Court: EPA must reduce IQ risks of fluoride for children (1)

A federal court ruled that adding fluoride to drinking water poses such a great risk of lowering children’s IQs that the EPA must respond with appropriate regulations.

“The court finds that there is an unreasonable risk of such a violation, a risk sufficient to require the EPA to take regulatory action,” the chief judge ruled. Edward M. Chen in the U.S. District Court for the Northern District of California on Tuesday.

There must be a response from the US environmental protection authorities because adding 0.7 milligrams of fluoride per liter (mg/L) to drinking water – the amount currently recommended by the US health authorities – is too risky, said Chen.

“It should be noted that this finding does not conclude with certainty that fluoridated water is harmful to public health,” Chen said. However, the EPA must investigate the mineral’s harmful potential and decide how to respond.

“This order does not prescribe exactly what that response must be,” Chen said. That remains the EPA’s decision under the 2016 amendments to the Toxic Substances Control Act (TSCA), he said. But “one thing the EPA cannot do in light of this court’s finding is ignore that risk.”

“Huge” population revealed

The National Academies of Sciences, Engineering, and Medicine, the federal government’s primary scientific advisory agency, recommended in 2006 that the EPA lower its enforceable maximum contaminant level (MCL) of 4 mg/L for fluoride in drinking water to protect children. And the agency announced in 2011 that it would begin a review of that limit. However, the MCL and the non-enforceable public health goal or maximum contaminant level (MCLG) remain at 4 mg/L.

Groups led by Food & Water Watch and the Fluoride Action Network had sued the EPA after the agency rejected a request to ban the 75-year-old practice of adding fluoride to drinking water to prevent tooth decay. The agency argued that doing so posed a disproportionate risk to public health because scientific studies showed that fluoride lowered babies’ IQs.

The number of people exposed to fluoride in drinking water is “huge,” Chen said. “Approximately two million pregnant women and over 300,000 exclusively formula-fed babies are exposed to fluoride,” he said. That number far exceeds the population size the EPA has used to determine whether regulatory action is warranted in other risk assessments, he said. “The EPA has determined risks to be unreasonable when the affected population is less than 500 people.”

However, Chen had previously ruled that the benefits of a chemical under the TSCA cannot be considered when the EPA decides whether that chemical poses an unreasonable health risk. The agency considers the benefits of a chemical, the cost of regulation and other information when deciding how to regulate the substance.

“There is little doubt that there is a statistically significant association between IQ declines in children and fluoride concentrations of 4 mg/L,” Chen said.

Even “the ‘optimal’ level of water fluoridation in the United States of 0.7 mg/L is almost twice the safe level of 0.4 mg/L for pregnant women and their offspring,” he said, citing the vast amount of scientific data he reviewed and consulted his lawyers about during the litigation that began in 2017.

Dentists, water utilities, and chemical policy advocates are some of the groups that have pursued this case. It was made possible by a provision of the TSCA amendments that imposed a duty on courts to determine whether a chemical poses an unreasonable risk without deference to the EPA. This provision applies to situations where the EPA has denied a citizen’s petition to take action based on the unreasonable risks posed by a chemical.

“The court has done what EPA has long refused to do: It applied EPA’s risk assessment framework to fluoride,” said Michael Connett, a partner at Siri & Glimstad LLP, which, along with Nidel and Nace PLLC and Waters Kraus & Paul LLP, is representing lead plaintiff Food & Water Watch. “It’s a historic decision. And while we wait for EPA’s legislative process, policymakers would be wise to ask themselves: Should we really be adding a neurotoxin to our drinking water?”

The case is Food & Water Watch, Inc. v. EPA, ND Cal., No. 17-cv-02162, 9/24/24.