FLUORIDATION OF WATER TUESDAY, MAY 25, 1954 HOUSE OF REPRESENTATIVES, COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D. C. The committee met, pursuant to notice, at 10 a. m., in the committee room, 1334 New House Office Building, the Honorable Charles A. Wolverton (chairman) presiding. (H. R. 2341 and the reports thereon are as follows:) [H. R. 2341, 83d Cong., 1st sess.] A BILL To protect the public health from the dangers of fluorination of water Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That no agency of the Government of the United States (including the government of the District of Columbia, and of each Territory and possession of the United States), and no agency of any State, or of any municipality or other political subdivision of a State, shall treat any public water supply with any fluoride compound, or make any water so treated available for general use in any hospital, post office, military installation, or other installation or institution owned or operated by or on behalf of any such agency. GOVERNMENT OF THE DISTRICT OF COLUMBIA, EXECUTIVE OFFICES, Washington 4, D. C., April 29, 1954. Hon. CHARLES A. WOLVERTON, Washington, D. C. MY DEAR MR. WOLVERTON: The Commissioners have for report H. R. 2341, 83d Congress, a bill to protect the public health from the dangers of fluorination of water. The bill would prohibit the United States Government, the Government of the District of Columbia, every State, and every municipality or other political subdivision of a State, from treating any public-water supply with any fluoride compound, or from making any water so treated available for general use in any hospital, post office, military installation, or other installation or institution owned or operated by the United States Government, the government of the District of Columbia, and State, and any municipality or other political subdivision of a State. This report is directed to the harm which, in the light of scientific opinion, would result to the residents of the District of Columbia if the use of sodium fluoride in the water supply of the District were prohibited. It should particularly be noted that while H. R. 2341 purports to be a bill to protect the public health from the dangers of fluorination of water, such dangers appear to be imaginary. The real danger lies in the elimination of flouride from the District's water supply, since it has been estimated by the Director of Public Health of the District that should such action be taken, after a period of 10 years there would be 65 percent more caries in the teeth of the children of the District, and that by the time such children were 40 years of age, 95 percent of them would have lost the majority of their teeth. The loss to the public would be 1 twofold: the cost of increased dental work, and a deterioration of the public health arising from the increase in defective and missing teeth. The May 1953 Journal of the American Dental Association discusses the fluoridation of water in an editorial reading as follows: "Evidence favoring fluoridation continues to mount. "Resolutions passed last month by two of dentistry's leading scientific agencies, decisions made by 2 of the country's larger cities and reports presented by 2 different groups of researchers strengthen the already sound position of proponents of water fluoridation. The Council on Dental Research, April 10, after a reevaluation of evidence, reaffirmed its support of fluoridation as a dental health measure and commended departments of public health for their scientific contributions to the problem of caries control through fluoridation. The Council on Dental Health on April 14 restated its support of fluoridation as a safe anticariogenic measure, pointing out that the volume of accumulated scientific data has established beyond any reasonable doubt both its safety and efficiency. Milwaukee citizens on April 7 by referendum overwhelmingly approved fluoridation, and Cincinnati by an 8 to 1 vote of its city council on April 1 decided similarly. Three researchers from the University of Rochester reported on April 7 that 'if all fluoride in drinking water containing one part per million fluorine were to be deposited in the skeleton, the situation would be perfectly safe.' And lastly, a Yale University School of Medicine scientist again scotched the rumor that fluoridation of water increases the incidence of cancer by reporting to the International Association for Dental Research, March 20, that tumors transplanted into mice developed more slowly if the mice received fluoride. Thus the scientific evidence mounts monthly in favor of fluoridation, leaving to opponents of the process only vapid arguments based either on emotionalism or misinformation." The Commissioners have been informed that the American Medical Association, the American Dental Association, the American Public Health Association, the State and Territorial Health Officers Association, the United States Public Health Service, the National Research Council, and other leading professional and scientific organizations have fully endorsed controlled water fluoridation as an outstanding public health measure. The Commissioners are therefore of the view that the controlled fluoridation of the water supply of the District of Columbia is of benefit to the citizens of the District, and they strongly recommend that the bill not be enacted. The Commissioners have been advised by the Bureau of the Budget that there is no objection on the part of that office to submission of this report to the Congress. Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Washington 25, D. C. MY DEAR MR. WOLVERTON: This is in response to your request for a report from this Department on H. R. 2341, a bill to protect the public health from the dangers of fluorination of water. I recommend that the bill be not enacted. H. R. 2341 would prohibit the treatment of any public water supply with any fluoride compound by any agency of the United States, including the District of Columbia and the Territories and possessions of the United States, or by any agency of any State, including any municipality or other political subdivision thereof. It would prohibit these agencies also from making available any water treated with fluorides for general use in any hospital, post office, military installation, or other installations or institutions owned or operated by or on behalf of any such agency. In connection with the operation of a program for prevention and treatment of dental disease among American Indians, this Department has had occasion to give considerable study to the effect of fluorine in drinking water. It is the opinion of our specialists in this field that the addition of 1.0-1.5 parts per million of fluorine to water supplies produces a beneficial effect upon the oral health of individuals consuming such reconstituted waters. Furthermore, we have been unable to find any scientific evidence which shows that the ingestion of water containing 1.0-1.5 parts per million of available fluorine ions has any deleterious toxicological effect upon the human body. We are much opposed to any action which would deprive the American Indian of the health benefits to be derived from the carefully controlled usage of fluorides in their drinking water. Several of the Territories under the jurisdiction of this Department are considering fluorinating their water supplies, and some have begun the process. The Alaska Board of Health has recognized the benefits of fluorinating drinking water, and has established procedures which must be followed by Alaskan communities which choose to utilize this process. At the present time, there are three communities considering fluorination in Alaska, and completed plans have been received by the board of health for the installation of fluorination equipment at Anchorage, which is the largest city in Alaska. By House Concurrent Resolution No. 64 of the 26th Legislature of the Territory of Hawaii, the matter of fluorination of the water supply of Honolulu and Hilo was placed before the board of health of the Territory, the board of water supply in the city and County of Honolulu, and the board of water supply of the County of Hawaii, for their study and report back to the legislature. Comprehensive compilations of source materials, findings, and conclusions have been prepared by these boards, and have been submitted to the Legislature of Hawaii for consideration. In the Virgin Islands, fluorination of water supplies is in the planning stage. At present no fluoride compounds are added to the public or semipublic water supplies in that territory. American Samoa has done nothing about the fluorination of its water supplies, but plans to give the matter consideration because of the high percentage of tooth decay among Samoan children. The Commonwealth of Puerto Rico has taken steps toward the fluorination of its water supply, based on the evidence contained in various scientific literature, and especially on the resolution approved by the Association of State and Territorial Health Officers at its annual meeting held in December 1952. By Act No. 376 of 1952, the Puerto Rican Legislature appropriated to the aqueduct and sewer authority the sum of $96,000 for the purchase of equipment and materials necessary for the fluorination of the water serviced by the metropolitan aqueduct system. An appropriation in the sum of $165,000 is being requested from the legislature this year for the purchase of equipment and supplies for the fluorination of water in other public water systems. The 6-year economic plan for 1953-54 to 1958-59 calls for appropriations in the sums of $145,000, $169,000, $195,000, $222,000, and $183,000 in successive years for the purchase of equipment and materials for broadening the fluorination program. It is expected that by the year 1958-59, all major public water systems in Puerto Rico will be supplying fluorinated water to consumers. In the administration of the Territories of the United States, a steady policy has been followed of placing the responsibilities of local self-government in the control of the territorial peoples as their political, economic, and social development has warranted. The beneficial result of this policy has been recognized generally. Enactment of H. R. 2341 would be a reversal of this beneficial policy as far as local public health is concerned. All of the Territories have the human resources with the accumulated wisdom, intelligence, and judgment sufficient to enable them to determine matters of local public health. We believe this opinion is substantiated by the manner in which the several Territories are now studying the matter of fluorinating their water supply. It would appear also that to the extent H. R. 2341 purports to control State action concerning local health matters it would be subject to constitutional objections. Such objections are not, of course, within the purview of this Department. Therefore, I recommend that H. R. 2341 be not enacted. The Bureau of the Budget has advised that there is no objection to the submission of this report to your committee. Sincerely yours, ORME LEWIS, Acting Secretary of the Interior. DEPARTMENT OF THE ARMY, Washington, D. C., May 13, 1953. Hon. CHARLES A. WOLVERTON, Chairman, Committee on Interstate and Foreign Commerce, House of Representatives. Dear Mr. CHAIRMAN: Reference is made to your request to the Secretary of Defense for the views of the Department of Defense with respect to H. R. 2341, 83d Congress, a bill to protect the public health from the dangers of fluorination of water. The Secretary of Defense has delegated to the Department of the Army the responsibility for expressing the views of the Department of Defense thereon. The Department of the Army, on behalf of the Department of Defense, is opposed to the enactment of H. R. 2341 for the reasons set forth below. The bill, H. R. 2341, would prohibit all agencies of the Government of the United States, and all agencies of any State or municipality or other political subdivision of a State, from treating any public water supply with any fluoride compound. Further, it would prohibit the use of such treated water by any hospital, post office, military installation, or other installation or institution owned or operated by or on behalf of any of the aforesaid agencies. The principle of fluorination of certain potable water supplies as a means of preventing dental caries in children has been accepted by the house of delegates of the American Dental Association (October 1950), by the governing council of the American Public Health Association (November 1950), by the Surgeon General, Department of the Army (November 1950), by the American Medical Association (December 1951), by the United States Public Health Service, and by other Federal and State agencies interested in public health. In April 1951, the National Research Council convened an Ad Hoc Committee on Fluorination of Water Supplies to review the evidence on this subject and to prepare an impartial report. Special attention is invited to the conclusions of the report which state in part: "In view of these considerations, the committee recommends that any community which includes a child population of sufficient size, and which obtains its water supply from sources which are free from or are extremely low in fluorides, should consider the practicability and economic feasibility of adjusting the concentration to optimal levels. This adjustment should be in accord with climatic factors and a constant chemical control should be maintained. With proper safeguards, this procedure appears to be harmless." Present medical service policy is against the fluorination of water supplies on military posts because the number of children on a military post is usually very small as compared with the adult population. However, as the controlled studies on this subject are continued, there is increasing evidence that older populations may also benefit from this practice. If this point is proved, then it will be desirable for the Army to fluorinate water at posts where the water is deficient in this chemical. It is the opinion of this Department that, under certain conditions, the fluorination of water supplies is a public health asset and that legislation which would prohibit this practice would be detrimental to the public interests. In this connection, it is to be noted that fluorination of public water supplies has been accomplished in 703 communities with an estimated population of 16,500,000, and that scientific studies in these areas indicate that great benefits in the reduction of dental caries have been derived from the fluorination of water. For the foregoing reasons, the Department of the Army, on behalf of the Department of Defense, recommends that H. R. 2341 be not favorably considered. The Department of the Army is unable to estimate the fiscal effects of the proposed bill. This report has been coordinated among the departments and boards of the Department of Defense in accordance with procedures prescribed by the Secretary of Defense. The Bureau of the Budget has been consulted and advises that there is no objection to the submission of this report to the Congress. Sincerely yours, ROBERT T. STEVENS, |