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HomeMy WebLinkAboutSS4 - Fluoridation IssuesCOMMUNITY WATER FLUORIDATION AND THE MET David F. Nelson, D.D.S., M.S. Consultant to the Office of Oral Health California Dept. of Public Health November 1312007 6- � ©- \ `. RU y«?z ���� § ■ >.� .,x ... . �- ^ DENTAL DECAL( IN CALIFORNIA • Dental disease, not asthma, childhood obesity or diabetes is the number one health problem for children • California's children experience TWICE the amount of decay as their counterparts nationwide. Why? • By 3rd grade, tooth decay affects almost 2/3 of children in California • More than 750 ®000 school -age children have untreated tooth decay ADDITIONAL FACTS • Among school -aged children, low- income and minority children suffer most from dental disease 28% of California's children do not have dental insurance • In the US, over 20 million work days and 51 million school hours were lost due to dental disease • In a recent survey of 25 states, only Arkansas children are worse off than California's when it comes to the prevalence of dental disease! • Oral disease such as dental caries is almost entirely preventable. CWF is the safest, most effective and economical public health intervention for reducing tooth decay THE MET • Voted in 2003 to fluoridate its' 5 treatment plants • MET has spent billions of $$ to improve its treatment plants and infrastructure to safeguard the public's health. • The State of California continues to endorse and support efforts to fluoridate the community water supply to help attain the Healthy People 2010 national objective • CDPH stands ready to assist you with scientific and technical expertise • The ADA, CDC, AMA, WHO and over 150 of the world's most prestigious health organizations CONTINUE to support fluoridation!! AND MORE • Over 60 years of experience and 3,500 peer- reviewed scientific articles have proven that fluoridation is SAFE and EFFECTIVE • 67% of the US population ( 168million) has access to fluoridated drinking water • LEGACY - -- millions of California children will grow up cavity free and pain free because of the decision the MET made in 2003H Some anti - fluoride websites Nofluoridexom - 4 main arguments against fluoridation: • AMA not willing to state that fluoride will harm no one! — Of course not. Would not say that about any element • Not FDA approved — And never will be. FDA doesn't regulate drinking water. Regulates bottled water, toothpaste, etc. F 4K in toothpaste — EPA has the responsibility for drinking water, not the FDA • Forced mass medication of the public — No more so than immunizations, helmets, iodine in salt, vitamin D in milk AND F IS NOT A MEDICINE • The chemicals are not pharmaceutical quality — Don't have to be. As long as they pass the NSF Standard 60 water quality tests they are pure enough for drinking water ANOTHER ANTI= FLUORIDE WEBSITE... • Keepers of the Well Their claims: — Mass medicates at a level that no doctor could Rx — FDA reports the chemicals used in fluoridation have never been studied for safety — EPA unions call for a moratorium — Chemicals contain arsenic and lead — The increased lead levels responsible for learning disabilities, substance abuse, hyperactivity and crime — Kidney and brain lesions causing Alzheimers — We are already overdosed on fluoride from foods and beverages. Fluoride Myths vs. Reality Fluoridation causes osteosarcoma (bone cancer) in young boys – Harvard study by Dr. Bassin -very small cohort – Did not control for length of residency – Even the author cautions -no conclusions can be drawn – Her mentor Dr. Chet Douglas, says the same thing – Part one of a two part study. Part two does not seem to replicate the results re: osteosarcoma. Part two not finished yet There are harmful contaminants e.g.arsenic and lead in the fluoridation chemicals – Hardly measurable, well below the MCLs, in ppb – Basis for the Escondido lawsuit which was dismissed by the judge with no hearing Exposure from foods, beverages is overdosing us – NAS— toxicity level to produce symptoms is 20 -80 ppm for 10 -20 years, or 10ppm of naturally occurring for 10 -20 years More myths • We are using "industrial grade" chemicals — All chemicals used in treating water are "industrial grade" — Natural F and added F are the same ion. F is F is F • Is fluoride effective in reducing decay? — In the US, 113 studies alone showing significant reductions — Effectiveness ranges between 15 -60% depending on age group and type of teeth. Not as effective as in 1945 due to "halo effect" — Current estimates are between 20 -40% REDUCES ROOT DECAY BY AS MUCH AS 60% • Fluoride causes rampant fluorosis — Antis claim fluorosis rates are 60% — Reality is more like 22% — Dentists don't seem to see even that much And even more.... • Fluoridation is wasteful because only a tiny portion goes for human consumption — Used for watering lawns, washing cars, industry — Impossible to treat just the drinking water portion — No more wasteful than with all the other water additives • Fluoridation will kill my fish!! — Sea water is 1.2 -1.5 ppm naturally • Fluoridation is compulsory mass medication — It is neither compulsory nor medication — Use Bottled water; F is not a "medicine" — Adjustment of a naturally occurring element FINALLY.... • WARNING WARNING The ADA has "warned" people NOT to mix baby formula with • fluoridated water for infants under the age of one year! —The truth —ADA issued interim guidelines for the use of fluoridated tap water. NEVER issued a warning —Worst danger is very mild fluorosis of teeth. Detectable only by a dentist - Risk vs benefit of fluoride COMMUNITY WATER FLUORIDATION IS: OVER 60 YEARS OF USE AND THOUSANDS OF CREDIBLE PEER= REVIEWED STUDIES TELL US THIS COMMUNITY WATER FLUORIDATION IS: DECAY IS REDUCED BY UP TO 40% IN CHILDREN, 20% IN ADULTS AND UP TO 60% IN SENIORS COMMUNITY WATER FLUORIDATION IS: COSTS PER PERSON RANGE FROM 504/PERSON /YR TO $3 /PERSON /YR (A, SINGLE FILLING MAY COST $60- $180) David Satcher, ICI D. Ph D Assistant Secretary for Health U.S. Surgeon General �� � � \ \� \\ / :. >,�. � ~� � �� » ^� - :� � , 2 � /� � � : � , Fluoride receives clean bill of health By Associated Press 10/6/00 LONDON -- The first examination '�w a f resear adding luoride to drinkin'`� g �. ound no evidence of harm, and some experts said the findin should allay lingering fears it could cause cancer, osteoporosis or Down's Syndrome. The review, published this week in the British Medical Journal, involved 214 studies and was the most comprehensive since fluoridation was first introduced in the United States after World War 11. Fluoride opponents dismissed the research, saying it ignored some studies showing adverse effects, such as an increase in bone fractures among the elderly. The researchers from the University of York said their analysis confirmed that fluoridation reduces tooth decay by about 15 percent, but found that it was also linked to dental 'fluorosis, or mottled teeth, about 48 percent of the time. tip, Cancer Facts Risk Faii Fluoridated Water Virtually all water contains fluoride. In the 1940s, scientists discovered that the'" community water supply, the fewer the dental caries (cavities) among the residents Americans live in areas where fluoride is added to the water supply to bring it up to health. The possible relationship between fluoridated water and cancer has been ( revealed no evidence that fluoride is carcinogenic, a National Toxicology Pi considerable interest in this subject. In this study, a small number of male drinking water containing fluoride in amounts that were 25 to 100 times g fluoridated water. No cancers were seen in the female rats or in the male 4 the scientists who conducted the study, the fact that a few male rats deve� link fluoride ingestion with cancer. ,t In February 1991, the Public Health Service reported the results of a association between fluoride and cancer in humans. The survey, whi epidemiology studies produced over the past 40 years, led the inveR water "does not pose a detectable risk of cancer to humans." dental at tang . Although earlier animal studies stud+ "s ompleted in April 1990 generated �3r of 3 0) developed bone cancer after ia' the levels found in municipal mice that were also tested. According to mors could not be used as firm evidence to ing survey that showed no evidence of an Lied a review of more than 50 human to conclude that optimal fluoridation of drinking In one recent study, scientists at the National Cancer Institute v uated the relationship between fluoridation of drinking water and the cancer' mortality (deaths) in the United States g a 36 -year period and the relationship between fluoridation and the cancer incidence (rate) during a 15- yea r,p £nod. 'After examining more than 2.2 million cancer death records and 125,000 cancer case records in counties using ,' oridated water, the researchers saw no indication of a cancer risk associated with fluoridated drinking water. '' American Academy of Asthma Allergy and Immunology A Statement On The Question of Allergy to Fluoride as Used in the Fluoridation of Community Water Supplies A request to the American Academy of Allergy has been made by the Unites the question of allergy to fluoride as used in the fluoridation of community such an evaluation include a review of clinical reports of allergy to fluoride reports constitute valid evidence of a hypersensitivity reaction. The response to this request has been handled as follows: Reports of allergic reactions have been reviewed. First, these reports not there is sufficient clinical or scientific information to classify any major classes of hypersensitivity reaction (types I to IV).' These imn or reaginic, the cytotoxic, the toxic complex, and the delayed -type r ` determine whether or not there was sufficient clinical evidence to s 'i fluorides might occur as one of the less -well understood types of mediated.2 The reports of fluoride allergy reviewed 3'' listed a wide ve headaches, scotomata, personality changes, muscular wee headaches, dryness in the mouth, oral ulcers, convulsions, congestions, skin rashes, epigastric distress, and hematen The review of the reported allergic reactions showed IV had been presented. Secondly, the review of the c laboratory evidence to state that true syndromes of f }ealth Service for an evaluation of It was further requested that opinion whether or not such r ted in an attempt to determine whether or sumed fluoride allergy in one of the four illy mediated reactions are the anaphylactic Second, the reports were evaluated to possibility that intolerance or allergy to s that may or may not be immunologically )P�mptoms including vomiting, abdominal pain, iainful numbness in extremities, joint pain, migraine deterioration, colitis, pelvic hemorrhages, urticaria, nasal ence that immunologically mediated reactions of the types I to )orted demonstrated that there was insufficient clinical and allergy or intolerance exist. As a result of this review, the members of the Exec4 -t ve Committee of the American Academy of Allergy have adopted unanimously the following statement: "There is nn '% vidence of allergy or intolerance to fluorides as used in the fluoridation of community water supplies." FROM THE DIRECTOR OF THE CA DEPARTMENT OF PUBLIC HEALTH "As the Director of the California Department of Public Health, and former HEALTH OFFICER FOR ORANGE COUNTY. I commend the MWD for its water fluoridation program. Fluoridated water is a time - tested method for safely delivering oral health to all sectors of the community. Water fluoridation has led to a significant reduction in tooth decay, thereby preventing cases of tooth loss and chronic pain and significantly reducing health care costs. I am very pleased that the MWD is undertaking this important public health action" Mark B Horton, MD, MSPH 1/1 a �W ;r �F I� t Water Fluoridation Additives - Engineering - Community Water Fluoridation - DOH - C... Community Water Fluoridation Oral Health Home > Community Water -Flu n ation Home > Engineering View by Topic Water Fluoridation Additives *sq - Page 1 of 4 Search: __... .. IS] E -mail this_pa( 8 Printer- friendl± > Bengfits > Safety Community water systems in the United States use one of three additives for water fluoridafi Statistics cost of product, product - handling requirements, space availability, and equipment. > Engineering and Operations > Other Fluoride Products • Fact Sheets • FAQs -- Guidelines and RecommendatigDs > Journal Articles_ > .R_.elateA Links Limited Access s Water Fluoridation Reporting Svstem > Lab Proficiency—Testing Contad Info Centers for Disease Control and Prevention Division of Oral Health Mail Stop F -10 4770 Buford Highway NE Atlanta, GA 30341 Contact P5 ....................... ............................... • Sodium fluoride: a dry additive, typically used in small water systems, dissolved i solution before being added to water. • Sodium fluorosilicate: a dry additive, also dissolved into a solution before being a water. • Fluorosilicic acid: an aqueous solution used by most water fluoridation programs United States because of easier handling, purity of the product, and lower cost. F acid is also referred to as hydrolluorosilicate or FSA. The effectiveness and safety of fluoridation have been analyzed by numerous studies and re repeatedly by expert scientific groups over the past 60 years. Water fluoridation at optimal le health is safe, healthy, and effective in reducing tooth decay. Sources of Fluoride Additives FSA has been used for water fluoridation since the early 1950s, and has long been the pred( additive used for water fluoridation in the United States. Since the early 1980s, most fluoride used in the United States have been derived from the FSA produced as a co-product in the r of phosphate fertilizer. This source is used because of the favorable cost and high purity of F The phosphate fertilizer manufacturing process begins with apatite rock, a calcium mineral, v refluxed (heated) with sulfuric acid to produce a phosphoric acid - gypsum (calcium sulfate -Cs Hydrogen fluoride (HF) gas, silicon tetrafluoride (SiF4), and excess water are captured by th( and then condensed to FSA with a nominal solution concentration of 23 %, with the remainde water. The extraction of FSA by negative- pressure evaporators is a deliberate strategy for re content to minimize drying energy while recovering the high -purity FSA. FSA that is sold to the water industry is occasionally further processed by activated carbon a reduce color, much of which is a result of iodine. FSA then is either transported to regional di locations or is further processed to derive dry fluoride additives, including sodium fluorosilica fluoride. A minor source of FSA (approximately 5%) is produced by acidifying calcium fluoride (fluorit sulfuric acid to generate hydrogen fluoride, and then adding silicate (sand). Less than 1% of derived from hydrogen fluoride etchings of silicon chips. The dry additives sodium fluorosilicate and sodium fluoride are predominantly derived from F be partially neutralized by either table salt (sodium chloride) or caustic soda to obtain sodiurr fluorosilicate. If sufficient caustic soda is added to completely neutralize the fluorosilicate, the resulting product is sodium fluoride. Sodium fluoride could also be produced by mixing caust hydrogen fluoride, but represents less than 10% of the sodium fluoride used in the United St because the procedure costs more. Regulatory Purview on Additives http : / /www.cdc.gov /fluoridation/fact_ sheets /engineering/wfadditives.htm 11/8/2007 Water Fluoridation Additives - Engineering - Community Water Fluoridation - DOH - C... Page 2 of 4 Questions sometimes arise regarding the toxicity, purity, and risk to humans from adding fluc additives to drinking water. The safety of water fluoridation at optimal levels (approximately 1 been documented extensively by scientific and public health organizations using thorough re scientific literature and expert panels (e.g., U.S. Public Health Service, National Research C( Health Organization, Institute of Medicine, and the University of York Center for Research Di The U.S. Environmental Protection Agency (EPA) and the U.S. Food and Drug Administratio a 1979 Memorandum of Agreement specifying that the EPA has purview over safe communi water in accordance with the Safe Drinking Water Act, and the FDA has purview over bottled consumer beverage (Federal Register, Volume 44, No. 141, July 20, 1979). The EPA sets standards for drinking water because its regulatory purview concerns the Maxi Contaminant Level (MCL) concentrations based on health effects resulting from drinking wat consumption. The FDA regulates fluoride in over - the - counter products, such as toothpaste a rinse, and in prescription items, such as fluoride supplements and professional- strength gels along with fluoride in bottled water that is marketed as a consumer beverage. In accordance with the EPA -FDA Memorandum of Agreement, the FDA does not regulate ac community drinking water because its regulatory purview concerns the safety and efficacy of or cosmetic-related products. In 2006, the FDA announced that bottled water with greater tha to 1.0 mg /L could be labeled with the statement "Drinking fluoridated water may reduce the h decay." To ensure the public's safety, all additives used at a water treatment facility must meet strict standards. All of the additives used in drinking water treatment are subject to a system of sta testing, and certificates by the American Water Works Association (AWWA) and the National Foundation /American National Standards Institute (NSF /ANSI). Both of these entities are not nongovernmental organizations. AWWA sets the minimum requirements for a product's desi installation, performance, and manufacturing, while NSF /ANSI standards 60 and 61 limit a ct product's contribution of contaminants to drinking water applications. Almost all of the more t treatment additives that may be used at the water plant are toxic to humans in their concentr e.g., chlorine gas used for disinfection. AWWA Standards The AWWA standards are ANSI /AWWA 8701 -99 (sodium fluoride), ANSI /AWWA B702 -99 (: fluorosilicate) and ANSVAWWA B703 -00 (FSA). AWWA's standards are prepared by its Flu( Standards Committee and are reviewed and updated at least every 5 years. AWWA standan product quality testing requirements and verification. NSF Standards NSF /ANSI standards 60 and 61 were developed by a consortium of associations, including t International, the AWWA, the ANSI, the Association of State Drinking Water Administrators, Conference of State Health and Environmental Managers. This consortium prepared Standa 61 in response to a competitive request for proposals by the EPA, which sought a basis to e: minimum requirements for controlling potential adverse effects from products added to water treatment. The standards replaced the former EPA Additives Advisory Program. Standards 60 and 61 provide for product purity and safety assurance that aim to prevent add levels of contaminants from water treatment additives. Forty-six states have laws or regulatic product compliance with Standards 60 and 61. Compliance with the NSF /ANSI standards is I independent verification entities including NSF International and Underwriters Laboratories. - independent certification entities must meet the criteria in the NSF /ANSI standard. Tests on f additives by the independent certification entities include the 11 regulated metal compounds EPA MCL. For a product (e.g., FSA) to meet certification standards, regulated impurities at tt home) must not have a concentration that is more than 10% of the MCL. EPA Regulatory Criteria for Fluoride Additives Because fluoride sometimes is naturally present at much higher levels in water, the EPA has conservatively established a MCL for fluoride of 4.0 mg /L ( parts per million), a MCL Goal of and a Secondary MCL of 2.0 mg /L, to avoid cosmetic dental fluorosis. The EPA has not esta MCL for silicates, since there are no recognized health concerns, but NSF Standard 60 has http : / /www.c&.gov /fluoridation/fact_ sheets /engineering /wfadditives.htrn 11/8/2007 . ., • Water Fluoridation Additives - Engineering - Community Water Fluoridation - DOH - C... Page 4 of Additional Resources • Fluoridation Additives__EA-CI_s • Ten]por�ry.$hgrtages_of Fluoridation Add.tiyes_FAQs_ • American Water Works Association,* 6666 W. Quincy Ave., Denver, CO 80235 —: Fluoride Additives Standards B701 -99, B702 -99 and 8703 -00, and Manual of P 4, Water Fluoridation Principles and Practices, 2004. • N$F International,' 789 North Dixboro Road, Ann Arbor, MI, 481134140, for Dri Treatment Chemicals Standards NSF/ANSI 60-2002 and NSF /ANSI 61 -2002. • Brown, Cornwell, MacPhee. Trace contaminants in water treatment chemicals: se fate. J Am Water Works Assoc 2004 Dec: 111. Links to non - Federal organizations are provided solely as a service to our users. Links do not cc endorsement of any organization by CDC or the Federal Government, and none should be inferre is not responsible for the content of the individual organization Web pages found at this link. Page last reviewed: September 17, 2007 Page last modified: September 17, 2007 Content source: Division of Orai_Health, National Center for Chronic Disease Prevention annd Promotion Home I Policies and Regulation I Disclaimer I e_- i mmer t i E_O_.IA I Contact Us SAPM, H KAL44fEM- PCOPLr" . Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, y�- ` �'l U.S.A Tel: (404) 639 -3311 ! Public Inquiries: (404) 639 -3534 ! (800) 311 -3435 i �. ,,... anc J. S4..:{ http: / /www.edc.gov/ fluoridation/ fact_ sheets /engineering /wfadditives.htm 11!8!2007 To Newport Beach Councilmember Daigle and Councilmember Gardner From - Dolores Otting 11/11/07 DHS, NEWPORT BEACH & FLUORIDATION I`' F) PRINTED:° ?T7 VJV 13 I'M 7: 4 b AGENDA I-13�2�0� From Sandy Genis My question: Do they have any statistics demonstrating that we:4M_an inordinate ammount of tooth decay compared to other areas that have fluoridation or araiF eg just J©ing it because "everyone else does "? If they don't have a demonstrated need, b"ed;bri,local'dental,health, wouldn't It be a waste of our money, even if It were innocuous? From Mr. Diamond He has studied the issue and feels as follows: Studies show that in general it (fluoride) is Ok , however there are also studies that show for infants Oto 1 year old there are adverse effects and where is the warning for new mothers? It is like a drug company that has a good drug and only advertises the success of the drug and sells it that way, however those people have a choice as to whether or not they want to take the drug. In this instance we have no choice and there should be a warning and list of side effects especially for families with children that are adversely effected. ? ? ? ?? Where are the side effects? What are the poorer families supposed to do that cannot afford. bottled water or reverse osmosis will there be subsidies for them? http• / /www ada ora /prof /resources /oositions/stat mentsMuoride infants aso The American Dental Assoc. & the CDC have posted new guidelines for infants and children http: / /www cdc gov /fluoridationtsafety /nrc raoort htm CDC Statement on the 2006 National Research Council (NRC) Report on Fluoride in Drinking Water The Committee found that water at 2 mg/L or greater may put children 8 years old and younger at increased risk for severe enamel fluorosis, a condition that causes staining and pitting of the enamel surface of teeth. In communities with fluoride levels greater than 2 mg /L, CDC recommends that parents and caregivers of children 8 years and younger should provide children with drinking water from an alternative water source. At levels less than 2 mg/L (equivalent to 2 ppm), the committee found that the prevalence of severe enamel fluorosis was very low (near zero). hftp://www.thirdworldtraveler.com/Environment(Bathtub Toxic Dump html Studies done by Brown, Bishop and Rowan in the early 1980s showed that an average of 64 percent of the total dose of waterbome contaminants is absorbed through the skin. The skin is the largest organ of the body. In 1991, the EPA concluded that the average person can absorb more contaminants from bathing and showering than from drinking polluted water. Children are most at risk. Children's bath times may range from 45 minutes to two hours. As the EPA acknowledged in a June 30, 1998 report, "Children have a greater surface - area -to- body - weight ratio than adults, which may lead to increased dermal absorption." Circulatory flow rates are generally higher in children, which may increase a child's susceptibility to toxic effects. Despite these elevated risks, most toxicological data is based on occupational exposures for adults In 1997, the EPA concluded that a person can absorb more contaminants from bathing and showering than from drinking polluted water. A study by British researchers at the Health and Safety Laboratory in Sheffield published in the February 19, 2000 issue of Human Experimental Toxicology suggests that toxicants such as fluorides can be stored in the skin and released over a period of time. A review of nearly 40,000 research papers listed on National Institutes of Health and other US government Internet sites has failed to discover a single study addressing water fluoridation and dermal absorption. All dosage recommendations developed by EPA are based on ingestion alone. The EPA and Centers for Disease Control have never commissioned studies on the dermal absorption of fluoridated water and refuse to do so. ? ? ?? Based on the Information above and the fact that many drugs including Ritalin are available in 'Patch form' for better and faster absorption into the bloodstream through the skin and is now recognized by all as a known science, where is the study or information for the amount of fluosilicic acid that can be absorbed through the skin? ? ? ?? Since fluosilicic acid (FSA) does not evaporate & children spend so much time in pools and in swim teams, where are the studies that determine when a swimming pool is toxic? How does a person test their pool water for hydrofluosilicic acid levels? Considering the new interim ADA guidelines infants 0 -12 months basically no fluoride while children less than 8 years of age are to get no more than 2 mg/L (equivalent to 2 ppm), Considering all the food sources and dermal absorption of fluoride -where does ay child get less than 2mg/L and how does a parent determine the amount of fluoride a child receives when none of the foods are labeled? ? ? ?? What are the safe levels of fluoride for children ranging from ages 1-8? Is it also dependent upon weight? htti):dwww.nidcr. nih.gov/ Funding/ CurrentFundinciODDortunitiea lRecengvCleared /Concei)tClea ra ncePharmac oaeneticsofFluodde.htm Ingested fluoride is rapidly and efficiently absorbed through the gastrointestinal system and approximately 35 -70% is eventually cleared by the renal system. Most of the fluoride retained in the body is incorporated into bones and teeth. ? ? ?? Where are the studies that tell where the rest f the fluoride goes? It has been estimated that between 20-80% of these children have mild fluorosis and 4% have moderate to severe fluorosis. A recent analysis of the NHANES datasets indicated that the prevalence of fluorosis among 6 -19 year old children increased by 9% since 1987. This increase is thought to be due, in part, to the increase in fluoride intake from sources other than drinking water including fluoridated beverages, supplements and topical fluoride- containing dental products that may be ingested. Factors such as nutrition have been implicated in an increase in an individual's susceptibility to fluorosis but probably do not fully account for the prevalence observed in the population. ? ? ?? The CDC says 33% of the population & the NIDCR says between 20 -80 %, where are the studies that gives a true number to what is going on with the youth of this country? Furthermore, the possibility that fluoride can damage the kidney is boosted by the fad that, of all soft tissues, the kidney is exposed to the highest levels of fluoride (with the possible exception of the pineal gland). As noted in the NRCs scientific review of the EPA's Standards of Fiuorlde in the Drinking Water, when will the study be done that gives true information regarding glucose intolerance, liver & kidney damage due to fluoride? hftp:// www .cdc.ciov/fluoridationisafety /nrc report htm CDC Statement on the 2006 National Research Council (NRC) Report on Fluoride in Drinking Water CDC recommends community water fluoridation as a safe, effective, and Inexpensive way to prevent tooth decay (dental caries) among populations living in areas with adequate community water supply systems. ? ? ?? Considering the fact that we will be implementing a Toilet to Tap water supply in the county of Orange, do we live in and have an adequate community water supply system? ? ? ?? Where are the studies that show synergistic effects of FSA water with other water chemicals, e.g. chloramines at al— and with reactions with metals (plumbing, equipment, etc). ? ? ?? Where is one long term solid study (not claims /endorsements) for the toxicological safety and effectiveness for this product from ? ? ? ?? according to material safety sheets fluosilicic acid may dissociate to form extremely toxic hydrofluoric acid (HF) a molecule smaller than water, what type of RO or filtering system is on the market that can take this out off our drinking & bathing water? ? ? ?? What's the legal justification for the DHS accepting no liability for potential health effects from FSA? If they're so confident about FSA, then, in writing, why reportedly do they not stand behind the public's exposure to it on a continuous and daily basis? ? ? ?? Has FSA, Hydronuosilicic acid, fluosilicic acid been improved by the FDA? ? ? ?? Where are the studies that discuss the health concerns of ingesting the arsenic and lead that come free with hydrofluosilicic acid? ? ? ?? Is it legal to add arsenic and or lead to the drinking water? ? ? ?? There are people that are extremely allergic to hydrofluosilicic acid, what are they to do? ? ? ?? according to table 8 -2 on page 262 on the new NRC report, a fluoride intake of .)7 to .4 mg/kg/day can impair glucose tolerance in some individuals, will DI-Is ask Hoag to do a study and keep monitoring those people with diabetes to see If they will be increasing their medications with time? Has a study been done in other parts of the country? Will the City of Newport Beach fund this Health study and others such as thyroid to name another since we have no choice. And, lastly, since we buy our water from the City of Newport Beach do we hold you liable for any adverse effects to the population?