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Agenda November 14, 2012 Page 2  Dr ORANGE WATER AND SEWER AUTHORITY A public, non-profit agency providing water, sewer and reclaimed water services to the Carrboro-Chapel Hill community. MEMORANDUM TO: Natural Resources/Technical Systems Committee Terri Buckner (Chair) Dana Stidham Stephen Dear Michael Hughes Will Raymond Amy Witsil Alan Rimer (ex officio) THROUGH: Ed Kerwin FROM: Mason Crum DATE: November 14, 2012 SUBJECT: December 4, 2012 Natural Resources/Technical Systems (NRTS) Committee Meeting The NRTS Committee will meet December 4, 2012 at 4:00 PM in the OWASA Community Room. The Committee will discuss the two petitions received from the public on August 23rd and September 27th requesting that OWASA discontinue its current practice of adding fluoride to drinking water as part of the treatment process at the Jones Ferry Road Water Treatment Plant. The Committee Chair, Ms. Terri Buckner, and the OWASA staff have contacted Dr. Rebecca King, Section Chief of the NC Oral Health Section and Mr. Allen Spalt, co-founder of Toxic Free North Carolina and previous Carrboro Alderman, and they will participate in the Committee’s discussions. We will invite to the meeting the two petitioners and all OWASA customers (approximately 25) that have asked questions about our fluoridation practices since 1998. Please note that the NRTS Committee will not receive comments from the public at this Committee meeting. However, the public is welcome to present comments or petition the OWASA Board at any of its regularly scheduled Board meetings. Attached are statements from the following individuals/organizations stating their support for fluoridation of drinking water: Dr. L. Herald, State Health Director Dr. K Buckholtz, Dentist with Oral Health Section of the NC Division of Public Health (statements made to the Durham City Council) 400 Jones Ferry Road Equal Opportunity Employer Voice (919) 968-4421 Carrboro, NC 27510-2001 Printed on Recycled Paper www.owasa.org NRTS Committee Agenda November 14, 2012 Page 2 Dr. C. Bridger, Orange County Health Director Dr. T. Wright, UNC Department of Pediatric Dentistry Dr. S. Keener, Mecklenburg County Medical Director American Water Works Association Additional attachments include: Centers for Disease Control and Prevention (CDC) (fluoridation statistics) Fluorine – A current literature review. An NRC and ATSDR based review of safety standards for exposure to fluorine and fluorides Below are links to additional information: In New Jersey, a Battle Over a Fluoridation Bill, and the Facts This Daily Habit Can Damage Your Brain, Disrupt Your Bones, and Stain and Pit Your Teeth Fluoride Risks Are Still A Challenge: Conference debates water fluoridation, sulfuryl fluoride, and problems with EPA limits Fluoride in drinking water: a scientific review of EPA's standards Fluoride in Drinking Water - 2009 Health Canada Consultation In light of the attached information, staff recommends that the Committee and OWASA staff remain abreast of current fluoride research, but that the Committee should recommend that the full OWASA Board deny the petitions received, and that OWASA’s current practice of fluoridation should continue. We look forward to seeing you at 4:00 PM on December 4th. Mason Crum, P.E. Director of Engineering and Planning Attachments cc: Board of Directors Robert Epting Notes for Durham City Council Meeting 3-22-2012 Kevin Buchholtz, 1306 Clarendon Drive in Greensboro, dentist, with the Oral Health Section of the North Carolina Division of Public Health in Raleigh. Mr. Mayor and Council members, thank you for allowing me some time on your agenda this afternoon to talk about water fluoridation. The first point I’d like to make is that all water contains fluoride. As water washes over rocks which contain fluoride, the fluoride ion is released into the water. So, lakes, rivers, oceans all contain naturally occurring amounts. Most water sources used for drinking do not contain enough fluoride to prevent tooth decay. Some water sources have too much but most do not contain enough. That’s where added fluoride through community water fluoridation comes in - effectively raising the level of fluoride in the water supply to an amount that has been proven to prevent cavities. We strongly support water fluoridation as an effective, safe, inexpensive and equitable method of preventing tooth decay in children and adults. As a state agency, we take our lead from federal health agencies such as the Centers for Disease Control and Prevention (CDC). As the leading federal organization concerned with the health of all Americans, they have folks in their Division of Oral Health working on fluoridation and continually monitoring the literature. They strongly endorse fluoridation and recognize it as a top public health achievement. Based on their review of credible scientific studies, CDC concludes that water fluoridation has the net effect of safely reducing tooth decay experience between 18-40 percent for U.S. schoolchildren, while also reducing dental caries and tooth loss in adults. These benefits are evident even now, with almost universal fluoride toothpaste usage and other forms of personal and professional use of fluorides. Fluoridation is endorsed by the American Dental Association (ADA), the American Medical Association (AMA), the American Academy of Pediatrics, and many other organizations in the fields of advocacy, health, science and public affairs. When discussing potential adverse health effects, many claims are made. You’ve heard about some of them today and a couple of months ago. Those claims are presented on web sites whose organizations oppose fluoridation and all products that contain fluoride. We don’t feel that the information contained on those sites is balanced. Rather, it is highly biased against fluoride. That’s their agenda. For example: about a year and a half ago I was on one of the web sites and saw a quote attributed to the past-president of the AMA, C. Gordon Heyd, against fluoridation. But his remarks were from the 1930s. The AMA strongly supports fluoridation and their current policy statement, from September 2010, was not included on the site. It didn’t seem above board. While factually correct, there was intent to mislead. According to the CDC and to our reading of the literature, the only proven potentially adverse consequence of drinking optimally fluoridated water is the development of dental fluorosis, a typically very mild condition that causes discoloration of the teeth. We know that as the fluoride content in the water increases, the prevalence and severity of dental fluorosis increases as well. At the amount of fluoride that we’re dealing with for fluoridation, dental fluorosis, if it is even present, is overwhelmingly of the very mild forms. Does Optimally Fluoridated Water Cause Alzheimer’s disease? The exact causes of Alzheimer’s disease have yet to be identified. Age and family history are major risk factors. An early head injury may predispose someone to getting the disease. There was a study published about 15 yrs ago that raised concerns about the potential relationship between fluoride and Alzheimer’s disease. According to the ADA, a subsequent study published later that year in JADA stated that there were serious flaws in the experimental design that that precluded any definitive conclusions from being drawn. Drinking optimally fluoridated water is not generally accepted within the medical community to be a risk factor for the development of Alzheimer’s disease Fluorde and Low IQ There are studies reportedly supporting the theory that fluoridation causes lower IQ in children. The studies often cited are from China, India and Mexico where conditions are not similar to those in the US. The vast majority has never been published in peer-reviewed, English language journals. Many of the studies have been critically evaluated in England in 2009 by an independent company that provides evidence-based support for healthcare decisions. They noted that the study design and methods used by many of the researchers had serious limitations. According to the ADA, the quality of these studies does not stand up to scientific scrutiny and promotion of these papers only clouds the issues and plants fear in the minds of the public. Furthermore, the amounts of fluoride in the studies that demonstrated lower IQ were generally very high, significantly above the 0.7 mg/L used in community fluoridation here. Fluoridation and elevated blood lead levels-learning disabilities, ADD etc., We asked CDC for guidance on this a couple of months ago since there was conflicting research out there. Because of time, I won’t read you the email exchange, which was rather lengthy, but I would like to provide each of you with a copy. Basically, CDC doesn’t feel the concerns are warranted for several reasons. Among them are that they did not use real world conditions to carry out their study, and as a result, their results were more a factor of the manufactured conditions. We strongly agree that to balance risks, benefits and economic considerations, fluoride must be used in the correct amount and frequency. As with many substances, more is not better and the folks like Vickie Westbrook from Durham frequently test the amount of fluoride in the water to ensure that it is not too high. Leading federal organizations have recently reconfirmed the value of fluoridation while recognizing that it is now possible to receive enough fluoride with slightly lower levels of fluoride in water. After an extensive review of the scientific literature on the relationship between fluoride and oral health the U.S. Department of Health and Human Services (HHS) and the U.S. Environmental Protection Agency (EPA) jointly announced in January, 2011 a proposed change to the optimal fluoride level in drinking water to prevent tooth decay from a range of 0.7 to 1.2 milligrams per liter (mg/L) to a fixed point (0.7 mg/L) at the bottom end of the previous range.
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