CLEARWATER – By the end of the year, water fluoridation in Pinellas County will be no more.
County Commissioners voted, 4-3, during an Oct. 4 work session to stop the practice. But not everyone is happy.
Commissioner Ken Welch said “this is one of the most difficult decisions” the commission has ever made, as he and other fluoride supporters lobbied Oct. 11 to reverse the decision.
Fluoridation wasn’t on the day’s regular meeting agenda, but a local newspaper reported beforehand that Welch planned to ask Commissioners Neil Brickfield, Nancy Bostock, John Morroni and Norm Roche to reconsider their vote. Word also got out that staff would present its recommendations on how best to stop the seven-year practice of putting additional fluoride in the county’s drinking water.
A small crowd assembled in the fifth floor assembly room and more than 20 speakers came to the podium during the public comment segment.
The first side bar of controversy came when a representative from the Florida Dental Association prepared to show a short video on the benefits of fluoridation.
“When people come and ask to show videos, we routinely say no,” Brickfield said.
“It’s a prerogative of the chair,” Commission Chair Susan Latvala said, explaining that the association had asked to play the video the day before the meeting.
Commissioner Karen Seel said asking ahead of time made a difference.
Commissioner Nancy Bostock said the ability to play videos by the public should be the same for all. She asked how people know (to ask ahead).
Fluoride pros and cons
Commissioner Norm Roche, who made the motion Oct. 4 for a vote to stop adding fluoride to public drinking supply, said he wasn’t against the practice of fluoridation per se. He said he understood the merits. He is concerned about the type of fluoride used and the levels added to the water.
Calcium fluoride occurs naturally. It is found in ground water in many areas of the world including the state of Florida. However, for fluoridation of drinking water, most communities use sodium fluoride or fluorosilcic acid, which are industrial byproducts.
Pinellas County uses 23 percent fluorosilcic acid, which is a liquid by-product of phosphate fertilizer manufacture. Bob Powell, who is in charge of the county’s water and sewer division, said in an Oct. 12 email that the form and amount of fluorosilcic acid Utilities adds to the water supply conforms to standards set forth by the federal government. The county has used the same form of fluoride since July 2004.
The increase in the occurrence of fluorosis is one of the reasons the Environmental Protection Agency and the U.S. Department of Health and Human Services lowered its recommendation of 0.7 to 1.0 milligrams of fluoride per liter of water to 0.7 milligrams per liter in a report released Jan. 7.
The updated recommendations are based on recent EPA and HHS scientific assessments to balance the benefits of preventing tooth decay while limiting any unwanted health effects.
“HHS and EPA reached an understanding of the latest science on fluoride and its effects on tooth decay prevention and the development of dental fluorosis,” the report said.
Dental fluorosis is caused by excessive exposure to fluoride when teeth are being developed, usually in children younger than age 8. However, it can occur in any age. It usually appears as white streaks or spots on the teeth and, in the past, was considered nothing more than a cosmetic problem. The spots and streaks are permanent and sometimes get darker over time. In severe cases, black or brown stains may appear and the teeth may crack or develop pits.
Public speaks out
The EPA and HHS report fueled those who have opposed fluoridation since the 1960s when studies pointed to potential harmful effects. More people, including scientists and even some dentists, question the wisdom of the practice started in the 1940s.
Opponents of fluoridation say the use of industrial byproducts, which have warning labels that say corrosive and toxic, in drinking water supplies and toothpastes is poisoning the population.
They believe the practice may be the cause of a myriad of health problems beyond that of dental fluorosis. Several speakers talked about personal health problems they believe are tied to fluoridated water. They say it can accumulate in the bones, a permanent affliction. They say it affects the thyroid and the brain.
Others say fluoridation is not at all about preventing tooth decay, but instead is a way for industries to get rid of their toxic waste. They say it is unfair for the government to put what they believe are toxins in the water, especially since it is so expensive to filter it out. Fluoride opponents say it is about the public’s right to choose. The commissioners also heard warnings of potential lawsuits, as speakers compared fluoride with lead, asbestos and tobacco.
People who support fluoridation say talk about fluoride being a poison is nothing more than a scare tactic. Supporters say there is no conspiracy or partnership with industry to help it rid itself of toxic waste. They say there is no clear evidence of harm.
Fluoridation is nothing more than an inexpensive way to help reduce the occurrence of dental caries. And it is working, according to statistics that show the reduction in dental decay, especially among children, that has occurred since fluoridation began. Fluoride supporters say the amounts used, as recommended by the EPA and HHS, are safe. The Centers for Disease Control and Prevention agrees.
“For 65 years, community water fluoridation has been a safe and healthy way to effectively prevent tooth decay, the CDC says on its website.
CDC hails “water fluoridation as one of 10 great public health achievements of the 20th century.”
Local dentists fear that without fluoride in the water supply, the incidence of tooth decay will rise, increasing the suffering of those who cannot afford dental care. They say the county won’t be able to afford to help those in need.
CDC says dental caries increased by as much as 27 percent in locations that ceased water fluoridation. In areas with fluoridation, a reduction of 15 to 40 percent has been reported.
During the Oct. 4 meeting, commissioners talked about their own dental health. Seel said she grew up without fluoride in the water and, as a result, had spent thousands of dollars on her teeth. Brickfield said he grew up with fluoride and had spent a large sum of money keeping his teeth healthy too. He questions the effectiveness.
Bostock believes there is enough science to question the potential harm from cumulative effects of fluoride in the body overtime.
Morroni supported a referendum to decide during the Oct. 11 meeting. He said he talked to Supervisor of Elections Deborah Clark who told him it would not be that difficult to do. Welch said he would only support a referendum if it meant fluoridation would continue until the people could vote.
“I can’t support it otherwise,” he said.
People in the audience from both sides of the argument spoke against a referendum, saying the public wasn’t educated enough about the matter to make a good decision.
No one made a motion to call for a referendum.
When will it end?
Assistant County Administrator Mark Woodard said at least 60 days was needed to inform the public through stuffers in with their bi-monthly Utilities bills. He said wholesale customers needed to be told, as well as the Florida Department of Health.
Wholesale customers are Pinellas Park, Clearwater, Safety Harbor, Oldsmar and Tarpon Springs.
Staff estimates enough supplies are available to continue fluoridating through Dec. 31. Woodard said more could be purchased, if necessary.
Roche and Bostock were against buying more and suggested an absolute date not be used. They said staff should instead tell the public that sometime before the first of next year, when supplies ran out, fluoridation would stop.
A final decision on the matter wasn’t clear; however, Woodard said the county’s supplier had indicated it would be willing to buy back any unused product, but the county would likely be responsible for transportation costs.
Work session vote
Morroni brought up the subject of the initial vote at a work session. He said in past years, it had been a given that votes on matters other than direction to staff would not occur. He questioned if a policy was needed to make sure decisions of public interest were not made at work sessions in the future.
Latvala pointed out that while no one had expected a vote to be taken at the work session, removing fluoride from the water was a policy decision to be made by the board. No public hearing was required. She said work sessions often require direction to be given to staff.
Latvala, Seel and Welch lobbied to schedule another work session to discuss a referendum and again weigh the pros and cons. One of their reasons was the unexpected vote during a work session, and they said there was a great deal of public interest.
Bostock objected to continuing talks.
“We’ve already done that,” she said. “The vote’s been taken.”
“We weren’t anticipating a vote would be taken at the last work session,” Latvala said. “A lot of attention is being given to this.”
She advocated more discussion, saying the commission was “responsible for public health in Pinellas County.”
Welch questioned the “rush to get this implemented,” saying after seven years a little more time would not make a difference.
Seel said they needed to look at all the scientific evidence.
“I read everything I could get my hands on,” Bostock said. “We had scientific evidence. We had a workshop. Maybe some people disagreed on the outcome.”
Latvala said very few issues that had come before the commission had received “this much public outcry.”
Morroni agreed that the issue was drawing a lot of public attention.
“We’ve not seen an issue like this,” he said.
He said email feedback he had received showed “95 want it and 119 don’t.” Roche said his email was about 60 percent to 40 percent against fluoride.
Bostock said the time for work sessions was over, repeating she had listened to all the evidence presented at the Oct. 4 meeting.
“We’ve done this. I stand by it,” she said.