April 4, 2006.

Dear Dr. Gerberding:

Since at least 1999, and possibly before, the CDC has based its oft-repeated assertion that water fluoridation is safe on a 1993 National Research Council (NRC) review of the literature on fluoride’s toxicity. This review was done at the request of the US EPA, which wanted to know if the science up to 1993 supported its safe drinking water standard for fluoride, i.e. the Maximum Contaminant Level Goal (MCLG) of 4 ppm.

Another distinguished panel appointed by the NRC has just completed (March 22) its 3-year review of the same question and concluded that the science published since 1993 shows that the 4 ppm standard is not protective of human health; specifically it does not protect against severe dental fluorosis in children nor does it protect against bone fracture, and possibly stage II skeletal fluorosis, in the general population. In light of these clear findings, will the CDC now be reassessing its position on fluoridation and will CDC immediately cease active support for mandatory fluoridation throughout the country as it re-evaluates its own position?

While some pro-fluoridation commentators have said that the NRC findings are irrelevant to water fluoridation at 1 ppm, a careful review of the full report does not support such a position. In a separate memo, I discuss other health effects covered in the 450 page NRC report.

There is no doubt that the new report is highly relevant to the deliberate addition of fluoride to the drinking water. The NRC report concluded that the MCLG should be lowered, but did not specify to what level. However, the report’s exposure analysis indicates that some population subsets may exceed the existing “safe” dosage limit (let alone a lowered one) by drinking water at 1 ppm fluoride. Subsets in this category include children and people who drink larger quantities of water such as diabetics, outdoor laborers, athletes, and certain military personnel. Also, people with thyroid disorders may be more susceptible to fluoride’s toxicity at 1 ppm. Thus, there is virtually no margin of safety for these people drinking water at concentrations used for water fluoridation.

To this evidence, we must now add the publication of Dr. Elise Bassin’s research in which she found an increased risk for developing osteosarcoma in young boys consuming fluoridated water at 1 ppm or lower during their 6th, 7th and 8th years (See the May issue ofthe journal Cancer Causes and Control). So, in addition to there being a vanishing margin of safety for fluoridation in general, there is now peer-reviewed evidence that one of the risks being faced is life threatening to children. For this there is absolutely no margin of safety for children drinking water at 1 ppm.

While we realize that it will be difficult for members of the dental profession to reverse their position on a practice for which they have long claimed a great benefit to children’s teeth, the CDC, a government agency charged with protecting the entire nation’s health, should no longer endorse such a dangerous risk/benefit calculation.

This topical effect mechanism may partially explain why, according to WHO figures available online, children’s teeth in largely unfluoridated Europe are as good, if not better than, children’s teeth in the US, and why the largest NIDR survey of tooth decay in the US found very little difference in the permanent teeth of children who had lived all their lives in fluoridated, as opposed to non-fluoridated, communities (Brunelle and Carlos, 1990).

I also ask you consider the following: since the NRC has made a great many suggestions for research to clarify many unanswered questions on serious health issues related to fluoride ingestion, is that not tantamount to acknowledging that adding fluoride to water is an ongoing human experiment? How can we continue fluoridating with so many unanswered questions on its human health effects?

If, indeed, this research means that US authorities are conducting a massive experiment on the American people, it is in violation of the Nuremberg code, which strictly forbids human experimentation on individuals without their informed consent. While some may have given their consent in the form of local referenda, the majority has not. Most frequently, the decision to fluoridate is made by largely unqualified elected municipal entities. Moreover, as the NRC report has made clear, there are far more health questions in play now than have been considered in the past. Thus, how many of the 160 million people drinking fluoridated water in the US today would you consider to be fully informed on the potential side effects of fluoride ingestion described by the NRC report at levels very close to 1 ppm?

If, despite all of the above arguments, your agency continues to support the practice of water fluoridation and continues to aggressively campaign for it, at the very least you should bifurcate your staff on this. By this, I mean you should assign a number of scientists in your agency, who hitherto have had no allegiance to the fluoridation promotion, to a separate division which would evaluate the health concerns identified by the NRC and other new research as it comes out. This staff should be free to do its work independent of the Oral Health Division, which sees its role primarily as promoting fluoridation, and not with objectively examining its potential dangers.

Indeed, it is most unseemly that staff members who actively support fluoridation are the very same people charged with analyzing health findings that may threaten the same program for which they work and on which they have staked their reputations. Such a conflict of interest is obvious and should be eliminated (ideally, from CDC in its entirety). However, it is essential that personnel evaluating the scientific literature relating to fluorides have a strong background in medicine, toxicology and epidemiology and do not bring a pro-fluoridation bias to their analysis. In other words, assign one division to deal with fluoride’s dental effects and create another to evaluate fluoride’s impacts on all other tissues and organ systems in the body.

Meanwhile, you should know that we intend to do everything we can to have you and key CDC staff involved in this matter brought to testify and be cross-examined under oath in a full Congressional inquiry into fluoridation at the earliest possible time.

Dr. Gerberding, please do not refer this to Dr. William Maas, or anyone at the Oral Health Division, for a reply to me. This letter is concerned with the total health of our citizens, not just the dental effects of fluoride. Dr. Maas’ response is totally predictable. It would reflect his own long-standing pro-fluoridation bias, which is, unfortunately, set in stone.

When lives are at stake from a policy your agency actively pursues, you - the Director of the CDC - must bear ultimate responsibility for the consequences of continuing this policy in light of new evidence of its harmfulness.

I will appreciate and look forward to an early reply.

Sincerely,

Dr. Paul Connett
Professor of Chemistry,
St. Lawrence University,
Canton, NY 13617.
315-229-5853
pconnett@stlawu.edu(now changed to