Questions arose over City of Austin water quality Nov. 9 at Travis County Commissioners Court when Dr. Paul Connett, professor emeritus of chemistry at St. Lawrence University in New York, persuaded the court to take a serious look at Austin’s fluoridation policy. Attention to the issue has been growing since Austin’s Environmental Board requested an independent study from City Council in August 2009.

Water fluoridation is a policy endorsed by numerous global health organizations, most notably the American Dental Association and the Centers for Disease Control and Prevention. The CDC promotes community water fluoridation and in some states contributes funding and operational support for the practice, according to its website.

Controversy surrounding the practice has grown in recent years, however, as an increasing number of scientists and health professionals argue that fluoride in drinking water causes many negative health effects when looked at beyond dental health to the impact on the whole body.

“Some very alarming data has been revealed today,” said Travis County Commissioner Ron Davis at the Nov. 9 meeting. “I feel that we should do something as a governmental body … What I’m hearing here is that fluoride is another type of situation that may have been proven to pose a problem through drinking water.”

Davis said he would pass along a resolution drafted by Dr. Neil Carman, the Sierra Club Clean Air Program director who also spoke at the meeting, to Austin/Travis County Health and Human Services for assessment before deciding whether to send the resolution to the Austin City Council. The resolution urges the mayor and City Council to fully investigate and consider ceasing fluoridation of city water.

Dr. Philip Huang, HHS medical director, said he has not yet seen the request from Travis County but, without giving further details, said he would “respond appropriately.”

Huang also said HHS, which was one of the city departments responsible for responding to the environmental board’s request in December 2009, “responded appropriately,” providing the environmental board with the requested information.

The board received a three-page report in response that contained no apparent research, yet concluded that fluoride levels were within safe limits, according to CDC guidelines, said Mary Gay Maxwell, chairwoman of the environmental board.

“We had enough concern about it and enough interest in it to forward it to the council, but it wasn’t taken seriously,” Maxwell said.

Huang responded to Maxwell’s comments. “We have looked at and done a conscientious review of the literature and information that is available,” he said. “I think we feel comfortable with the recommendations of the CDC, the ADA and others on this issue.”

The CDC decides Austin’s water policy

A change in Austin’s fluoridation policy requires two councilmembers to put it on the agenda and four to vote it out. Although the public voted to fluoridate in the early 1970s, the fluoridation referendum was put on the agenda by the council and not by public request, so another referendum is not required for the policy to change. But city and county officials who could urge the city to look into the issue and the members of City Council themselves all look to HHS for guidance on this issue. HHS in turn looks to the CDC.

Fluoride is qualitatively different from the other chemicals that Austin Water Utility puts in the drinking water. Most chemicals are added to treat the water, but fluoride is added to treat people. This puts fluoridation policies outside the purview of the water utility, said Jane Burazer, assistant director of Austin Water Utility.

“We’re relying on the Health and Human Services Department to make the determination [about health impacts],” Burazer said.

Travis County Commissioners are also depending on the medical expertise of HHS for direction on this issue. Davis will not move forward to make any recommendations to the City of Austin until he receives an assessment from HHS, he said.

“At this point we are consistent with the recommendation of the CDC and the ADA,” Huang said. “We are comfortable with the different standards that the water meets. We are comfortable that it is safe and effective, and we support those findings.”

HHS’s reliance on the CDC is problematic, Connett said, because the group within the CDC making the determination on the safety of fluoride is the Oral Health Division—a division consisting of about 30 people, most of whom have only dental qualifications.

Carman said that such a group does not have the scientific or medical training to address the effects of fluoride on the whole body.

“They are not trained in toxicology or epidemiology,” Carman said. “They are not medical doctors. Really the people who are pushing this are not qualified to do so.”

Fertilizer byproduct in the water

Austin’s water is not fluoridated with natural fluoride but with fluosilicic acid, a controversial practice that is another cause for debate in questions on fluoride.

“It can sound really bad that [Austin’s fluoride] comes from the production of fertilizer,” said Health and Human Services Medical Director Dr. Philip Huang, “but it is a chemical reaction and [being produced from a chemical reaction] does not make it bad.”

Austin’s fluosilicic acid is a by-product of a phosphate fertilizer company, Lucier Chemical Industries, said Jane Burazer, assistant director of Austin Water Utility.

“The stuff they put in the water is not pharmaceutical grade. It is an industrial hazardous waste,” said Dr. Neil Carman, Sierra Club Clean Air Program director. “It does not just contain the fluosilicic acid. There is also elemental fluorine, hydrofluoric acid. There are also trace contaminants of heavy metals like lead, chromium 6, mercury, barium, selenium and radionuclides.”

The product is held to national standards by the American National Standards Institute and the National Science Foundation, Burazer said. The manufacturing process, ingredients and potential contaminants are reviewed annually by NSF toxicologists and minimum test battery for all fluoridation products includes metals of toxicological concern and radionuclides, according to the NSF fact sheet.

“Why would you want to put radioactive chemicals in the water at any level?” Carman said. “The only safe level is zero.”

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