What a miracle modern water systems are. With a gentle flick of a finger or twist of a wrist, cool, clear, life-giving water comes rushing out of the faucet without a moment's delay. Oh, sure, a faint whiff of chlorine reminds us someone's treating that water for impurities. But as we dutifully swallow our eight glasses a day, we tend to forget we're being mass-medicated with fluoride with every sip and there's nothing our Britas can do about it.
As scientists continue to tap into health risks around drinking water (in fact, they're converging at a conference in New York State this week to present their latest findings), and fluoridation battles flare up across the globe, you've got to wonder whether Toronto authorities are asleep at the water cooler.
What kind of health concerns are we talking about? Besides making bones brittle and elevating fracture risks, scientists have been digging up connections between fluoridated water and neurological impairment, drops in IQ, depression of thyroid function and the pineal gland. And most recently, a study was published out of Harvard this spring (after purportedly being suppressed by a Colgate-funded research supervisor there) that highlighted a connection between fluoridated water and a sevenfold increase in bone cancer in young boys.
That's kind of disturbing when you think Toronto's been adding fluoride to its water since the 60s. A push to overthrow the system and hold a public referendum on the matter in 1999 failed. But across North America about 150 towns and cities have rejected fluoridation since 1990. Most recently, debates have been sparked in Montreal, Palm Beach, Boulder and Lismore (Australia). Israel suspended its national mandatory fluoridation policy last month.
Public pressure did lead to lowering our dose from 1 part per million (ppm) per litre, down to .8 and down again to .6 this year. But scientists and concerned citizens are saying that's not good enough.
"It is far too high," says Paul Connett, environmental chemistry and toxicology prof at St. Lawrence University and exec director of the U.S.-based Fluoride Action Network (one of the organizers of this week's conference). He says the health effects we're seeing on the brain, thyroid gland, bones and teeth are occurring very close to if not at 1 part per million and even lower. Connett warns we're not giving ourselves much of a margin of safety.
"No honest toxicologist would for one moment entertain exposure to people where the beneficial dose and the toxic dose are so close in a situation where you cannot control who it's going to. It's going to the very young, the very old, the infirm, people with poor kidney function [who can't clear fluoride from their system]. It's totally non-discriminatory."
Connett stresses that no matter what level you set fluoridation at, you can't control how much water people drink. "Some kids in Toronto may be drinking more water and getting larger doses than kids in China [where studies showed lowered IQs.]
And that's not to mention all the sources of hidden fluoride we consume every day in products processed in fluoridated areas, including pop (71 per cent of sodas tested had levels of fluoride at or above Toronto's current tap water levels), cereal, wine, beer, seafood, juice and tea (which can soak up as much as 6 ppm from the fluoride in soil in volcanic regions). It's even added to some bottled water in response to public concerns that drinking non-fluoridated water could rot kids' teeth.
In fact, Hazel Stewart, director of dental and oral health services at the Toronto Public Health Department admits that's partly why the city decided to drop the dose last year to .6 ppm. "We have no control over the amount of fluoride in these products whatsoever. People are being exposed to a lot more fluoride."
Thanks to excessive exposure, she says, some people suffer from dental fluorosis (where white or brown discolourations appears on the enamel; about 15 per cent of Toronto kids have objectionable fluorosis and need bleaching, bonding or veneers).
But although the city has quietly lowered the amount of fluoride in our water and Stewart admits its major beneficial effects come from topical use (as in toothpaste), she denies that there are any real risks to human health besides the whole browning-enamel thing. "To date, there have been no scientific studies that meet the rigours of peer review that support that point of view."
Hardy Limeback, head of preventive dentistry and former president of the Canadian Association of Dental Research, says such broad statements fly in the face of a vast scientific literature on the topic. "I was on the National Academy of Sciences committee that reviewed hundreds of these studies, and our committee recently published a review of them. I wonder if Dr. Stewart read that review."
Limeback points to study after study, including one that examined more children than all the fluoridation studies combined. It found that the use of hydrofluorosilicic acid, a type of fluoride commonly used by municipalities like Toronto, is associated with a significant increase of lead levels in the blood of children. (Hydrofluorosilicic acid, by the way, is a pollutant produced by the fertilizer biz. It's collected in scrubbers, then sold to municipal fluoridation programs as a cheap source of fluoride).
Other studies indicate the levels we use to fluoridate Toronto water could trigger thyroid problems in the population. "All of these studies have been well-conducted, peer-reviewed and published in respectable journals."
Limeback adds, "Environment Canada recommends that our freshwater lakes and rivers not contain any more than 0.12 ppm fluoride to protect all stages of freshwater life. Why is it okay for humans to drink fluoridated water that is 10 times the level that is toxic to other life in the environment?"
South of the border, unions representing the employees of the U.S. EPA have been wondering the same thing. Last summer, in response to their discovery of the Harvard study's connection to bone cancer, they demanded that action be taken and asked the EPA to drop the health standard for fluoride in drinking water down to zero.
"Like it is for all carcinogens," says EPA scientist and VP of the EPA scientist union, William Hirzy. "We asked Congress to call for a moratorium on water fluoridation programs around the country until this issue could be resolved. It didn't make a lot of sense to us to continue exposing the country to this cancer risk."
So why are we still swallowing this stuff? Critics say it's a bit like swallowing sunblock to protect our skin from UV damage. But Health Canada stands by the line that yanking your fluoridation system leads to a town full of rotten teeth. Says Health Canada rep Renee Bergeron, "Canadian researchers are... finding increases in the rates of tooth decay for communities that no longer fluoridate."
When pressed for examples, Bergeron cites Dorval, Quebec, the hub of recent controversy thanks to a study that found cavity rates doubled in the Montreal suburb after it cancelled its fluoridation program three years ago. Of course, that unpublished study only looked at 120 kindergarten kids.
Retired med school prof Pierre Jean Morin, co-author of Fluoride: Autopsy Of A Scientific Error, laughs at the suggestion that Dorval should be taken as a rigorous example of fluoride's benefits. He oversaw a three-year study of more than 20,000 kids in central Quebec and says, "There was no difference in the dental decay rate between the fluoridated and non-fluoridated, and that's a large sample."
Indeed, Finland ended its fluoridation in 1992 and saw no increase in dental decay. The same was found in cities in Germany, North Carolina and BC. Still, roughly 40 per cent of Canada remains fluoridated, and the chances of reopening the T.O. debate look slim.
Aliss Terpstra, the Toronto-based research coordinator for the Fluoride Toxicity Research Collaborative says she and her group asked the mayor for a fair and open re-examination of water fluoridation back in the fall and were told the matter was being passed along to the chief medical officer of health. They haven't heard back.
"We've put our requests in front of the mayor, the works committee and the board of health. There's nothing we can do to force them to look at the science. We can only ask politely."
In a city whose mayor has gone on record saying he blames his bad teeth on that fact that he grew up in England without fluoridated water, we might just be stuck swallowing this stuff.