What started as a local debate of relative benefits for public health versus views of governmental interference in private lives has escalated into a confrontation between local citizens’ groups and Los Angeles County health policy, with county board Supervisor Zev Yaroslavsky running interference.

Last fall, the Metropolitan Water District began treating locally delivered water with hydrofluorosilicic acid (a fluoride additive) after receiving a $20 million grant from First 5 LA, a children’s advocacy organization on whose commission Yaroslavsky was sitting when the fluoridation program began.

The issue has attracted the attention of many Malibu locals, including celebrities Martin Sheen, Suzanne Somers and her husband Alan Hamel, and activists Valerie Sklarevsky, Steve Hoye, Cary O’Neal and others. Several have written letters to the editor regarding the mandated fluoridation. Others have gathered together to demand more accountability and information on the local fluoridation program, but are not receiving any answers.

Boosting fluoride in community water supplies was introduced systemically around 50 years ago to treat tooth decay. The results were dramatically positive and fluoridation as a policy is approved by the U.S. Center for Disease Control and Prevention, American Dental Association, National Cancer Institute and California Department of Public Health, among others. The ADA and the CDC, however, advise against giving infants up to the age of 12 months fluoride-in other words, to not mix infant formula with tap water.

Dr. Heidi Hame, a pediatric dentist in Malibu, said, “When kids drink fluoridated water, they don’t get cavities. I respect parents’ decisions on this issue, but, as long as they are not being over-medicated with fluoride supplements, fluoride’s a good thing. In my practice, I see a big difference between populations exposed to fluoridated water and those who aren’t.”

However, swelling grassroots movements have objected to the practice, noting that documented and anecdotal evidence of water fluoridation have proven to be damaging to people, from fluorosis in children (too much intake of fluoride characterized by white spots on teeth) to women suffering osteoporosis. Harvard University did a study on heightened levels of fluoride, which showed a definable increase of risk for osteosarcoma, a bone cancer typically found in children.

Topanga resident Rabyn Blake heads the activist group Coastal Citizens for Safe Drinking Water and said they are alarmed at the lack of transparency in the decision-making process with this public health policy.

“We have asked for product reviews on the toxicology of hydrofluorosilicic acid from the MWD and it is not forthcoming from the manufacturer or the certification agency,” she said.

California law requires any water additive be tested and certified as meeting specifications of the American National Standards Institute’s “Standard 60.” The institute is a private, non-profit organization that develops standards for every aspect of American business which defines acceptable levels of risk, contamination and usage for elements of business, from dairy and livestock production, i.e. hormones delivered to animals and vitamin additives in dairy products, to construction to farming. The Standard 60 was developed with the National Sanitation Foundation, also a private agency, to certify that any additives comply with ANSI standard levels and are now to be reviewed annually.

“The NSF has refused to publish any product review studies, saying that it is ‘propriety information’ of the manufacturers,” Blake said. “It’s a Catch-22.”

Other local residents have personal arguments with fluoridation of public drinking water.

“I have osteoporosis,” Sherry Jason, director of the charitable group City Hearts, said. “My doctor told me directly that I should not drink local water anymore.”

Paul Steinberg is a Topanga resident who works in pharmacological research.

“I do clinical trials,” he said. “Given that they won’t release any studies on long-term toxicological effects of this additive, I am skeptical when we are talking about public health. From my research, I don’t see any real evidence that fluoride, taken systemically, has that great an effect on communal tooth decay, when there is ample evidence that effective fluoride treatment can be provided by other products on the market, like toothpaste.”

Dr. Jeff Bronstein, a neurologist with UCLA Medical Center, echoed this concern.

“I was one of those who thought that people who objected to water fluoridation were like fringe nuts who didn’t like vaccinations,” he said. “But when I started to check modern literature and research, I saw deeper questions.”

Bronstein said that the MWD’s goal of boosting local water fluoride to .8 parts-per-million was alarmingly close to harmful levels.

“Two times that amount can be dangerous, particularly to kids who swallow toothpaste. It is extremely difficult to measure the variability of amounts consumed,” he said. “Fluoride has been linked to renal issues and hip fractures in the elderly. Plus, we don’t really know how much fluoride is absorbed through our skin from treated water. As public health policy, it’s force compliance.”

Regarding the Harvard study linking fluoride and osteosarcoma, Bronstein said, “It’s a relatively rare cancer, but still a risk.”

Awakened to the questions surrounding water fluoridation, County Supervisor Yaroslavsky has requested that future bid specifications for the MWD’s purchase of the additive include all documentation of certification test reports. Also, a coalition of 15 local groups had requested to be heard by the First 5 L.A. at a March meeting to propose a requirement that any grants of funding to water districts in L.A. County for purposes of fluoridation include requirements for accountability and transparency from manufacturers of any fluoride product. However, as of last week, the request has gone unanswered.

Galvanizing public agencies into investigating established public policy isn’t easy. Gene Burke of the Santa Monica Safe Drinking Water Coalition said they have repeatedly requested toxicology studies on the additive from the city, to no avail.

“They even ignored their own environmental task force’s request for this information,” Burke said. “All we’re asking for is proof of its safety!”

MWD Spokesman Bob Muir said, “There are no plans to review this decision. We have asked concerned parties for peer-reviewed data on any danger fluoridation presents and it hasn’t been forthcoming. Our best available science says the public health benefits of this program are inarguable.”

Muir did say, however, that they “might” revisit the question, should the county Board of Supervisors present them with appropriate data.

Bronstein said, “Forty years ago, it was a good idea to fluoridate water. But recent research has raised questions about wholesale water treatment, when you can get adequate fluoride from other sources. As with any public health policy, you have to carefully weigh the relative benefits with the potential real harm.”

Information on the National Research Council’s review of water fluoridation can be found online at www.nap.edu/catalog/11571.html <http://www.nap.edu/catalog/11571.html>