Water Fluoridation Challenge

The Centers for Disease Control and Prevention (CDC) received a request from a private citizen November 19, 2002 challenging a published statement that indicates fluoridation of public water supplies is safe. Request for Correction The challenged statement is from CDC⦡mp;#8364;?s frequently asked questions page for community fluoridation, which reads -- "Extensive research conducted over the past 50 years has shown that fluoridation of public water supplies is a safe and effective way to reduce tooth decay for all community residents." The petitioner contends that the presence of fluoride in water can cause chronic fluoride poisoning and no scientific studies are available to support the challenged statement. The petition states, "There is no reliable method to detect the difference between a case of arthritis caused by excess fluoride and a case of arthritis caused by something else." The requester recommends that CDC should modify its claims on fluoridation safety, as a means of correcting the claimed oversight. The new claims should state that the methods used in safety studies were not able to detect the arthritic pre-crippling phases of skeletal fluorosis. Namely, that data on the prevalence of fluoride-induced arthritis is not available and that physicians do not have access to laboratory test that can identify fluoride-induced arthritis. Agency Response The CDC denied the request for correction in a January 9, 2003 letter, explaining that the Center believes the statement is correct and that "the fluoride information is comprehensive, informative, and understandable within the context of its intended purpose." The response also cited a number of publications that contain further detail and references on water fluoridation. Petitioner Appeal The petitioner submitted an appeal to CDC on January 19, 2003 asserting that the agency⦡mp;#8364;?s response was false and the claim of safety is unsubstantiated. The individual contends that none of the documents cited in CDC⦡mp;#8364;?s response contain references or details about distinguishing characteristics between individuals experiencing arthritis from fluoridation and other types of arthritis. Appeal Response In a March 9, 2003 letter CDC denied the request for reconsideration, stating that extensive peer-reviewed scientific research supports the statement about the safety of fluoridation. Furthermore, CDC asserts that:
  • There is no evidence that that consumption of fluoridated water, which is present in quantities of 0.7 to 1.2 mg/L, when combined with other daily exposures causes symptoms of arthritis or other forms of joint pain.
  • Recent reviews of fluoride intake have found that even water with very high naturally occurring levels of fluoride does not cause skeletal fluorosis; only five cases have ever been reported in the U.S. and was due to extremely high levels of exposure over 20 years.
  • The daily intake level of fluoride necessary to cause skeletal fluorosis or any clinical symptoms surpasses the level received by people in fluoridated water systems.
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