FLUORIDE 31(3)
 1998, p. 170		 International Society for Fluoride Research Table of Contents

REPORT ON SYMPOSIUM

PUBLIC HEALTH GOAL FOR INGESTED FLUORIDE
David Kennedya and William Hirzyb

On June 19-21, 1998, the International Academy of Oral Medicine and Toxicology (IAOMT) co- hosted a symposium as a final step in developing a public health goal (PHG) for ingested fluoride. We firmly agree with the findings of the November 1997 Canadian Dental Association conference on fluoride drops and tablets which found "no reliable scientific evidence of significant dental benefit from ingested fluoride." The IAOMT has received scientific input for this PHG from more than a dozen sources. Adverse health effects demonstrated were: fluorosis; cancers; genetic damage; bone pathology; trans placental and brain transport; histological brain, artery, and kidney damage; and neurological impairment.1-4

The Environmental Protection Agency (EPA) Guidelines for Carcinogen Risk Assessment recommend using a multistage model procedure and linearized upper bounds for low-dose extrapolation in developing quantitative dose-response assessments. The degree of multistage polynomial fitted to the data was selected by the GLOBAL 86 program. Reference doses (RfD) are calculated from animal experiments (cow, rat) and a human study from the peer reviewed literature. Modifying factors of 10 for each condition of uncertainty factor were used for animal to human conversion, human variations in sensitivity, conversion from lowest-observed-adverse-effect level (LOAEL) to no-observed-adverse-effect level (NOAEL), and severity of effect (diminished IQ, brain damage, abortion rate and calf death).

The resulting PHG is calculated at 1 x 10-4mg/kg-day (human)5,6 and 1.5 x 10-4 mg/kg-day (cow)7 and 7 x 10-6mg/kg-day (rat).8 Current human exposure in fluoridated communities may exceed 7 x 10-2 mg/kg-day. This risk assessment raises serious concerns about the pervasive over-exposure to fluoridated drinking water, fluorine-containing foods, beverages, pharmaceuticals, time-release dental cements and fillings and oral care products.

_________________________________

aPast-President, International Academy of Oral Medicine and Toxicology. davidkennedy-dds@home.com
bSenior Vice-President, Chapter 280 National Treasury Employees Union, (Representing Headquarters Professionals, US Environmental Protection Agency).

Postscript note by ISFR webmaster: the references to the risk assessment Drs. Hirzy and Kennedy did for the International Academy of Oral Medicine and Toxicology in San Diego in 1998 are added herewith. They were omitted in the journal due to space but were presented at the conference.

References:

  1. Cancer promoting:
    1. Carcinogenesis, Vol. 9, pp. 2279-2284 (1988)
    2. Sodium Fluoride: individual animal tumor pathology table [rats], Battelle Memorial Institute, February 23, 1989
    3. Sodium Fluoride: individual animal tumor pathology table [mice], Battelle Memorial Institute, April 11, 1989
    4. Lancet 36, page 737 (1990) and Dr. William Marcus' May Day Memo (1990) EPA Senior Science Advisor Office of Drinking Water member of NFFE 2050.
    5. Review of Fluoride: Benefits and Risks, U. S. Public Health Service, pp. F1-F7 (1991) 6) Fluoride Vol. 26, pp. 83-96 (1992)
    6. A Brief Report on the Association of Drinking Water Fluoridation and the Incidence of Osteosarcoma among Young Males, New Jersey Department of Health, November 1992
    7. Fluoride, the Aging Factor, Health Action Press, pp. 72-90 (1993)

  2. Hip fracture increase linked to water fluoride levels
    1. Jacobsen SJ, Goldberg J, Miles TP, Brody JA, et al. Regional variation in the incidence of hip fractures: U.S. white women aged 65 years and older. JAMA Vol. 264, pp. 500-502 (1990)
    2. Cooper C, Wickham CAC, Barkcr DJR, and Jacobsen SJ. Water fluoridation and hip fracture [letter]. JAMA Vol. 266, pp. 513-514, 1991
    3. Danielson C, Lyon IL, Egger M, and Goodenough GK. Hip fractures and fluoridation in Utah's elderly population. JAMA Vol. 268, pp. 746-748 (1992)
    4. Journal of the American Medical Association Vol. 273, pp. 775-776 (1995)
    5. Jacobsen SJ, Goldberg J, Cooper C, and Lockwood SA. The association between water fluoridation and hip fracture among white women and men aged 65 years and older: A national ecologic study. Ann Epidemiol 1992: 2:617-26
    6. Sowers MFR, Clark MK, Jannausch ML and Wallce RB, A prospective study of bone mineral content and fracture in communities with differential fluoride exposure. Am J Epidemiol 1991; 133:649-60
    7. Keller C. Fluorides in Drinking Water. Paper presented at the Workshop on Drinking Water Fluoride influence on Hip Fractures and Bone Health. April 10, 1991, Bethesda, Md.
    8. May, DS and Wilson MG. Hip fractures in relation to water fluoridation: an ecologic analysis. Presented at the Workshop on Drinking Water Fluoride Influence on Hip Fractures and Bone Health. April 10, 1991, Bethesda, Md.

  3. Dental fluorosis has increased since water fluoridation began.
    1. Science Vol. 217, pp. 26-30 (1982)
    2. Journal of the American Dental Association Vol. 108, pp. 56-59 (1984)
    3. Journal of public Health Dentistry Vol. 46, pp. 184-187 (1986) 4) Health Effects of Ingested Fluoride, National Research Council, page 37 (1993)

  4. Decrement in human intelligence and neurotoxicity from fluoride
    1. Mullenix, Phyllis et. al Neurotoxicity of Sodium Fluoride in Rats, Neurotoxicology and Teratology, Vol. 17, No. 2, pp. 169-177, 1995
    2. Li, XS; Zhi, JL; Gao, RO Effects of fluoride exposure on intelligence in children, Fluoride 28:4, pp. 189-192 (1995)
    3. Zhao, LB; Liang, D; W Wu Lu-Liang Effects of a high fluoride water supply on children's intelligence. Fluoride vol. 29:4 pp. 190-192 1996
    4. Varner, J.A., Jensen, KF., Horvath, W. & Issacson, R.L. (1998) Chronic Administration of Aluminum-Fluoride or Sodium-Fluoride to Rats in Drinking Water: Alterations in Neuronal and Cerebrovascular Integrity. Brain Research 784: 284-298.

  5. Bucher et al. (1991) Human eq. doses surface area RfD = 7 x 10-2 RfD = 7 x 10-2 mg/kg-day ÷ 10 x 10 x10 x 10 = 7 x 10-6

  6. Zhao, LB; Liang, D; W Wu Lu-Liang (1996) 40 kg child who drinks 1 liter H20 Dose: 1 L/day x 4 mg/L 40 kg RfD = 0.1 mg/kg-day RfD = 0.1 mg/kg-day ÷ 10 x 10 x10 x 10 = 1 x 10-4 mg/kg-day

  7. Eckerlin et al. Findings of increased abortion rate and calf death. Doses: 393-560 mg/day ÷ 330 kg RfD = 1.2- 1.7 RfD = 1.2- 1.7 mg/kg-day ÷ 10 x 10 x10 x 10 = 1.5 x 10-4

  8. Isaacson et al. and Varner et al. (1998) Effect level RfD = 0.07 mg/kg-day RfD = 0.07 mg/kg-day ÷ 10 x 10 x10 x 10 = 7 x 10-6 mg/kg-day

FLUORIDE 31(3)
 1998, p. 170		 International Society for Fluoride Research
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