Arsenic, the legendary king of poisons, is being added to drinking water in Manchester and other New Hampshire communities that fluoridate.

The cancer-causing metallic element is among the contaminants found in hydrofluosilicic acid, which is used to deliver tooth decay-preventing fluoride to Manchester’s drinking water.

In recent weeks, both the state Department of Environmental Services and the U.S. Environmental Protection Agency have announced plans to tighten — by 80 percent — the so-called safe standard for arsenic in drinking water. Dartmouth College scientists, backed by a $15 million federal grant, have embarked on a five-year study of the toxicity of small amounts of arsenic.

Yet the same government officials who are ordering public water systems to remove arsenic and urging homeowners to purge it from their private wells defend the addition of the clear, odorless, tasteless poison to drinking water through fluoridation.

The officials see no irony in that position.

In interviews, they insisted the dental benefits of fluoridation greatly outweigh the risks of the arsenic that fluoridation adds to the drinking water.
“There is no reason that arsenic would be ever considered beneficial,” agreed Dr. William J. Kassler, the state medical director.

But, with regard to fluoridation, Kassler emphasized that, “It’s the concentration, the dilution that matters. . . I wouldn’t say that we are putting arsenic into drinking water. I would say it’s traveling along with something we are putting in at an infinitesimally small dilution.”

“If you consider the fact that this is the raw hydrofluosilicic acid product and that that product will be diluted roughly 190,000 fold to achieve a fluoride concentration of 1 part per million, the arsenic levels will become fractions of a percent of (the EPA’s arsenic standard),” said Paul R. Harp, health risk analyst for the state’s Office of Community and Public Health.

The new arsenic standard of 10 parts per billion (ppb) at the tap will be of particular interest in New Hampshire, where the soils and waters have been found to contain levels of arsenic substantially higher than those found in other regions of the country. New Hampshire was known as the arsenic state in the mid-19th century when more than 300 mines produced high grade arsenic that found its way into pesticides, paints, ceramics and wallpaper.

The state Department of Environmental Services has estimated 15 percent of the bedrock wells in New Hampshire have arsenic concentrations that will exceed the new drinking water standard. State environmental and public health officials have urged homeowners who draw from private wells to test their water for arsenic and spend $800 to $2,000 to filter it out.

They expect about 115 of the 1,100 public water systems in the state will be affected as the new arsenic standard is phased in over five years. It will cost the public systems approximately $3.5 million to buy and $350,000 a year to operate the filtration equipment they will need to meet the tighter arsenic standard.

In addition to arsenic, a chemical analysis done for Manchester Water Works by the Eastern Analytical laboratory in Concord on the first 4,000 gallon tanker truck load of hydrofluosilicic acid purchased by Manchester found minute amounts of lead, chromium, cadmium and barium.

City water officials, acting on the recommendation of state health officials, will also test at three-month intervals this year to determine if the fluoridation process adds to the levels of radionuclides that occur naturally in water taken from Lake Massabesic. The tests, which have to be done at a lab in Maine, detect the presence of uranium, radium and other radioactive elements believed to be carcinogenic.

The arsenic was measured at 4 milligrams per liter (mg/L) in that first batch of hydrofluosilicic acid delivered to Manchester. When that liter is diluted 190,000 times, the arsenic measures out at 0.00021 mg/L, or .021 ppb in the treated water delivered at the tap — amounts that are well below the EPA’s new 10 ppb standard.

Comparatively, the arsenic detected in the hydrofluosilicic acid delivered to Manchester was substantially less than the arsenic that has been found in typical samples of the acid tested by the National Sanitation Foundation International, the industry-supported organization that evaluates and sets quality standards for drinking water chemicals.

The foundation, in a July 18, 2000, letter to Harp that contained much of the same information it provided in response to a congressional inquiry, described arsenic as “the most common contaminant detected” in fluoridation products. In samples where arsenic was found, the National Sanitation Foundation International measured the average concentration at the tap as 0.43 ppb and the maximum concentration at 1.66 ppb — amounts higher than that found in Manchester hydrofluosilicic acid, but still well below the EPA’s 10 ppb standard.

The Foundation has also been testing fluoridation chemicals for radioactive contaminants since 1998, but reported that, to date, it has “not found any sample with a positive, detected, result.”

The hydrofluosilicic acid began trickling into Manchester’s water supply two months ago.

Types of fluoride
Of the half-dozen chemical supply companies that initially expressed interest in selling to Manchester what is referred to in the business as “silly acid,” only one, Solvay Fluorides Inc. of Allston, Mass., offered an analysis of each railcar load of its product and expressed a willingness to meet the city’s stringent standards, according to David Paris, water supply administrator for Manchester Water Works.

“We (the Manchester Board of Water Commissioners) wrote a specification for hydrofluosilicic acid that. . . would limit the amount of impurities to one-twentieth of what the national standards would allow. We felt that was an appropriate, prudent step on our part and we currently are under contract with a supplier who is meeting that,” Paris said of Solvay.

Manchester will spend about $55,000 a year for its liquid acid, about one-third what it would cost for an equivalent amount of sodium fluoride, the powdered product that is better suited for small water systems.

Both the acid and the dry sodium fluoride are derived from the chemical-laced scrubber gases generated during the refining of ore to make phosphate fertilizer. They would be labeled hazardous waste if not for their use as water fluoridating agents.

Nine other New Hampshire communities fluoridate their drinking water: Concord, Dover, Portsmouth and Rochester use hydrofluosilicic acid; Durham, Hanover, Laconia, Lancaster and Lebanon add powdered or crystallized sodium fluoride.

The Sunday News contacted water works officials in Concord, Dover, Rochester, Durham, Hanover, Laconia and Lebanon. They all said they do not analyze their fluoridation chemicals, confident that what is sold to them meets purity standards set by the chemical industry and the American Water Works Association.

Fluoridation is an issue debated with religious fervor.

In interviews, it was difficult to focus the discussion on the potential dangers of adding arsenic and other contaminants to the drinking water along with the fluoride.

Proponents inevitably referred to pre-fluoridation horrors, describing poor children with painful decays and abscesses. They lauded drinking water fluoridation as one of the most important medical advances of the past 50 years. Nationally, about 70 percent of the population currently drinks fluoridated water. In New Hampshire, about 275,000 people draw drinking water from public systems that fluoridate.

Opponents of fluoridation had horror stories of their own, citing research linking lead poisoning to aggressive behavior and learning disabilities in children. They claimed fluoridation increases the amount of lead in drinking water. They noted that many European countries have rejected fluoridation, yet studies there show cavities continue to decrease as individuals choose to supplement their fluoride intake with certain foods, fluoride tablets or fluoride-enhanced toothpaste.

Both sides found support for their arguments in the writings of Professor John Featherstone, chairman of the Department of Dental Public Health and Hygiene at the University of California in San Francisco.

“The Science and Practice of Caries Prevention,” the most recent of more than a dozen articles penned by Featherstone was published in the Journal of the American Dental Association in July 2000.

Proponents see Featherstone as an ally because he credits water fluoridation for helping reduce decay by repeatedly bathing the teeth in fluoride. Opponents underscore the professor’s belief that fluoride swallowed by young children and incorporated in the structure of the tooth is insufficient to play a significant role in cavity prevention.

“The clinical effects of fluoride,” Featherstone wrote, “can be optimizedby using delivery methods that bring fluoride to the surface of the tooth and into the plaque. . . These topical delivery methods are equally applicable to adults and children and include fluoride in beverages and foods, dental products and drinking water.”

Debate continues

The benefits of fluoridation aside, the question of arsenic remains, said Gerhard F. Bedding, executive director of the New Hampshire Pure Water Coalition.

“The question is: Is it OK to give us arsenic, lead and other contaminants? Shouldn’t we have been told, when we were voting, that we were getting this? . . .

“In America, we expect disclosure and disclosure has been sorely lacking in this area. That to me is a major concern,” Bedding said.

And, when it comes to arsenic, small amounts matter:

— A study of how water treatment chemicals contribute to the arsenic levels in drinking water, done by three water quality engineers at the South Central Connecticut Regional Water Authority, was published last October in Opflow, a newsletter of the American Water Works Association.

Cheng-nan “Mike” Weng, the senior water quality engineer who co-authored the Opflow report, said he did no special testing of the water chemicals used at the water authority’s treatment plants and well heads. He based his calculations on the amounts of arsenic that the chemical suppliers reported in their products.

“These data show that in finished water the theoretical arsenic concentrations attributable to normal dosages of water treatment chemicals are extremely low,” said the report, written at a time when the EPA was considering setting its drinking water standard for arsenic as low as 3 ppb.

If the EPA had adopted a 3 ppb standard, “about 10 percent of the maximum contaminant level would come from the treatment chemicals, hardly a minimal amount. It is also interesting to note that about 90 percent of the arsenic that would be contributed by treatment chemicals is attributable to fluoride addition,” Weng wrote.

— “The fatal dose was known to be an amount equivalent in size to a pea,” wrote Roger Smith of Dartmouth College, in an article titled, “Arsenic: a murderous history” that recounts the element’s value as a poison over the past 2,000 years.

More than 60 Dartmouth faculty scientists and physicians, students and staff are involved in seven research studies collectively known as the Dartmouth Toxic Metals Research Program, a five-year, $15 million effort sponsored by the EPA and the National Institute of Environmental Health Sciences.

Remains focus
The focus is on arsenic: Specifically, whether levels of arsenic found in drinking water raise the risk of disease and precisely how arsenic affects the cellular processes known to contribute to skin and bladder cancer and heart trouble.

Joshua Hamilton, the program’s director, said debate continues on what is a safe drinking water standard for arsenic, but that at this point he sees “no reason to be concerned about the minute amounts” of arsenic added to drinking water by fluoridation.

Influenced in part by studies conducted in other countries, the EPA set its new arsenic standard at 10 ppb, Hamilton said, “because they felt there was compelling evidence that 50 ppb (the old standard) was not low enough to be protective of human health. But the direct data to support that will require additional study.”

Others challenge the addition of any amount of arsenic to drinking water, arguing that is contrary to the government’s stated goal of removing all such toxic contaminants.

State Rep. Barbara Hull Richardson, D-Richmond, is a fluoridation foe who sponsored legislation last year that would have required a community’s voters to approve fluoridation by a two-thirds vote, rather than a simple majority. That bill died on a voice vote after the House Municipal and County Government Committee recommended it be killed, but Richardson is coming back this year with a proposal to regulate fluoridation products by requiring the U.S. Food and Drug Administration certify them as safe and effective.

“To me this is a motherhood-and-apple-pie issue: You don’t want to introduce stuff into the drinking water that is very, very bad. I don’t think fluoridation is good, but at the very least we don’t want to introduce the arsenic and the lead and whatever other bad stuff there is in there,” Richardson said of the contaminants in hydrofluosilicic acid.