During a recent city council meeting, Regina Imburgia, a 58-year-old homemaker and self-described anti-fluoridation activist, walked to the microphone to talk about why Dallas should stop putting fluoride in its drinking water. She had spoken to the council several times before, and also to the television reporters who cover City Hall, whom she hoped would do stories about her cause. But the reporters weren't biting, and the council never gave an indication it was even listening.
This time was different. Three of the council's 15 members, making no promises, said they thought the city should at least take another look at fluoridation. That may not seem to you like a history-making moment, but it was for Imburgia. On the way out, she says, she slipped up to one of the reporters who had shot her down in the past and said, "Now is it news?"
"Yup," he responded, according to Imburgia. "Now it is."
Indeed, the story received a smattering of blog, TV and print coverage that evening and the next morning. The news value in most of it seemed to be the fact that anyone had listened to her at all.
Anti-fluoridation activism has a long, bad name in this country, dating to the 1950s, when it was a trope in the larger phenomenon of the anti-communist "Red Scare" movement. One of my own childhood memories is some kind of battle — I was too little to get most of it — in which my dad, an Episcopal minister, wound up tossing a bunch of anti-fluoridation militants out of his church.
Ours was a household in which the father was always the hero. I grew up thinking of anti-fluoridationists as being sort of like the creatures in the movie The Body Snatchers, which I saw somewhere in that same general time period. If there were a movie poster, it would say, "First, they infiltrate the churches! Then, the minister kicks them out!"
In Imburgia's case, I thought I saw some of that same old trope surfacing in the week after her first little wavelet of news coverage. The Dallas County Dental Society immediately published a statement characterizing Imburgia and her band as marginal types, if not actual body snatchers, saying, "We believe the claims and tactics used by fluoride opponents are not founded in research, but fear ..."
A couple days later Dallas Morning News columnist Jacquielynn Floyd, normally thoughtful and measured in her considerations, had a column in the paper under an uncharacteristically strident headline: "Anti-fluoride Cranks at City Hall: Is it Something in the Water?"
She wrote: "Boy, talk about a crusade that never dies! Fluoride conspiracy paranoia has waxed and waned since the days of Howdy Doody and coonskin caps."
On the one hand, all my own biases and childhood memories made me want to view the anti-fluoridationists the way she did. On the other, I was mindful of the public debate we experienced here in Dallas recently over airplane spraying of pesticides to control West Nile disease. When activists first raised doubts about the safety of the chemicals being sprayed, The Dallas County Medical Society rushed forward to denounce them as unscientific fear mongers. As that debate unrolled, though, we found out that the anti-spray people had a surprising amount of new science on their side, and that maybe some members of the medical society had been out of med school too long.
With that experience in mind, I went looking to see what had been published lately. I came across a very disturbing article published in March in The Lancet, a British peer-reviewed medical journal considered one of the most prestigious in the world. I guess I found the article disturbing, in part, because I was so ill-informed. Until I read it, for example, I did not know that over the last eight years fluoride was one of six chemicals added to what previously had been a list of only five chemicals known to have damaging effects on brain development in infants and children.
A few cautions: Even though The Lancet is considered one of the world's most respected medical and public health journals, its recent history has not been unblemished. In 2010 the journal was forced to retract an article linking vaccines to autism after it was revealed some researchers working on the article were paid by lawyers for families seeking to sue vaccine makers. There were also scientific conflicts The Lancet said the author had concealed from editors.
And for this recent paper, 25 of the 27 fluoride studies they looked at were in China, the authors told me by email. They're not claiming any knowledge of the safety of American drinking water fluoridation, they wrote, and they've written that "fluoride released into the ground water in China in some cases greatly exceeded levels that are typical in the U.S."
"These results do not allow us to make any judgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the U.S.," they wrote. "On the other hand, neither can it be concluded that no risk is present."
They haven't always been so cautious, though. In July 2012, speaking to the newsletter of the Harvard School of Public Health for a story about their ongoing research, one of the authors sounded a bit more emphatic about fluoride. Phillippe Grandjean, an adjunct professor of environmental health at Harvard, said, "Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain."
"The effect of each toxicant may seem small," he went on, "but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us."
Fluoride is only one of several industrial chemicals discussed in the Lancet article. The core issue is not so much the dosage required to produce a toxic reaction in an adult or poisoning in a child, but the effect on infant brain development of much more minute doses. The authors even go so far as to estimate the gross number of I.Q. points they think may be lost annually among U.S. children due to specific neurotoxins, and the economic costs associated with that diminished intelligence: $50 billion a year lost because of lead, and another $5 billion from mercury poisoning. They did not offer an estimate for I.Q. losses due to fluoride because there are no current U.S. studies.
(By the way: Among the chemicals they urge should be studied for brain effects is permethrine, the substance sprayed from airplanes over our city last summer to combat West Nile.)
Still, nobody with his or her name on the current article about neurotoxins is offering any kind of opinion about the safety of American water fluoridation. They say instead that they lack the knowledge to offer an opinion. But that's also the point.
As much as the article is a review of scientific literature, it is also a kind of cry from the heart for massive fundamental change in the way we approach the social, political and moral problems posed by the manufacture and global dispersal of industrial chemicals. The way it is now, industry can begin manufacturing, marketing and distributing a chemical before anybody has any idea what effect it may have on brain development. And once on the market, it's very difficult to get one off.
They want to reverse that: "Untested chemicals should not be presumed to be safe to brain development, and chemicals in existing use and all new chemicals must therefore be tested for developmental neurotoxicity," they write. They propose creation of an international clearinghouse to carry out the testing.
When I wrote to them, I asked if they were aware of any practical interest in the clearinghouse idea anywhere. They said no.
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Of course, the very idea of telling the industrial chemical industry that it cannot market any chemical, new or old, until that chemical has been tested for effects on brain development would be the world turned upside down, not just in industry but in politics and power, in society itself. The problem seems so huge and so heavy that the thought alone of lifting it is almost self-defeating. But then when we think of tens of millions of I.Q. points burned from brains of babies every year, we may decide to bestir ourselves.
I had coffee with Imburgia, the local anti-flouride activist, recently. We talked a little about why there was such intense negative reaction and name-calling in response to the mere fact of her having been taken seriously by a few city council members.
"When your eyes are open," she said, "it's a lot more work. It's easy to just believe you can move along and not worry about it."
She believes, deeply, that we should stop fluoridating now, until we see more of what the new research will yield. The dental society makes a case that fluoridation is a proven dental-health benefit, supported by decades of experience and testing, and that we should not forego its benefits unless and until somebody shows up with a smoking gun to show it's dangerous. Both arguments have merit. The only one that doesn't have any merit is the one that says we should stop listening to anybody. This is the wrong moment for that.