It was a long time in coming, but members of Coastal Citizens for Safe Drinking Water were gratified when they recently received a letter, dated November 27, 2007, from Los Angeles County Supervisor Yaroslavsky responding to their two previous requests for his intervention in plans, now operative, by the Metropolitan Water District of Southern California (MWD) to fluoridate the drinking water supplied by Los Angeles County Waterworks District No. 29 (District 29) to residents of Topanga and Malibu. In his response Yaroslavsky stopped short of calling for a halt to fluoridation, but he agreed with the local safe drinking water activists that the product review data and toxicological studies, if any, submitted by the chemical manufacturers to obtain safety certification of the hydrofluorosilicic acid to be used in the fluoridation process should be made available for public review.

As Yaroslavsky observed in his response, California law requires that any water additive be tested and certified as meeting the specifications of the American National Standards Institue (ANSI) Standard 60 before it can be added to the public water supply. Since the EPA stepped out of the business of regulating water additives in the late 1990s, that role has fallen to the National Sanitation Foundation International (NSF), a private trade association, which charges manufacturers a fee to test their products and certify their compliance with ANSI Standard 60 and other industry standards. Long-term toxicological studies are just one element of the product review data required to be submitted by the manufacturer of water additives to the NSF in order to demonstrate compliance with the ANSI 60 Standard. MWD spokesman Ed Dymally has previously told the Messenger that there are no long-term, peer-reviewed toxicological studies of the safety and efficacy of hydrofluorsilicic acid, arguing that MWD is not required to obtain any such data before adding the chemical to the public water supply and that the certification of these chemicals for use as water additives in the absence of such data is an issue to be taken up with the Environmental Protection Agency (EPA).

In his letter, Yaroslavsky writes that he directed County Counsel to research the Citizen group’s request for public viewing of “the actual dated product-review documents submitted by the manufacturer of the hydrofluosilicic acid to earn certification as California law requires.” However, he reports, “NSF has refused County Counsel’s request to produce these documents, asserting that NSF is not a public agency and is therefore not subject to laws, such as the California Public Records Act or the federal Freedom of Information Act, that would compel it to do so. My staff also spoke with NSF staff to determine whether they would voluntarily release these documents. NSF staff has advised us that both the documents submitted by the manufacturers to earn certification and the written report issued by NSF upon certification are considered the private property of the manufacturer, and that therefore NSF does not have the authority to release them.”

The position taken by NSF creates a conundrum: California law expressly requires that “no chemical or product shall be added to drinking water by a water supplier as part of the treatment process … unless the chemical or product has been tested and certified as meeting the specifications of [ANSI/NSF] Standard 60….” In this age of deregulation, a private entity, the NSF, performs an essentially public function of testing and certifying the manufacturer’s compliance with these requirements. However, in light of the unwillingness of NSF to disclose the underlying product safety data, not just the public at large, but even Yaroslavsky, in his position as a director of Water District 29, is denied access to the documents on which NSF bases its (paid) conclusion that the chemical manufacturer and its product has in fact complied with that standard.

Perhaps that is why Yaroslavsky concludes in his letter, “I believe the public should have the right to obtain these documents.” To that end, Yaroslavsky attached a letter he had written to the MWD requesting that “as a part of future bid specifications for the purchase of fluorosilicic acid, bidders supply copies of all documents submitted to NSF to earn certification for the fluorosilicic acid as well as their latest NSF fluorosilicic acid certification test reports. Receipt of these documents by MWD should make them available for public review, assuming that agency does not assert any of the exemptions under the California Public Records Act.”

“We consider this a real step forward,” said Rabyn Blake, one of the organizers of Coastal Citizens for Safe Drinking Water. “First and foremost, we are glad to see a dialogue opened between Zev and the community on this important health and safety issue.” Relations had been strained with long-time Yaroslavsky supporters after Yaroslavsky’s press secretary Joel Bellman initially announced that the supervisor did not intend to respond to the Citizen’s group’s September letter seeking his help and that the supervisor declined to comment or meet with the community regarding their concerns about the fluoridation of Topanga and Malibu drinking supplies or his own subsequent decision, as chair of the First 5 LA Board of Commissioners, to approve a $20 million dollar grant to fluoridate additional communities throughout the county. (See “Citizens to Zev: ‘Halt Fluoride,’” and “Zev to Citizens: ‘No Comment,’” Messenger, Vol. 31, No. 20 (Oct. 4, 2007).) The situation worsened as MWD commenced fluoridation in the community and District 29 released a mailer which many viewed as falsely reassuring on the safety of the process. On November 13, Coastal Citizens for Safe Drinking Water sent a second letter to Yaroslavsky, pressing for a response and escalating the rhetoric. “We believe it is our right to have a look at this data; that it should be an ‘open book,’” the group wrote, asking, “Why would you choose to keep your supportive Topanga/Malibu constituents in the dark? How many days does it take to prepare an answer?” (See “County Offers Reassurances While Citzens’ Group Renews Demand for Proof as Fluoride Start Date Nears,” Messenger, Vol. 31, No. 24 (Nov. 29).)

In fact, it appears that back channel efforts were underway to open a more productive dialogue on the fluoridation subject and a response was already in the works. Unfortunately, Yaroslavsky’s November 28 letter was returned to sender by the Post Office after it arrived in the mailbox of Topangans for a Scenic Community (TASC), which is allowing the Coastal Citizens Safe Drinking Water coalition to share its address. Apparently, the letter did not find its way to the proper hands among the loosely knit Citizen’s coalition until after the holidays. Once it did, the recipients were pleased with what they found, says Blake.

“We were impressed with the time and diligence Zev and his staff obviously devoted to the effort to obtain access to the product safety data for hydrofluorosilicic acid. And we think now Zev may understand something of our frustration. Here you have what is an undeniably toxic chemical, and these are records that should have been made available before MWD started pouring that chemical into Topanga and Malibu drinking water. And they’re still not available, not to us as citizens and taxpayers, not even to Zev and his staff as responsible government officials. If, as we are repeatedly asked to believe by the spin doctors who are promoting fluoridation, this process has such a long-term track record of safety, these records should be readily at hand. In fact, they are not, because the track record isn’t there, and we think what Zev’s letter shows is that he’s beginning to recognize it,” said Blake.

“We’ve always known Zev to be an advocate for our community,” added Blake, “and this letter is much more in keeping with that history than the initial response we heard from some—not all—of his staff. His letter to the MWD asking them to require disclosure of the safety documentation as part of the bid process demonstrates creative thinking and shows that Zev ‘gets it.’ We’re hopeful that Zev will take the obvious next step and impose the same requirement on dispersement of County funds, such as the First 5 LA grant, that he is asking MWD?to impose on itself. Those, too, should only go to projects where the manufacturers can show documentation, through long-term, peer-reviewed toxicological studies, of the safety and efficacy of their product, hydrofluorosilicic acid. The truth is: they can’t do that,” said Blake.

Blake noted that she remained disappointed with the one-and-a-half page memo from Dr. Jonathan Fielding, the County’s Director of Public Health and Health Officer, which Yaroslavsky attached to his letter in putative response to the question, “Where is the study on long term effects of the actual hydrofluosilicic acid substance added to our water?” Rather than citing any such study, Fielding’s memo simply affirms his support for MWD’s policy of “adjusting the fluoride content of its water supply,” and announces ipse dixit that “[f]luoridation’s safety is continually reaffirmed by every credible scientific and professional organization,” that “[t]he claims against water fluoridation by its opponents have triggered an enormous body of peer reviewed scientific evidence that refutes all these claims,” and that “[n]o charge against the benefits and safety of fluoridation has ever been substantiated by generally accepted scientific knowledge.” In support of these bald assertions, Fielding cites only the American Dental Association’s (ADA) Fluoridation Fact sheet on the safety of fluoridation (and, by reference, the literature citations contained therein). (He also cites the Agency for Toxic Substances and Disease Registry (ASTSDR) to the effect that “there are no data to suggest” that exposure to fluoride levels associated with community water fluoridation would raise Superfund issues, but that was never in question.)

While there is no doubt that the ADA has long been an enthusiastic supporter of fluoridation, many of the 350 citations in the fact sheet to which Fielding points are 30 to 40 years old; some are as many as 70 years old. Many are references to pamphlets, brochures, press releases, correspondence and other publications of the ADA and other agencies and government organizations and are not peer-reviewed scientific studies (however obsolete). Most, due to their age, deal with other chemical compounds, such as calcium fluoride, sodium fluoride and aluminum fluoride. None can be identified by its title as a long-term toxicological study on the safety and efficacy of hydrofluorsilicic acid.

Neither does Fielding even attempt to engage with any of the recent scientific data calling into question the risks associated with hydrofluorosilicic acid or the considerations that have led to discontinuation of the practice in most of Western Europe (where rates of dental decay remain on a par with those in fluoridated communities of the United States, by the way. A recent article in Scientific American summarized some of those recent findings questioning the safety of fluoridation and noted the need for further research. The article noted that the 2006 report on fluoridation by the federally funded National Research Council’s (NRC) is “prompting some researchers to wonder whether even 1 mg/L is too much in drinking water, in light of the growing recognition that food, beverages and dental products are also major sources of fluoride, especially for young children. The NRC committee did not formally address the question, but its analyses suggested that lower water fluoridation levels may pose risks too.” Dan Fagin, “Second Thoughts on Fluoride: New Research Indicates That a Cavity-Fighting Treatment Could Be Risky if Over Used,” Scientific American 74, 80-81 (Jan. 2008).

“‘What the committee found,’” said John Doull, professor emeritus of pharmacology and toxicology at the University of Kansas Medical Center and chair of the NRC committee, in the Scientific American article, “‘is that we’ve gone with the status quo regarding fluoride for many years—for too long, really—and now we need to take a fresh look…. In the scientific community, people tend to think this is settled. I mean, when the U.S. Surgeon General comes out and says this is one of the 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on.’”

“We don’t doubt Dr. Fielding’s good intentions said Blake, “but the advice he is giving Zev is not up to date with the latest research. At the very least it is incomplete. At worst, it is misleading and just plain wrong about the risks of the poison that is being put in our drinking water.”

“That’s why we hope Zev will keep the door open to us. We understand that District 29 doesn’t have a lot of choices—it has to get its water, at least for now, from MWD. As Zev’s letter points out, there are no alternative water sources. But Zev Yaroslavsky can be a very persuasive force. And District 29 has the legal right to demand of MWD that the water it buys be demonstrably safe. There’s a long way to go but we’re happy to have taken a first step in that process.”