The History of Water Fluoridation, Part One |
Is it true that fluoridation is simply a way for industries to get rid of their toxic waste?
BFS suggested answer
It is not true. Water fluoridation is a proven SAFE AND EFFECTIVE PUBLIC HEALTH MEASURE to reduce tooth decay.
BFS suggested answer refuted
Of course there were also those gigantic financial benefits for the industries who could at least sell a poisonous waste product for stupendous amounts of money.
Dr Hans Moolenburgh
Fluorine
Fluorine (F), a member of the halogen group of elements, is a pale yellow gas. It is never found on its own in nature but always bound to other elements in compounds called fluorides. The three most common sources of fluoride are: calcium fluoride, or fluorspar, a beautiful cubic glasslike crystal, in a variety of colours, found in England, Germany, Iceland, Mexico and Newfoundland (a deep blue variety from which vases and other ornaments are made, found in Derbyshire, England, is called Blue John); cryolite, or aluminium fluoride, found in Colorado, USA, Greenland, Russia and Spain; and fluorapatite, a complex calcium phosphate compound, found in Florida, Tennessee, and South Carolina, USA, South Africa and the West Indies.1 The form of fluoride that is found naturally in fresh water is calcium fluoride.
During the nineteenth century, iron and copper factories’ chimneys belched fluorides into the air, poisoning animals, plants and people.2 The effects were devastating, particularly to agriculture. The first damages were paid in 1855 by iron smelters in Freiburg, Germany. In 1893 damages for injuries from fluoride contamination cost over DM700,000, and by 1900, the very existence of the smelting industry, both in Germany and Great Britain, was threatened.3 By the 1920s, rapid industrial growth meant unimaginable pollution in the USA, Britain and other industrial countries. Medical writer Joel Griffiths explains that ‘it was abundantly clear to both industry and government that spectacular US industrial expansion – and the economic and military power and vast profits it promised – would necessitate releasing millions of tons of waste fluoride into the environment’.4 It didn’t affect just commerce: the armed forces could not function without the tools of war – tools that simply could not be made if the toxic fluoride waste generated could not be disposed of.
The Mellon connection
The American Mellon family founded the Aluminum Company of America (ALCOA), one of the biggest fluoride polluters. When smelting and reducing aluminium, bauxite (aluminium ore) is dissolved in molten cryolite. This releases hydrogen fluoride gas and other volatile compounds into the atmosphere, while sodium fluoride remains in the bath.5 Hydrogen fluoride, or hydrofluoric acid (HF), is so powerful an acid that it even etches glass. Dr Jag Cook, a member of Britain’s National Chemical Emergency Group, which is responsible for dealing with disasters involving toxic chemicals, says, ‘Hydrogen fluoride is about the only chemical that really frightens me.’6 None of these substances could be dumped with impunity into the environment. Their disposal was expensive. It became imperative that industry find a way to eliminate, or at least reduce, these costs.
When the connection between fluorosis and fluoride was first made, American dentists had called for the removal of fluoride from water supplies. But in 1928, Dr Frederick S. McKay observed that teeth affected by fluorosis seemed less susceptible to dental caries.7 Surveys funded by the US public health service, under the direction of the then US Treasury Secretary, Andrew W. Mellon, ALCOA’s founder, appeared to reveal fewer cavities among children living in naturally fluoridated communities.
Public health service dental surgeon and epidemiologist Henry Trendley Dean led one of the three research teams. He became such a fervent researcher at that time that he is now known as ‘the father of fluoridation’. In a major study of twenty-one cities in Colorado, Illinois, Indiana and Ohio, Dean reported that communities which had 0.9–1.4 ppm fluoride in their drinking water had only one-third as much dental decay as cities with less than 0.4 ppm fluoride,8 and suggested ‘the possibility of partially controlling dental caries through the domestic water supply’.9
In 1938, Dr Gerald Cox, a biochemist at the University of Pittsburgh’s Dental School, and colleagues at the Mellon Institute, founded in 1913 to advance science and industry, claimed that fluoride, in small quantities, was not harmful and suggested that ‘[t]he present trend toward complete removal of fluoride from water may need some reversal’.10 Dean had been working with water naturally fluoridated with calcium fluoride, but Cox fluoridated some laboratory rats with sodium fluoride (ALCOA’s waste), concluded that fluoride reduced cavities, and said: ‘The case should be regarded as proved.’ A proposal was aired to add sodium fluoride to the entire nation’s drinking water. While the dose to each individual would be low, ‘fluoridation’ on a national scale would require hundreds of thousands of tons of fluoride annually.
Not surprisingly, industry and the US government strongly supported the Mellon Institute’s recommendation. In 1939, the first public proposal that the US should fluoridate its water supplies was made – not by a doctor, or dentist, but by a scientist working for a company threatened with huge claims for fluoride damage.
In 1950 ALCOA advertised: ‘ALCOA sodium fluoride is particularly suitable for the fluoridation of water supplies . . . If your community is fluoridating its water supply – or is considering doing so – let us show you how ALCOA sodium fluoride can do the job for you.’11
But the ‘waste’ definition was a problem. In 1955 ALCOA denied that sodium fluoride was a waste product of aluminium manufacture. ‘We make no direct sales of sodium fluoride, all of our production being handled through chemical distributors,’ they said, as if the handling by a wholesaler somehow changed the origin of the product.12 Doctors and dentists were persuaded to endorse the new health measure. Having once declared that fluoride was perfectly safe and had a wide margin of safety, it would be difficult for them to do a U-turn later without losing face. Now anyone who opposed this new ‘health-enhancing’ initiative for the benefit of small children could be derided as a quack. Reputable scientists who expressed their concern were listed with convicted felons and the Ku Klux Klan, and open scientific debate was stifled. It was one of the greatest public relations coups of all time.
The first experiment at Grand Rapids
In 1945 Grand Rapids, Michigan, became the first US city to be fluoridated. This was to be the intervention group in a ten-year study, with unfluoridated Muskegon as the control group. The hypothesis to be tested was that ‘a concentration of about 1 part per million of fluoride in the drinking water, mechanically added, inhibits the development of dental caries in the user’.
Dr Philip Sutton of the Dental School of the University of Melbourne did a meticulously detailed review of this study, showing the errors and omissions that invalidated its results.13 For example:
•Water supplies to both populations were not similar.
•The Grand Rapids groups varied in number from 1,806 children to 3 children; in Muskegon, fewer than 20 children were examined in twelve of the categories, and one ‘group’ consisted of just one child.
•Different methods of sampling were used in the two cities.
•The trial was of insufficient duration to measure any change in permanent teeth.
An American Dental Association press release telling of a reduction in tooth decay in Grand Rapids as a result of fluoridation was deceptive advertising – there had also been a similar decline in Muskegon without fluoride.14
The Grand Rapids experiment was supposed to last for ten years to allow sufficient time for health benefits or hazards to be evaluated. In 1946, however, just one year into the experiment, six more US cities adopted fluoridation without waiting for the results. In 1947, eighty-seven more communities were fluoridated. Such haste may seem surprising until we learn that in 1947 an ALCOA lawyer was appointed to head the public health service. He launched a campaign to change fluoride’s image. ‘Almost overnight . . . the popular image of fluoride – which at the time was being widely sold as rat and bug poison – became that of a beneficial provider of gleaming smiles, absolutely safe, and good for children, bestowed by a benevolent paternal government. Its opponents were permanently engraved on the public mind as crackpots and right-wing loonies,’ writes Griffiths.
There were several other trials in the USA and Canada. There are marked deficiencies and omissions in the compilation and reporting of data in all.
Newburgh, to be fluoridated with sodium fluoride, and unfluoridated Kingston are two cities about thirty miles apart in New York State. They were said to be comparable in all ways, including water supplies. But an analysis of the two cities’ water supplies, carried out by the US Geological Survey, showed them to be of quite different composition: Newburgh’s water contained nearly six times as much calcium and four times as much magnesium as Kingston’s water. Calcium and magnesium are known to mitigate the effects of fluoride. Different methods of data collection and result presentation were used. There were changes in examiners and statisticians. There was uncertainty about population shifts in both cities.
In 1956 the study’s final report found in favour of fluoride.
In May 1989, Dr J.V. Kumar and colleagues at the New York State Department of Health published a follow-up study that revealed that dental decay declined in both Newburgh and Kingston.15 The difference in terms of DMFT for 7- to 14-year-old children was less than one tooth. And by 1995, the average number of DMFTs in Kingston, which was still unfluoridated, was slightly better than in fluoridated Newburgh – and Kingston had only half the level of dental fluorosis.16
Fluoridation marches on
The McCarthy era after World War II saw witch-hunts to uncover ‘communists’ within American society. Those who questioned the benefits of fluoride were now branded not just as quacks, but as left-wing subversives.
By 1950, fluoridation’s image was a sterling one, and there was not much science could do to stop it. The public health service, established to protect the health of US citizens, was caught in a trap of its own making: having publicly promoted fluoride and funded it with taxpayers’ money, the health authorities risked losing face if fluoridation were found to be unsafe and ineffective and laws were repealed, since scientists, politicians, dentists and physicians unanimously supported fluoride.17 Consequently, proper studies concerning the effects of fluoride were not undertaken. Dr George Waldbott summed up the situation when he said that from the beginning, the controversy over fluoridating water supplies was ‘a political, not a scientific health issue’.18
Disinformation and ‘Newspeak’
Leading those who were pushing for universal fluoridation at that time was a Wisconsin dentist, J.J. Frisch. Frisch, with the support of Frank Bull, director of dental education for the Wisconsin State Board of Health, organised political campaigns to persuade local government officials to approve fluoridation. They successfully lobbied the American Dental Association and the United States public health service and, with the support of these bodies, removed any doubts that the public might have had about this new ‘wonder drug’. In 1950, long before any studies into the safety or efficacy of fluoridating drinking water had been carried out, fluoridation of drinking water was deemed beneficial and safe.
At a conference in Washington, DC, in 1951, Dr Bull gave a keynote speech about how to get fluoridation accepted and discredit any opponents. Bull talked about the terminology to be used by pro-fluoridationists. They were to overcome the problem of dental fluorosis by calling it ‘eggshell teeth’, ‘the most beautiful looking teeth that anyone ever had’. ‘Artificial fluoridation’ was to become ‘controlled fluoridation’, and they should never use the word ‘experiment’. ‘In Wisconsin’, Bull said, ‘we set up “demonstrations”. They weren’t experiments.’ On adverse effects of fluoride, Bull said:
Now in regard to toxicity – I noticed that Dr Bain used the term ‘adding sodium fluoride’. We never do that. Sodium fluoride is rat poison. You add fluorides. Never mind that sodium fluoride business . . . If it is a fact that some individuals are against fluoridation, you have just got to knock their objections down. The question of toxicity is on the same order. Lay off it altogether. Just pass it over. ‘We know there is absolutely no effect other than reducing tooth decay,’ you say and go on.19
Bull knew that fluoride caused cancer – and covered it up. Later he said: ‘With regard to cancer, when this thing came out we never mentioned it in Wisconsin.’ Bull’s speech revealed the key emphasis of fluoride promotion – they were not to use the scientific evidence, only propaganda.
Not long after this conference, a number of symposia were held. A notable one, set up by the American Association for the Advancement of Science in 1952, had in its preface: ‘The eminent qualifications of each of the chapter authors should be sufficient evidence as to the high caliber and unbiased authenticity of the content.’20 All participants, however, were fervent supporters of fluoridation. No-one opposed to fluoride was allowed to take part.
The Commission on Chronic Illness endorsed the recommendations. It is significant that the chairman of this committee was the same man – K.F. Maxcy, professor of public health at Johns Hopkins University, Baltimore, Maryland.21
The National Academy of Sciences and the National Research Council
The US National Research Council committee that considered fluoride, also chaired by Professor Maxcy, had nine members. These included three other scientists with close connections with fluoride-promoting industries: H. Trendley Dean, who had supplied much of the data on which fluoridation was based – hardly an impartial observer; B.G. Bibby, director of the Eastman Dental Dispensary of Rochester, New York, who had done research for the Sugar Research Foundation, Inc.; and F.F. Heyroth, assistant director of the Kettering Laboratory, which was financed by ALCOA. Their ‘evidence’ that fluoridation was harmless was that three million people had been drinking naturally fluoridated water for generations!22
The American Medical Association is duped
In 1943 F.J. McClure, a biochemist working for the National Institute of Dental Research, estimated that the typical American diet contained 0.3–0.5 mg fluoride. McClure acknowledged that excess fluoride could have adverse side effects when he wrote: ‘The data suggest that these [4.0–5.0 mg fluoride daily] may be the limits of fluorine which may be ingested daily [by healthy adults] without an appreciable hazard of body storage of fluorine.’23 Nevertheless, in 1951, McClure convinced the American Medical Association’s Council on Pharmacy and Chemistry, as well as its Council on Foods and Nutrition, that adding fluoride to drinking water was not hazardous.24
A third of the AMA delegates did vote against fluoridation. But an ‘endorsement in principle’ was passed, and this was taken to mean that the AMA supported fluoridation without reservation. With AMA backing, there was no stopping fluoridation. All who opposed fluoridation were shouted down. A member of the US House of Delegates wrote to Dr Waldbott in 1957: ‘To oppose fluoridation openly is political suicide’ – a situation that, sadly, still obtains today.
WHO endorsement of fluoridation
In 1958 the WHO set up a committee to look at fluoridation. The deck was already stacked, as five of the committee’s seven members had promoted fluoridation in their respective countries. Research documenting poisoning from fluoridated water was rejected. Yet WHO did not endorse fluoridation at that time.
Despite cautions from G. Penso of the Italian delegation, who warned about ‘possible genetic damage to future generations’, in 1969 a motion to ‘examine the possibility of introducing fluoridation’ where ‘fluoride intake is below optimum levels’ was carried at the end of business, when only 45 of the 1,000 delegates were present.25 There was also a request to the director-general of the WHO to ‘continue to encourage research into the etiology of dental caries, the fluoride content of diets, and into the effects of greatly excessive intake of fluoride from natural sources’.
In 1975, a report was presented to the 28th World Assembly.26 The report is notable in that it is little more than propaganda for fluoridation. The fundamental question of what level, if any, of fluoride ingestion is optimal was ignored. Despite this, the WHO began a programme to promote fluoridation of water supplies.
Fluoride comes to Britain
In Britain, there were also studies that purported to demonstrate that fluoride in the water resulted in a reduced incidence of decay. Hartlepool,27 a town whose drinking water contained a naturally occurring fluoride level of 2 ppm, was compared with York, which was not fluoridated. The lower incidence of dental caries in Hartlepool was ascribed to the fluoride in its water supply.
Throughout any country, it is not difficult to find a variety of levels of tooth decay in both fluoridated and unfluoridated areas. If one picks a fluoridated area with a low level of tooth decay and an unfluoridated area with a high level, disregarding any other differences between them, it is not difficult to ‘prove’ that fluoride prevents caries.
But there are several comparable districts, fluoridated and unfluoridated, where levels of carious teeth are the same. Gateshead and Liverpool are demographically quite similar, and both have 1.85 carious teeth per child. But Gateshead is 100 per cent fluoridated, whereas Liverpool is unfluoridated.
So when comparing towns like Hartlepool and York, one has to look more closely at other possible confounding factors. Doing this, we find that in the 1960s, when the study was conducted, the biggest employer in York was the sweets manufacturer Rowntree. Rowntree’s employed a sizeable proportion of the city’s population. Not only were its workers allowed to eat as much confectionery as they wished while they were at work, they were also allowed to collect all the bits left over at the end of the week to take home. Thus, it is likely that their friends and relatives also had a higher intake of sweets than most. It is just as likely, therefore, that the reason York had a higher dental decay rate than Hartlepool was simply its greater intake of caries-causing sweets.
The British learn from America
Britain had sent a team of four dentists to the USA during the early part of 1952 to look at their studies.28 When they returned to the United Kingdom, all were fervent supporters of fluoridation.
Enoch Powell was the first British Minister of Health to recommend the fluoridation of public water supplies, saying: ‘There are no authoritative criticisms of fluoridation.’ But many British scientists were against its introduction in Britain:
•Dr Hugh Sinclair, fellow of Magdalen College, Oxford, was concerned in 1963 about the ‘entirely new principle that the public should in general be forced to consume something believed by the government to be good for them’.29
•The British Medical Association’s chief press officer in 1964 stated: ‘The British Medical Association regard fluoridation as a preventive medical treatment.’ But as Lord Douglas of Barloch pointed out: ‘Doctors are not permitted by our laws to operate on patients or to force drugs on patients against their will. If our law does not permit this, why should it be considered right for a water supply authority to put drugs in the water supply, which admittedly are of no value if consumed by the adult population and which cannot be proved to be safe.’
People in the know didn’t want fluoride, and most others were suspicious. Nevertheless, in the 1960s and 1970s, proponents managed to get water companies to fluoridate the water supplies to a total of about 9 per cent of English residents.
Scotland
Fluoride has never been accepted in Scotland, and English laws do not apply there. In a landmark legal case brought against the Strathclyde Regional Council in 1983, Lord Jauncey ruled that water fluoridation was medicinal and therefore unlawful.30 While this judgement applied only to Scotland, it set a precedent for the rest of the United Kingdom. So in 1985, the Conservative government changed the law. However, since that change no new fluoridation project has been started. At a judicial review in the High Court over the refusal of Northumbrian Water Plc to fluoridate its water supply in 1998, Justice Collins ruled that Northumbrian Water ‘is perfectly entitled to refuse to fluoridate’.31 This is the present situation.
Ireland
All natural sources of water in Ireland are low in fluoride. This was a golden opportunity for the US public health service to ‘improve’ the situation by introducing artificial fluoridation to the Irish. Funded by the US public health service, the Irish fluoridation law was passed in 1960 with almost no public consultation. A legal challenge in 1963 failed in the High Court, and subsequently in the Supreme Court. The government legal team defending fluoridation was helped by US government agencies.32
Fluoridation started in 1964, and the Republic of Ireland is now probably the most fluoridated country on earth. Today, 75 per cent of public water in Ireland is fluoridated with hydrofluorosilicic acid imported from The Netherlands – a country in which water fluoridation is banned.
Fluoride is a US export flop
Since the inception of fluoridation in the USA, its advocates have attempted to get fluoride accepted throughout the world. Yet despite the apparently overwhelming enthusiasm for fluoridation in the USA, the rest of the world has not been so easy to fool, and acceptance of this ‘health’ measure outside the USA has been decidedly limited.
During the 1950s and 1960s, the United States public health service gave millions of American taxpayers’ dollars to Western European countries, including the United Kingdom, Ireland, Australia, New Zealand and Canada, in a huge push to promote fluoridation. UK and Irish institutions received at least the following sums:33
|
1958 |
1960 |
1963 |
Ireland |
$19,078 |
$62,250 |
$78,730 |
UK |
$232,035 |
$900,048 |
$2,751,215 |
Poster campaigns proliferated in hospitals, doctors’ and dentists’ surgeries, libraries, schools and work canteens. Yet despite this effort, most of continental Europe dismissed fluoride outright, and of those countries that tried it, almost all have given it up, and some have banned it outright (see Chapter 27).
Conclusion
A more truthful answer to this question would be: Yes. It is precisely because industry had a vexing and costly toxic-waste problem that fluoride began to be put in tap water. The fluoride compounds used to fluoridate drinking water do not include naturally occurring calcium fluoride. They are not ‘simply the fluoride ion in water’; they constitute a complex cocktail of toxic substances that most countries have labelled as hazardous air pollutants.
1.Waldbott GL, in collaboration with Burgstahler AW, McKinney HL. Fluoridation: The great dilemma. Lawrence, KS: Coronado Press, 1978: 21–2.
2.Griffiths J. Fluoride: Commie plot or capitalist ploy. Covert Action 1992; 42: 27.
3.Ost H. The fight against injurious industrial gases. Z Angew Chem 1907; 20: 1689–93.
4.Griffiths J. Fluoride: Commie plot or capitalist ploy. Covert Action 1992; 42: 28.
5.Davenport SJ, Morris GG. US Bureau of Mines Circular No. 7687. US Department of the Interior, June 1954: 8.
6.Cook J. Quoted in Townson N, Campbell D. Deadly risks of lead-free petrol. New Statesman, 20 October 1988.
7.McKay FS. Relation of mottled enamel to caries. J Am Dent Assoc 1928; 15: 1429–37.
8.Dean HT. Epidemiological studies in the United States. In: Moulton FR, ed. Dental caries and fluorine. Washington, DC: American Association for the Advancement of Science, 1946.
9.Dean HT. Endemic fluorosis and its relation to dental caries. Public Health Rep 1938; 53: 1443–52.
10.Griffiths J. Fluoride: Commie plot or capitalist ploy. Covert Action 1992; 42: 28.
11.J Am Water Works Assoc 1950; 43 (6).
12.J Am Dent Assoc 1955; 51: 373.
13.Sutton PRN. Fluoridation: Errors and omissions in experimental trials. Melbourne University Press: Melbourne, 1959.
14.Maxcy KF, Appleton JLT, Bibby BG. Report of the Ad Hoc Committee on Fluoridation of Water Supplies. Publication No. 214, National Academy of Sciences/US National Research Council, 1952.
15.Kumar VK, Green EL, Wallace W, Carnahan T. Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, New York. Am J Public Health 1989; 79: 565–9.
16.Kumar JK, Swango PA, Lininger LL et al. Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York. Am J Public Health 1998; 88: 1866–70.
17.Morning Call, Allentown, Pennysylvania, 7 February 1990.
18.Waldbott GL, in collaboration with Burgstahler AW, McKinney HL. Fluoridation: The great dilemma. Lawrence, KS: Coronado Press, 1978: 255.
19.Proceedings of the Fourth Annual Conference of State Dental Directors with the Public Health Service and the Children’s Bureau, Federal Security Building, Washington, DC, USA, 6–8 June 1951.
20.Shaw JH, ed. Fluoridation as a public health measure. Washington, DC: American Association for the Advancement of Science, 1954: iv–v.
21.Maxcy KF et al. Report of the Ad Hoc Committee on Fluoridation of Water Supplies. Publication No. 214, National Academy of Sciences/US National Research Council, 1952.
22.Waldbott GL, in collaboration with Burgstahler AW, McKinney HL. Fluoridation: The great dilemma. Lawrence, KS: Coronado Press, 1978: 276.
23.McClure FJ, Mitchell HH, Hamilton TS, Kinser CA. Balances of fluorine ingested from various sources in food and water by five young men. Excretion of fluorine through the skin. J Ind Hyg Toxicol 1945; 27: 159–70.
24.American Medical Association Councils on Pharmacy and Chemistry and Foods and Nutrition: Fluoridation of water supplies. J Am Med Assoc 1951; 147: 1359.
25.WHO. Resolution of the World Health Assembly: Fluoridation and dental health. WHO Chronicle 1969; 23: 512.
26.Barmes DE, Infirri SJ. WHO activities in oral epidemiology: Global Oral Epidemiology Data Bank. Community Dent Oral Epidemiol 1977; 5(1): 22–9.
27.Murray J. Adult dental health in fluoride and nonfluoride areas. Br Dent J 1971; 131: 437–42.
28.Forrest JR, Longwell J, Stones HH, Thomsom AM. The fluoridation of domestic water supplies in North America as a means of controlling dental caries. London: HMSO, 1953.
29.Oxford Times (United Kingdom), 15 February 1963.
30.Lord Jauncey (1983): Opinion of Lord Jauncey in Causa Mrs Catherine McColl (AP) v Strathclyde Regional Council, The Court of Session, Edinburgh, 29 June 1983.
31.Judicial review sought by Newcastle Upon Tyne Health Authority, November 1998.
32.Waldbott GL. A struggle with titans. New York: Carlton Press, 1965.
33.Public Health Service, Grants and Fellowships. US Dept. of HEW, PHS, Publ 621 (1958); Publ 777, PT1 (1960); Publ 1075 PT1 (1963).