Fluoride has been added to city water supplies for decades, but a federal judge in California has ordered the Environmental Protection Agency (EPA) to further regulate it, saying high levels could pose an “unreasonable risk” to children's intellectual development.
U.S. District Judge Edward Cheng ruled Tuesday that scientific evidence about the health risks of fluoride when ingested at currently prescribed levels requires stricter regulation under the Toxic Substances Control Act (TSCA) of 2016, which provides a legal avenue for citizens to petition the EPA to review whether industrial chemicals pose health risks.
In his 80-page ruling, Chen said there was “little dispute” whether fluoride is harmful and ordered the EPA to take steps to reduce the risks, but did not say what steps to take.
“Indeed, EPA experts agree that ingesting some amount of fluoride is harmful,” the judge said, “and ample evidence establishes that maternal exposure to fluoride during pregnancy is associated with reduced IQ in their children.”
Fluoride in water leads to reduced intelligence
A drop of water drips from a leaky tap. (iStock)
“Between 1981 and 1984, there was a lot of talk about the association between fluoride and its adverse effects, such as osteosclerosis, enamel fluorosis, and psychological and behavioral problems,” Chen said.
At the same time, he wrote, the court's decision “does not conclude with certainty that fluoridated water is harmful to public health. Rather, as required by TSCA as amended, the court found that there is an unreasonable risk of such harm sufficient to require EPA to take regulatory action,” Chen said.
“The order doesn't dictate exactly what action must be taken. TSCA as amended leaves that decision up to EPA first. But what EPA cannot do in the face of this court's decision is to ignore the risk,” Chen added.
“If the Court again determines that the chemical at issue poses an unreasonable risk, it will order EPA to rule on that chemical,” the judge wrote. “EPA has reactive authority, and regulatory action could range from simply requiring warning labels to banning the chemical.”
EPA spokesman Jeff Landis told The Associated Press the agency is reviewing the decision but would not comment further.
This is the first time a federal judge has ruled on the risks that recommended levels of fluoride in U.S. water pose to children's neurodevelopment, said Ashley Mullin, a researcher at the University of Florida. Researched Effects of high fluoride levels in pregnant women.
She called it “the most historic decision yet in the U.S. water fluoridation debate.”
Currently, over 200 million Americans, or about 75% of the population, drink fluoridated water.
Many brands of toothpaste contain added fluoride (iStock)
Does fluoride in drinking water harm the brain?
In 1950, federal officials approved water fluoridation to prevent tooth decay and continued to promote it even after fluoridated toothpaste brands appeared on the market a few years later. In 1945, Grand Rapids, Michigan, became the first city in the world to add fluoride to its water supply.
Critics have long said that cleaning teeth with fluoride doesn't compare to the risks posed by ingesting it, which can cause harmful neurotoxic effects.
Federal health officials have recommended 0.7 milligrams of fluoride per liter of water since 2015. For the previous 50 years, the recommended upper limit was 1.2, but the judge wrote that this was changed “because evidence increasingly established a link between fluoride and adverse effects, including severe enamel fluorosis, risk of fractures, and potentially skeletal fluorosis,” a potentially disabling condition that weakens, stiffens, and hurts bones.
The World Health Organization has set the safe limit for fluoride in drinking water at 1.5. Separately, the EPA has a long-standing requirement that water systems must not contain more than 4 milligrams of fluoride per liter of water.
The lawsuit was brought by Food and Water Watch, an advocacy group that petitioned the EPA to investigate fluoride-related declines in children's IQs. The EPA denied the group's 2016 petition to ban or limit fluoridation of drinking water.
Food & Water Watch and several co-petitioners then sued to compel the EPA to act, citing mounting scientific evidence about the toxicity of fluoride when ingested.
“Today's ruling is an important recognition of the vast amount of scientific evidence showing that fluoridated drinking water poses serious human health risks,” the group said in a statement.
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A water utility foreman at a plant in Healdsburg, California, that adds fluoride to drinking water. (Michael McCol/San Francisco Chronicle via Getty Images)
“This court has considered the science and acted accordingly. Now EPA must respond by implementing new regulations that adequately protect all Americans, especially our most vulnerable infants and young 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 linked to lower IQ in children.
“Despite EPA experts acknowledging that fluoride is dangerous, the EPA points to technical problems at various stages of its risk assessment and concludes that fluoride does not pose an unreasonable risk,” Chen said. “The EPA primarily argues that the hazard levels and the precise dose-response relationships at lower exposure levels are not entirely clear. These arguments are unpersuasive.”
The Associated Press contributed to this report.
