gastrointestinal tract; both of these effects lead to an increase in the body’s calcium requirement. If dietary calcium is inadequate to support the increased requirement, the response is an increase in PTH (secondary hyperparathyroidism).” p. 250

• DIABETES: “…More than one mechanism for diabetes or impaired glucose tolerance exists in humans, and a variety of responses to fluoride are in keeping with… variability among strains of experimental animals and among the human population. The conclusion from the available studies is that sufficient fluoride exposure appears to bring about increases in blood glucose or impaired glucose tolerance in some individuals and to increase the severity of some types of diabetes…..therefore, any role of fluoride exposure in the development of impaired glucose metabolism or diabetes is potentially significant.” pp 259-260

In the last chapter, the committee politely chided the EPA that to determine a Maximum Contaminant Level Goal (MCLG), it is necessary to have certain inputs not available. The EPA responded with a rather confused history about the creation of the fluoridation scheme. In her 2011 comments to the EPA in response to their non-responsive response, a panelist on the 2006 Committee on Fluoride in Drinking water, Dr. Thiessen was very specific in outlining the risks to sensitive populations and the EPA’s responsibility:

• “While it would be nice to have good dose-response information for various adverse health effects, the lack of it should not be a justification to eliminate a "known" or "anticipated" effect from being considered in setting an RfD or MCLG. As described in the IRIS

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Glossary's definition (EPA 2011d), an RfD can be set from a NOAEL (no observed adverse effect level) or LOAEL (lowest observed adverse effect level) in the absence of dose-response information.” p. 3

• “…. a LOAEL for some adverse health effects is lower than EPA's new RfD, which is supposed to protect the population, including sensitive subgroups, from deleterious effects during a lifetime (EPA 2009; 2011d).” p. 4

• “For persons with iodine deficiency (one example of a sensitive subgroup), average intakes as low as 0.01-0.03 mg/kg/day could produce effects (NRC 2006).” p. 4

• “Thyroid dysfunction and Type II diabetes presently pose substantial health concerns in the U.S. (NRC 2006). Of particular concern is an inverse correlation between maternal subclinical hypothyroidism and the IQ of the offspring. In addition, maternal subclinical hypothyroidism has been proposed as a cause of or contributor to development of autism in the child (Román 2007; Sullivan 2009). Calcium deficiency induced or exacerbated by fluoride exposure may contribute to a variety of other health effects (NRC 2006).” p 8

• “As reviewed by NRC (2006), fluoride also ‘may impact the normal function of the thyroid’ and ‘may disrupt the thyroid's ability to produce hormones that are critical to developing fetuses and infants.’" p. 8

In her 2011 comments to the EPA, Dr. Thiessen also spoke to the potential carcinogenic and genotoxic nature of fluoride, stating the NRC “unanimously concluded that ‘Fluoride appears to have the potential to initiate or promote cancers.’” She also provided charts of fluoride exposure levels and of increased non-traumatic bone fractures correlated with dental fluorosis.

One of three of the 2006 Committee who have been outspoken about the harmful practice of fluoridation, which is in large part based on the IOM DRI levels of fluoride, Dr. Thiessen has also filed an affidavit in a Canadian lawsuit. We suggest that filing in particular should be read carefully by the IOM. It focuses on the concept of ‘gross disproportionality,’ i.e. the potential of small benefit to some does not justify an action with risk of great harm to others.

The national protest against mandated fluoridation in Ireland is also focusing on the endocrine effects. Those with diabetes mellitus are particularly vulnerable due to their high water intake which logically results in high levels of cumulative fluoride sequestered in their bones and tissues. However, the glucose metabolism of diabetics are also exacerbated by fluoride. Diabetics in the fluoridated Republic of Ireland have a 470% higher death rate than their cousins living in non-fluoridated Northern Ireland per “2001 Inequalities in Mortality Report.” Environmentalist and fluoride researcher Declan Waugh has also noted in his 2013 analysis that not only does the Republic of Ireland have some of worst health records in the European Union, their dental health is not as good as that in several non-fluoridated European Union countries.

Also from our cousins across the sea is a 2015 University of Kent epidemiological study which reviewed data from Public Health England from all English General Practitioners for diagnosed incidences of low thyroid. Researchers found that those living in fluoridated communities with .7

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "9

Expert on Preventative Dentistry:  “The evidence

that fluoride is more harmful than beneficial is now

overwhelming… fluoride may be destroying our

bones, our teeth, and our overall health.”

- Dr. Hardy Limeback (2007)

Expert on Risk Assessment: "The available data,

responsibly interpreted, indicate little or no

beneficial effect of water fluoridation on oral health."

 - Dr. Kathleen Thiessen (2011)

Expert in Neuroscience: “There’s no doubt that the

intake of fluoridated water is going to interrupt basic

functions of nerve cells in the brain, and this is

certainly not going to be [for] the benefit of

anybody.” - Dr. Robert Isaacson (2007)

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ppm had approximately twice the incidence of low thyroid as those living in communities with naturally occurring levels at .3 ppm. They also noted that those living in communities at .5 ppm had incidences in between the other two regions, establishing a dose-response trend line. This study was published in the Journal of Epidemiological Community Health. It was also featured in Newsweek on 24 Feb 2015 where it was praised by other researchers including members of the 2006 Committee and disparaged by dentists. Its findings are consistent with studies and concerns about thyroid broader and deeper than even those of the NRC.

Several studies out of India in the past half dozen years concerning thyroid, fluoride, iodine deficiency, dental disease, and delayed tooth eruption also confirm endocrine disruption at levels deemed safe and even “optimal’ by the USA. Delayed tooth eruption was noted in many of the early fluoridation trials, including by Feltman & Kosel. The pattern of delayed eruption has always been believed to be a result of fluoride’s inhibition of thyroid hormones in young children, i.e. subclinical hypothyroidism.

Not documented in any study, an increase in orthodontia due to this inhibition of normal tooth eruption has been observed by and commented on by those in this field. Although perhaps not as worrisome as the hormonal impact on thyroid disorders and diabetes, increased orthodontia is an also adverse impact of fluoridation justified by the IOM DRI for fluoride. We suggest the IOM consult NRC committee member Dr. Hardy Limeback for more information on the dental impact of delayed eruption that results from the ingestion of fluoride by children under age 12.

RESOURCES: see endnotes

65. 2015 Thyroid in J Epidemiol Community Health: http://jech.bmj.com/content/early/2015/02/09/jech-2014-204971 66. 2014 Fluoride ingestion, TSH & Dental Fluorosis: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890436/ 67. 2014 Canadian lawsuit & Dr. Thiessen Affidavit: http://fluoridealert.org/wp-content/uploads/peel.june2014.pdf  68. 2013 Ireland: http://www.enviro.ie/Feb2013.pdf 69. 2011 Dr. Thiessen Comments to EPA: http://www.fluoridealert.org/wp-content/uploads/thiessen.4-19-11.pdf70. 2007 Dr. Limeback Statement to Canadian govt: http://www.eidon.com/dr-hardy-limeback.html 71. 2007Dr. Isaacson Position Statement: http://www.newmediaexplorer.org/chris/

Isaacson_My_Fluoride_position2.pdf 72. 2011 Oral manifestation of thyroid disorders: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169868/ 73. 2009 Dietary protein & calcium & thyroid dysfunction in rats: http://www.ncbi.nlm.nih.gov/pubmed/1931850474. 2001 Inequalities in Mortality, A Report on All Ireland Mortality, 1989-99, Institute of Public Health, 2001. http://

www.publichealth.ie/files/file/Inequalities%20in%20Mortality.pd75. 1942 Fluorosis & the Parathyroid: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2199852/pdf/jhyg00202-0056.pdf

IMMUNE SYSTEM: ADJUVANT & PROLIFERATIVE AGENTWe know that the endocrine and immune system enjoy a sensitive bi-directional synergy. The 2006 NRC commented:

• “There is no question that fluoride can affect the cells involved in providing immune responses. The question is what proportion, if any, of the population consuming drinking water…. will have their immune systems compromised?” The committee also noted that no study examined whether a person with an immunodeficiency disease can tolerate fluoride ingestion from drinking water. p. 295

The NRC did refer to the old studies of Feltman & Kosel, Waldbott, and Grimbergen; however, we suggest that the NRC may have missed a few pre 2006 studies relevant to autoimmune disease and fluoridation. There are also a few since 2006.

In the 1950s, Feltman & Kosel documented a 1% allergic-like response in their controlled dose study of over 1,000 pregnant women and children. George Waldbott, similarly noted an

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approximate 1% exhibition of the allergic wheal in skin tests, although also noted a more common adverse reaction that he did not characterize. In the 1970s, Grimbergen and Moolenburgh noted that over a period of months, the types of illnesses they saw in a recently fluoridated community changed and increased in number:

• “As a summary of our research, we are now convinced that fluoridation of the water supplies causes a low grade intoxication of the whole population, with only the approximately 5% most sensitive persons showing acute symptoms. The whole population being subjected to low grade poisoning means that their immune systems are constantly overtaxed.…. this can hasten health calamities.” (Moolenburgh, 1993)

Between 1981 and 2001, the National Academy of Sciences and others confirmed that about 15% of the general US population has Multiple Chemical Sensitivities (MCS), a condition acquired from either a catastrophic or chronic exposure to a chemical sensitizing agent.

The 2008 Research Advisory Committee on Gulf War Veterans’ Illnesses confirmed that at least 25% of previously healthy young soldiers suffered from MCS. They wrote:

• “It is well established that some people are more vulnerable to adverse effects of certain chemicals than others, due to variability in biological processes that neutralize those chemicals, and clear them from the body.”

The trend line is clear. From 1% in the 1950s to 5% in the 1970s to 15% or more in the 21st century, chemical sensitivity is having a greater adverse health impact on populations with each decade as more and more Americans find they can only tolerate bottled water.

That trend is reflected in allergies, which are estimated to affect approximately 55% of the US population, as well as in asthma and Celiac Disease.

• From 2001 to 2011, the CDC says the number of Americans with asthma grew by 28 percent. According to the CDC, “the greatest rise in asthma rates was among black children (almost a 50 percent increase) from 2001 through 2009.” - CDC, 2013

• Learned experts in allergies and environmental disease have made the following comments: • “Whatever has happened with Celiac Disease has happened since 1950. The increase

affected young and old people equally.” - Dr. Joseph A. Murray, quoted in “Against the Grain,” The New Yorker. Nov 3, 2014.

• “There is an alarming increase in peanut allergies, consistent with a general, although less dramatic, rise in food allergies among children in studies reported by the [CDC]…” - Dr. Scott Sicherer quoted in “Peanut Allergy Cases Triple in Ten Years,” Live Science. May 13, 2010.

Fluoride is a known and ‘potent adjuvant.’ It intensified allergic responses in both a 1990 animal and 1999 in vitro study. Fluoride is also a ‘proliferative agent,’ with a confirmed inflammatory impact on Peyer’s patches, the immune sensors of the gut implicated in Celiac and Crohn’s diseases. In other words, allergic reactions and symptoms of Celiac and Crohn’s diseases are intensified in the presence of fluoride.

A 1977 study by Drs. Waldbott & Zacks indicate

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "11

UK Advisory Board Member: "No physician in his

right senses would prescribe for a person he has

never met, whose medical history he does not

know, a substance which is intended to create

bodily change, with the advice 'take as much as

you like, but you will take it for the rest of your life

because some children suffer from tooth decay.’”

- Dr. Peter Mansfield, 2000 York Review scientist

Expert in Enzyme Chemistry: "The fluoride ion

exerts its toxic effect by inhibiting the action of

many enzyme systems." - Hugo Theorell, MD,

Nobel Prize Winner

5.1-15

that the distinctive hive-like lesions called Chizzola maculae experienced by some women and children living in fluoridated communities is an abnormal blood coagulation, another inflammatory autoimmune response.

A gene study published in 2015 identifies a gene that predicts which people will have a lower tolerance to fluoride. Fluoride exposure for those with this gene results in permanent dental fluorosis and cognitive deficits.

The inflammatory nature of fluoride is a particular risk for those who have ingested fluoride over a period of years because fluoride is a cumulative poison stored in bones and tissue. The early symptoms of fluoride toxicity in the bones are symptoms of arthritis. Arthritis is the leading disability in the US, and is afflicting us at younger ages. Claims that there are no fluoridation induced “stage 4 skeletal fluorosis in the US” ignores stages 1 to 3, which is characterized by inflammatory arthritic pain. Rheumatoid arthritis is an inflammatory autoimmune disease. RA is associated with fibromyalgia, another autoimmune disease. Fibromyalgia has an unknown etiology and symptoms that align with the symptoms of fluoride toxicity.

Per the 2006 report on Fluoride in Drinking water, there is no question that fluoride ingestion has an adverse impact on those with autoimmune conditions. There is also no question that the number of Americans suffering with autoimmune diseases and environmental health issues is unacceptably high. Moreover, science beginning in the 1950s and extending to 2015 indicates that adverse impact of fluoride on those with autoimmune disease is at doses listed as safe by the IOM in the DRI table.

RESOURCES: see endnotes

76. 2015 Gene predicts which children are most susceptible: http://www.ncbi.nlm.nih.gov/pubmed/25556215 77. 2010 Peyer’s Patches, Celiac & Crohn’s: http://www.hindawi.com/journals/iji/2010/823710/78. 2008 Gulf War Illness: http://www.va.gov/rac-gwvi/docs/committee_documents/gwiandhealthofgwveterans_rac-

gwvireport_2008.pdf79. 2006 Peyer’s Patches, Celiac disease: http://www.ncbi.nlm.nih.gov/pubmed/1640360180. 2004 MCS in America: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448331/81. 1999 Fluoride makes allergies worse, in vitro: http://www.ncbi.nlm.nih.gov/pubmed/989278382. 1998 Preskeletal Fluorosis: http://www.fluoridation.com/waldbot.htm 83. 1993 Moolenburgh affidavit: https://fluorideinformationaustralia.wordpress.com/legal/affidavits/84. 1990 Fluoride makes allergies worse, rats: http://www.ncbi.nlm.nih.gov/pubmed/170785385. 1978 Major Fluoride Symptoms: https://fluorideinformationaustralia.files.wordpress.com/2013/01/

flier_waldbott_symptoms_ftgd.pdf 86. 1977 Blood Clotting in Patients with Chizzola Maculae. Fluoride. vol.10:1. p 29-33. http://

www.fluorideresearch.org/101/files/FJ1977_v10_n1_p001-044.pdf 87. 1974 Grimbergen, G.W. A double blind test for determination of intolerance to fluoridated water. Preliminary

report. Fluoride 7(3):146-152 88. 1961 Reuben Feltman, D.D.S. and George Kosel, B.S., M.S. Prenatal and postnatal ingestion of fluorides -

Fourteen years of investigation - Final report. Journal of Dental Medicine 1961; 16: 190-99: http://www.cafan.net/flashdrive/Studies/FeltmanKosel1961.pdf

NEUROSCIENCESince 1995, there has been a coalescing of dozens of animal, tissue and epidemiological studies proving that fluoridation, even at so called “optimal” water concentration levels expected to result in safe individual doses, has an adverse impact on brain development in young children and fetuses.

These studies have been published by researchers from Cambridge MA (at Forsyth Dental Center and the Harvard School of Public Health) to China and the Middle East. They all indicate

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that like exposure to lead and mercury, fluoride ingestion results in higher incidences of learning impairment among children. Some studies have traced the types of disabilities to the period of exposure, i.e. one type of disability when a rat is exposed to fluoride in utero v. another type of disability when the rat is exposed to fluoride during youth. The range of neuro-cognitive deficits include hyperactivity, attention-deficit disorder, poor memory, and lowered IQ, as well as emotional disorders such as depression and anger management issues.

A pilot study published by the Harvard School of Public Health in 2015 correlated the severity of dental fluorosis with performance on memory tests in 7 year olds who were life long residents in a community with a stable water supply at 1 mg/L fluoride. This pilot study is only the most recent in a series of studies from this team. Its results are consistent with a 2014 meta-analysis of world wide epidemiological studies proving a positive dose-response trend for neurological impairment that includes fluoride concentrations in water at or slightly below 1 ppm.

A 2014 study on rats also confirmed the level of fluoridation supported by the CDC and World Health Organization as a carie prophylactic is neurotoxic to the developing brain. These studies are just the latest in series dating back to 1995. Fluoride was declared a neurotoxicant in 2012 in an Environmental Health Perspectives meta-analysis, a classification which was confirmed in a 2014 Lancet Neurology study.

A 2015 study on 84 regions of the U.S., predicted a higher rate of diagnosed cases of hyperactivity in fluoridated regions. Every one percent increase in the regional population drinking fluoridated water in 1992 was associated with 67,000 to 131,000 additional cases of ADHD 11 years later after controlling for socioeconomic status.

The 14 year study sponsored by the Public Health Service (PHS) conducted by Feltman and Kosel noted that fluoride crosses the placental barrier, the first of many. Based on their observations, those PHS scientists took it upon themselves to modify the study, excluding children under age two exposed in utero, and reducing the dose for children under age two not exposed in utero. That study also noted that tooth eruption was delayed, speculating as did others then and now, that this delay is a result of endocrine disruption specific to the thyroid. 21st century science is connecting the endocrine disruption specific to thyroid with concurrent brain development changes that result in deficits. The CDC Toxipedia confirms, as does the NRC, that fluoride crosses the placental barrier where it accumulates in the fetus.

Regardless of any possible benefit, the evidence that fluoride is neurotoxic at the levels added to drinking water should be enough to immediately remove the fluoride AI from the DRI table where it is associated with the word “safe” and ages of children starting at 6 months.

RESOURCES: see endnotes

89. 2015 in Environmental Health. Exposure to fluoridated water and attention deficit hyperactivity disorder prevalence.....http://www.ehjournal.net/content/14/1/17/abstract

90. 2015 in Neurotoxicology and Teratology. Pilot Study. http://www.sciencedirect.com/science/article/pii/S0892036214001809

91. 2014 in Physiology and Behavior. Fluoride exposure during development affects both cognition and emotion in mice. http://www.ncbi.nlm.nih.gov/pubmed/24184405

92. 2014 Meta-analysis. http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2813%2970278-3/abstract 93. 2012 Neurotoxic: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70278-3/abstract 94. 1995 Mullenix rat study, Forsyth Dental: http://www.fluoridealert.org/wp-content/uploads/mullenix-1995.pdf

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KIDNEYThe kidneys, along with the liver, play a major role in eliminating toxins from the body. The rule of thumb over the past few decades has been that the “healthy adult” excretes 50% of the fluoride ingested. The remainder is sequestered primarily in skeleton. Consequently, the prevention toxic build-up of this cumulative poison is dependent on the functional capacity of kidneys. 

The 2006 NRC on Fluoride in Drinking Water, like many bodies before and since, stated that “Early water fluoridation studies did not carefully assess changes in renal function.” They also wrote that the renal system is at “higher risk of fluoride toxicity than most soft tissues.”

Consequently, there are two major questions concerning fluoride and kidneys: 1. What happens to kidneys that are over-burdened with fluoride? 2. What is the health impact of increased fluoride retention due to renal inadequacy?

A 2014 study published in Toxicology titled “Effect of water fluoridation on the development of medial vascular calcification in uremic rats” concluded, “WHO's recommended concentrations in drinking water become nephrotoxic to CKD rats, thereby aggravating renal disease and making media vascular calcification significant.” Let us restate this, estimated safe fluoridation levels for ‘dental health’ kills kidney cells when kidneys are operating at less than optimum efficiency.

The fluoride excretion by kidneys of infants and young children is less efficient than in “healthy adults.” The elderly also have less efficient kidneys. Dr. Mark Diesendorf has written extensively on the fluoride risk to infants whose intake can be many times higher than the IOM AI and whose bones are growing so rapidly. 

One in three American adults is at risk of developing kidney disease. Many of the 26 million with kidney disease don’t know their kidneys are compromised until their disease reaches stage 4. Kidney disease is 3 to 4 times higher among the same non-white populations living in fluoridated communities who have double the incidence of dental fluorosis.

Symptoms of excessive build-up of fluoride due to poor excretion are the usual inflammatory, gastrointestinal, auto-immune and bone disease symptoms of fluoride toxicity. They are very easy to mislabel and dismiss, like most low-dose chronic poisoning, but they result in disability.

It’s been known since the 1960s that using fluoridated water in dialysis can result in a sudden and painful death for the kidney patient. Kidney patients have reported that their kidney health has improved once they removed fluoride from their diet. Those who must avoid fluoride also report how difficult it is to avoid fluoride when water is fluoridated. Even leafy greens and fruits with their

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "14

Although the National Kidney Foundation withdrew their support of CDC/ADA sanctioned water fluoridation in 2008, the politically correct NKF maintains a “neutral” position, stating it may be “prudent” to “monitor” fluoride intake of children, the elderly, and anyone with prolonged disease. This weak position seems to be the result both false assumptions and false logic, i.e. that the perceived (if small) dental benefit of fluoride overrides the risk of kidney disease and that benefit is only achievable through a policy of water fluoridation.

The inadequate assessment of renal function that the NRC and other committees refer to are two 1940s controlled dose studies of “five healthy

young men” that resulted in increasing the proposed safe level of fluoride concentration from 0.1 ppm to 1.0 ppm (in Waldbott pp. 48, 354-355).

EPA scientists, engineers and lawyers in NTEU 280 stated in the 1980s and 90s that they were prevented from publishing truthful conclusions from kidney, liver and other fluoride toxicity studies because those results conflict with the US policy supporting water fluoridation, a policy underpinned by the IOM DRI “adequate intake.”

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high water content can be problematic, as is anything made with water, such as sorbet or rice.

A 2007 study from China concluded, “water fluoride levels over 2.0 mg/L can cause damage to liver and kidney functions in children” and that kidney damage is correlated with dental fluorosis. This should be of concern to the IOM and residents of the US, because our daily dose of fluoride in our over fluoridated environment is not limited to water. The visible evidence is seen in the fluorosed teeth of approximately half of our population under age 20.

A 2014 review of fluoridation referenced a 1991 CDC report of total fluoride intake for those living in fluoridated communities as between 1.58 and 6.6 mg per day for adults and between 0.9 and 3.6 mg per day for children. In other words, Americans regularly ingest amounts of fluoride capable of causing kidney disease, and have been for years. Note that approximately half of adolescents living in fluoridated cities exhibit the dental fluorosis that was correlated with kidney disease in the Chinese study, an expected dose-response relationship to poison.

There is sufficient evidence to indicate that the ubiquitous fluoride in our diets is destroying the kidneys of many of us in a less dramatic fashion than fluoridated water used in dialysis kills patients, but nevertheless killing us one kidney cell at a time. There is no safe and adequate level of fluoride for anyone with reduced kidney function or who is at risk for kidney disease.

RESOURCES: see endnotes

95. 2014 Medial vascular calcification in uremic rats. http://www.ncbi.nlm.nih.gov/pubmed/24561004 96. 2014 Review Article: http://www.hindawi.com/journals/tswj/2014/293019/ 97. Kidney Disease statistics: http://kidney.niddk.nih.gov/KUDiseases/pubs/kustats/#3 98. 2008 NKF Position Statement: http://www.kidney.org/sites/default/files/docs/fluoride_intake_in_ckd.pdf 99. 2007 Dose–effect and damage to liver and kidney: http://www.ncbi.nlm.nih.gov/pubmed/16834990 100.2007 Letter to NDT: http://ndt.oxfordjournals.org/content/23/1/411.1.full 101.Kidney Disease by race: http://nkdep.nih.gov/learn/are-you-at-risk/race-ethnicity.shtml 102.NKF on Kidney Disease: https://www.kidney.org/news/newsroom/factsheets/FastFacts 103.1997 Formula-fed infants & fluoride. Mark Diesendorf. http://www.researchgate.net/publication/

11696965_Suppression_by_medical_journals_of_a_warning_about_overdosing_formula-fed_infants_with_fluoride

104.1986 Fluoride: New Grounds for Concern. http://www.slweb.org/ecologist-1986.html105.1978 The Great Dilemma by George Waldbott: http://www.whale.to/b/Waldbott_DILEMMA_ocr.pdf

CLOSINGPrior to World War II, scientists and doctors were united in their statement that fluorine was a poison, and that exposure to all types of fluorides at any level was harmful to life. Pregnant women and children up to age 12 were specifically called out as needing protection from fluoride exposure. Communities were encouraged to remove fluoride from their water supplies and most of the pollution cases in the US were against industrial fluoride producers. That opinion changed suddenly and over the objections of many renowned scientists and medical organizations. That change was based on a medical hypothesis, dental myth, biased and since debunked “trials” masquerading as science, and governmental policy. Simply stated, any assumption that dietary fluoride is good for teeth is without merit while the evidence of harm is scientifically and clinically documented many times over.

Communication to NAS/IOM Food & Nutrition Board re Fluoride DRI, 27 April 2015 "15

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More Quotes from Experts

Expert in Neurotoxicity & Behavioral Psychology: “The addition of fluorides to drinking water

was, and is, a mistake.” - Dr. Robert Isaacson, 2006 National Research Council Scientist (2007)

Expert on Medical Chemistry: “Community water fluoridation is a malignant medical myth.”

 - Dr. Joel Kauffman, Professor Emeritus in Chemistry (2006)

Expert on Dental Research: “Water fluoridation is the greatest case of scientific fraud of the

twentieth century.”  - Dr. Philip R.N. Sutton (1996)

Expert on Neuroscience: “Prevention of chemical brain drain should be considered at least as

important as protection against caries.” - Dr. Philippe Grandjean, Chair of Environmental

Medicine at the University of Southern Denmark and Adjunct Professor of Environmental Health

at Harvard School of Public Health. (2014)

Expert on Environmental Protection: “The EPA’s solution to fluoride pollution is dilution!”

- Dr. Wm Hirzy, VP NTEU 280 and Risk Assessment Scientist, EPA (2001)

Expert in Medical Research Review: "Previously neutral on the issue, I am now persuaded by the arguments that those who wish to take fluoride (like me) had better get it from toothpaste

rather than the water supply.”

- Douglas Carnall, British medical writer after reviewing the 2000 York Review (2003)

Expert in Sustainability & Innovation: “A good scientist spends his whole career questioning his own facts. One of the most dangerous things you can do is believe.”

- Nigel Noriega, Environmental Scientist and Endocrine Biologist (2011)

Expert in Fluoridation Activism: “Tooth decay is a disease of poverty. Feed these children; don't fluoridate them!”

- Paul Beeber, esq., New York State Coalition Opposed to Fluoridation (2003)

Expert in Dental Public Health: “It is my best judgement, reached with a high degree of scientific certainty, that fluoridation is invalid in theory and ineffective in practice as a preventive of dental caries. It is dangerous to the health of consumers.”

- Dr. John Colquhoun, former chief Dental Officer of New Zealand (1993)

Expert in Medicine and Social Responsibility: "Studies in animal and human populations suggest fluoride exposure, at levels that are experienced by a significant proportion of the population whose drinking water is fluoridated, may have adverse impacts on the developing

brain." - Greater Boston Physicians for Social Responsibility (2000)

Expert in Social Planning: “Even today there are no legal constraints against the suppression of scientific data from privately funded studies….Some members of the medical community are calling for a public database on clinical trials, so that data unfavorable to a sponsor will not be

suppressed.” - Sheldon Krimsky, professor of urban and environmental policy and planning at

Tufts University. Author of "Science in the Private Interest" (2004)

Expert in Consumer Protection: “It’s way overdue for this country to have an extended and

open scientific and regulatory debate on fluoridation.'” – Ralph Nader (2011)

Expert on Legal Decision Making: "Marginal benefit in exchange for significant risk is the sine

qua non of gross disproportionality…the stronger the scientific evidence of risk of harm, the

greater the gross disproportionality.” - Nader R. Hasan, esq. (2014)

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Questions & Statements

This attachment to the IOM communication dated April 27, 2015 assumes that all the resources referenced in that communication will be thoroughly examined by the IOM.

It is expected that the IOM in fulfillment of their mission to ‘ask and answer the nation’s most pressing questions about health and health care’ will want to engage in some sort of event to ‘facilitate discussion, discovery, and critical, cross-disciplinary thinking.’

As an aid to that process, we are suggesting some questions for consideration and providing a few statements from leading scientists on the topic of dietary fluoride and water fluoridation, some but not all of which were included in the resources of the communication. We certainly expect the IOM to expand this list which is offered simply as a starting spot.

1. Question: Is it responsible for the IOM to publish an estimated safe & adequate intake (AI) of “fluoride,” a toxin that includes other elements, in the “Dietary Guide to Nutrient Requirements” on the same table as iodine and calcium?

2. Question: Are the conclusions in the 1997 IOM report used to establish the 1997/2006 estimated safe & adequate intake (AI) of fluoride (or fluorine) valid in the light of recent science regarding the toxic effects of fluoride?

3. Question: Is any IOM estimated safe & adequate intake (AI) of fluoride in the best interest of human health, given current understanding of the risks of fluoride ingestion?

4. Question: Should Boards of Health and medical professionals be relying on the IOM estimated safe & adequate intake (AI) of fluoride on the DRI table as a “public good” justification for municipal water fluoridation?

5. Question: What is the environmental risk of fluoridated waste water?

6. Question: Is a fluoridated water supply safe for the most vulnerable residents, such as the very young, elderly and those with prolonged health conditions, i.e. endocrine disorders, kidney disease, and autoimmune disease?

7. Question: Is it responsible for the IOM to assume any estimated safe & adequate intake (AI) of fluoride protective of the health of fetuses, young children, those with thyroid disorders, diabetes, kidney disease, autoimmune disease or environmental sensitivities when “fluoride,” an inorganic chemical toxin, in common usage refers to several substances used intentionally and unintentionally in our water supplies as a dietary supplement, i.e. fluorosilicic acid, sodium fluorosilicate, calcium fluoride, aluminum fluoride, etc.?

STATEMENTS OPPOSING FLUORIDATION: hyper-linked

A. 1999 Letter to BSA Environmental Services from Dr. Phyllis Mullenix, toxicologist

B. 1998 Letter to Santa Cruz, CA Board of Supervisors from Dr. David Kennedy, dentist C. 2007 Letter to UK Health Authority from Dr. Hardy Limeback, 2006 NRC, dentist

D. 2014 Letter to Israeli Minister of Health from Dr. Hardy Limeback, 2006 NRC, dentist E. 2007 Position Statement by Dr. Robert Isaacson, 2006 NRC, expertise in neurotoxicity F. 2014 Affidavit from Dr. Kathleen Thiessen, 2006 & 2008 NRC, expertise in risk assessment

G. 2014 Letter to FDA from Dr. Robert Sauerheber, chemist

H. 1993 Expert Affidavits (23) of documented harm caused by water fluoridation, MD, PhD, etc.

KSpencer

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01/13/16 Henry Rodriguez Founder and Executive Director LULAC Concilio Zapatista 4383 2404 Leal San Antonio, TX 78207

Dear Water Fluoridation Committee Members, Regional Councilors, City Solicitors and City Staff, I am writing to you, as a lifelong Civil Rights activist, 2015 League of United Latin American Citizens (LULAC) "Man of the Year," Founder and Director of the LULAC Concilio Zapatista 4383, Past LULAC Texas Civil Rights Chair, and co-author of the 2011 LULAC Resolution Opposing Water Fluoridation as a Civil Rights Violation. LULAC is the oldest and largest Hispanic Civil Rights organization in the United States and I am proud to say that my council, Concilio Zapatista 4383, is one of the most active, dynamic, and well-respected councils in LULAC. We are known for taking action on the most important issues facing our membership and country. Artificial water "fluoridation" with the known toxicant, Hydrofluosilicic Acid, is one such issue. Our council opposed "water fluoridation" each time the issue was brought before the voters in San Antonio, TX, but when faced with a well-financed public relations campaign armed with extensive resources in November 2000, we were unable to protect the public from this failed public policy. San Antonio is one of the last big cities in the U.S. to be "fluoridated." Hydrofluosilicic Acid was added to our water in August of 2002. In 2011, we became aware (through the work of Daniel Stockin of the Lillie Center) that this practice was causing disproportionate harm, in the form of fluorosis, (the permanent mottling of teeth), to minorities. Furthermore, we learned that the percentage of people affected had been steadily increasing, information that had been withheld from the public and only made available after safe drinking water advocates issued FOIA requests. Had we been 'armed' with that information in 2000, perhaps we could have defeated the Pro-Fluoridation mantra, that the chemical to be used was "safe and effective." Additionally, in 2011, trusted agencies (the American Dental Association (ADA), Health and Human Services (HHS) and the Centers for Disease Control (CDC)), major promoters of this practice, released statements advising parents that baby formula should not be made up with fluoridated tap water exclusively to lessen the chance of this disfiguring condition. We decided to research this issue further and found even more evidence of subterfuge to protect this policy, in the story of Dr. Wlliam Marcus, Senior Science Adviser and Toxicologist in the Office of Drinking Water. Dr. Marcus "blew the whistle"when he reported a systematic down-grading of evidence for carcinogencity in studies of sodium fluoride.

Cancer Bioassay Findings

"In 1990, the results of the National Toxicology Program cancer bioassay on sodium fluoride were

published, the initial findings of which would have ended fluoridation.

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But a special commission was hastily convened to review the findings, resulting in the salvation of

fluoridation through systematic down-grading of the evidence of carcinogenicity. The final, published

version of the NTP report says that there is, "equivocal evidence of carcinogenicity in male rats," changed

from "clear evidence of carcinogenicity in male rats." - Dr. J. Wm Hirzy

Dr. Marcus was fired for his honesty and only after a long court battle with the EPA was reinstated with back pay and benefits. When confronted with this information, we asked ourselves : How can this happen in our great country ? and countered with - There ought to be a law! Well, in fact, there are many laws: Election laws governing contributions that unfortunately allowed huge amounts of money to be funneled into the campaign deceptively named "SAFE - San Antonio Fluoride is for Everyone." There is the Fair Campaign Act, a Voluntary Act, that asks political groups and candidates to amongst other things, be truthful in their campaigns. The group pushing Fluoridation promised a "safe and effective" chemical additive that was exhaustively researched and tested. Perhaps, they viewed this as a form of 'Free Speech', since their promises were/are patently false. There are laws governing chemicals being put into drinking water, yet our local water companies exceeded these limits but were never fined by the State of Texas / Texas Commission on Environmental Quality, which has enforcement powers. There are laws regulating contaminants in the water, which are "sidestepped" by diluting the highly contaminated additive. In 1991, the EPA published the Lead Copper Rule to minimize lead and copper in drinking water. The rule established a maximum contaminant level goal (MCLG) of zero for lead in drinking water, yet Hydrofluosilicic Acid is contaminated with lead, a fact that has not stopped it from being added to public water supplies. There are laws designed to protect citizens, such as the Safe Drinking Water Act, however, according to the NTEU, National Treasury Employees Union Chapter 280,( the union which represents the professional employees at the headquarters location of the U.S. Environmental Protection Agency in Washington D.C.) the MCL (Maximum Contaminant Level) established for this "protected pollutant" Violates the Safe Drinking Water act because it is NOT protective of the most sensitive of our population, including infants, with an appropriate margin of safety for ingestion over an entire lifetime.: There are laws regulating all aspects of transporting and certifying water additives, many not being followed. There are laws regulating product claims, forcing the suppliers of Hydrofluosilicic Acid to hide behind disclaimers of Liability and Intended Use statements, protecting them from litigation based on Deceptive Trade Practices Act. All of these laws and regulations exist - .. and more, .. yet people continue to be harmed !! Please note, I did not declare that this harm exists, the HHS, the CDC and ADA admitted it ! Of special concern, this admitted harm is affecting minorities, the poor and their children - my community. After reviewing this issue fully, I decided that the focus of our advocacy should be centered on our rights as free people to NOT be medicated, because after all is said and done, the civil rights of minorities, the poor and children exist and must be protected, something that all of the above laws have NOT been able to do.

When questioned about the 'Civil Rights' focus, I was reminded by a fellow Zapatista that the Supreme Court has never decided whether fluoridation of public water systems is a valid exercise of state police powers.

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To which I responded, "I do not need the Supreme Court to tell me what a Civil Rights Violation is."

Do you ? I think NOT !

Please stand with LULAC as we join with Andrew Young, former U.N. Ambassador and former Atlanta Mayor, and the Reverend Dr. Gerald Durley, Pastor of Providence Baptist Church in Atlanta, (both inductees in the International Civil Rights Walk of Fame) by opposing water fluoridation as a Civil Rights Violation.

"I am most deeply concerned for poor families who have babies." Dr. Young said. "If they cannot afford unfluoridated water for their babies' milk formula, do their babies not count?" "This is an issue of fairness, civil rights, and compassion," he said. "We must find better ways to prevent cavities, such as helping those most at risk for cavities obtain access to the services of a dentist."

2011 LULAC Resolution :

Our Resolution was passed at the 2011 82nd National LULAC Convention held in Cincinnati, Ohio. I was unaware at the time, but later found out that Cincinnati had been fluoridated for 32 years (since 1979) and yet was in "dental crisis" like so many other cities in the United States. Hydrofluosilicic acid, the chemical used in over 90% of communities to "fluoridate" has been pumped into our public water system since August 2002. It has been 13+ years that San Antonians have been ingesting this Hazardous Class 8 (Corrosive) Poison, and we now know :

Fluoridation is NOT Safe for all.

Promoters (the HHS - Health and Human Services, CDC - Centers for Disease Control, and the ADA - American Dental Association) now warn "if your child is exclusively consuming infant formula

reconstituted with fluoridated water, there may be an increased chance for mild dental fluorosis. To lessen

this chance, parents can use low-fluoride bottled water some of the time to mix infant formula; these

bottled waters are labeled as de-ionized, purified, de-mineralized, or distilled." This is clearly a hardship for poor families, and affects the very children promoters claim to be helping with fluoridation chemicals. Promoters posted warnings on their web pages and alerted their members but did not ask that water utilities put this information on water bills, they did not ask local health officials to inform the public, and they did not inform local governments to issue Public Service Announcements to warn the public. Therefore, we believe these organizations (HHS, CDC, and the ADA) are more protective of the public policy of fluoridation than they are of public health.

Fluoridation is NOT Effective.

'Dental caries experience' rates are actually HIGHER after fluoridation in Head Start Children than before fluoridation in San Antonio. Data supporting this assertion is posted on our website, http://www.lulaczapatista.org - Click on the Fluoridation tab.

Dental health officials decided to omit 'dental caries experience rates' from the annual Bexar County

Health Profiles report claiming that the public "does not need the data". From this action we have concluded that our Health Department is more protective of the public policy of fluoridation than they are of truth and transparency.

And, we found the following to be true:

Water utilities (SAWS) cannot control the concentration of fluoride (necessary to determine dose); Water utilities (SAWS) list "fluoride" as a Regulated Water CONTAMINANT on Annual Reports;

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Water utilities (SAWS) cannot prevent "fluoride spills" (Dec. 2004 dangerous fluoride levels were found in the water at the Westin Riverwalk Hotel at 280 PPM - see http://www.TexansForSafeDrinkingWater.com); City/County health officials (Bexar Metropolitan Health District) are more protective of the public policy of fluoridation than they are of public health. Locally, our public health Director, Dr. Thomas Schlenker refused to warn mothers about the risks of dental fluorosis. Elected Officials (San Antonio City Council) are also very protective of this policy, no matter how much evidence comes out showing possible harm and lack of effectiveness, they refuse to rescind fluoridation. [SAWS = San Antonio Water System]

Background information on how the LULAC Concilio Zapatistas became involved :

In 2000 the voters trusted the HHS, the CDC and the ADA that fluoridation chemicals were safe for all to drink at 1.0 PPM and would lower dental caries rates. However, in January 2011 we were warned by these trusted organizations that infants should be breast-fed or fed formula made with low-fluoride water, to protect the child from developing the permanent mottling and pitting of teeth, a condition called fluorosis. Additionally, these trusted organizations admitted that studies ending in 2004, showed that 41% of adolescents exhibited harm from fluoride, in the form of dental fluorosis and that minorities are more likely to be harmed. They also admitted that fluorosis rates had been increasing over time and it seemed likely that by 2011, the rates would be even higher. The LULAC Concilio Zapatistas, had opposed fluoridation in 2000, and with this new evidence of possible harm to infants and minorities, we became determined to find out exactly what benefits could possibly outweigh this danger. We subsequently contacted local elected officials and they responded that there are "no documents" showing any benefit for the 10 years of fluoridation expense. We met with the Director of Public Health (Dr. Thomas Schlenker) and Dental Coordinator (Dr. Jennifer Bankler), however, neither had proof of effectiveness. The Director of Public Health refused to advise mothers about the HHS, CDC, and ADA warnings of possible "mild dental fluorosis." Ultimately, in our quest to uncover the benefits of fluoridation, we instead found proof that dental caries rates were HIGHER after fluoridation in the target group (poor children in the Head Start Program) than before fluoridation ! It was then, that we decided to oppose this wasteful, potentially damaging policy. In February 2011, we authored a resolution opposing fluoridation as a Civil Rights Violation because it essentially forces medication on everyone that eats food or drinks liquid processed with water treated with fluoridation chemicals. We submitted our resolution to the LULAC Texas Organization, and it passed in February 2011. In July 2011, we introduced our resolution at the National LULAC Convention in Cincinnati and it passed unanimously. (Please see our videos on http://www.lulaczapatista.org - Click on the Fluoridation tab.) Promoters of fluoridation promise a reduction in dental caries that will lower oral healthcare expenses, a sizeable burden to the taxpayers. However, we have not seen a reduction in oral healthcare expense locally. In fact, in January of 2013, perhaps as a result of higher dental caries rates, our county oral health officials applied for $ 937,000 in additional ANNUAL expenditures and most recently, on April 15, 2013 our City Council voted to expand the fluoride varnish program by another $ 72,000. Promoters claimed in 2000 that fluoridation would cost "12 cents per water connection per month." In January 2013 the San Antonio Water System contract for hydrofluosilicic acid was approved by the San Antonio Water System Board of Trustees at a cost of $ 1.124 MILLION. This expenditure is only for the fluoridation chemical and does not include the cost for training employees to handle this toxic corrosive chemical, the costs for the hazardous materials gear that water utility employees must wear to put the chemicals in the water, the costs for their time, the costs for transporting the chemical to each pumping station, the costs for the pumping station equipment, the costs to test water samples for fluoride concentrations, and the costs to replace the equipment as it degrades from interaction with this corrosive chemical. Additionally, water utilities must pay the salaries of all management employees tasked

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LULAC: Civil Rights Violation Regarding Forced Medication

http://lulac.org/advocacy/resolutions/2011/resolution_Civil_Rights_Violation_Regarding_Forced_Medication/[9/1/2011 3:27:42 PM]

WHEREAS, the U.S. Health and Human Services and the EPA (January 2011) have recently affirmed the NRC Study

results that citizens may be ingesting too much fluoride and that the exposure is primarily from drinking water; and

WHEREAS, the proponents of fluoridation promised a safe and effective dental health additive, but the San Antonio

Water System’s (SAWS) contract for fluoridation chemicals proves a “bait and switch”; as SAWS is adding the toxic

waste by-product of the phosphate fertilizer industry, that has no warranty for its safety and effectiveness for any

purpose from the supplier (PENCCO, Inc.) or the source (Mosaic Chemical); and

THEREFORE, BE IT RESOLVED, that LULAC commends efforts by organizations that oppose forced mass medication

of the public drinking supplies using fluorides that are industrial grade, toxic waste by-products which contain

contaminants (arsenic, lead, mercury) which further endanger life; and

BE IT FURTHER RESOLVED, that LULAC supports efforts by all citizens working to stop forced medication through the

public water system because it violates civil rights; and

BE IT FURTHER RESOLVED, that LULAC opposes the public policy of fluoridation because it fails to meet legislative

intent; and

BE IT FURTHER RESOLVED, that LULAC demands to know why government agencies entrusted with protecting the

public health are more protective of the policy of fluoridation than they are of public health.

Approved this 1st day of July 2011.

Margaret Moran

LULAC National President

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January 20, 2016

We are riti g to e press CHEJ’s oppositio to the additio of fluoride to pu li dri ki g ater supplies. CHEJ has come to this conclusion because of the research we have done examining

the evidence of the effe ti e ess of this pra ti e. I additio , CHEJ’s S ie e Director Stephen

Lester was a member of the Natio al A ade ies’ Committee on Toxicology during the

publication of the Natio al Resear h Cou il’s report on Fluoride in Drinking Water and was

assigned to oversee this project as a member of the committee. As a result, Mr. Lester attended

several of the Fluoride committee’s meetings and had access to the deliberations and

information made available to this committee. Based on this experience, and for the reasons

listed below, CHEJ opposes the addition of fluoride to public drinking water supplies.

Fluoride is a toxic substance that results in many adverse health effects when people are

exposed to this substance. When fluoride is added to a public drinking water supply, it is

added as an industrial grade chemical, not a pharmaceutical grade substance. These

chemicals (primarily sodium fluorosilicate and hydrofluorosilicic acid) are classified as

hazardous waste and are contaminated with various impurities.

It is ethically wrong to intentionally give people a toxic substance against their will. By

adding fluoride to public drinking water, we are allowing the government to do to whole

communities what individual doctors cannot do to individual patient without their

consent. By adding fluoride to public drinking water, everyone gets exposed regardless

of age, health, sensitivity or vulnerability. Certain groups are especially vulnerable to

harm from ingested fluoride, such as seniors, babies, kidney patients, and diabetics.

Before fluoridation began, important research was not done to evaluate the possible

adverse health effects on the human body. Despite the fact that fluoride has been

added to community water supplies for over 60 years, no randomized trials of water

fluoridation have every been done to evaluate its effectiveness or safety.

Fluoridation is unnecessary and ineffective. Multiple peer-reviewed studies have shown

that fluoride is not effective in stopping cavities, which is the primary reason it was

added to public drinking water in the first place. Modern large scale studies show no

consistent or meaningful difference in the cavity rates of fluoridated and non-

fluoridated o u ities. Further ore, it is o k o that fluoride’s ai e efit

comes from topical contact with teeth, not from ingestion.

It is now understood that the major reasons for the general decline of tooth

decay worldwide, both in non-fluoridated and fluoridated areas, is the widespread use

of fluoridated toothpaste, improved diets, and overall improved general and dental

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health. Western industrialized countries that have rejected water fluoridation have

nonetheless experienced the same decline in childhood dental decay as fluoridated

countries.

Adding fluoride to public drinking water is causing numerous adverse health effects in

children and adults. The NRC committee report points out that fluorides have the ability

to interfere with brain function, and that there is substantial evidence of developmental

neurotoxicity. Published studies indicate that fluoride exposure is linked to reduced IQ

and to other neurotoxic effects. Furthermore, there’s a gro i g od of e ide e that

reasonably indicates that fluoridated water, in addition to other sources of daily fluoride

exposure, can cause or contribute to a range of serious adverse effects including

reduced thyroid function, arthritis and bone damage including possibly bone cancer in

adolescent males.

Research clearly shows that fluoridation is causing millions of children to develop dental

fluorosis, a discoloration of the teeth caused by excessive fluoride intake. In 2010, the

U.S. Centers for Disease Control and Prevention (CDC) reported that 41% of American

adolescents had dental fluorosis. This estimate is based on rates in both fluoridated and

non-fluoridated areas, so rates in fluoridated areas are even higher.

African American and Hispanic communities experience disproportionately higher rates

of teeth disfiguration due to dental fluorosis. Those most likely to suffer from poor

utritio a d thus are ore likel to e ore ul era le to fluoride’s to i effe ts are the poor who are the very people who historically have been targeted by fluoridation

efforts. These populations are least able to afford avoiding fluoride once it is added to

the water supply.

Love Canal taught us the lesson that health, environment, and justice are inextricably linked.

We oppose water fluoridation as it harms our health, it harms the environment, and is a

textbook case of environmental justice harm affecting low income and families of color. Most

families do not know about the issue and/or do not have the funds to avoid fluoridated water if

they desire to not consume it. For all of these reasons, we oppose the addition of fluoride to

public drinking water supplies.

Respectfully submitted,

Lois Marie Gibbs

Founder, Center for Health Environment & Justice

Stephen Lester

Science Director

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From: Dr.Oksana M.Sawiak Sent: January 27, 2016 2:27 PM To: Regional Council Subject: Flouride Vote This email was sent by the following person. Please reply to them: Sender's Name: Dr. Oksana M. Sawiak Sender's Email: The message was submitted through an Automated Email Service on Peel's Website Wed Jan 27 14:29:35 2016: -------------------------------------------------------------------------- The FLUORIDE debate: Letter to the keepers of public trust of Mississauga, Brampton and Caledon (Region of Peel). A quote from a presentation by Dr. Hardy Limeback and Dr. Paul Connett: on Jan 21st: “When policy becomes king---science becomes a slave”. Endorsements by figures of authority such as politicians, dental associations and public health officials have made the medicating of our population by fluoridating our water supply acceptable. All those esteemed authorities do not seem to be taking into account that the dose for a baby is far too great in comparison to the dose of an adult. The science behind water fluoridation is flawed as proved by Toxicologist Dr. Paul Connett among others. The product being used to fluoridate our water supply is a byproduct of the fertilizer industry that is considered TOXIC WASTE – not clean pharmaceutical grade sodium fluoride. There is no benefit to drinking fluoridated water as found in research done by Dr. Hardy Limeback -the expert on Preventive Dentistry and Professor Emeritus of the University of Toronto Dental School. We are poisoning our children and thereby negatively affecting their thyroids, their immune systems, their fertility and their precious IQ ! As a retired dentist and a Wellness Consultant I see the cumulative damage this toxicity wreaks on my clients. I urge you to carefully look at the science and not let political ambitions and policies govern your decision when you vote on this issue. God Bless you, Dr. Oksana M. Sawiak DDS, IMD, MAGD, AIAOMT. Wellness Counsellor, Author, Lecturer “The Health Detective” (click here for my Curriculum Vitae http://www.drsawiak.com/about.htm )

REFERRAL TO ______________________________

RECOMMENDED

DIRECTION REQUIRED _______________________

RECEIPT RECOMMENDED ____________________P

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3 February, 2016 Clerk’s Office Peel Regional Council 10 Peel Centre Drive Brampton ON L6T 4B9

WATER FLUORIDATION

Readers of Tough Times are concerned about possible cancellation of water fluoridation in Peel. Tough Times target readership is people who are homeless, using soup kitchens and food banks, families having hard times. Many are unemployed, few have jobs that include dental insurance. Others are putting off dental appointments until they have money. Many already have dental damage that affects their ability to eat. Many adults among our readers are at risk of exposed root decay, and fluoridated water helps to reduce that risk. This is not the time for the Region of Peel to consider ending fluoridation. The website of the Centres for Disease Control and Prevention reports that every $1 invested in fluoridation saves $38 by avoiding the need for fillings and more costly dental treatments. Tough Times’ readers urge Peel Regional Council to retain fluoridation of water for the benefit not only of homeless and poverty-stricken people, but for the benefit of all residents of Peel. On behalf of Tough Times readers (signed) Edna Toth Editor, Tough Times

#4 – 287 Glidden Road, Brampton ON L6W 1H9

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2

Given the past reviews, the credible evidence-based research along with clear recommendations from the Chief Medical Officer of Health, the Minister of Health and Long Term Care and indeed the Region’s own Medical Officer of Health, I hope and trust that the debate will be short and elected officials in Peel will fully support continuing the long-standing practice of water fluoridation.

Sincerely,

__________________________________

Maria Britto

Board Chair

Cc Scott McLeod, CEO, Central West LHIN

David Szwarc, Chief Administrative Officer, Region of Peel Dr. Eileen de Villa, Medical Officer of Health, Region of Peel Janette Smith, Commissioner of Health, Region of Peel

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REFERRAL TO ______________________________

RECOMMENDED

DIRECTION REQUIRED _______________________

RECEIPT RECOMMENDED ____________________

Additional Item

Communication Item - 8.115.7-1

REFERRAL TO ______________________________

RECOMMENDED

DIRECTION REQUIRED _______________________

RECEIPT RECOMMENDED ____________________

Additional Item

Communication Item - 8.105.8-1

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February 18, 2016

Mr. Frank Dale

Chairman

Region of Peel

10 Peel Centre Drive

Suite A and B

Brampton, ON

L6T 4B9

RE: Community Water Fluoridation

Dear Mr. Chairman:

The Ontario Dental Association (ODA) and the Halton-Peel Dental Association (HPDA) were recently made

aware that Community Water Fluoridation (CWF) has been raised in Peel Region Council. We understand

that councilors recently attended an educational workshop, and that the Oral Health in Peel Committee has

been struck that will further examine CWF and oral health issues and programs in Peel Region.

In 2014, when CWF was originally raised in Council, the ODA and HPDA wrote to former Peel Region

Chair Kolb to express our concern with arguments against CWF, and noted the value that CWF brings to

every resident of Peel Region. As voluntary professional organizations which represent the dentists of

Ontario, promote the highest standards of dental care and advocate for accessible and sustainable optimal

oral health, the ODA and HPDA continue to have significant concerns with the direction of the debate about

the fluoridation of Peel Region’s community water supply.

The decision to implement CWF in Peel Region was a knowledge-based decision, based on information from

peer-reviewed scientific articles, and support from leading researchers and experts in the oral health and

health community. The ODA and HPDA believe that optimally fluoridated water is necessary to ensure the

oral health, and therefore the overall health, of all Ontarians. The cost of prevention is far less than treatment.

For every one dollar spent fluoridating the community water supply, the U.S. Centers for Disease Control

and Prevention estimates that 38 dollars will be saved in dental costs, which is less than the cost of one

dental fillingi.

At a time when every level of government is faced with economic realities and tough decisions to cost-

control, consideration must be given to the significant long-term cost-effective and economic benefits of

continuing to add fluoride to the community water supply. Although all socio-economic groups benefit from

the addition of fluoride to the community water supply, dental disease disproportionately affects lower socio-

economic individuals who, along with immigrants from countries with sub-optimal access to preventive

interventions and oral health care services, bear the ravages of an avoidable disease. The ODA and HPDA

urge you to ensure that the economic disparity that exists in your communities does not act as a barrier to

oral health in terms of access to optimally fluoridated water. Preventing dental disease also benefits the

Region and taxpayers who fund dental treatment programs for low-income Ontarians and residents of the

Region of Peel. REFERRAL TO ______________________________

RECOMMENDED

DIRECTION REQUIRED _______________________

RECEIPT RECOMMENDED ____________________

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Date: February 18, 2016

To: Mr. Frank Dale

Re: Community Water Fluoridation

Pg: 2 of 3

Experts in dental disease around the world agree that community water fluoridation is safe, effective and

valuable in preventing dental caries and other disease. In a systematic review of CWF studies, Cochrane (a

world-renowned scientific research review organization), concluded that water fluoridation is effective at

reducing levels of tooth decay among childrenii. Another such review of CWF studies from around the world,

conducted by the Community Preventive Services Task Force in the United States (whose members are unpaid

and independent), found the ratio of the benefit of CWF to costs of not fluoridating drinking water can be up to

135:1 in large communities, and that CWF results in reductions in the prevalence of dental caries across socio-

economic groupsiii.

Fluoride is a fiscally responsible, safe, and effective means to prevent tooth decay. The three mayors in Peel

Region, Mayors Crombie, Jeffrey and Thompson, as well as Minister of Health and Long-Term Care Dr.

Eric Hoskins, Ontario’s Acting Medical Officer of Health Dr. David Williams, all are asking that Peel

Region continue to fluoridate the community water supply. Your decision to support community water

fluoridation will undoubtedly have an impact on oral and general health and the prevention of dental disease

for your constituents. It will also ensure that the communities you represent will continue to bear

significantly lower costs of treating dental disease than other, non-fluoridated communities.

Should you have any questions relating to this or any other dental related matter, please do not hesitate to

contact Amanda MacKenzie, ODA Government Relations Manager, at 416-355-2272 or

amackenzie@oda.ca.

Sincerely,

Dr. Victor Kutcher Dr. Sanjukta Mohanta

President, Ontario Dental Association President, Halton-Peel Dental Association

Distribution:

Mr. Alan Thompson Mayor of Caledon

Ms. Johanna Downey Ward 2 – Caledon

Ms. Annette Groves Ward 5 – Caledon

Ms. Jennifer Innes Wards 3 & 4 - Caledon

Ms. Barb Shaunessey Ward 1 – Caledon

Ms Linda Jeffrey Mayor of Brampton

Mr. Grant Gibson Wards 1 & 5 – Brampton

Mr. Martin Madeiros Wards 3 & 4 – Brampton

Ms. Gael Miles Wards 7 & 8 – Brampton

Ms. Elaine Moore Wards 1 & 5 – Brampton

Mr. Paul Palleschi Wards 2 & 6 – Brampton

Mr. John Sprovieri Wards 9 & 10 – Brampton

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Date: February 18, 2016

To: Mr. Frank Dale

Re: Community Water Fluoridation

Pg: 3 of 3

3

Ms. Bonnie Crombie Mayor of Mississauga

Mr. George Carlson Ward 11 – Mississauga

Ms. Chris Fonseca Ward 3 – Mississauga

Mr. Iannicca Nando Ward 7 – Mississauga

Mr. John Kovac Ward 4 – Mississauga

Mr. Matt Mahoney Ward 8 – Mississauga

Ms. Sue McFadden Ward 10 – Mississauga

Ms. Carolyn Parrish Ward 5 – Mississauga

Ms. Karen Ras Ward 2 – Mississauga

Ms. Pat Saito Ward 9 – Mississauga

Mr. Ron Starr Ward 6 – Mississauga

Mr Jim Tovey Ward 1 – Mississauga

i “The Power of Prevention: Chronic Disease – the Public Health Challenge of the 21st Century”, p. 9 (2009). National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf. Last accessed February 5, 2016. ii Iheozor-Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny A. Water Fluoridation for the

Prevention of Dental Caries. Cochrane Database of Systematic Reviews 2015, Issue 6. http://www.cochrane.org/CD010856/ORAL_water-fluoridation-prevent-

tooth-decay . Last accessed February 4, 2016. iii Guide to Community Preventive Services. Preventing dental caries: community water fluoridation.

www.thecommunityguide.org/oral/fluoridation.html. Last accessed February 5, 2016.

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From: Anna Louise Tolan

Sent: February 29, 2016 10:35 AM

To: council@peelregion.ca

Subject: Community Water Fluoridation

Mar 1, 2016

Region of Peel Council

10 Peel Centre Dr.,

Brampton, ON L6T 4B9

council@peelregion.ca

Dear Frank Dale,

Re: Community Water Fluoridation

As a registered dental hygienist and a resident of am

writing to express my concern about my community’s consideration to end community

water fluoridation, as such action would severely undermine the health and quality of life

for Peel residents.

I am writing to express my concern about my community’s consideration to end

community water fluoridation, as such action would severely undermine the health and

quality of life for Peel residents.

Fluoride is a mineral that exists naturally in virtually all water supplies. Communities,

including the Brampton, Caledon and Mississauga, adjust the amount of fluoride in their

community water source to levels that protect teeth from decay. Canadians have been

doing this for nearly 70 years. That experience (and hundreds of studies and

international experiences) demonstrates that fluoridation of drinking water remains safe

and the most effective means of achieving community-wide exposure to cavity

prevention effects of fluoride. Leading health organizations, including Health Canada,

the Canadian Paediatric Society, and the Canadian Public Health Association, continue

to support water fluoridation as a means of preventing dental decay to all residents

regardless of age, socioeconomic status, education, employment or dental insurance

status.

In these tough fiscal times, communities are increasingly looking for health interventions

that save money. For every $1 invested in community water fluoridation, $38 is avoided

for dental treatments costs by reducing the need for fillings and other costly dental

procedures; that’s a Return on Investment of 3700%! At a time when thousands of

Canadians, including residents of Peel, lack dental insurance and experience significant

barriers to achieving optimal oral health, community water fluoridation offers a simple,

safe and effective strategy that all residents of a community can benefit from simply by

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RECOMMENDED

DIRECTION REQUIRED _______________________

RECEIPT RECOMMENDED ____________________P

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turning on their tap. The City of Calgary is already seeing poor oral health outcomes

since removing fluoride from their water in 2011.

As you continue to discuss community water fluoridation, I urge you to carefully consider

the overwhelming evidence that supports continued fluoridation. When it comes to

community water fluoridation, the science is solid; please continue to protect the oral and

overall health of all residents.

Sincerely,

Anna Louise

Anna Louise Tolan RDH, FADIA

cell

"It's kind of fun to do the impossible." Walt Disney

The information contained in this message and in its attachments is confidential. Its distribution

or disclosure is strictly prohibited. If you are not the intended recipient, please contact the

sender at and delete the message.

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