a small amount of money, and we cannot go out and do the kind of work that a big Government agency can.

The CHAIRMAN. We thank you, Mr. Palmer, for your statement.

Mr. PALMER. Thank you, Mr. Chairman and gentlemen.

I understand that my full statement will appear in the record?

The CHAIRMAN. Yes. Without objection, the statement of Mr. Palmer will be inserted in the record.

(The statement referred to follows:)

THE MISCALCULATED RISK OF MASS FLUORIDATION-A STATEMENT BY CLAUDE N. PALMER, MEMBER OF THE BOARD OF DIRECTORS, IN SUPPORT OF H. R. 2341, PRESENTED ON BEHALF OF THE NATIONAL COMMITTEE AGAINST FLUORIDATION (FORMERLY CITIZENS COMMITTEE ON FLUORIDATION)

PART I

"May God grant me the wisdom to discover my own mistakes." With this prayer, the young scientist, Arrowsmith, began his career as a researcher into the causes and prevention of contagious disease. The National Committee Against Fluoridation, a nonprofit, nonsectarian group of American citizens, chartered under the laws of the District of Columbia, will endeavor to show by their own words how this creed of medical and research ethics is ignored by those who advocate most vociferously a regimen of mass medication by adding fluorine to community water supplies.

We lay no claim to being a group of scientists, though our membership, which extends from Maine to California and from Florida to Alaska, includes physicians, dentists, chemists, educators, and other professional men, as well as lay citizens from all levels of society. Since other witnesses will discuss fluoridation from a purely scientific viewpoint, in which some differing opinions may be expressed, this statement will deal mainly with certain contradictory assertions made by the proponents of fluoridation as to its possible benefits and potential dangers.

THE CHEMICAL PROPERTIES OF FLUORINE

On one subject, however, no disagreement will be expressed on either side of this issue. As every standard work on chemistry shows, no doubt exists as to the violent reaction of fluorine and its compounds on both animal and vegetable life. In support of this fact, we quote in part a statement of the International Nickel Co., published under the caption, "When Metal Bursts Into Flame."

"Imagine, if you can, an element so fierce it burns up steel. One that claws its way through firebrick * * * makes water burn like alcohol * ** destroys almost everything it touches. That's fluorine for you. And for over 200 years

chemists racked their brains to find some material that would hold fluorine ** * for even a few minutes' study. Numerous materials *** were tried. Most went up in a flash."

With these and other facts about the violent nature of fluorine and its compounds readily available, many people have become alarmed at the addition of this chemical to their drinking and cooking water, and are not convinced by statements from unknown sources, no matter how official, that taking this element into their systems for the rest of their lives, even though in minute doses, cannot possibly have a toxic effect upon their own and their children's future health.

These doubts and anxieties would not have been so widespread, nor would public resistance to and defeat of fluoridation have occurred in so many localities, both before and after its inception, were it not for the fact that this system of compulsory mass medication was in many instances introduced without the knowledge and consent of those who might be injured by it and often despite the protests of people who considered it an invasion of their personal rights and liberties.

THE POLICY OF FLUORIDATION BY STEALTH

That the advocates of fluoridation have adopted a deliberate policy of keeping the general public in ignorance on the subject-at least preventing a referendum vote in the community if possible—is shown by the record of proceedings at

the fourth annual conference of State dental directors and the Public Health Service in Washington, D. C., in June 1951. At this meeting Dr. F. A. Bull, director of dental education, Wisconsin State Board of Health, and evidently keynoter for the advocates of fluoridation, said in part as follows:

"If you can-I say if you can, because five times we have not been able to do it keep fluoridation from going to a referendum. After you have just a little experience, you will find you can walk into a mayor's office and after about three sentences you will know whether he is for fluoridation or against it.' At another point in his address, referring to the toxicity of drinking water with a concentration of 1 part fluoride to 1 million parts of water, Dr. Bull is quoted in the official conference proceedings as saying:

"Now, in regard to toxicity, I note that Dr. Bain used the term 'adding sodium fluoride.' We never do that. That's rat poison. You add fluorides. Never mind that sodium fluoride business, because in most instances we are not adding sodium fluoride anyhow. All of those things give the opposition something to pick at, and they have enough to pick at without our giving them any more. But this toxicity question is a difficult one. I can't give you the answer on it. After all, you know fluoridated water isn't toxic. But when the other fellow says it is, it's difficult to answer him. I can prove that we don't know the answer to that one, because we had a city of 18,000 that was fluoridating the water for 6 or 8 months. A campaign was started by organized opposition on the ground of toxicity. It ended up in a referendum and they threw out fluoridation."

With such mixtures of professional candor and confusion reaching the ears of intelligent people, it is easy to understand why such communities as Los Angeles, Seattle, Minneapolis, Chicago, Kansas City, St. Louis, Philadelphia, Reading, New York, Rochester, Boston, Cambridge, Worcester, Cincinnati, Tampa, Lansing, Tallahassee, and some 300 other places rejected fluoridation either before it began or after it had been in operation, sometimes for a year or more.

THE FLUORIDATION PROPAGANDA LINE

Besides telling only what it wants the public to believe, carefully omitting any reference to the possibility of chronic fluorine poisoning, the proponents of fluoridation adroitly sidestep all mention of the rising flood of opposition that faces them in well-informed communities. The public hears only about new installations; never of rejections. We are asked to believe that many cities and towns eagerly await fluoridation; never that hundreds of communities have rejected it.

It is not strange that authentic data on the number of fluoridated areas are difficult to obtain, since profluoridation propaganda has used approximately the same figures-600 to 700-during the past several years. Fluoridation proponents have, however, recently made the satement that some 17 million American citizens are now drinking artificially fluoridated water. As the fluoridation program has been running in high gear for more than 10 years, this figure is not impressive, since it represents only about 10 percent of today's national population.

Compared with the rather poor showing on a nationwide basis, after nearly a decade of ceaseless propaganda and enthusiastic endorsement by medical and dental societies, public officials, chambers of commerce, and welfare groups, it is significent that the 17 cities previously noted, all of which have rejected outright or postponed fluoridation of their water supplies, represent a population of more than 20 million. It is thus apparent that these few cities in which fluoridation has been turned down outnumber by upward of 3 million persons the most optimistic claims of profluoridation enthusiasts.

We believe it safe to say that more resistance would have developed and more communities would have abandoned the idea of fluoridating their water systems if the public had been informed of what was going on, and if both sides of the issue had been discussed openly. That this was not the policy of those most interested in fluoridation is shown by the fact that many people are unaware that fluorides are being added to their drinking water, and do not know about the difference between fluorine and chlorine in their action upon animal organs and tissues.

In this connection, it is doubtful that all Members of Congress know whether or not the public water supplies in their own districts contain fluorine. A survey among adult citizens of Newburgh, N. Y., a community that has received more

profluoridation publicity perhaps than any other town, revealed that only 8 percent had any idea as to what "fluoridation" means, 72 percent said they did not know, the remaining 20 percent were undecided. Of the Newburgh group, only 22 percent were aware that fluorides were added to their drinking water, while 61 percent did not, but 83 percent said they believed they should have been consulted, and only 2 percent raised no objection.

DOES FLUORIDATION DO WHAT ITS BACKERS CLAIM FOR IT?

Other witnesses will discuss the therapeutic and physiological sides of this issue. It is my intention to point out the difficulty of obtaining authentic and unbiased data regarding the results of fluoridation in its job of reducing dental caries among children up to 8 years of age. While there is little doubt that fluoridated drinking water makes the teeth of young children somewhat more resistant to decay, there is much difference of opinion among dental authorities as to whether fluorine alone can be credited with producing the result. Some observers report that when fluoridation appears on the scene, certain other influences take a hand in the work, contributing a considerable share to its outcome.

Since data on all pilot experiments in this country are apt to be influenced by the experimenter's personal predilections, no matter how conscientious he happens to be, we take the experience of Canadian cities to show the error of giving full credit to fluoridation for reducing tooth decay among school children in one place, while equally good results were obtained in another without fluoridation.

Brantford, Ontario, adopted fluoridation in 1944. After 6 years its public health officer reported (February 1950) a reduction of 31 percent among children of school age requiring dental repairs. This report gave a sudden spurt to the campaign for public water fluoridation in Toronto. But health officials in Toronto had meanwhile been watching the condition of their school children's teeth. When the cry for fluoridation became insistent, they announced that dental decay among Toronto's children declined 45.3 percent during the same period of years.

The reason for Toronto's experience is simple. While Brantford was treating its children's teeth with fluorine, Toronto was plying its children with information on proper diet, exercise, and other aids to good health and teeth. This is an essential to every health program among school children, whether the community water supply is fluoridated, or whether it remains free of artificial medication. The Brantford-Toronto picture could be repeated many times over in this country.

HOW ACCURATELY IS THE FLUORINE PRESCRIPTION FILLED?

A favorite assertion of the professional and amateur fluoridators is that no harmful effect is possible from water containing "the prescribed concentration”— one part of fluorine to a million parts of water-other than a slight mottling or discoloration of the teeth. This formula completely overlooks the fact that some persons consume in the course of a day many times the amount of water consumed by others, that in summer most people drink much more than during cold weather, that persons afflicted with certain diseases need much more than the average needed by well persons, and that the susceptibility of one person to a given treatment differs widely from all others.

Prescribing the same pill to everyone, regardless of age, health, or ability to withstand its cumulative effect, and telling the patient to take as much or as little of the drug as he pleases, would hardly be considered acceptable procedure on the part of a practicing physician. Yet men who are not practicing physicians assume the prerogative of prescribing the same amount of fluorine to every person in every community on a lifelong basis, despite individual tolerance or needs.

The "safe" dosage of fluorine is presumed to be one part per million. That is the amount appearing most frequently in published literature on the subject Yet we find an admitted authority on fluoridation, the same Dr. Bull previously mentioned herein as the official spokesman for the form of universal medica tion, telling his fellow dental directors-behind closed doors, of course that not 1 part per milion, but 1.2 parts per million is the fluoride concentrate "we are recommending."

Granting that this prescription is the last word in fluorine therapy, can we be sure it is compounded accurately in every case and all circumstances? We have sound evidence that it is not. In Charlotte, N. C., for example, one of our larger fluoridated communities, monthly analyses of fluorine concentration at the city water plant between September 1949 and August 1950 showed variations from 14 percent above to 35 percent below the prescribed amount, an overall spread of 48 percent.

This 48 percent variation at the water plant might not be highly significant, if it were not for the fact that three other monthly tests of the same water drawn from the same source showed as great or greater variations in fluorine content, seldom agreeing with each other or with the water plant's analyses. Samples analyzed by the city health department showed a difference of 51 percent between maximum and minimum concentrations. The Charlotte water district tests showed variations of 53 percent during the 12-month period. Tests at a military post which draws its water from the Charlotte system showed a difference of 51 percent between maximum and minimum fluorine concentrations. While the latter percentage coincides with that of the city waterworks, it is significant that in no month of the 12 were all 4 tests in complete agreement as to the fluorine content of their individual samples.

If it were true, as promoters of fluoridation assert, that mixing and metering equipment used to combine fluorides with water are infallible, there would be only one reason why water enters the city mains with one concentration and leaves them a few miles away with a higher or lower concentration. This reason would be that part of the fluoride is deposited somewhere along the line. While there are indications that this is true to some extent, there is good evidence that certain amounts of fluoride remain in the mixing device, temporarily at least,

THE CORROSIVE ACTION OF FLUORINE ON PLANT EQUIPMENT

Evidence that even the most modern fluoride-mixing equipment in the hands of expert operators does not always compound the prescription accurately is given in a public statement by H. E. Wirth, assistant sanitary engineer of the State board of health, Madison, Wis. Mr. Wirth was quoted as follows in the transcript of a discussion on fluoridation at the University of Washington:

"Some operating difficulties have been noted, such as the clogging of solution piping by deposition of inert materials, the presence of foreign material consisting of pieces of heavy paper, slivers of wood, nails and staples, found in compounds described as 98 percent pure white sodium fluoride. There is (also) the more difficult problem of incrustation.

"This problem, common in hard waters, has been experienced in soft waters as well. When mixed with the water supply, sodium fluoride forms a precipitate with the calcuim in the water, which plugs the injection lines, incrusts tanks and solution chambers.

"Even in soft-water makeup, precipitates form in the tanks, which, if not periodically removed, plugs the feeder. Control of this condition is secured by periodic back-washing of the tanks, which brings the sludge to the top, where it can be removed. Madison used cast iron for both tanks. Originally, attempt was made to feed into the well discharge lines. Severe erosion at the point of installations was everpresent, however, requiring weekly replacement of the fittings." [Italic added.]

If sodium fluoride added to public drinking water by the most modern device, and superintneded by a professional sanitary engineer, is as difficult to control as Mr. Wirth's statement admits, we submit that this procedure presents a serious health problem, especially when handled by unskilled persons, such as the village barber or hardware man. To show that this responsibility is sometimes given to untrained persons, we again quote from the remarks of Dr. Bull, previously referred to in this statement:

"So we took them to several little installations, where the village barber is the waterworks man, or the hardware man is the waterworks man. And we turned them over to him, and let the engineers question him, and find out what he is doing and how he is doing it. Now, in large cities, we do not concern ourselves, because they know how to handle the equipment and have trained help. But, in a small community, where the barber is going to operate the feeder, if anything goes wrong, he throws up his hands."

This revelation should make any reasonable person think twice before approving, let alone promoting, fluoridation in his own or any other community. It has

been shown that serious mechanical difficulties appear in large cities (Charlotte and Madison), and that the risk of more serious trouble can be expected in places where the responsibility is given to unskilled workers. Despite such hazards, it is understood that the Public Health Service has supplied fluorinemixing devices to certain communities at the American taxpayer's expense.

Granting that the formula is correct and safe under all circumstances, it is unthinkable that the prescription should be filled by the village barber or hardware merchant. Prudence demands that such work be performed by registered pharmacists, not by handymen with part-time jobs in the local waterworks. Because of its dangerous nature, one may not buy hydrofluoric acid or other fluorides from a druggist. Yet these chemicals are now being administered in wholesale quantities to large groups of people by employees of municipal pumping stations all over the country under the qualified endorsement of the American Medical Association.

In

Much has been made by fluoridation advocates of this AMA endorsement. its statement of some years ago to another congressional committee, the organization endorsed the program in principle only, said its councils "did not know of any injury" from drinking water with the recommended flourine content, did not believe such water to be toxic, and "purposely refrained" from suggesting or urging that any community fluoridate its public water supplies. This statement does not impress us as an unqualified endorsement of mass fluorine therapy.

HOW GOOD ARE THE PRECEDENTS FOR FLUORIDATION?

Proponents of fluoridation cite the practice of adding chlorine to community water systems as a precedent for adding fluorides. They also cite compulsory immunization against certain contagious diseases, now practiced in many localities, as analogous to fluoridation. These analogies are not sound, however, since dental caries is neither epidemic, contagious, infectious, nor fatal. At its worst, tooth decay is a minor health problem, the causes and prevention of which are not yet fully understood after many years experimentation and research.

There is, however, a single precedent in this field of therapy, though it is never mentioned publicly by the sponsors of fluoridation. We refer to an attempt of the United States Public Health Service and others a generation or more ago to promote the universal addition of iodine to public water supplies as a preventive of goiter. This early attempt to use city water mains as an avenue to mass medication failed for the simple reason that its backers learned in time that, rather than preventing or curing goiter, iodized drinking water tended to increase it.

When the facts become known about fluoridation, we believe this therapy will follow universal compulsory iodinization into the discard. Meanwhile, the public is being subjected to a regimen of treatment for a minor ailment affecting almost wholly a small part of the population, the long-range effects of which are as yet unknown. To determine whether any person will be injured by this treatment would require observation covering one or more generations. In these circumstances, it is difficult to understand why the program was launched throughout the Nation, after only 2 or 3 years of pilot tests among children under 9 years of age.

THE GOVERNMENT'S RESPONSIBILITY FOR FLUORIDATION

It has been intimated that Congress may be reluctant about enacting the Wier bill (H. R. 2341) on the ground that it might infringe the police powers reserved to individual State legislatures. This doctrine might be tenable, if the Federal Government were not already invading such police powers through its Public Health Service, which is one of the chief and most ardent promoters of mass fluoridation on a nationwide basis, supplying both fluoride-mixing equipment and printed publicity for which the Federal Treasury foots the bill.

Thus, the Congress is already responsible for any invasion of State or local police powers that might be involved in the passage of this legislation, since it appropriates the funds by which the Public Health Service is able to spread a web of profluoridation propaganda throughout the United States and even into foreign countries. Therefore, if the Wier bill is not acceptable to Congress, neither is the profluoridation program now in progress by another branch of Governmentthe United States Public Health Service.