It has been added to municipal water for decades, but a federal judge in California has ordered the Environmental Protection Agency (EPA) to further regulate fluoride because high levels could pose "an unreasonable risk" to the intellectual development of children.
U.S. District Judge Edward Chen ruled Tuesday that the scientific evidence of fluoride’s health risks when ingested at current prescribed levels requires stricter regulation under the 2016 Toxic Substances Control Act (TSCA). The act provides a legal pathway for citizens to petition the EPA to consider whether an industrial chemical presents health risks.
Chen, in his 80-page ruling, wrote there is "little dispute" over whether fluoride is hazardous and ordered the EPA to take steps to lower that risk, but didn’t say what those measures should be.
"Indeed, EPA’s own expert agrees that fluoride is hazardous at some level of exposure," the judge said. "And ample evidence establishes that a mother’s exposure to fluoride during pregnancy is associated with IQ decrements in her offspring."
FLUORIDE IN WATER LINKED TO LOWER INTELLIGENCE
"Between 1981 and 1984, fluoride’s association with adverse effects including osteosclerosis, enamel fluorosis, and psychological and behavioral problems was contested," Chen said.
At the same time, he wrote that the court’s finding "does not conclude with certainty that fluoridated water is injurious to public health," Chen said. "Rather, as required by the Amended TSCA, the Court finds there is an unreasonable risk of such injury, a risk sufficient to require the EPA to engage with a regulatory response.
"This order does not dictate precisely what that response must be. Amended TSCA leaves that decision in the first instance to the EPA. One thing the EPA cannot do, however, in the face of this Court’s finding, is to ignore that risk," Chen added.
"If the Court finds anew that the chemical at issue presents an unreasonable risk, it then orders the EPA to engage in rulemaking regarding the chemical," the judge said. "The EPA is afforded in the first instance the authority to respond; regulatory actions can range from requiring a mere warning label to banning the chemical."
An EPA spokesperson, Jeff Landis, told The Associated Press that the agency was reviewing the decision but offered no further comment.
It's the first time a federal judge has made a determination about the neurodevelopmental risks to children of the recommended U.S. water fluoride level, said Ashley Malin, a University of Florida researcher who has studied the effect of higher fluoride levels in pregnant women.
She called it "the most historic ruling in the U.S. fluoridation debate that we’ve ever seen."
Currently, more than 200 million Americans, or about 75 percent of the population, drink fluoridated water.
DOES FLUORIDE IN DRINKING WATER HURT YOUR BRAIN?
In 1950, federal officials endorsed water fluoridation to prevent tooth decay, and they continued to promote it even after fluoride toothpaste brands hit the market several years later. In 1945, Grand Rapids, Michigan became the first city in the world to fluoridate its water supply.
Critics have long said that washing teeth with fluoride is not comparable to the risks posed by ingesting fluoride, with the latter potentially triggering harmful neurotoxic effects.
Since 2015, federal health officials have recommended a fluoridation level of 0.7 milligrams per liter of water. For five decades before that, the recommended upper range was 1.2 "after evidence increasingly established fluoride’s connection to adverse effects, including severe enamel fluorosis, risk of bone fracture, and potential skeletal fluorosis," the judge wrote. Skeletal fluorosis is a potentially crippling disorder which causes weaker bones, stiffness and pain.
The World Health Organization has set a safe limit for fluoride in drinking water of 1.5. Separately, the EPA has a longstanding requirement that water systems cannot have more than 4 milligrams of fluoride per liter of water.
The case was brought by Food and Water Watch, an advocacy organization which petitioned the EPA to investigate lowered IQs in children allegedly caused by fluoride. The EPA denied the group’s 2016 petition calling for the agency to ban or limit the fluoridation of drinking water.
Food & Water Watch and several co-petitioners subsequently sued the EPA to compel action citing the mounting scientific evidence of toxicity when fluoride is ingested.
"Today’s ruling represents an important acknowledgment of a large and growing body of science indicating serious human health risks associated with fluoridated drinking water," the group said in a statement.
"This court looked at the science and acted accordingly. Now the EPA must respond by implementing new regulations that adequately protect all Americans – especially our most vulnerable infants and children – from this known health threat."
Tuesday’s ruling cited a review of 72 human epidemiological studies and available literature by the U.S. National Toxicology Program which concluded that fluoride is connected to reduced IQ in children.
"Notwithstanding recognition by EPA’s expert that fluoride is hazardous, the EPA points to technicalities at various steps of the risk evaluation to conclude that fluoride does not present an unreasonable risk," Chen said. "Primarily, the EPA argues the hazard level and the precise relationship between dosage and response at lower exposure levels are not entirely clear. These arguments are not persuasive."
The Associated Press contributed to this report.
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