Fluoride Still in the News: Risks Noted for Kidney Patients, Children, Seniors
Fluoride Still in the News: Risks Noted for Kidney Patients, Children, Seniors
By Lee Michaelson and Gail McDonald-Tune
The National Kidney Foundation (NKF) recently withdrew its longstanding support for fluoridation of public water supplies. Although scientists have long raised concerns about the risks of fluoridation to public health, especially in susceptible populations, including infants, seniors and those suffering from chronic renal diseases, the NKF had allied itself since at least 1981 with the American Dental Association (ADA), which listed the NKF on its website as an organization that "recognize[s] the Public Health Benefits of Community Water Fluoridation for Preventing Dental Decay." In a position paper issued in 1981, and relying on scientific data from the 1970s, the NFK also stated there was "insufficient evidence at this time" to recommend the use of fluoride-free water for those with kidney disease.
In a new position paper, dated April 15, 2008, the NKF reversed its previous stance, and the foundation's name has since been removed the list of fluoridation-endorsing organizations on the ADA website. However, the NKF issued no press release and its new position paper did not come to media attention until early June.
According to the new paper, the NKF was moved to reexamine its stance on fluoridation by a number of factors, among them a challenge by an attorney who intimated suit might be filed on behalf of renal patients who had relied on what he characterized as the foundation's "outmoded" advice that fluoridation was safe. But perhaps most compelling were the March 2006 report of the National Research Council (NRC) on fluoridation and a recently published review by Kidney Health Australia, strongly suggesting that NKF's position on fluoridation was obsolete.
The NKF's new position paper emphasizes the NRC's finding that "a potentially susceptible subpopulation comprises individuals with renal impairments who retain more fluoride than healthy people do." The NKF paper also takes note of the multiple vehicles, including foods, beverages, drugs, toothpastes (which contain 1,000-fold more fluoride than drinking water), as well as fluoridated drinking water, through which fluoride is ingested; the fact that many of these products are not labeled for fluoride content, making it impossible to monitor the fluoride dosage actually being received by renal patients and others; and the scientific research documenting the health risks of fluoride, among them, dental and skeletal fluorosis, weakening of the bones, and an increased rate of fractures. The NKF observes that the worst of these risks appears to be associated with intake of fluoride at levels as much as four times higher than those commonly used in the fluoridation of public drinking water. However, the NKF report notes that those in the advanced stages of chronic kidney disease (CKD)–stages 4, 5 and 5D–"retain more fluoride than healthy individuals,"; in fact, their "[f]luoride blood levels are approximately 4-fold higher" than those of the general populace. "
It has long been acknowledged that fluoridated water cannot be used in dialysis, which sustains the lives of patients in renal failure. However, the NKF paper reports instances of severe illnesses and even several deaths following water system and hospital equipment accidents which allowed the introduction of fluoridated water into the dialysis process–including one in Annapolis in 1979 in which "approximately 1,000 gallons of 22 percent hydrofluorosilic were accidentally added to the ... public water system."
As a result, the new position paper concludes, "The 1981 NKF position paper on fluoridation is outdated. The paper is withdrawn and will no longer be circulated...." The new paper also states definitively: "The NKF has no position on the optimal fluoridation of water. The oral health of people with CKD is certainly of interest to the NKF, but balancing the overall benefits and risks of fluoride exposure is the primary concern." The foundation goes on to recommend additional research on fluoride toxicity, and specifically advises: "Individuals with CKD should be notified of the potential risk of fluoride exposure by providing information on the NKF website including a link to the report in brief of the NRC and the Kidney Health Australia position paper."
Kidney patients are not the only ones at risk from fluoride exposure, say many scientists. Infants and young children are another susceptible population. "[H]uman breast milk has about 1/100th the level of fluoride that so-called optimally fluoridated water has.... [I]f Mother Nature had intended for human beings to get fluoride at that level, the human breast would have accommodated it," says J. William Hirzy, a chemist and fluoride expert at the American University in Washington, D.C.
"It is now the consensus view of the dental research community that fluoride's primary benefit to teeth comes from topical application to the exterior of teeth, not from ingestion through the water supply," adds Michael Connett, project director of the Fluoride Action Network. Connett continues, "Since … the risks are primarily from ingestion … adding fluoride to the nation's water–and thereby to the bulk of the nation's processed food–increases public ingestion of fluoride."
Phyllis Mullenix, Ph.D., a neurotoxicologist, former head of the toxicology department at the Forsyth Dental Center, a world renowned dental center associated with Harvard Medical School, and currently a research associate in psychiatry at the Children's Hospital Medical Center in Boston, reported impacts on the central nervous system that flagged fluoride as having the potential to cause motor dysfunction, IQ deficits, and learning disabilities in humans. In a study published in the Journal of Neurotoxicology and Teratology, Mullenix showed that fluoride crosses the blood-brain barrier in baby rats, which–depending on when they were exposed to fluoride dosages similar to what human children receive–exhibited hyper and hypo-activity.
In two other studies published in 1999, the same journal noted that some children exceed the total daily fluoride ingestion simply by using toothpaste alone. (Commercially packaged toothpastes contain warnings not to swallow.) The second study found that more than 50 percent of infants are currently formula-fed at one month of age, and, because of the fluoride in the formula, they "are likely to be continuously exposed to high intakes of it for nine or 10 months."
Fluoride is also contained in most of our nation's processed and packaged infant foods and beverages, including "healthy choices," such as many fruits and vegetables sprayed with pesticides containing fluoride. For example, non-organic grapes and raisins are among the highest fluoride-containing foods eaten by children. Some sodas are also made with fluoridated water. As early as 1996, the Journal of the American Dental Association presented data suggesting that young children who drink substantial quantities of juice "should not receive dietary fluoride supplements, since they might be at increased risk of developing dental fluorosis." Another ADA article from 1997, found high-fluoride-content chicken in infant food.
More recently, a 2001 study by Oregon State University showed that foods made with mechanically separated chicken contribute to fluoride intake, reporting that infant foods had the highest amounts of fluoride. The study concluded that "a single serving of chicken sticks alone provides roughly half of a child's upper limit of safety for fluoride."
Parents may be surprised to learn that the substances used to fluoridate their water is a waste material, hydroflusilic acid, taken from the smokestack pollution scrubbers used in the phosphate fertilizer industry. Hydrofluosilicic acid is classified as a hazardous industrial waste.
Those wishing to avoid the potential health risks associated with fluoride may want to consider feeding their children organic foods, including organic baby foods now carried by many markets. Filtering water is a bigger obstacle–most common household water filters do not screen out fluorides. Reverse osmosis water filters are required to remove or substantially reduce fluorides in the water supply, and such filters often waste as much as two-thirds of the water being processed. If choosing fluoridated tooth paste, be certain that your children use only small, pea-sized amounts and do not allow them to swallow it.
For more information, check out the following websites: Fluoride Action Network, www.fluoridealert.org; Citizens For Safe Drinking Water, www.keepers-of-the-well.org; Scientists, Doctors and Researchers Warn of Fluoride Dangers, www.nofluoride.com.
By Lee Michaelson and Gail McDonald-Tune
The National Kidney Foundation (NKF) recently withdrew its longstanding support for fluoridation of public water supplies. Although scientists have long raised concerns about the risks of fluoridation to public health, especially in susceptible populations, including infants, seniors and those suffering from chronic renal diseases, the NKF had allied itself since at least 1981 with the American Dental Association (ADA), which listed the NKF on its website as an organization that "recognize[s] the Public Health Benefits of Community Water Fluoridation for Preventing Dental Decay." In a position paper issued in 1981, and relying on scientific data from the 1970s, the NFK also stated there was "insufficient evidence at this time" to recommend the use of fluoride-free water for those with kidney disease.
In a new position paper, dated April 15, 2008, the NKF reversed its previous stance, and the foundation's name has since been removed the list of fluoridation-endorsing organizations on the ADA website. However, the NKF issued no press release and its new position paper did not come to media attention until early June.
According to the new paper, the NKF was moved to reexamine its stance on fluoridation by a number of factors, among them a challenge by an attorney who intimated suit might be filed on behalf of renal patients who had relied on what he characterized as the foundation's "outmoded" advice that fluoridation was safe. But perhaps most compelling were the March 2006 report of the National Research Council (NRC) on fluoridation and a recently published review by Kidney Health Australia, strongly suggesting that NKF's position on fluoridation was obsolete.
The NKF's new position paper emphasizes the NRC's finding that "a potentially susceptible subpopulation comprises individuals with renal impairments who retain more fluoride than healthy people do." The NKF paper also takes note of the multiple vehicles, including foods, beverages, drugs, toothpastes (which contain 1,000-fold more fluoride than drinking water), as well as fluoridated drinking water, through which fluoride is ingested; the fact that many of these products are not labeled for fluoride content, making it impossible to monitor the fluoride dosage actually being received by renal patients and others; and the scientific research documenting the health risks of fluoride, among them, dental and skeletal fluorosis, weakening of the bones, and an increased rate of fractures. The NKF observes that the worst of these risks appears to be associated with intake of fluoride at levels as much as four times higher than those commonly used in the fluoridation of public drinking water. However, the NKF report notes that those in the advanced stages of chronic kidney disease (CKD)–stages 4, 5 and 5D–"retain more fluoride than healthy individuals,"; in fact, their "[f]luoride blood levels are approximately 4-fold higher" than those of the general populace. "
It has long been acknowledged that fluoridated water cannot be used in dialysis, which sustains the lives of patients in renal failure. However, the NKF paper reports instances of severe illnesses and even several deaths following water system and hospital equipment accidents which allowed the introduction of fluoridated water into the dialysis process–including one in Annapolis in 1979 in which "approximately 1,000 gallons of 22 percent hydrofluorosilic were accidentally added to the ... public water system."
As a result, the new position paper concludes, "The 1981 NKF position paper on fluoridation is outdated. The paper is withdrawn and will no longer be circulated...." The new paper also states definitively: "The NKF has no position on the optimal fluoridation of water. The oral health of people with CKD is certainly of interest to the NKF, but balancing the overall benefits and risks of fluoride exposure is the primary concern." The foundation goes on to recommend additional research on fluoride toxicity, and specifically advises: "Individuals with CKD should be notified of the potential risk of fluoride exposure by providing information on the NKF website including a link to the report in brief of the NRC and the Kidney Health Australia position paper."
Kidney patients are not the only ones at risk from fluoride exposure, say many scientists. Infants and young children are another susceptible population. "[H]uman breast milk has about 1/100th the level of fluoride that so-called optimally fluoridated water has.... [I]f Mother Nature had intended for human beings to get fluoride at that level, the human breast would have accommodated it," says J. William Hirzy, a chemist and fluoride expert at the American University in Washington, D.C.
"It is now the consensus view of the dental research community that fluoride's primary benefit to teeth comes from topical application to the exterior of teeth, not from ingestion through the water supply," adds Michael Connett, project director of the Fluoride Action Network. Connett continues, "Since … the risks are primarily from ingestion … adding fluoride to the nation's water–and thereby to the bulk of the nation's processed food–increases public ingestion of fluoride."
Phyllis Mullenix, Ph.D., a neurotoxicologist, former head of the toxicology department at the Forsyth Dental Center, a world renowned dental center associated with Harvard Medical School, and currently a research associate in psychiatry at the Children's Hospital Medical Center in Boston, reported impacts on the central nervous system that flagged fluoride as having the potential to cause motor dysfunction, IQ deficits, and learning disabilities in humans. In a study published in the Journal of Neurotoxicology and Teratology, Mullenix showed that fluoride crosses the blood-brain barrier in baby rats, which–depending on when they were exposed to fluoride dosages similar to what human children receive–exhibited hyper and hypo-activity.
In two other studies published in 1999, the same journal noted that some children exceed the total daily fluoride ingestion simply by using toothpaste alone. (Commercially packaged toothpastes contain warnings not to swallow.) The second study found that more than 50 percent of infants are currently formula-fed at one month of age, and, because of the fluoride in the formula, they "are likely to be continuously exposed to high intakes of it for nine or 10 months."
Fluoride is also contained in most of our nation's processed and packaged infant foods and beverages, including "healthy choices," such as many fruits and vegetables sprayed with pesticides containing fluoride. For example, non-organic grapes and raisins are among the highest fluoride-containing foods eaten by children. Some sodas are also made with fluoridated water. As early as 1996, the Journal of the American Dental Association presented data suggesting that young children who drink substantial quantities of juice "should not receive dietary fluoride supplements, since they might be at increased risk of developing dental fluorosis." Another ADA article from 1997, found high-fluoride-content chicken in infant food.
More recently, a 2001 study by Oregon State University showed that foods made with mechanically separated chicken contribute to fluoride intake, reporting that infant foods had the highest amounts of fluoride. The study concluded that "a single serving of chicken sticks alone provides roughly half of a child's upper limit of safety for fluoride."
Parents may be surprised to learn that the substances used to fluoridate their water is a waste material, hydroflusilic acid, taken from the smokestack pollution scrubbers used in the phosphate fertilizer industry. Hydrofluosilicic acid is classified as a hazardous industrial waste.
Those wishing to avoid the potential health risks associated with fluoride may want to consider feeding their children organic foods, including organic baby foods now carried by many markets. Filtering water is a bigger obstacle–most common household water filters do not screen out fluorides. Reverse osmosis water filters are required to remove or substantially reduce fluorides in the water supply, and such filters often waste as much as two-thirds of the water being processed. If choosing fluoridated tooth paste, be certain that your children use only small, pea-sized amounts and do not allow them to swallow it.
For more information, check out the following websites: Fluoride Action Network, www.fluoridealert.org; Citizens For Safe Drinking Water, www.keepers-of-the-well.org; Scientists, Doctors and Researchers Warn of Fluoride Dangers, www.nofluoride.com.
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