People at Risk from Fluoride |
Is fluoridated water safe for people with certain medical conditions, such as diabetes or kidney failure?
BFS suggested answer
Yes. Fluoridated water is safe for everyone to drink. There is no evidence that drinking fluoridated water is harmful to anyone irrespective of their state of health.
BFS suggested answer refuted
Subsets of the population may be unusually susceptible to the toxic effects of fluoride and its compounds. These populations include the elderly, people with deficiencies of calcium, magnesium, and/or vitamin C, and people with cardiovascular and kidney problems.
US Agency for Toxic Substances and Disease Registry, 1993
It was known over a quarter of a century ago that some people are more susceptible to the adverse effects of fluoride than others. In 1972, the Journal of the American Medical Association published a paper on the effects of fluoride in people with impaired kidney function. It read:
Children, the elderly and any person with impaired kidney function [which includes many AIDS patients], are in the high risk group for fluoride poisoning and must be warned to monitor their fluoride intake. Also at high risk are people with immunodeficiencies, diabetes and heart ailments, as well as anyone with calcium, magnesium and Vitamin C deficiencies. At the level of 0.4 ppm renal [kidney] impairment has been shown.1 [Note that 0.4 ppm is less than half the ‘optimal’ amount that is put in drinking water.]
Five years later, another researcher published similar findings, saying:
. . . the ever-increasing use (and release) of fluoride compounds in the environment should be of long-term concern in population sub-groups who are most susceptible, and therefore, most at risk. One of these sub-groups consists of people with impaired kidney function, including subjects with nephropathic diabetes. The diabetes factor is of particular relevance, not only because the incidence of diabetes has increased by 6%/yr during the period 1965–1975, but also because subjects with nephropathic diabetes can exhibit a polydipsia–polyurea syndrome that results in increased intake of fluoride, along with greater-than-normal retention of a given fluoride dosage. People with inadequate dietary intakes (particularly of [Calcium] and/or Vitamin C) are also likely to be more at risk as a consequence of low-dose long-term fluoride ingestion.2
In the same year, the US National Academy of Sciences warned:
. . . renal patients have a lower margin of safety than the average person . . . One case of symptomatic skeletal fluorosis (radiculomyelopathy) has been reported from an area in Texas with natural fluoride at 2.3–3.5 ppm in the water (1965). There have been two cases of suspected skeletal fluorosis . . . The combination of renal impairment and very high water intake was thought to account for these findings.3
That made it official.
In 1993, the US Agency for Toxic Substances and Disease Registry reiterated:
Existing data indicate that subsets of the population may be unusually susceptible to the toxic effects of fluoride and its compounds. These populations include the elderly, people with deficiencies of calcium, magnesium, and/or vitamin C, and people with cardiovascular and kidney problems . . . Because fluoride is excreted through the kidney, people with renal insufficiency would have impaired renal clearance of fluoride. Impaired renal clearance of fluoride has also been found in people with diabetes mellitus and cardiac insufficiency. People over the age of 50 often have decreased renal fluoride clearance . . . This decreased clearance of fluoride may indicate that elderly people are more susceptible to fluoride toxicity . . . Because of the role of calcium in bone formation, calcium deficiency would be expected to increase susceptibility to effects of fluoride.4
Drink mineral water instead?
Many people drink mineral water, at vastly inflated prices, precisely in an effort to avoid impurities believed to be present in tap water. In 1986, a French medical journal reported skeletal fluorosis in patients with impaired kidney function who drank the French mineral water Vichy Saint-Yorre, which has a particularly high calcium fluoride content. The paper concludes: ‘[T]he prolonged administration of Vichy Saint-Yorre water containing 8.5 mg of fluoride ion per liter, provokes a skeletal fluorosis. This intoxication appeared very quickly if the patient suffered from an even mild renal failure.’5
The difficulty now is that, as the fluoride content is generally not stated on bottles of mineral water and may be inaccurate even when it is, those attempting to avoid fluoridated tap water may not be able to do so.
Dialysis is dodgy
On 30 August 2000, one dialysis patient died and sixteen were hospitalised after being treated at dialysis centres in Youngstown, Ohio, in the United States. It was the latest in a long list of such disasters. Sam Brooks, chairman and chief executive officer of Renal Care Group, which runs the centres, said: ‘They got very ill, were nauseous and throwing up and our medical director immediately shut down the water system because when something like this happens, it’s most likely [the fault of] the water system.’6 The cause of this accident is under investigation, but there have been similar instances in which malfunctions in the dialysis machines, resulting in the patients’ taking in fluoridated water, were found to be the cause. Here are just two.
On 16 July 1993, fluoride poisoning was blamed for the deaths of three dialysis patients at the University of Chicago Hospitals. Spokeswoman Susan Phillips said symptoms suffered by the victims, and by six other dialysis patients who developed symptoms similar to allergic reactions, ‘were consistent with fluoride exposure’. Traces of the chemical were found in patients’ blood and in water samples. As the Chicago Sun-Times noted, water standards in the USA are based on exposure in healthy people to 14 litres per week – but dialysis patients use more than 300 litres per week.7
A dialysis patient died in Annapolis, Maryland, in November 1979. Other dialysis patients suffered cardiac arrest, nausea, hypotension, chest pain, diarrhoea, itching, flushing, vomiting, difficult breathing, profuse sweating, weakness, numbness, and stomach cramping. Water consumers not on dialysis also reported nausea, headache, cramps, diarrhoea and dizziness.8 This was caused by a malfunction of the fluoridation equipment that released fluoride into the drinking water. ‘Even though state and county health officials learned of the spill . . . no public announcement was made and the City Council was not told of the situation for six more days.’ A county health officer said that the delay in notification was because ‘[w]e didn’t want to jeopardise the fluoridation program’.9
Conclusion
Despite the BFS’s cavalier answer, which is either a display of crass ignorance or of wilful deceit, it is no secret that fluoridated water is not ‘safe for everyone to drink’. There is no justification to take chances with a whole population, which includes people who are known to be particularly vulnerable or sensitive to fluoride. No risk is acceptable if it is avoidable.
The BFS is funded by government. Is it not the responsibility of government and health authorities to protect the vulnerable in our society from such unnecessary risks?
1.Juncos LI, Donadio JV. Renal failure and fluorosis, fluorine and dental health. J Am Med Assoc 1972; 222 (7): 783–5.
2.Marier JR. Some current aspects of environmental fluoride. Sci Total Environ 1977; November: 253–65.
3.Drinking water and health. Safe Drinking Water Committee, National Academy of Sciences, US National Research Council, 1977: 380.
4.Toxicological profile for fluorides, hydrogen fluoride, and fluorine (F). US Department of Health and Human Services, Agency for Toxic Substances and Disease Registry, April 1993: 112.
5.Boivin G, Chavassieux P, Chapuy MC, Baud CA, Meunier PJ. Histomorphometric profile of bone fluorosis induced by prolonged ingestion of Vichy Saint-Yorre water. Comparison with bone fluorine levels. Pathol Biol (Paris), 1986; 34: 33–9.
6.Man dies after dialysis treatment: 16 people hospitalized from problems caused at Youngstown center. Akron Beacon Journal, 2 September 2000.
7.Fluoride blamed in 3 deaths: Traces found in blood of U. of C. dialysis patients. Chicago Sun-Times, 31 July 1993.
8.Fluoride linked to death. Evening Capital, Annapolis, MD, 29 November 1979.
9.Middletown, Maryland, latest city to receive toxic spill of fluoride in their drinking water. Townsend Letter for Doctors 1994; 135: 1124–6.