Fluoridation Testimony to City of Portland

7/28/2019 Fluoridation Testimony to City of Portland

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CCTestimony.rtf 9/11/12 1:0

Fluoride TestimonyFor Portland City Council Hearing of 9/6/12

By Don Bain

6245 SW 39th Ave

Portland, OR 97221

FLUORIDATION SHOULD BE TREATED AS USING AHAZARDOUS SUBSTANCE

Fluorine is a highly reactive toxic element, which readily combines withmany other elements and compounds to form substances known as

fluorides. Fluoride in many of its forms, including the form put inpotable water (sodium hexafluorosilicate, aka sodium silicofluoride), isa "hazardous substance" under ORS 453.005(7), a "corrosive"substance under ORS 453.005(3), is "highly toxic" under ORS453.005(8), and is a "toxic substance" under ORS 453.005(18):

(7) Hazardous substance means:(a) Any substance that is toxic, corrosive, an irritant, a strong

sensitizer, flammable, combustible, or generates pressure throughdecomposition, heat or other means, if such substance or mixture of

substances may cause substantial personal injury or substantial illnessduring or as a proximate result of any customary or reasonably foreseeablehandling or use, including reasonably foreseeable ingestion by children, orany substance that the Director of the Oregon Health Authority finds,

pursuant to the provisions of ORS 453.005 to 453.135, comes within thedefinition of this paragraph.

While it may be claimed that a glass of fluoridated water at EPA-approved concentrations (


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given ppm) is 10 times the dose - which the City has no control orknowledge of, totally unlike prescription drugs whose individual doseadministration is carefully calculated, controlled and monitored.

The EPA (EPA-822-R-00-001 of 2004) says infants


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Second, people already ingest significant daily amounts of fluoride frommany sources including toothpaste (1000-1500 ppm), dental treatments,infant cereals (.9-2.1 ppm), strained meats (


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illness, all of which occurs much faster when fluoridated water hastaken so many different paths into the body for a high daily intake.Thus, the above problematic concentrations can be reached, if not inone day, fairly quickly.

Fourth, dangerous accumulated amounts of fluoride (e.g., 7500-8000ppm in bone for stage 2 or 3 skeletal fluorosis and 1 ppm causes 32%bone marrow DNA damage in 6 weeks' exposure) are easily reached atthese intake levels. Again, when prescriptions are given the body'sabsorption, processing, storage and excretion of the drug; its half life inthe body; and individual circumstances are accounted for, but the Citycannot possibly do this because the rate if intake from all sourcescannot be controlled. Nor can the City adjust or control dosage basedon any individual factors.

The effects of long term fluoridation are devastating. Downs syndromeis 30% higher in fluoridated communities and hip fractures among theelderly commonly lead to death. Cancer death rates are 10% higher incommunities 13-17 years after fluoridation and oral cancers increase33-50% with water fluoridation. Osteosarcoma is higher among

younger males in fluoridated communities, by 50% (National Cancer

Institute), 3-7 times (NJ Dept. of Health) and 70% (in 3 studies reviewedin a Fluoride journal article).

Fifth, widespread deficiencies of magnesium and iodine aggravate theimpact of fluoride ingestion. More than three quarters of the general

population is estimated to be magnesium deficient and over half are notgetting enough iodine. The number of iodine-deficient persons whodropped below the WHO's critical 5 ug/dL (mean urine iodine

concentration) threshold from 1988 to 1994 went up by 4.5-fold.Bromine (a common dough conditioner) and fluoride both reduceiodine in the thyroid gland. So, the fluoride sensitive populationincludes persons magnesium or iodine deficient, or persons consuminghigher than average amounts of foods made with wheat flour - this is avery high percentage of the general population.


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Sixth, aluminum containers with fluoridated contents produce theneurotoxin aluminum fluoride, which at >=.5 ppm is very harmful - sothis potentially ubiquitous combination produces a hazardoussubstance. Think aluminum water bottles, cans and cooking pots.

Here, the Portland Water System may present challenges within itself.What is the naturally occurring aluminum content of water from Bull

Run and the Columbia Well Field? Is there anywhere (downstream ofthe proposed new fluoridation facility) where the water comes intocontact with aluminum, e.g., piping, tanks, fittings, sensor housings,etc? Does the Water Bureau ever use any clarifying agents containingaluminum and would these be banned? Is there any aluminum in anychemicals used to treat the water, or in any of their byproducts? Thesame questions also apply to lead.- - - - - - -

At the above levels there simply is no margin for safety at common waterfluoridation concentrations and many people will be exposed to levels offluoride sufficient for injury, illness or induced hypothyroidism inotherwise healthy people. A prudent policy would be to use largemargins of safety for cancerous and toxic substances to account forwide variations in human sensitivities, long term exposure andbioaccumulation, age & weight, nutritional status, widely different

unlimited rates of ingestion, and individual health. Such a marginwould reduce the prudent and much safer level of fluoride in Portland'swater to the naturally occurring concentrations of


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following categories:(a) Produces death within 14 days in one-half or more of a group of

10 or more laboratory white rats each weighing between 200 and 300grams, at a single dose of 50 milligrams or less per kilogram of body

weight, when orally administered;(b) Produces death within 14 days in one-half or more of a group of

10 or more laboratory white rats each weighing between 200 and 300grams, when inhaled continuously for a period of one hour or less at anatmosphere concentration of 200 parts per million by volume or less ofgas or vapor or two milligrams per liter by volume or less of mist or dust,

provided such concentration is likely to be encountered by humans whenthe substance is used in any reasonably foreseeable manner; or

(c) Produces death within 14 days in one-half or more of a group of10 or more rabbits tested in a dosage of 200 milligrams or less perkilogram of body weight, when administered by continuous contact withthe bare skin for 24 hours or less.

Note (a) could be a biased (easy) standard because rats & mice absorbfluoride poorly. If the three different tests don't produce the same bloodand glandular concentrations, they are not equally sensitive to thequestion and the test could be cherry picked. Also, are rats, rabbits and

humans equally sensitive to fluoride and equally representative ofhuman effects???

(18) Toxic substance means any substance, other than radioactivesubstance, that has the capacity to produce personal injury or illness tohumans through ingestion, inhalation, or absorption through any bodysurface.

To illustrate the issue of potential fluoridation toxicity, here are a fewexamples of public water fluoridation accidents which injured andkilled people: In 1993 at Popularville, Mississippi (15 in the hospital);in 1986 at New Haven, Connecticut (55 people with acute toxicity); at

Middletown, Maryland (reached 70 ppm), at Hooper Bay, Alaska(reached 150 ppm with 1 killed and 260 poisoned); in 1992 at Rice

Lake, Wisconsin (reached 40 ppm with ~40 children suffering toxicity


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symptoms); and in 1979 at Annapolis, Maryland (1 died and anotherwas left with serious brain injury). These were just immediate reactions,without accounting for delayed reaction impacts.

LABELING OF HAZARDOUS SUBSTANCES IS REQUIRED

Under ORS 453.005(11) such substances (types listed above) must belabeled. How will the City ensure all tap water and ingestible foods and

products made from or with its fluoridated water be properly labeled?

(11) Label means a display of written, printed, or graphic matter uponthe immediate container of any substance, or in the case of an article thatis unpackaged or is not packaged in an immediate container intended orsuitable for delivery to the ultimate consumer, a display of such matterdirectly on the article involved or on a tag or other suitable materialaffixed thereto, and a requirement made by or under authority of ORS453.005 to 453.135 that any word, statement, or other informationappearing on the label shall not be considered to be complied with unlesssuch word, statement, or other information also appears on the outsidecontainer or wrapper, if any, unless it is easily legible through the outsidecontainer or wrapper and on all accompanying literature where there are

directions for use, written or otherwise.

If such substances are not properly labeled they become "misbrandedhazardous substance(s)" under ORS 453.005(13) and ORS 453.085

prohibits their introduction, delivery, alteration of labeling or any actwhich results in a hazardous substance becoming misbranded:

453.005(13) Misbranded hazardous substance means a hazardous

substance that does not meet the labeling requirements of ORS 453.035.

453.085 Prohibited acts. A person may not perform any of the followingacts:

(1) The introduction or delivery for introduction into commerce of anymisbranded hazardous substance or banned hazardous substance.

(2) The alteration, mutilation, destruction, obliteration, or removal of


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the whole or any part of the label of a hazardous substance.(3) The performance of any act with respect to a hazardous substance

while the substance is in commerce, or while the substance is held for saleor resale after shipment in commerce, that results in the hazardous

substance being a misbranded hazardous substance or a banned hazardoussubstance.

ORS 435.035(2) requires the word "Danger" on substances which are"corrosive" or "highly toxic", and the word "Warning" or "Caution"on other hazardous substances. It requires at ORS 435.035(2)(c)disclosure of precautionary measures to be followed or avoided, whichincludes at (h) adequate directions for the protection of children. Sothis would include directions for sensitive persons, such as pregnantwomen and persons feeding infants, small children, persons withthyroid problems, the elderly, pesticide applicators, and people withvarious but common nutritional deficiencies (magnesium for example),etc. And this law requires warnings to be presented with the product,which for fluoridated water (and anything made from or cooked in it)should address:

* Children not swallowing fluoridated toothpaste

* Lead leaching by reactive action of fluoride in lead-soldered copperpiping or any brass plumbing fixtures, regardless of current "lead free"standards, and these on-going compound risks* Using aluminum containers or cookware with fluoridated water* Cancer and osteosarcoma risks* Genetic damage* Use by sensitive persons (magnesium or iodine deficient, or highintakes of wheat flour foods) and maintaining adequate nutritional

intake along with calcium* Neurological damage and abnormal brain development* Bioaccumulation in bone, kidneys, brain and the thyroid, from allsources of fluoride intake over time, not to aggravate* Dental and skeletal fluorosis and increased risk of osteoporosis* Lowered male fertility* Coexposure with pesticides (fluoride is a common ingredient)


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* Lower IQs among children (25 of 27 studies)* Not giving fluoridated water or foods to infants and young children

So, exactly how does the City propose to comply and enforce it on

others? Will a disclosure notice (satisfying the above labelingrequirements), acknowledgement, consent and release form accompanyevery request to supply City water and be inserted in every water bill?

How about notices at every public water fountain, pool, public buildingand community center? Will the City Water Bureau be responsible for

giving notice to travelers, the homeless, minors and incapacitatedpersons? What is enough to satisfy the ORS' labeling requirements inthe case of public water fluoridation?

Note the EPA's "lead free" plumbing standards and current ORPlumbing Code allow


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UNFUNDED MANDATE, IMPACTS

Labeling per ORS 435.035(2) constitutes an unfunded mandate on thelocal business community. Either they must install and maintain costly

reverse osmosis or distillation units (for volume production), or theyshould be labeling all beverages and foods made with fluoridated water.For example, this impacts local beer brewers, restaurants cooking foodand serving various reconstituted beverages, any business servingdrinking water, bakeries, tofu producers, catering companies, and softdrink bottlers. Performing such labeling would impose a huge price tobusiness and many customers will refuse service or demand somethingwhich is not contaminated.

INFORMED CONSENT ISSUES

Closely related to labeling is the issue of informed consent. How doesthe City propose to perform any informed consent duties in its role ofdispensing a regulated drug (fluoride is a drug under ORS 677.010(7))to the public?

677.010(7) Drug means all medicines and preparations for internal or

external use of humans, intended to be used for the cure, mitigation orprevention of diseases or abnormalities of humans, which are recognizedin any published United States Pharmacopoeia or National Formulary, orotherwise established as a drug.

The City is not in any position to practically, legally, morally or ethicallyperform informed consent and doing so on any comprehensive basiswould be very difficult and costly. A public meeting is by no stretch of

imagination performing informed consent and the City Council'sdecision process does not do it either.

Physicians must provide informed consent before any attempt toadminister any drug to any person, on a case-by-case basis:

677.097 Procedure to obtain informed consent of patient. (1) In order to


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obtain the informed consent of a patient, a physician, podiatric physicianand surgeon or physician assistant shall explain the following:

(a) In general terms the procedure or treatment to be undertaken;(b) That there may be alternative procedures or methods of treatment,

if any; and(c) That there are risks, if any, to the procedure or treatment.(2) After giving the explanation specified in subsection (1) of this

section, the physician, podiatric physician and surgeon or physicianassistant shall ask the patient if the patient wants a more detailedexplanation. If the patient requests further explanation, the physician,

podiatric physician and surgeon or physician assistant shall disclose insubstantial detail the procedure, the viable alternatives and the materialrisks unless to do so would be materially detrimental to the patient. Indetermining that further explanation would be materially detrimental the

physician, podiatric physician and surgeon or physician assistant shallgive due consideration to the standards of practice of reasonable medicalor podiatric practitioners in the same or a similar community under thesame or similar circumstances.

CITIZENS' RIGHT TO REFUSE DRUGS

Citizens clearly have the right to refuse any treatment or drug underORS 677.060(7), which they cannot practically do if a drug is in the

potable water supply and everything they encounter in everyday life iscooked, washed, grown or made from/with it. Fluoridated City waterwould be used in many ways where labeling is not practical or enforced,effectively making its avoidance impossible by residents and visitors.

677.060 Persons and practices not within scope of chapter. This

chapter does not affect or prevent the following:(7) The practice of the religion of persons who endeavor toprevent or cure disease or suffering by prayer or other spiritual means inaccordance with the tenets of any church. Nothing in this chapterinterferes in any manner with the individuals right to select the

practitioner or mode of treatment of an individual's choice,....


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COMMUNITY RIGHT TO KNOW

How does the City propose to include fluoride in its Community Right toKnow program under ORS 453.307-.414? This includes emergency

response planning (ORS 453.347) for a possible overfluoridationaccident like listed above, which addresses response across all affectedcommunities and populations. Such a plan (with budget) needs to bemade, presented, discussed and settled before any fluoridation decisionis made, i.e., a decision package is not complete without it. Not havingan emergency response plan in place before fluoridation starts risks Cityliability for bodily harm arising from its negligence.

CITY HAS NO AUTHORITY TO ADMINISTER DRUGS

How does a City Council decision to fluoridate public potable drinkingwater with a drug (ORS 677.010(5)) comply with the provisions of ORS677? Only limited classes of duly licensed medical practitioners may"undertake to prescribe, give or administer any drug or medicine for theuse of any other person" (ORS 677.085(2)) or "diagnose, cure or treatin any manner, or by any means, methods, devices or instrumentalities,any disease, illness, ..... of any person" (ORS 677.085(4)). The City

Council or the City Water Bureau:

Is not licensed or competent to practice medicine;Does not have a doctor-patient relationship with all affected persons;Cannot perform a personal medical diagnosis for or give treatment toanyone;

Does not have the authority to prescribe any drugs;Is not a licensed dispenser of any drugs;

Cannot provide a doctor's duty of care, skill and diligence, and;Is not qualified for a license to perform any of these acts.

If the City Council attempts to practice medicine, its exposed tocommitting a Class C felony under ORS 677.990 for violation of ORS677.080 or a court order to desist on these grounds. Adoption of publicwater system fluoridation by any person licensed to practice medicine


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would constitute "unprofessional or dishonorable conduct" (ORS677.188(4)) because they cannot possibly perform all these requiredduties in such a case.

WATERSHED ISSUES

Fluoridated water will end up in the watershed, which is protected bythe Clean Water Act from toxic pollutants like man-introduced fluoride.There simply is no practical way to avoid this from happening. Peoplewill water yards with fluoridated water, there will be runoffcontaminated by fluoride and it will enter water quality limited streams,e.g., Fanno Creek and its tributaries which takes runoff from SW

Portland. Vermont Creek also fits this category.

Has the City studied the impacts of fluoridation on such watersheds, vis-a-vis the Clean Water Act's limitations? Such an investigation and anyresulting plan (with budget) needs to be made and presented for publicdiscussion and settlement before any fluoridation adoption decision ismade, i.e., a decision package is not complete without it. Neglecting thisquestion risks City liability for environmental impacts and consequentunacceptable legal and budgetary surprises.

UNKNOWN COST IMPACTS

Other than a loose figure of $5M, no budget for the fluoridationprogram is available. A complete budget should include theCommunity Right to Know program with emergency response

planning, equipment and drills, plus any added costs to deal withfluoridated water getting into the watersheds - what and where are these

figures? How sure is the $5M amount? It does not appear to have anysound basis. Does the City have a binding quote for the needed facility?Or even a design? What are the on-going costs of fluoridation? Whatbudget will all this come out of? What would be the needed increase inthe Water Bureau's water rates? Would other jurisdictions who obtaintheir water from the Bull Run system also have to pay for fluoridation,even if they didn't want it? If the total costs of fluoridation are not


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coming out of increased water rates, how is who going to pay for it orwhat other budget would have to be cut?

Assuming all these costs were known and available, what is the cost

effectiveness of the overall program? How many persons are expectedto have what level of reduction in cavities? What is the per person costwhole fluoridation program budget? How does that cost compare withstandard treatments at the dentist's office? Or compare with the per

person cost of (potentially subsidized) teeth cleaning? How can anyonebe comfortable fluoridation is a wise use of money, compared to thealternatives? It appears none of these answers are available.

CONCLUSION

Plainly, any City Council or public decision to fluoridate public water isriddled with medical, health, financial, legal, moral, ethical andenvironmental issues and conflicts. Preventing cavities with

fluoridation, even if proven very effective, does not rise to the level ofpublic need or good sufficient to overcome these relatively grave issuesor the physical harm that would result from public water fluoridation.The per person cost effectiveness of fluoridation is completely unknown,

as is the true total cost and how its paid for. There are far betteralternatives for preventing cavities that are without such complications.The City has not presented any case that fluoridation is an emergencyissue that merits immediate decision in the absence of resolution of themany outstanding issues. If these and all other issues cannot be fullyaddressed to the public's satisfaction, fluoridation of potable waterbelongs in the same medical treatment ideas category as yesterday'sdraping people with mercury-soaked blankets and cocaine cure-all

elixirs.

Documents

Fluoridation Testimony to City of Portland