The Tacoma/Pierce County Board of Health voted unanimously Wednesday to require water fluoridation for most of Pierce County.
The decision came after three hours of emotionally charged testimony by fluoride opponents and proponents. About 100 people attended the board meeting and nearly 50 testified.
The board set a Jan. 1, 2004, deadline for fluoridation of all water systems serving more than 5,000 people – a mandate that will affect about 240,000 Pierce County residents in Lakewood, Puyallup, Bonney Lake, Sumner, Milton, Edgewood, Parkland and Spanaway.
The 300,000 people who live in Tacoma, University Place, Fircrest and the local military bases already receive fluoridated water.
The health department estimates the initial cost to buy and install fluoridation equipment will be about $1.5 million. The health agency pledged to pay at least half through its own funds and grants from various dental associations. The remainder of the cost would be borne by water districts and passed on to customers.
Some water districts and the anti-fluoride group Washington State Citizens for Safe Drinking Water are considering legal challenges.
Most water utilities opposed the mandate, arguing it would be expensive and should be decided by voters in each district.
But health board chairman Kevin Phelps said it’s the board’s responsibility to take steps to protect the public’s dental health, just as the board mandates health inspections for restaurants and adopts rules to stop the spread of infectious diseases.
“Public health is not a popularity contest,” he said.
The action makes the Pierce County health board one of the few in the nation to take on the contentious issue of water fluoridation. Usually, wary state and local lawmakers put the question to a public vote, which leads to protracted campaigns by fluoride opponents.
The Pierce County proposal took opponents – and water districts – by surprise when it first became public a month ago.
Health department Director Federico Cruz-Uribe developed the plan to stem what he calls an epidemic of tooth decay, particularly among low-income children. He praised the board for its quick action.
“The tactic of the anti-fluoride folks is to wear you out, bombard you with misinformation … and create confusion,” Cruz-Uribe said.
More than half of those who testified at Wednesday’s meeting opposed fluoridation, most saying it has harmful health effects.
But the board soundly rejected those arguments.
The nation’s top health experts, including the Centers for Disease Control and Prevention, the National Research Council and the surgeon general have all concluded fluoride is safe and effective, Phelps said.
Several local dentists testified about widespread tooth decay, especially among low-income children who live in unfluoridated areas.
Lakewood dentist Bob McFarland choked back tears as he compared the decay he sees in poor, local children with what he encounters when he works in Third World countries.
“To find this in children in my community in America defies understanding,” he said.
But equally passionate was Karen Munz, a mother of five from Parkland, who moved there to ensure that her children would not have to drink fluoridated water, which she considers poison.
Her family suffered few cavities because she insisted they brush regularly and get dental care, Munz said. If low-income families did the same thing, the problem with tooth decay would be much less severe, she said.
Phelps said a number of unfluoridated taps will be available for residents who don’t want to drink fluoridated water.
Randy Black, manager of Lakewood Water District, said the health department is underestimating the costs of fluoridation, perhaps by as much as a factor of two.
Water districts are polling their customers on the fluoridation question and consulting an attorney on whether the health board ruling is subject to challenge, said Black, who also heads the regional water association.
Emily Kalweit, director of Citizens for Safe Drinking Water, said her organization is also reviewing possible ways to fight the decision.
The resolution requires the health department to work with water districts on an implementation plan. The plan must be finished within two months.
If the board’s decision is fully implemented, an estimated 77 percent of the county’s population will be drinking fluoridated water.
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