Mr. BEAMER. What about the situation in your own State of Ohio? Do you have such a kit available? Dr. PORTERFIELD. Yes, sir. I don't have it available with me, but such could be sent you. Some of those would be duplicates of items you could receive from other associations, but it is our particular collection in Ohio that we use when a community expresses interest in considering this questior Mr. BEAMER. If you will do that, I think it will be very helpful. Now, in addition to that, do you know whether or not the State authorities send any agents or representatives around to the communities, either to explain what the State official position is or to attempt to stir up interest in introducing fluoridation of the local public water supply? Dr. PORTERFIELD. Yes, sir. That would be in keeping with our general operation. Most State health departments devote a considerable amount of their activity to educational activity; and in that connection both dentists and health educators from the various departments would travel in their State to communities, usually but not always on specific invitation of the local dental societies or the local medical society or the local board of health or citizens health council. If I may etend my remarks in xthat connection, however, this question and would like to have information, when such requests come in from the community, the State health department sends people to provide that information. There is no gainsaying the fact that when questions are not raised locally, the health educators and the dentists and such people from the State health department may, in their visits to local health departments, in discussing their overall programs, suggest to them that one item in their program which they have not considered is fluoridation. If I may extend my remarks in that connection, however, this matter of promotion of fluoridation is within controlled limits. The State health department in Ohio and I think, in most other States, reserves the right to disapprove a community's desire to fluoridate water if the engineers of the State health department have determined that its waterworks system and the personnel operating such are not competent to provide a control program. Mr. BEAMER. Has that right ever been exercised, to your knowledge, in Ohio? Dr. PORTERFIELD. Yes, sir; not formally by the State health department council action, but we have advised one or two small communities that until they develop a proper water supply system and a properly trained operator, we can't recommend to them that they consider the question. It has never gone further than that. Mr. BEAMER. Thank you, Doctor. That is all. Mr. HALE. Mr. Pelly? Mr. PELLY. Doctor, I would just like to ask you if in the State of Ohio you have had local votes in communities on whether they should or should not put in fluoridation? Dr. PORTERFIELD. Yes, sir. There has been one that is well known, in the city of Cincinnati. Mr. PELLY. That is the only vote you know of? Dr. PORTERFIELD. That is the only popular referendum of which I know, yes. Mr. PELLY. I asked Dr. Knutson before you came on the stand as to whether or not teams of Federal workers had gone around to promote fluoridation, and you may have heard a gasp from certain individuals, who I think were proponents of the bill, indicating that there was some doubt in their minds as to whether or not the public health service had done it or not. Do you know in the State of Ohio whether or not any State Public Health Service officials have gone around to promote fluoridation? Dr. PORTERFIELD. To the best of my knowledge, sir, Public Health Service officials have not, of their own volition, come into the State of Ohio and taken any community action. It depends, I think, a little bit on the context of the question asked. When the city of Cincinnati was considering the question of fluoridation, the city health officer, the health council of that city, the health federation, so-called, and certain other groups down there who were interested, sought the help and advise of the State health department. Our dental health chief and others, including myself, visited Cincinnati, indulged in public forums in which both sides of the issue were debated, both on television and in public meetings; and during that time, which extended over several months, it may well be, although I don't know this as a specific fact, that we had called in an employee of the Public Health Service from the regional office to travel with us or to advise us on certain material that was not immediately available at first hand to us. So it is possible; but not directly from the Federal Government to the community; not in Ohio. Mr. PELLY. I can understand how a misunderstanding might have arisen, and that possibly some local health authorities or State health authorities had called in regional Public Health Service members to travel to some community with them. Dr. PORTERFIELD. That is right, sir. Mr. PELLY. That is all. Thank you, Mr. Chairman. The last witness will be Dr. Harry Jordan, secretary of the American Water Works Association. STATEMENT OF HARRY E. JORDAN, SECRETARY AND CHIEF EXECUTIVE OFFICER OF THE AMERICAN WATER WORKS ASSOCIATION, BY DAVID AULD, DIRECTOR, AMERICAN WATER WORKS ASSOCIATION Mr. AULD. Mr. Chairman, Dr. Harry Jordan was unavoidably prevented from coming to this hearing. He asked me to present his paper to you. I am David Auld, a director of the American Water Works Association. [Reading:] My name is Harry E. Jordan. I have the honor to present to your committee comments in opposition to the enactment of H. R. 2341 (Wier), to protect the public health from the dangers of fluoridation of water. I have for more than 50 years been concerned with the production and distribution of safe water supply. I am a graduate of Franklin College, holding degrees of bachelor of science and doctor of science in chemistry. I am a life member of the American Society of Civil Engineers, the American Public Health Association; and an honorary member of the American Water Works Association and the New England Water Works Association. I have been since 1936 the secretary and chief executive officer of the American Water Works Association. The association, which is an organization of waterworks executives and staff numbering 9,890 persons on May 1, 1954, adopted in June 1949 a statement of policy concerning fluoridation of public water supplies which reads as follows: "In communities where a strong public demand has developed and the procedure has the full approval of the local medical and dental societies, the local and State health authorities and others responsible for the communal health, water departments or companies may properly participate in a program of fluoridation of public water supplies." It will be noted that the association expresses no professional opinion concerning the merits of fluoridation-but states that it relies upon the opinion of trained physicians and dentists to advise local administrative authorities whenever it appears that fluoridation of a particular water supply is needed. I wish to point out with full emphasis that the addition of fluorides to water in a treatment plant is an operation involving no unusual procedures or equipment. Fluorides are only one of a series of a large group of chemicals widely used in water treatment; carefully controlled by the operators in charge of the system; and no more likely to be fed in excess than any of the other materials. The apprehension expressed by some opponents of fluoridation that careless operation might poison a community is ridiculous. Such things simply do not happen. There also appears from time to time the statement that the addition of fluorides to the public water supply is wasteful-since the proportion of the total water produced in a city used for drinking is low. It is true that people drink only about one half gallon per day out of the average of 140 gallons produced per person per day. The same proportions affects the use of any treatment material intended to make water safe for drinking. Fluoride-bearing minerals are in ample supply to supply the needs for water treatment. But it is just as true that it cannot be considered wasteful when we realize how great has been the value of modern water quality. In 1900 more than 50 persons per 100,000 living died each year from typhoid fever in the United States. Today thanks to efficient water treatment and the general increase of sanitary protection of the people, less than 1 person per 200,000 living dies of typhoid. A reduction of such magnitude in waterborne disease should convince any thinking person that the care taken to make all the water safe to drink is worth many times over what it costs. I shall leave to representatives of the dental and medical professions the opportunity to present their opinions concerning the value of fluoride-bearing water in prevention of, or reduction of dental caries. You should, however, be advised that over 1,100 communities having a population totaling over 3,500,000 persons have for many years used water supplies containing fluorides naturally present in accepted amounts. As one trained in the science of chemistry, I may state there is no significant difference in the character of fluoride as it naturally occurs in water and fluoride as it may be added to water in amount recommended by the dental profession. Therefore, the more than 17 million persons in over 900 communities, who have been furnished in the years since 1945, water to which fluoride has been added in controlled amounts are under no exposure to fluoride different from the 3,500,000 who have for years used natural fluoride-bearing water. However, speaking for the public water-supply industry which today serves 110 million persons in the United States, I wish to state my opinion that the Congress cannot with propriety legislate what material may not be used in the treatment of a public water supply. Similarly, I doubt that it could with reason legislate what is to be used in water treatment. The Federal Government today includes a large group of agencies upon which Congress has conferred the duty of acting in areas assigned to each and controlling procedures and practices, in their respective fields. The Congress has established among others, the Department of Health, Education, and Welfare and has granted it powers, which among other things, cover dental health and quality of water used in interstate commerce. Consistent with the authority given by the Congress, staff members of the Health, Education, and Welfare Department have, with full professional competence, investigated fluoridation and have announced their opinion that controlled addition of fluorides to public water supplies is proper and highly desirable. Unless the Congress has available to it a mass of professional evidence which shows that the Government's own agents are professionally incompetent, it is not proper for legislation to run counter to the opinion of the Government's own experts. I wish, however, to object on broader grounds to a legislative enactment which will forbid the use of a water-treatment material recommended by competent professional authority. The water works industry now uses widely two chemicals in purification to which objections were once made by persons presumably well informed. The Army engineers, who about 1900 recommended purification of the Washington, D. C., water supply by means of coagulation with alum followed by filtration, was opposed in a hearing before a Senate committee by a group representing the District medical society. The water treatment plant, was, therefore, built so as to operate without coagulant. But in less than 5 years after the plant was built it was found necessary to use alum. It had been learned that the system could not function satisfactorily without alum. Its use continues to this day-with results satisfactory to the operators, to the medical profession, and to the public. Today there are more than 2,000 cities in the United States using water treated with alum or its functional equivalent. In 1910 the use of chlorine as an agent to destroy bacteria in water was being widely considered. Dr. Harvey W. Wiley, then Chief Chemist of the Department of Agriculture, when asked a question about the propriety of using chlorin, stated (without studying the question carefully) that "chlorine in water is as much an adulterant, as formaldehyde in milk." Fortunately, for the public good, Dr. Wiley's comment gained little attention. The use of chlorine spread and the evidences of its great benefit grew. Today more than 3,500 communities in the United States drink safer water because chlorine is used to remove the last bacteria which may have polluted it. If your committee had been in existence in 1902 and the opposition to alum as a coagulant had led you to recommend that alum or its equivalent not be used in water purification, you would have been in error-as history now shows. If your committee had been faced with the opposition to chlorination in 1910, you might have been led to recommend legislation forbidding the use of chlorine in water treatment. You would have been in error-as history now demonstrates. In the last 50 years, improvements in the quality of public supply-improvements made possible because valid progress was not hampered by adverse legislation-have saved the lives of at least 5 million persons who would have died of waterborne diseases if the water-supply industry bad not kept in step with the advances in scientific knowledge. I therefore appeal to you as reasonable and intelligent public servantsnot to recommend legislation forbidding the fluoridation of public water supply. Let the decision to fluoridate or not to fluoridate be left to the State and local authorities and let them base their action upon the advice of the medical and dental professions. Mr. BEAMER. I have no questions to ask, but only a comment to make. Isn't it a fact that not too many years ago some people thought it was dangerous to bring water through copper pipes? Mr. AULD. I think that did come under study, yes; lead, too. Mr. BEAMER. Once upon a time isn't it true that the tomato was considered a poisonous fruit? Mr. AULD. Right. Mr. BEAMER. I had the opportunity to have passed around some good Indiana tomato juice to my colleagues recently, and they enjoyed it. And I am trying to point out what I think you are trying to point out, that as we advance in science and the development of products, something that may have seemed injurious at one time has been proved not to be injurious but rather helpful. Mr. AULD. Time has seen that repeatedly in many fields. And it would seem unfortunate to stop it by legislation at this time with respect to fluoridation. Mr. HALE. Thank you. 48391-54- -27 Mr. AULD. Thank you, Mr. Chairman. Mr. HALE. This will conclude the hearings on H. R. 2341. When the committee adjourns, it will adjourn to meet tomorrow morning at 10 o'clock. At this point we will insert statements of opponents of the bill which have been submitted for the record. I have a letter from the Honorable John W. McCormack enclosing a telegram from a number of doctors; A letter from Dr. Clifton O. Dummett, Chief, Dental Service, Veterans' Administration, Tuskegee, Ala., enclosing some information; A letter from Dr. Francis Lehr of the New Jersey State Dental Society; A letter from Dr. Earl G. Ludlam, New Jersey State Department of Health; A letter from Dr. Thomas Parran, former Surgeon General of the United States; A letter from Francis J. Garvey of the American Dental Association; A letter from the Plainfield Dental Society, Plainfield, N. J.; A letter from Dr. George F. Lull, secretary and general manager, American Medical Association; A letter from Katherine Ellickson, CIO; A letter from A. P. Black of the University of Florida; A letter from Dr. Kenneth F. Maxcy of Johns Hopkins University; A letter from Prof. Harold C. Hodge, of the University of Rochester. (The statements referred to are as follows:) Hon. CHARLES B. WOLVERTON, CONGRESS OF THE UNITED STATES HOUSE OF REPRESENTATIVES, House Office Building, Washington, D. C. Dear Chairman WOLVERTON: I am enclosing a telegram received from Dr. James M. Faulkner and a number of other doctors in opposition to H. R. 2341, which I am respectfully sending to you without comment on my part for the information of yourself and the other members of your committee. With kind regards, I am Sincerely yours, JOHN W. MCCORMACK. BOSTON, MASS., May 18, 1954. Representative JOHN W. MCCORMACK, House of Representatives, Washington, D. C. We the undersigned Massachusetts public officials, research workers, teachers and Representatives of voluntary organized medicine and dentistry urge the defeat of H. R. 2341. We believe that fluoridation of communal water supplies by one part per million a safe and effective measure to combat dental caries and that the passage of H. R. 2341 would be a serious step backward in this important phase of the public health. Dr. James M. Faulkner, Dean, Boston University School of Medicine; |