Fluoride Action Network

Work site access to fluoridated tap water and retail beverages. An assessment of the University of California, San Francisco campuses.

Source: JADA (Journal of the American Dental Association) | December 21st, 2021 | Kalair N, Mousli LM, Jacobs LM, Schmidt L, Kearns C.



Employees with fluoridated drinking water access at work can reap oral health benefits. The purpose of this study was to assess the availability, appeal, and promotion of fluoridated tap water in publicly accessible spaces compared with retail beverages at the University of California, San Francisco.


The authors collected information on beverages available in publicly accessible spaces at University of California, San Francisco hospitals and campuses in San Francisco, California, from December 2019 through February 2020 using a web-based survey tool. Data collected included fluoridated water and retail beverage locations; type of water or retail beverage source; number of water sources per station; cleanliness, flow, and any obstruction of water sources; proximity of water stations to retail beverage locations; signage near the beverage locations about water and beverage consumption; and type of retail beverages available.


Fluoridated water stations were identified in 230 locations and had 377 water sources (for example, traditional drinking fountain and motion-sensor bottle-filling station). One water station was available for every 80 students and employees; however, 25% were obstructed, dirty, or had unsatisfactory flow. Approximately 1 in 5 watercoolers lacked disposable cups. Of 41 retail beverage locations identified, 29% had a water station within sight. Only 11% of beverage locations had signage encouraging healthier beverage choices.


A systematic assessment of work site access to fluoridated water can provide actionable evidence to improve availability, appeal, and promotion.

Practical Implications

This study provides a model to assess work site availability of fluoridated drinking water that can be used for future evaluations.

Key Words

Abbreviation Key:

HBI (Healthy Beverage Initiative), SSB (Sugar-sweetened beverage), UC (University of California), UCSF (University of California, San Francisco)


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Dr. Kalair is a general dentist, Familia Dental, Abilene, TX.


Ms. Mousli is a research analyst, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA.


Dr. Jacobs is a research analyst, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA,


Dr. Schmidt is a professor, Philip R. Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA.


Dr. Kearns is an assistant professor,