The Damage Is Done BEHIND A CLUTTERED desk at the Newburgh Free Academy, under a portrait of Coretta Scott King, nurse -practitioner Audrey Carey daily performs physical exams on students at the large public school, which has 2,500 children in grades ten through twelve. The former mayor is in a unique position to see some of the health effects from her community s long experiment of adding fluoride to water supplies. Fifty years earlier, Dr. Harold Hodge had assured local citizens that the Newburgh experiment had proved water fluoridation safe and had urged it upon the entire country. Health hazards do not justify postponing water fluoridation, he had told Congress in '95 4 1 The Hudson Valley town quickly became the poster child for a global sales effort. Newburgh s smiling youngsters were paraded before scientists from the United Kingdom, New Zealand, and the World Health Organization. 2 And, for six days in 1963 Dr. Hodge sang Newburgh s praises before the Supreme Court in Dublin, prescribing mandatory fluoridation for Ireland. 3 Ireland, and several other countries, swallowed his story. But today, back in Newburgh, Audrey Carey is no longer certain. The most visible effects from fluoride in Newburgh water are not fewer cavities, but instead the high rates of speckled and mottled teeth. Careys friends and family, among many others in the community, have this condition, which is known as dental fluorosis. And after fifty years Newburgh children have virtually the same amount of dental decay as their counterparts in the neighboring town of Kingston, which was the control city in the original experiment. 218 CHAPTER SEVENTEEN Kingston has resisted all efforts in subsequent years to add fluoride to its water supply. But following Newburghs fluoridation, the rate of fluorosis was always higher there than in Kingston, and during the 1990s it rose again. Fluorosis also occurs more frequently in African American children, according to recent surveys done by the New York Department of Health.' I see the mottling that occurs, mainly in poor children, Carey told me. She also sees it in her own family: both her grandchildren have dental fluorosis. Although their mother is now very careful in reading the products she buys, to make sure that there is no fluo ride, Carey believes that the damage is done. Medically, it looks very bad for them," she says. "I am not sure what other physical effects they may have, or defects for that matter. Newburghs legacy of mottled teeth is shared by much of the rest of the country. Today, many dentists face a disturbing dilemma. Dental decay is still a serious and painful problem, especially in the inner city and even in fluoridated areas, where children are often trapped in a crossfire of poverty, poor nutrition, and a woeful public provision of dental care.' In some American cities as many as 3 out of every 4 children have dental fluorosis, and simply adding fluoride to public water supplies may have reached the end of the road as an easy proposal for fixing bad teeth.' The dental researcher Dr. Hardy Limeback, of the University of Toronto in Canada, is so concerned about the dangers of fluorosis that he claims fluoride toothpaste should be a prescription drug — at least until a child can spit, after the age of three. And even spitting is not foolproof; fluoride is absorbed directly into the body through the oral mucosa, notes Limeback. Poor nutrition can also raise the likelihood of dental fluorosis.' And if there is fluoride in the water supply, fluoride toothpaste may further increase the jeopardy. "Physicians have to get involved, Limeback insists. Before prescribing fluoride toothpaste, "you have to figure out, is this kid at risk for dental fluorosis? Better food, regular brushing and flossing, access to a dentist, and using nonfluoride toothpaste may be required. You can get perfectly healthy teeth with resistant enamel without having any kind of fluoride exposure, notes Limeback. (His son has dental fluorosis, and Limeback no longer keeps fluoride toothpaste in his home.) THE DAMAGE IS DONE 219 Newburgh Mayor Careys concern that dental fluorosis may signal more serious health problems is also warranted. We are now bathed in fluoride from cradle to grave, from industrial, dental, and a multitude of other and sometimes unexpected sources.' But the health implications of such long-term fluoride ingestion remain woefully underexamined. Dental fluorosis is a bio-marker for systemic fluoride poisoning during early childhood, notes Dr. Limeback. Teeth are windows to the rest of the body, adds Paul Connett, a chemistry professor and antifluoride campaigner at St. Lawrence University in New York, who likens the symptomatic nature of dental fluoro-sis to the thin blue gum line that can indicate lead poisoning.' Yet when scientists peer behind the polished facade of row upon row of brilliantly shining teeth to explore whether fluoride may be injuring us in other ways, they often get a rude surprise. In 1992 Dr. Joseph Lyon of the University of Utah coauthored a study published in the Journal of the American Medical Association which found that water fluoridation was associated with an increased risk of hip fracture.' He was stunned at the lack of interest shown by U.S. public-health agencies in the study s results, and he has since found it difficult to get additional funding to further research this issue, he says. Today the United States has one of the highest rates of hip fracture in the world and is witnessing an epidemic of arthritis in 21 million Americans." Yet doctors are as likely to blame fluoride as flying saucers. My sense is there has been very little attention paid to toxicity, said Dr. Lyon. Almost on the grounds that it is an impossibility, and it is a waste of everybody s time and money to even think about it. (Subsequent studies have found similar associations between fluoride in water and bone fractures)." It is not just the elderly who are at risk. Fluoride may be weakening young peoples bones as well. In 2001 a study in Mexico reported that dental fluorosis was correlated with a higher incidence of bone fractures in children.' In the United States we now pay an annual half-billion-dollar hospital tab as a result of 775,000 childhood sports injuries. Although more young people are now playing sports — particularly girls, who have a high incidence of knee and ankle injuries — Dr. Lyon wonders whether the white, chalky blotches seen on teeth also predict the likelihood of a juvenile sports injury.' Is there some association [between childhood sporting 220 CHAPTER SEVENTEEN injury and] living in a fluoridated area? he asked. There would be a plausible physiologic basis for it. The assurances that drinking fluoride for a lifetime would be harmless flowed strongest from Dr. Hodge s cold war laboratory at the University of Rochester. In 1954 he had poured oil on the troubled waters of the growing citizens movement opposing fluoridation — telling Congress that it would require ingesting 20-8o milligrams of fluoride each day for ten to twenty years before injury would occur. After hearing Hodge, Congress rejected the appeals to ban water fluoridation (see chapter 11). In the late 198os, however, two antifluoride activists, Martha Bevis and Darlene Sherrell, questioned the data Hodge had given Congress. By then Hodges numbers had mutated further and were now being draped by fluoride promoters over all possible adverse chronic health effects. The American Dental Association (ADA) stated in a pamphlet that the daily intake required to produce symptoms of chronic toxicity after years of consumption is 20 to 8o milligrams or more depending on weight. 15 It was a plain falsehood. Sherrell wrote to the National Academy of Sciences (NAS) asking where the numbers had come from. This dogged researcher spotted that even Hodge had changed his data. Hodge stated in 1979 that io mgs of fluoride a day — not 20 — would cause crippling fluorosis.' Hodge had given no accompanying explanation for why he had halved his estimate. In any case, the government and the ADA ignored Hodge s correction; they continued to use his higher estimate of the amount of fluoride one could safely consume in a day, even though Hodge himself had repudiated it.' It was only with the help of Florida's Senator Bob Graham that Sherrell won a response in 1990 from the NAS, to whom she pointed out the error. The persistence of the citizen activist paid off. Three years later, in 1993 the NAS National Research Council (NRC) published yet another fluoride report, entitled Health Effects of Ingested Fluoride. This time, although there was no accounting or apologizing for the forty years of false reassurances, the numbers were quietly corrected. Crippling skeletal fluorosis, the NRC stated, might occur in people who have ingested 10-20 mg of fluoride per day for 10-20 years.' THE DAMAGE IS DONE 221 It was an astonishing state of affairs. Two citizen activists, neither of them scientists, had torn away the flimsy garment that had concealed a half-century of scientific deception. The corrected 1993 NRC figures laid bare the facts: countless thousands of Americans have been exposed to dangerous levels of fluoride throughout their lives. In particular, the generation of baby boomers who have ingested a lifetime of fluoridated water and might more accurately be called Hodges Generation, may be suffering a variety of musculoskeletal and other health ailments that can be traced back to the toxicologist's false promise that fluoride in water was safe. The whole thing is bogus, explained the former EPA and U.S. Army scientist Dr. Robert J. Carton. In 1985 he got a close look at what he calls the dangerous joke at the heart of the government s fluoride policy and the very real likelihood that fluoride is injuring our bones. That year EPA scientists, including Carton, were asked to set a new and higher national level for the publics permissible exposure to fluoride in drinking water. Until the EPA review Carton had not been aware the subject was controversial. I was just like everybody else, said Carton, it was a no-brainer — fluoride is completely safe and effective, all that kind of stuff. Under Reagan-appointee administrator William Ruckelshaus, EPA senior management had proposed raising the safe permissible level of fluoride in drinking water from 2.3 mg to 4 mg. They had a simple way of justifying this. The blotchy teeth — dental fluorosisproduced by as little as 1 mg of fluoride per liter, which worsened greatly and grew more brittle at 4 mg per liter, were deemed a harm-less "cosmetic" side effect. And despite the voluble protests of Car-ton, fellow EPA scientist Dr. William Hirzy, the Natural Resources Defense Council, and the EPA's employee union — Local 2050 of the National Federation of Federal Employees — the new national standard was approved. The EPA got away with it, says Carton — but only at the price of embarrassing its staff as professional scientists and jeopardizing the nations health. As Carton explains it, even according to the EPA's own figures, 3 percent of the population drink more than five liters of water a day. If that water contains 4 mg of fluoride — the supposedly safe new standard — then those thirsty people will cross the threshold at which even the EPA admitted severe health effects 222 CHAPTER SEVENTEEN were likely to occur. You basically have a standard that, based on their own information, shows it is going to cause crippling skeletal fluorosis, says Carton. Of course, the 1993 revised estimate by the National Academy of Science for how much fluoride can cause crippling skeletal fluorosis is not 20 mg, but 10 mg. That means that the EPA standard is way off and would permit crippling bone injuries in a very great many people. They are really causing problems, Carton said. Moreover, the crippling fluorosis estimate specifies a limited time period of ten to twenty years for crippling fluorosis to appear. But fluoride is a poison that accumulates in the body over a lifetime. What happens when you get 10 mg a day for forty or sixty or even eighty years? In that case, you still reach the levels that cause crippling skeletal fluorosis, but at a later age. This simple consideration was not even addressed in the EPAs new exposure standard, says Carton, now retired. None of it makes sense. All you have to do is look at it for ten seconds and it falls apart, he concludes. Bone defects possibly linked to fluoride had been noticed at New -burgh back in 1955, after just ten years of water fluoridation. A radiologist, Dr. John Caffey of Columbia University, called the defects striking in their similarity to bone cancer. They were detected on X-rays and seen more than twice as frequently among boys in Newburgh as among boys in nonfluoridated Kingston. Caffe ys cancer suspicions, however, were not discussed in the 1956 Newburgh Final Report. In 1977 a National Academy of Sciences panel took a second look at Dr. Caffey's report, which had been published in 1955. The Newburgh cancer clue had "never been followed up," the experts said. "It would be important to have direct evidence that osteogenic sarcoma [bone cancer] rates in males under 30 have not increased with fluoridation," the panel stated' Also in 1977 Congress discovered that despite a quarter-century of endorsing water fluoridation, federal health authorities had never cancer-tested fluoride. When cancer tests were finally performed twelve years later, it was found that fluoride caused excess bone cancers in young male rats. The government concluded that the results showed equivocal evidence that fluoride was a carcinogen." In truth, fluorides link to cancer may have been much stronger than authorities conceded. The above-mentioned tests also THE DAMAGE IS DONE 223 showed increased liver cancers in rats, but both the bone and liver cancer evidence was systematically downgraded, according to Dr. William Marcus, chief scientist at the EPAs Division of Water Quality." After Dr. Marcus aired those allegations in an interview on ABC News, he was fired (for supposedly unrelated reasons). But a federal judge later ruled that Marcus had been terminated because he had publicly questioned and opposed EPAs fluoride policy. The toxicologist was reinstated, and the government was ordered to pay damages. 24 Since then additional epidemiological studies have found more cancer in fluoridated areas, especially bone cancer in young men. 25 Even the verdict of "equivocal" carcinogen is disturbing. Maybe fluoride doesn't cause cancer, but maybe it does. Is it worth the risk? How many cavities would have to be saved to justify the death of one man from osteosarcoma? asked the late Dr. John Colquhoun, the former chief dental officer of Auckland, New Zealand, and a fluoride promoter turned critic. 26 Harold Hodge had also reassured American families about fluoride while secretly worrying about the chemical s effects on the central nervous system of nuclear workers. Today central-nervous-system illnesses shadow our young and old alike, with an epidemic of attention deficit and hyperactivity disorder (ADHD) in children, and with 4.5 million elderly citizens who are diagnosed with Alzheimer s dementia. The increase in Alzheimer s in the United States is largely attributed to the aging of the population, but "environmental" causes are also blamed. Does fluoride play a role in causing the disease? Quite possibly: In 1992 the American scientists Robert Isaacson, Julie Varner, and Karl Jensen found that fluoridated water carried aluminum into rat brains, producing Alzheimer's-like changes in brain tissue. 27 Phyllis Mullenix, who gave laboratory mice moderate doses of fluoride and generated symptoms resembling ADHD, fears that the high incidence of both diseases in the general population is direct evidence of fluorides toxic effects and that both the number and kind of such injuries may worsen in the coming years. I think we are going to see a lot more neurological problems that currently have no answers, Mullenix said. Extremes of behavioral problems are going to start showing up. There will be more children 224 CHAPTER SEVENTEEN and people with unexplained convulsions, more unexplained cases of Alzheimer s and that kind of thing. There were other data on Newburgh s health that warranted concern. In the 1956 Newburgh Final Report, researchers noted that young women in Newburgh reached puberty at an earlier age than did girls in nonfluoridated Kingston. Laboratory experiments have recently reproduced similar fluoride effects in gerbils.' In other words, fluoride has the ability to impact the female reproductive system and may be lowering the age at which women are reaching puberty. And following the introduction of fluoride into city waters, Newburgh's heart-disease rate was found by researchers to be one of the highest in the United States, another fact missing from the official Final Report. 29 Heart disease also doubled just five years into the nation's other early fluoridation experiment, in Grand Rapids, Michigan. Fluoride concentrates in the arteries, attracting calcium, and can contribute directly to their hardening, according to scientists. 30 The folly of adding fluoride to water supplies in a nation so burdened by heart disease would seem obvious. Mayor Carey now sees the 1945 "demonstration project in her hometown in a very different light. "The more I read and the more I listen, the more I understand that we were subjected to experimentation," Carey stated. The newly uncovered Manhattan Project documents about Newburgh suggest to Carey that her townspeople were not told the truth about the 1945 fluoride experiment. What happened to all of the samples that they took from me as a child?" she asked. Where did they end up? What were they taken for? Certainly it wasnt for preventative health care. Today some dentists are shocked to learn that a classic bait and switch was pulled on the public and on health professionals alike regarding the chemicals used in fluoridation. Pure sodium fluoride was used for the early Newburgh and Grand Rapids experiments, but today 90 percent of fluoridated public water supplies in the United States use not pharmaceutical-grade fluoride but industrial-grade silicofluoride "scrubbed" from the smokestacks of the Florida phosphate industry.' Important long-term toxicity tests have never been performed on these silicofluorides, although some studies have associated the chemical with higher levels of blood lead in children who live where they are used for fluoridation. Silicofluorides also THE DAMAGE IS DONE 225 frequently contain arsenic at levels that may present a risk of cancer, according to data from the National Academy of Sciences.' "You are sticking this poison into the water supply supposedly to prevent dental disease. It is not even doing that — and you are causing cancer just from the arsenic alone. This is totally criminal," argued the University of Toronto s Dr. Limeback. Even the Paley Commissions long-ago predictions that these silicofluorides produced by the Florida phosphate industry would become an important and valuable source of industrial fluoride have not come to pass (see chapter 11). Today most industrial fluoride used in the United States is the raw mineral fluospar, now mined and imported from China. 33 For now, absent trouble with the Chinese and with a low price of fluorspar on world markets, silicofluoride waste from the Florida phosphate production is not used as an industrial raw material; rather, it is collected, billed to the taxpayer, and dumped into public water supplies around the country — all under the guise of protecting children s teeth." Whether a dentifrice, pollution-control measure, or cold war national security blanket, EPA chemist Dr. William Hirzy put the loony logic of such dumping of industrial silicofluorides this way: If this stuff gets out into the air, its a pollutant; if it gets into the river, its a pollutant; if it gets into the lake, its a pollutant; but if it goes right straight into your drinking water system, its not a pollutant. Thats amazing! While much of the medical profession in the United States remains ignorant about fluorides potential for harm, there are exceptions. Since 1968, scientists at the International Society for Fluoride Research (ISFR) have catalogued fluorides impact on human health and the environment. In scores of peer-reviewed papers, their journal Fluoride has linked the chemical to multiple human-health effects, including thyroid problems, Downs Syndrome, arthrititis, central-nervous-system effects, cardiovascular problems, and breathing difficulties." George Waldbott — who founded ISFR — believed that fluoride's ability to wreak such biological havoc was a function of its basic nature. Although the exact mechanism of action was then unknown, Waldbott speculated that fluoride buried deep into different organ systems and then disrupted the numerous chemical systems (such as enzymes) that regulate life. 226 CHAPTER SEVENTEEN Waldbott may have been right. Enzymes are spectacularly sensitive to fluoride. In files that were only declassified in the mid-1990s it was revealed that in 1944 Harold Hodge's bomb-program researchers at the University of Rochester had experimented with hog liver enzymes to measure fluoride pollution in bomb factories. Fluoride was so much more toxic to the esterase enzyme than uranium that contamination by fluoride and uranium could easily be differentiated. And twenty years after George Wald-boa's death scientists may be on the brink of unlocking a crucial cellular mechanism for how fluoride acts on our bodies. That detective story has a disturbing twist. The aluminum industry has spilled a great deal of fluoride into the environment in the last century and has been closely associated with efforts to promote water fluoridation. Ironically, it may be that aluminum combined with fluoride is especially responsible for fluoride s toll on health and the environment. In 1994 the American scientists Alfred G. Gilman and Martin Rodbell won the Nobel Prize for discovering the importance of G-proteins in biology. The protein molecules act as biological amplifiers or relay stations, converting information received at a cells surface and producing changes inside that cell. For example, when we are angry, the adrenal gland produces the adrenaline hormone. When the hormone reaches the liver or the heart, the G-protein is activated, telling the organ to produce extra energy. The bad news is that G-proteins are easily fooled by aluminum and fluoride, which gang up violently and at a molecular level on our bodies, double-teaming for extra effect, according to the Czech scientist Anna Strunecka, a researcher at King Charles University in Prague. In an abstract titled Fluoride and Aluminum: Messengers of False Information, Strunecka reports: It appears probable that we will not find any physiological process which is not potentially influenced by [alumino-fluorides]. 37 She added, The synergistic action of fluoride and aluminum in the environment, water and food can thus evoke multiple pathological symptoms. The dangers of pumping fluoride and aluminum into our environment, and our duties to future generations are clear, according to the scientist. An awareness of the health risks of this new eco-toxicological phenomena ... would undoubtedly contribute THE DAMAGE. IS DONE. 227 significantly to reducing the risk of a decrease in intelligence of adults and children, and many other disorders of the twenty-first century, noted Strunecka. The Strange Case of the Missing Debaters THE POTENTIAL NUMBER of fluoride-linked health issues may be enormous." But the willingness of scientists to confront them is not. Fifty years of state propaganda have left too many scars and phobias. In the spring of 2001 scientist Tom Webster attempted to organize a debate about water fluoridation — and was unable to find anyone willing to speak in defense of the chemical. The Boston University environmental health professor had first grown curious about fluoride in the early 1990s, when his scientist friend Paul Con -nett had confided that he was worried about the potential negative health effects from small doses of fluoride to which Americans are regularly exposed. At first Webster himself had been dismissive about the issue of fluoride. My knee-jerk reaction was, "Oh man, what are you getting involved in that stuff for? They are all nuts, - he said. But then I stopped myself, and I said, Well, you know, I actually dont know anything about this. All I could remember was the Dr. Strangelove image and the John Birch Society. Their two big issues were get the U.S. out of the UN and stop water fluoridation. The more I thought about it, the more I thought, Here I am in the public health profession, I teach about this stuff, and I don't know anything about fluoride," he remembers. "It turns out there is a huge literature on this which I would never have guessed a couple of years ago. The professor was baffled. He did not know what to make of the gulf between the nice things the government said about fluoride and the worries of scientists such as Paul Connett. 39 He was especially perturbed by a study he read by a Dr. Phyllis Mullenix showing central-nervous-system effects in rats. "Is this bad?" he said. "My gut reaction was that I dont really like the sound of this. So Webster scheduled the fluoridation debate. He had joined a new group called the Association for Science in the Public Interest (ASIPI). The members were all professional scientists who had grown concerned that research was too often disconnected from 228 CHAPTER SEVENTEEN the public interest. Now, as he scrambled to organize a debate at the groups first national conference in May 2001, Webster was scratching his head. Phone call after phone call, letter after letter, he got the same banged-door rejection from profluoridationists. He felt that many of their dismissals had a mechanical, Stepford-wife similarity that almost sounded as if they were reading from a common script. Several respondents had even been quite rude. I got a couple of really obnoxious replies like, How dare you even hold such an event, it is really unprofessional. One of those was from a guy at the CDC — one of the big fluoridation guys," said Webster. " It reminded me of the kind of stuff that you read about: "Advice to dentists on why they should never debate antifluoridationists.' It was that kind of thing." There were even whispers from his own group. A generation gap divided scientists, he realized. "One or two people inside the organization said, We really shouldnt have a thing on fluoride, it will give us a bad image,'" said Webster. While the younger researchers were willing to host the fluoride debate, Webster found that older members were gun shy as a result of the painful experiences many scientists and health professionals had undergone in the 19505 and 196os. It is our older colleagues who remember that stuff and how bad it was, and say This is just poison for your career, said Webster. This is an old battle from the '50s. " Even liberals in his organization shied from hosting the 2001 debate. It wasnt about science, it was about the politics, Webster said. Activist scientists already have a hard enough time in this world. Industry is trying to kill us and it is hard to survive in aca-demia. This is like, why push beans up your nose? The May 2001 debate in Virginia finally took place and was well attended, despite the lack of any profluoridation speakers, said Webster. His friend Paul Connett spoke. Most people did not know that there was an issue — fluoride is just not on the radar screen. If people like Connett are crazy, I would have loved to see the CDC people come and squash em like a bug. There seems to be almost a taboo about discussing this subject, and that really doesnt seem right in public health. Tom Webster is not alone in his frustration. That same year, in the fall of 2001, a second scientists organization, the American Col- THE DAMAGE Is DONE 229 lege of Toxicology, hosted a Great Debate on water fluoridation at its annual Washington, DC, conference. Phyllis Mullenix was a speaker. Again, no one from the profluoride side would speak. The president of the organization, Robert E. Osterberg, had given the debate organizer many names and telephone numbers of scientists at leading drug companies; he was astonished that none of them showed up. I find it extremely difficult to believe, said Dr. Oster-berg, that companies that make hundreds of thousands of dollars a year by putting fluoride into kids multiple vitamins wouldnt stand up there and justify why they are doing it, and answer any concerns that people may have. Epilogue Blind to the Truth?
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