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11-13-18

From Doctor Sauerheber:

11 years since the initial ban petition was submitted to the FDA, the Agency has denied the petition for reconsideration.

This is sad news and the reasons for the denial are very vague, attached below.

The only hopeful positive after all these years of sending information to them is that perhaps when fluoridation promoters seek FDA approval for water fluoridation, that the FDA will not reverse its own position that has always been to not approve any fluoride compound for ingestion.

Sorry I couldn’t get the FDA to act to ban the infusions.

Richard Sauerheber
p.s. For anyone who wants to see the actual 3 page FDA response I could send a scanned copy.

FDA Response:

U.S. Food and Drug Administration
Nov. 7, 2018
Petition for reconsideration Docket No. FDA-2007-P-0346/PRC1 Dear Dr. Sauerheber,
FDA’s regulations state that the Commissioner may grant a petition for reconsideration if the Commissioner determines the petition to be in the public interest and in the interest of justice. The Commissioner shall grant a petition for reconsideration if the Commissioner determines that all of the following apply:

  1. The petition demonstrates that relevant information or views contained in the administrative record were not previously or not adequately considered.
  2. The Petitioner‘s position is not frivolous and is being pursued in good faith.
  3. The petitioner has demonstrated sound public policy grounds supporting reconsideration. 4. Reconsideration is not outweighed by public health or other public interest.
    In addition, a petition for reconsideration may not be based on information and views not contained in the administrative record on which the decision was made. Accordingly our decision today is based only on information contained in the administrative record on which the petition response was based.
    We have reviewed the information submitted in support of the citizen petition, our responses and conclusion in the petition response, and the petition for reconsideration. Although the petition for reconsideration asserts that FDA did not correctly interpret the request in the original citizen petition, it appears that you simply disagree with the conclusion that the Agency reached upon considering that information in response to the citizen petition. FDA considered and extensively discussed all the issues raised in the citizen petition. Therefore, we conclude that granting the petition for reconsideration would not be in the public interest or in the interest of justice. We also conclude that the relevant information and views in the administrative record were adequately considered when we reviewed and denied the citizen petition. Accordingly we need not address whether the other criteria are met.
    For the reasons described above, the Agency denies the petition for reconsideration. Sincerely,
    Leslie Kux
    Associate Commissioner for Policy

95 Letters to the FDA regarding Fluoridation

Fluoridation Letters

Sent to the

U.S. Food and Drug Administration

95 Set Series

July, 2011 – November, 2015

Regarding the 2007 petition to halt artificial fluoridation of public water supplies

FDA2007-P-0346

And the 2010 Petition for Reconsideration

Richard D. Sauerheber, Ph.D., Chemistry
Palomar College, San Marcos, California
1140 W. Mission Rd.
San Marcos, CA 92069

Special thanks go to those who kindly read these letters before submission and provided comments and corrections, including: Anita Baker, Audrey Adams, Cathy Justus, Attorney James R. Deal, the team at Moms Against Fluoridation, Attorney Gerald Steel, Lady Carla Davis, Rozanne Bazinet, Scott Olson , my students at Palomar College, and others.

First Table of Contents lists letters 1 – 64, the second lists letters 65-95.
The appendix contains the original FDA Petition, accepted for review in 2007, and the 2010 Petition for Reconsideration which describes why the FDA, not the EPA, regulates compounds administered for general consumption for putative heatlh beneft in the United States.
The 95 letters describe various aspects of water fluoridation, including lack of effectiveness, regulatory policy, harm, legal issues, expense, and ethics of the procedure by which whole body fluoride dosing of consumers is widely conducted in the U.S..

Table of Contents

  1. Rebuttal to FDA decision that the U.S. EPA regulates water fluoridation.
  2. EPA/FDA memorandum of understanding; questions to fluoridation chemical suppliers. 3. Water fluoride compared to prescription Luride.
  3. Hydrofluoric Acid HF content in fluosilicic acid and in GI tract.
  4. Fluoride as contaminant violates WPCA, as additive violates SDWA, as supplement or drug violates Food Drug & Cosmetic Act. 6. U.S. Centers for Disease Control Deceptive Practices on Industrial Fluoride. 7. Sworn affidavit for litigation on unusual chemistry of fluosilicic acid. 8. Fluoride crosses the blood brain barrier.
  5. Dental fluorosis endemic.
  6. Infant mortality in U.S. and intrinsic toxicity of industrial fluorides taken internally. 11. Water contaminants and fluoride interactions.
  7. Definitions for ingested synthetic industrial fluorides; interactions with FDA-approved drugs.
  8. Caries are caused by calcium deficiency and are aggravated by high water fluoride 14. Vitamin D deficiency and tooth decay
  9. Letters from Metropolitan Water, Los Angeles, the CA Department of Public Health, and the U.S. CDC.
  10. Alzheimer’s Disease Incidence Exponential Rise from 1978 to Present, and Water Aluminum Fluoride.
    17.Cardiovascular Effects of Fluoride; Removal of Fluosilicic Acid from Selmer; EPA Admits lack of Regulation of Fluoridation.
  11. Communication with Metropolitan Water, Los Angeles that EPA advises fluoride dosages.
  12. France 24 International News TV interview with MWD general manager and Dr. Kennedy on tooth fluorosis.
  13. Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, submitted for publication, 2012.
  14. Incidence of diseases for which fluoride taken internally is contraindicated.
  15. Recommended FDA actions to decrease dental caries, reference for responses to critics.
  16. Adverse Effects of Long-term Industrial Fluoridation in Soft Water Southern Ireland.
  17. Questions on toothpaste vs. water fluoride to CDC, letter to Windsor, Canada, Requests of FDA.
  18. U.S. CDC is stumped by question, stating that no answer is available and CDC will search for an answer.
  19. Orthosilicic acid can ionize lead salts in older plumbing and calcium phosphate as in teeth enamel.
  20. Ireland cancer incidence map correlates with industrial fluorosilicic acid in public water supplies.
  21. Response to fluoride physician lobbyist of the Washington State Board of Public Health.
  22. FDA in 1967 banned the sale of fluoride compounds for ingestion by pregnant women in the U.S.
  23. Fluorosilicic acid misbranded; FDA fluoride drugs for horses complicated with fluoridated water. 31.Elder care, fluorine drugs, fluoridated water.
  24. Letters:EPA cannot regulate fluoridation; No clinical trials; FDA allowed to regulate fluoridation. 33. Mother/fetus fluoride, silicic acid unregulated, toothpaste fluoride data. 34. Abby Martin TV news broadcast, Washington, D.C. transcript.
  25. Journal of Environmental and Public Health article accepted for publication; EPA chemical data sheet
  26. Final J.Envir. Pub. Health article; FDA rules fluoride unsafe to add to food. 37. Industrial verus natural fluoride accumulation into bone.
  27. Nutritional recommendation for drinking water higher than previously thought; Parkland,WA debate.
  28. Racehorse breakdowns increase after fluoridation in Los Angeles; Fluoridation trials discredited by Sutton.
  29. NSF violates regulations; generic and trade drug names for sodium fluoride; FDA category X rating for fluoride. 41. Blood fluoride levels causing significant bone fluorosis lifetime.
  30. Racehorse breakdowns and fluoridated water in Los Angeles published in Fluoride 46(4), 2013.
  31. EPA will not regulate fluoride infusions; water district rationale to infuse; FDA given permission to inspect drug facilities.
  32. Blood fluoride increases both calcitonin and parathyroid hormone and weakens bone; fluorotic bone exhibit, San Diego.
  33. 9 San Diego County cities will not fluoridate due to horse adversity; Dr Banks letter on topical fluoridated water.
  34. European Commission fluoridation deadline has passed; FDA attacks prenatal fluorides, 1966. 47. CDC sodium restrictions contrast with water fluoridation requests. 48. Fluoride in autism.
  35. Review article in The World Scientific Journal calls to halt fluoride infusions in public water supplies around the world. 50. Lead in fluoridation chemicals and treated water.
  36. Lack of effectiveness of fluoridated water
  37. FDA regulates public drinking water
  38. The FDCA was passed into law long before water fluoridation began in 1945 54. Bone fluoridation is skeletal fluorosis
  39. Fluoridated bone and brittle bone disease and kidney disease
  40. All lifetime consumers of fluoridated water have stage I fluorosis with bone weakening; Tommy John surgeries on the rise.
  41. Advertisements for fluoride rinses are off label claims, in violation of the FDCA.
  42. Ethnic groups are more susceptible to systemic fluoride poisoning; warnings imply safety for all others.
  43. CDC FOIA documents reveal kidney disease victims harmed from 1 ppm fluoridated water. 60. FDA Office of Compliance requirements, Jan. 2015
  44. Fluoridated bone is abnormal bone of low quality; topical fluorides
  45. Clinical case of hip replacement with fluoride measurements; three key facts about fluoridation 63. Irish doctors data; fluoridation halted in Dublin and Cork 64. NaF and CaF2 contrasted; glass etching, entropy differences in solution
    Removal of the 2.6 Angstrom fluoride ion from water molecules, themselves 2.5 x 2.7 Angstroms, is nontrivial. Particulate filtration removes protozoa and amoeba at 10 micron pore size. Microfiltration at 1 micron removes bacteria. Ultrafiltration at 0.1 micron removes viruses. Nanofiltration at 0.01 micron removes large molecules. Reverse osmosis to 0.001 micron size removes sodium which is 30% of fluoridation materials.High pressure ROto 0.0003 micron pore size eliminates fluoride ion but is impractical for whole house use.

#1.

Richard D. Sauerheber, Ph.D.
Palomar Community College
1140 W. Mission Rd., San Marcos, CA 92069
E-mail: richsauerheb@hotmail.com Phone: 760-402-1173 (address not repeated on all remaining letters) July 25, 2011

Department of Health and Human Services
Public Health Service
U.S. Food and Drug Administration
Center for Drug Evaluation and Research
Office of Regulatory Policy
Rockville, MD 20857

Dear FDA Project Reviewers,

I write this letter in support of my previous petition to ban fluoridation, that is adding synthetic fluoride to public drinking water supplies. See my original petition on this issue, FDA-2007-P-0346, formerly 2007P-0400.
The FDA, with its 2010 decision that “artificial fluoride compounds used to fluoridate public drinking water…is regulated by the U.S. Environmental Protection Agency (EPA) under the Safe Drinking Water Act of 1974
(SDWA),” may have forgotten certain historical and legislative facts, which I will discuss in this letter.
The EPA does not and has never regulated the injection of fluoride compounds into water supplies (i.e.
‘fluoridation’) and does not authorize or accept liability or responsibility for intentionally fluoridating drinking water. In fact no Federal agency currently accepts such responsibility.

The EPA labels fluoride in water as a “contaminant” and provides levels of this contaminant that should not be exceeded in order to prevent significant, widespread adverse health consequences. However, the EPA does not and has never regulated the injection of fluoride compounds into water supplies, and this is amply proven by statements published repeatedly by the National Research Council in its report “Fluoride in Drinking Water, a Scientific Review of EPA’s Standards”, The National Academies Press, Washington, D.C., 2006, referred to herein as 2006
NRC Report. In the summary on page 1, second paragraph of 2006 NRC Report, the U.S. EPA is correctly stated to be required to establish exposure standards for contaminants in public drinking water systems that might cause adverse effects on human health, including the maximum contaminant level goal (at which no adverse health effects were expected to occur from fluoride contamination), the maximum contaminant level (the enforceable standard), and the secondary maximum contaminant level (a guideline for minimizing, but not preventing, significant cosmetic effects caused by drinking fluoride-containing water). Fluoride is regulated as a contaminant by the EPA, but the EPA does not regulate fluoridation, the intentional addition of fluoride into water for perceived benefit. The EPA has no means to monitor for side effects when used as an intentional ingestible prophylactic.

On page xiii line four of the 2006 NRC Report it is stated that these EPA listed exposure values

are not recommendations for the artificial fluoridation of drinking water, but are guidelines for areas in the U.S. that are contaminated with, or have high concentrations of naturally occurring, fluoride. The goal of the EPA MCLG is to establish an exposure guideline to prevent adverse health effects, and the goal of the SMCL is to reduce the occurrence of adverse cosmetic consequences from exposure to fluoride.

On page 14 of 2006 NRC Report it is written that EPA’s

drinking water standards are restrictions on the amount of naturally occurring fluoride allowed in public water systems, and are not recommendations about the practice of water fluoridation.

Excessive contamination prevention is the goal of the EPA here; it is not to monitor side effects, subtle or otherwise, or any surmised effectiveness of fluoride compounds when used in drinking water as oral ingestibles.

Page 18 lines 8-12 and lines 17-23 of the 2006 NRC Report state that the EPA MCL for fluoride was promulgated to be the same as the MCLG of 4 ppm and EPA also established an SMCL for fluoride of 2 ppm to prevent objectionable enamel fluorosis in a major portion of the population (i.e. not everyone) and was considered adequate at that time for preventing for the most part severe enamel fluorosis that would be cosmetically objectionable. Here I quote from the 2006 NRC Report:

EPA does not regulate or promote the addition of fluoride to drinking water. Instead, as a known contaminant,
if fluoride in a community water system exceeds the SMCL but not the MCL, a notice about potential risk of enamel fluorosis must be sent to all customers served by the system (40 CFR 141.208[205]).

This is not an evaluation of any and all (studied or otherwise) adverse side effects or of expected chronic toxicity from long-term continuous uptake, but rather is a rough guide to minimize severe adversity for as many people as possible.

Page 20 the last line and page 21 the first three lines of the 2006 NRC Report state that the MCLG and SMCL were merely useful “guidelines for areas where fluoridated concentrations are naturally high. They are designed with the intent to protect the public from [overt] adverse health effects related to fluoride exposure and not as guidelines to provide health benefits.” In other words, the EPA was interested at the time in hoping to minimize adverse health consequences of too much of the fluoride contaminant. They had no role whatsoever in reviewing the safety or effectiveness or dosage instructions for adding artificial synthetic fluorides to be used as prophylactics.

The guidelines were not intended to be an invitation to “fill ‘er up” by those who hoped the fluoridation gamble would not backfire, and that artificial synthetic fluorides when ingested might make teeth white without somehow interfering at all with any other body component or process at the same time.

Please understand however that many city and state officials have indeed interpreted the SMCL as just that, where unnatural fluorides are added into water with what is perceived as the blessing and endorsement of the EPA, since the level used is below the 4 ppm and 2 ppm levels of naturally occurring calcium fluoride that are known to be toxic by the EPA.

The long term consequences of synthetic low level fluoride consumption lifetime, and for generations, at levels under that allowed by the EPA, are not addressed by the EPA.

As required by the Safe Drinking Water Act, the EPA asked the NRC to review the water fluoride standards for naturally occurring fluoride in drinking water and told the NRC specifically not to cover the adding of artificial fluorides to drinking water, presumably because the EPA knew it had no jurisdiction to regulate the addition of artificial fluoride. Nevertheless, much of what the NRC said did apply to artificial fluoridation.

Regarding naturally occurring fluoride, the NRC on page 2, last paragraph and page 3 first paragraph, wrote

After reviewing the collective evidence, the committee concluded unanimously that the present EPA MCLG of 4 ppm for fluoride should be lowered. Exposure at the MCLG puts children at risk of developing severe enamel fluorosis [not just minor or moderate, but severe]. The majority of the committee also concluded that the MCLG is not likely to be protective either against bone fractures.

According to the NRC, the essence of the problem is that artificially fluoridated drinking water typically contributes anywhere from 57 to 98% of total fluoride ingestion in individuals. Intake depends on naturally occurring fluoride levels, artificial fluoride added, diet, toothpaste use, total water intake, and age of the individual. Any EPA water guideline for naturally occurring fluoride in drinking water is of course useless when there are other significant additional sources of fluoride coming from other sources.

The NRC states on page 10, last paragraph of the 2006 NRC Report:

From a cosmetic standpoint, the SMCL does not completely prevent the occurrence of moderate enamel fluorosis. EPA intended to reduce the occurrence of moderate enamel fluorosis to 15% of the exposed population.

The U.S. Health and Human Services recently requested fluoride in water be lowered to 0.7 ppm as an interim measure to help decrease the mass incidence of tooth fluorosis now evident in U.S. children aged 12-15(which demonstrates clearly that the EPA SMCL was indeed too high and has failed in its intended objective).

Why would one expect any different result? Synthetic fluorides are fully water soluble with an LD50 of only 50 mg/kg body weight single dose in tested animals (Merck Index, 1976, Rahway, N.J.) We also know that natural calcium fluoride has limited water solubility where the calcium ion tends to exert an ionic strength effect on the

fluoride ion to reduce its chemical potential or activity and that calcium fluoride has a safe high LD50 of 2,500- 3,000 mg/kg body weight.

For this reason, the NRC states on page 88 of the 2006 NRC Report its conclusion that further analysis should be done regarding the concentrations of fluoride and various fluoride complexes using a range of water with different hardness and mineral content, and research is needed to characterize any changes in speciation that occur when tap water is used for various beverages, and on the effects of silicon and aluminum fluoride complexes including the conditions under which the complexes occur and have biological effects.

Some 100 years ago, it was reported that natural fluoride in water in Texas and Colorado caused whitish- appearing teeth, when in fact it was the extremely high calcium level. It was not the fluoride ion which is only a toxic calcium chelator, as detailed in my original petition.

Chemists then had, and many today still have, incomplete knowledge about the fluoride ion. Fluorine, with maximum electronegativity, oxidizes, and is thus is reduced by, every other substance in the known universe. Fluoride on the other hand has no electronegativity at all and instead seeks positive charge and cannot be reduced or oxidized by any substance on earth. Fluoride is indestructible, and its toxicity depends on whether it exists in water with lots of calcium, or not.

When the EPA set the guidelines for existing fluoride contaminants in water, those guidelines were based on natural fluoride in water which is often rich in calcium, not for synthetic toxic fluorides used today without regard to calcium content to treat people through water supplies under a wide variety of conditions. Synthetic fluorides do not behave in the same way as natural calcium fluoride, and any attempt to apply the EPA guidelines to artificial synthetic fluoridated water is mistaken. This misunderstanding has caused the massive tooth fluorosis epidemic in the U.S. compared to that seen in the original Texas locale, and ultimately is the reason the vast data the NRC examined led the panel to conclude that EPA standards for fluoride concentration, which pertain to naturally occurring fluoride, must be significantly lowered.

In reality EPA should ban the addition of any kind of fluoride to drinking water. There are no EPA guidelines whatsoever authorizing adding artificial fluoride to drinking water. Existing EPA fluoride guidelines are being used as if they set the maximum amount of fluoride which legally can be added to drinking water.

No controlled clinical trials exist either to support the use of fluosilicic acid or sodium fluoride as a drug, supplement, or oral anti-caries ingestible prophylactic in water. Further, waters in the U.S. are increasingly contaminated with a wide variety of substances, some of which interact with fluoride at various body pH levels (i.e. aluminum, silicic acid, beryllium) or act synergistically with fluoride (i.e. fluosilicic acid tends to dissolve lead from water fixtures and acts together with endogenous lead and arsenic in public water systems and with the lead and arsenic in the industrial grade synthetic fluorides). Thus, adding synthetic fluorides (or any substance for that matter) as a therapeutic agent in water today (far more so than in 1945) is a false medical practice.

As is clearly evident from the NRC report, regulating the intentional prophylactic use of fluoride compounds added into public drinking water is not the job of the U.S. EPA, in spite of the Memorandum of Understanding cited by FDA in the Oct. 27, 2010 response to my original petition. That MOU, signed in 1979, could have had different meanings to the two agencies. See the MOU at https://fluoride-class-action.com/wp- content/uploads/memorandum-of-understanding-epa-fda-19791.doc .

The EPA evidently wanted to take over regulation of adding fluoride to water. However, the Safe Drinking Water Act, in a provision enacted in 1974, forbad EPA or any agency from requiring the addition of chemicals for medical purposes. This is the exact wording:

No national primary drinking water regulation may require the addition of any substance for preventive health care purposes unrelated to contamination of drinking water.

The EPA can only make regulations requiring addition of chemicals which treat the water and make it drinkable. It cannot make regulations requiring the addition of a chemical intended for medical purposes such as artificial fluoride purports to do.

In the MOU, signed in 1979, it is evident that the FDA was under pressure to shed all responsibility for regulating the addition of fluoride to drinking water. The politics of the agencies under the Public Service is complex. The FDA administration back in 1979 was not courageous enough to ban water fluoridation. The FDA should have

done so then and could still do so today. Fluoridation of drinking water is the addition of a drug to water. Only the FDA can approve that.

The FDA will never approve the general introduction of artificial fluoride to public drinking water. For that the FDA should be praised. However, the FDA has failed to ban fluoridation, and that is its greatest error. It bans many other drugs each year, but it fails to ban the most widely used harmful drug of all, artificial fluoride.

Further, the FDA has approved the adding of fluoride to bottled water, provided it is disclosed on the bottle. It has also approved the undisclosed use of fluoridated tap water to make bottled water. The latter is a serious error, and the FDA should reverse it. For those who absolutely insist on taking fluoride internally, water containing naturally occurring calcium fluoride along with a lot of calcium should be allowed. The FDA could and should forbid the use of tap water containing artificial fluorides to make bottled water, or at minimum the FDA should require that the type and level of fluoride in bottled water or at least the calcium content of the water be disclosed on the bottle.

Moreover, the FDA should reassert its jurisdiction over adding artificial fluoride to public drinking water and should ban the practice entirely. Likewise, the EPA could and should ban drinking water fluoridation. However, this does not seem to be EPA’s intent at this time. It seems that the EPA’s intent is to encourage water fluoridation without requiring it and without certifying it to be effectual and harmless.

The EPA set up or reorganized a surrogate organization to do what it could not do. It reorganized the National Sanitation Foundation into a sham regulatory agency which would certify and authorize drinking water fluoridation and the artificial fluorides used to fluoridate.

Read about the NSF at https://fluoride-class-action.com/sham.

The NSF states repeatedly on its web site that toxicological studies are done on artificial fluorides. http://fluoride- class-action.com/wp-content/uploads/NSF-fact-sheet-on-fluoride-2008.pdf. However, when put on oath representatives of NSF admit that there are no toxicological studies. Yet 43 or more states allow fluoridation only if the fluoridation materials are NSF 60 certified.

Perhaps in the 1979 MOU the FDA transferred its jurisdiction over adding fluoride to drinking water with the assumption that the EPA would ban the practice. The EPA has taken no such course. The EPA allows naturally occurring fluoride in drinking water up to 4 ppm and 2 ppm levels and allows these levels to be perceived as allowing artificial fluoride to be added to drinking water.

The FDA is now in a position to walk through an obvious door that has opened to it, and to act responsibly, and without any justifiable criticism, on behalf of the country. The rationale for a ban, or temporary halt to await clinical trials data for examination, is that fluoride injections 1) have spread widely independent of endogenous local water conditions and hardness, 2) now represent only a portion of total fluoride ingestion since toothpaste fluoride use is pervasive, and 3) are complicated by the presence of contaminants in public drinking waters we now know affect fluoride toxicity (especially from commonplace injected residual aluminum). The FDA ruled in 1963 that fluoride compounds added into water would be “an uncontrolled use of a drug, where dosage cannot be controlled” (see original petition). That proclamation is even more profound today than then.

Currently, the EPA has not banned artificial fluorides in water that EPA labels as contaminants, because EPA knows the agents are being used at subacute toxic doses for most people as drugs, oral ingestibles, or supplements or dietary aids, that the Public Health Service in 1950 initially endorsed and that are not banned now by the FDA. On the other hand, the FDA has not banned artificial fluorides as drugs, because FDA has never approved these substances as oral ingestibles, supplements or dietary aids, and knows the EPA labels them as contaminants that EPA should regulate under the Safe Drinking Water Act, which strictly forbids the intentional injection into water of any contaminants (or drugs or any substance other than to sanitize water).

#2.

November 20, 2011

Food and Drug Administration
Centers for Drug Evaluation and Research
Rockville, MD 20857

Dear FDA petition reviewers,

The following material is submitted in support of the Petition for Reconsideration, 2010 and the original petition FDA-2007-P-0346 (originally assigned 2007P-0400/CP1). The first section deals with the disbanded FDA-EPA MOU of 1979 and the fact that synthetic fluorides are ingested as drugs, and the second section presents additional information on anionic fluorine chemistry and the questions that must be asked of suppliers of industrial fluorides intended for human ingestion.

I. EPA-FDA 1979 MOU. It has come to my attention, from an attorney who is expert on Federal drug law, that the FDA-EPA MOU Memorandum of Understanding of 1979 (described in your response letter 2010) was officially revoked by the EPA in 1988. This was also confirmed by several other attorneys who recently published a summary of litigation filed in Los Angeles for a water district using fluosilicic acid fluoride, which is an unapproved drug (PRWeb, August, 2011). Moreover, the FDA officially published in 1996 that Food Drug and Cosmetic Act regulations do indeed apply for substances added to drinking water, i.e. in particular compounds or drugs to alter human tissue or treat disease. Apparently CDER at FDA was unaware, as was I, that this revocation had already taken place, and that the EPA was not in charge of regulating water additives at the time the original petition P-0346 was filed with FDA in 2007. Details follow.

Injected Fluorides in Water are Drugs. Synthetic fluorides from processed materials, not foods, when added into human drinking water to treat cavities, are classified as drugs by reason of use. All drugs are regulated, approved, banned, or not approved but allowed, exclusively by the FDA, not the EPA. All drugs (legend by prescription and over-the-counter) are given and ingested (if swallowed) based on need, and citizens who have no dental caries have no need for any drug used to treat caries. This description is in full agreement with the official FDA position of
1963, that fluorides added into public water supplies would be an uncontrolled use of a drug (see original petition). Moreover, the Memorandum of Understanding (“MOU”), originally made by the FDA in 1979 to have the EPA regulate chemicals added to public water systems, was discontinued in 1988 (see attached pages), thereby relinquishing any authority of the EPA to regulate chemicals being used as drugs, either FDA approved and legal, or not FDA approved and illegal, or any supplement, mineral or additive intended to treat human tissue through ingestion in water.

Fluorides Named as Supplements. Some at the FDA may yet contend that synthetic fluorides from processed materials, not foods, are ‘supplements’, rather than drugs, being used to prevent, rather than to cure or treat, caries. This is a fine difference philosophically, where it might be argued, since anyone without cavities would not be being ‘treated with a drug’, but rather is ‘prevented’ from suspected future cavities by ‘ingesting a supplement’. This is however in contrast to the FDA ruling of 1963 that fluorides are not mineral nutrients. In any event, supplements, particularly from processed inorganic matter rather than extracted from natural foods, are also exclusively regulated by the FDA, not the EPA.

Fluorides Named as Additives. Some at the FDA may yet contend that synthetic fluoride from processed materials, not foods, are used to turn water into an ‘optimal’ state found in some waters naturally in the U.S. and that thus it is not a drug or a supplement but is a water-normalizing ‘additive’. Understand however that there is no stated or recognized purpose for forming ‘fluoride optimal’ water other than to alter the structure of human teeth enamel, whether consumers have or do not have dental caries, so the designation additive still indicates its function is to alter tissue. Children during teeth development age form a fluoridated derivative of abnormal teeth enamel hydroxyapatite. Since the added chemical is introduced into water for the purpose of altering teeth to prevent disease (caries), and since the agent also alters other tissues, particularly bone and pineal gland hydroxyapatite, then Food Drug and Cosmetic Act regulations apply to this substance regardless of being labeled an ‘additive’. Indeed,

FDA examined claims that fluoride strengthens bone hydroxyapatite decades ago and concluded that this is false (see petition for reconsideration, 2010), and FDA wrote that fluoride does not strengthen bone, while as we now know the National Research Council data prove ingested fluoride from treated water incorporates into bone pathologically and permanently to thousands of times that in water (National Research Council, Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C., 2006).

Fluorides Claimed as Foods. The fact that synthetic processed fluorides are not foods has been amply addressed earlier (see Petition for Reconsideration, 2010; and detailed materials submitted 2010 to FDA by Dr. Bill Osmunsen). That is, the essential feature of foods is to provide calories from metabolic action to eventually produce energy for cellular needs. Fluoride can be found naturally in certain foods in certain regions of the country, but the fluoride ion itself is not an essential part of any food since fluoride itself is not metabolized and in fact cannot be oxidized or reduced or altered in its chemical form, but rather fluoride in vivo binds [pathologically] to calcium-rich regions, especially bone, releasing no metabolic energy or calories of any kind.

Regardless of the label one prefers to ascribe to synthetic industrial fluoride compounds injected into water, and regardless of what hazardous inorganic source material is processed to provide them, the chemical is added to treat or prevent disease by altering human tissue, either to form abnormal fluoridated enamel, or to affect caries, while it binds, and accumulates in, bone and pineal gland hydroxyapatite with a permanent, pathologic unnatural abnormal mechanism over the lifetime of the consumer. Any agent intended to alter tissues through ingestion in order to treat or prevent disease is defined by Congress as a drug (see attached summary) and must be subject to FDA regulations, as prescribed and directed by the Food Drug and Cosmetic Act.

Summary of information provided by Federal drug law Attorney Group. The U.S. Constitution Article VI cl.
2 (supremacy clause) provides that the Congressional directives, to regulate and approve/disapprove drugs and to regulate dosage of drugs, that were given to the FDA, specifically means FDA, not the EPA, has these powers that
cannot be interfered with by the states. Moreover, in 1988 EPA published in the Federal Register that it terminated
the agreement it made in 1979 (1979 MOU) with FDA to regulate water additives. This was effective in terminating the 1979 MOU (53 FR 25586-89 to be forwarded later). Finally, the FDA in 1996 published it would
no longer avoid Food Drug and Cosmetic Act regulations for water additives in public water systems. Thus the
FDA is in full charge of chemicals added to municipal drinking water as drugs for the purpose of altering tissue to treat or prevent diseases, including dental caries.

Federal law prohibits marketing any drug without FDA pre-approval. According to statutory law (United States Code 21 U.S.C. 321(ff), for foods or water swallowed with ingredients to prevent disease, such ingredients are drugs. Public drinking waters are fluoridated to prevent dental caries disease and therefore are drugs (21 U.S.C.
321(g)(1)(B)). Bulk fluosilicic acid shipped interstate to water districts by truck or railcar intended for human ingestion to alter human tissues to prevent disease are Federal drugs, whether the chemicals are approved by FDA and legal, or not approved by the FDA and thus illegal. Although bulk sodium fluoride is a prescription drug listed in the United States Pharmacopoeia and an active ingredient in some approved over the counter anticaries drugs, fluosilicic acid has never been actively regulated as either a prescription or over the counter drug or allowed active ingredient by the FDA. If fluosilicic acid ever were approved for prescription use, even then its bulk use in water supplies is not consistent with Federal drug law, because A) it is not an over the counter drug that could be used or not by consumer choice, and B) as a prescription drug prescriptions are not given by water districts to consumers. Because under the Safe Drinking Water Act, all public water systems are in interstate commerce, FDA has jurisdiction when waters in these systems are made to contain substances with drugs by the addition of fluosilicic acid or sodium fluoride with intent to prevent dental caries, a disease. Fluoridated waters that were first manufactured after 1997 (active ingredients plus excipients) that do not meet monograph conditions in 21 CFR Part
355 are not permitted by FDA to be over the counter drugs without a NDA or ANDA (60 FR 52474 and 61 FR
52285) and also are not permitted to be prescription drugs without a NDA or ANDA because these drugs (active ingredients plus excipients) are new drugs.

An important distinction to be made is that fluoride in nature that can be present in foods or water naturally is considered a mineral although FDA has stated it does not find it to be an essential mineral. As such, fluoride ion can be present naturally (as calcium fluoride which is not a recognized toxic having LD50 > 3,500 ppm) in food. The statutory provision in 21 U.S.C. 321(g)(1)(C) regarding drugs being articles intended to affect the structure of man explicitly exempts foods and minerals in foods under 21 U.S.C. 321(ff) but this definition of drugs does not apply to synthetic unnatural fluorides not found in foods, such as sodium fluoride and fluosilicic acid. The

definition of drugs as “treatment or prevention of disease” applies to both fluoride water additives and fluoridated waters as drugs under this definition because of intent of fluoridation to treat and prevent dental caries; both are anticaries drugs pursuant to the definition in 21 CFR 355.3(c) because they are a “drug that aids in the prevention and prophylactic treatment of dental cavities (decay, caries)”. It is the intent to treat or prevent disease that makes fluorides and fluoridated waters a drug independent of effectiveness. Drugs are defined in Federal case law to be both the active ingredient(s) and excipients. Therefore new implementation of fluoridated water creates a new fluoridated water drug that can only legally be used if there is a new drug application for that new drug. Further, all manufacturers and cities that use the fluoride compounds are required to register annually with the FDA (21U.S.C. 360).

Conclusion: Since 1) the FDA regulates all drugs, that is any chemical substance for ingestion to intentionally alter human physiologic or morphologic processes to treat or prevent disease, and since 2) controlled human clinical trials have not been forwarded for synthetic fluorides to the FDA for intended use as ingestible drugs, then, according to the Food Drug and Cosmetic Act it is clear that FDA must either:

1: Ban intentional injections of all synthetic fluoride compounds into public water systems in the United States; or

2: Announce requirements to provide data of proof that ingesting synthetic fluoride compounds from drinking water long-term has no significant adverse health impact on humans, including those with severe infirmities such as Alzheimer’s disease, diabetes, kidney infirmity of any kind, autism and heart disease among others, and that data must be presented of controlled human clinical trials demonstrating effectiveness in its intended purpose; or

3: We request that FDA (for official records, being in charge of regulating all drugs, supplements, minerals and any chemicals other than natural foods, intended for human ingestion for the purpose of altering human physiology, pathology, or morphology to help prevent or treat disease) request from chemical suppliers, of synthetically processed inorganic fluoride compounds, any existing data that demonstrate safety and effectiveness for chronic ingestion of the materials in humans. Verbal or written endorsements and statements of safety and effectiveness do not constitute actual data of proof; and this information should be held in FDA records on such materials proposed to be continuously administered into public water systems in the U.S. for the purpose of altering human teeth, or any other purported metabolic/structural effect to help treat and prevent disease unrelated to that allowed by the Safe Drinking Water Act (i.e. to sanitize the water).

The U.S. FDA has a proud heritage for decades in maintaining correctly that anionic fluorine is not to be regarded as a normal component of fresh drinking water. We ask that you continue that tradition and actuate applicable provisions of the Food Drug and Cosmetic Act as requested above. There is no need to delay while waiting for new drug applications to arrive from those using the materials now for human ingestion purposes. No such applications will be filed, since fluorides used prior to the FD&C Act have given the false impression that the FD&C Act might not apply, unless such request is made by FDA.

II. The following information (in part from personal communications with a world expert fluorine chemist, and in part from published sources) adds to the petition and presents key questions that must be asked of chemical suppliers of synthetic fluorides sold for intentional human ingestion that is not FDA approved.

Fluorine Chemistry. As you know, fluorine is highly electronegative or electron-withdrawing, and for this reason does not exist as the uncharged element in nature. Unknown to many though, fluoride, which contains an extra electron and thus has a full negative charge, has no electro-negativity and in fact is ‘electro-positive’, the property that ensures that forces fluoride to bind positive charged calcium sites in bone in a pathologic, permanent accumulating manner.

As an employee 40 years ago of the prestigious Dr. Andrew Alm Benson, I am pleased to announce that Dr. Benson at age 94 remains brilliant and operates a laboratory to this date at the University of California, San Diego, La Jolla, CA. Benson is most notable for his elegant discovery of the actual carbon fixation reaction product in the Calvin Benson cycle of plant photosynthesis, but most do not realize Benson completed his Ph.D. at Berkeley in
1940 on the interaction of organic compounds with inorganic fluoride. Extensive discussions with Dr. Benson on the procedure of adding inorganic fluorides into public water supplies have been quite telling. In summary, Dr.
Benson is appalled and is now drinking bottled water without fluoride and is attempting to avoid, with difficulty,
the internal consumption of municipal water supplies containing industrial synthetic fluoride. I do not wish to apply controversy or mental pressure on the man and here provide this information for FDA private use only.

First, the metabolism and general viability of biologic cells are not compatible with the presence of even dilute amounts of inorganic fluoride. The main reason for this is that even at slight acidity (the internal fluid of cells is acidic at pH 6.9), the fluoride ion is protonated to hydrofluoric acid, HF, the most corrosive substance known which has wide use in industry to increase porosity of ceramics and to etch glass among other uses. Being a weak acid, HF corrosivity is not due to its acidity but rather to its extremely minute size and penetrability. Most organic reactions have low yield by the nature of the chemistry of carbon, but not so for fluoridated derivatives that are consistently of high yield under proper conditions. In the stomach at pH 3, ingested free fluoride in the absence of other chelators is quantitatively in the form of HF where it is able to gain access quantitatively where it does not belong, in the bloodstream.

Although 1 ppm is argued to be dilute and harmless, in actuality debridement of gastric mucosa is possible with HF in such a way as to not be sensed with any discomfort in most people. Remember that the one human controlled clinical type trials set of data that we have with cooperating regulated volunteers, summarized by the National Research Council (NRC, 2006) is the finding that drinking water with 1 ppm fluoride ion causes stomach discomfort in 1% of those tested. It is suspected that individuals with either thin stomach lining, or more nerves near the mucosal surface, or the elderly with slowed mucosa cell turnover, are those who detect discomfort from 1 ppm fluoride as HF.

Although 1 part in one million is argued to be ‘safe’ for human consumption, understand that one liter of water with its 32 trillion trillion molecules, at 1 ppm fluoride contains 32 million trillion fluoride ions in that liter. The kidneys eliminate half of all ingested fluoride contaminant, but are unable to prevent the remaining fluoride ion from binding to bone permanently for the life of the consumer, since calcium fluoride is insoluble at extracellular basic pH 7.4. 1 ppm fluoride water causes blood levels to be 0.21 ppm, a concentration that specifically inhibits the activity of DNA repair enzymes including glutamine synthetase about 50% (for review see: Yiamouyiannis, Fluoride: the Aging Factor, 1965, Health Action Press; National Research Council Fluoride in Drinking Water, a review of EPA’s Standards, Washington, D.C., 2006; Connett, Beck and Micklem, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, Vermont, 2010).

Benson made it clear that relying on the dental industry to determine the ingredients in public water supplies is reckless, particularly when the industry already grossly erred in its long-standing use of toxic mercury as filling for teeth caries. The ADA is heavily invested in procedures that remedy tooth morphology, but are extremely uneducated in terms of blood clinical chemistry. Benson was very pleased with the PRWeb, 2011 article on the litigation of the water district in Los Angeles for its use of fluosilicic acid for human ingestion without FDA approval. He also trusts that the FDA will act other than as a ‘paper pusher’ expecting others to regulate it, and instead to become actionable for the benefit of our country.

While the FDA continues to avoid regulating the injections of industrial fluorides into public water supplies, then we respectfully request that specific questions be asked by FDA of those chemicals suppliers of this material intended for ingestion without FDA approval. Example important questions are listed next.

Questions Required of Fluosilicic Acid Manufacturers.

Dear chemical supplier of fluosilicic acid materials for human consumption in municipal drinking water,

In anticipation of use of chemicals from your company sold for human ingestion by water districts in the United States, we here as overseers of citizen health and safety by Congressional statute, ask that you answer the following questions about the materials you supply for human ingestion. This information is appropriate to have on file in our records for reference.

  1. Please provide written documentation that demonstrates the fluosilicic acid material when ingested by consumers from treated water supplies causes decreased teeth cavities. What percent reduction in tooth decay rate is expected from long-term consumption of diluted fluosilicic acid in municipal water?
  2. Please provide written documentation that demonstrates the human experimental data that tested for safety of ingesting the fluosilicic acid materials for a continuous long-term period. Can you provide data demonstrating that long-term consumption is safe and without adverse health effect for all people, especially those afflicted with common serious illnesses such as kidney disease, diabetes, heart disease, cancer, and in particular those with Alzheimer’s disease and those with autism?

  3. Please provide written documents that denote the percent of increased incidence of tooth fluorosis that can occur in children consuming fluosilicic acid treated water during teeth development years, aged 5 – 8.

  4. Please provide a detailed chemical analysis of all known ingredients and their percent content in the fluosilicic acid preparations that will be provided for ingestion by all citizens in a treated city.

  5. The U.S. FDA has not approved any fluoride containing compound for either safety or effectiveness and has been unable to provide such data to city officials that have asked for such documentation. Can the FDA be assured freedom from litigation regarding dental fluorosis and other adverse effects known to be associated with consumption of water treated with industrial fluorides from your company?

  6. As you know, the U.S. Safe Drinking Water Act prohibits any chemical, food, drug, supplement, mineral, or other, from being injected into public water supplies other than to sanitize the water. Since fluosilicic acid is added to treat human teeth, we would also like any legal documents you have that will defend FDA against those who wish to follow the Safe Drinking Water Act as initially written, and what documents you have that demonstrate specifically that diluted fluosilicic acid preparations may be exempted as exceptions to these Statutes.

  7. Both the American Dental Association and the U.S. Centers for Disease Control now recommend parents not give fluoridated water to children under 5. Do you have official documents to defend against parents who complain after giving children under 5 the treated water, knowing that many parents will not be able to afford bottled untreated water in cities throughout the United States?

Final Comments. The bottom line is that un-natural synthetic fluorides without calcium, added into water to treat and prevent disease (cries) is using a fluoride compound (which happens to be a recognized poison by toxicologists, Merck Index,1976) in dilute form as a drug, and requires from the FD&CA a new drug application. The EPA has no jurisdiction over regulating fluoride compounds added into water–the FDA solely has such (in spite of the reviewers decision to the contrary in 2010). Attached is a recent letter from the EPA proving that EPA does not regulate the intentional addition of fluoride compounds into public water supplies (i.e to treat humans).

A summary copy of information gleaned from the above-mentioned attorney will be forwarded from his office to the FDA on a future date. The drug use of 140 million people is something that needs to be handled carefully while on the other hand wishing it could be done as quickly as possible.

My very best regards, and may God help you in this endeavor to return our National water supply to constitute natural, normal fresh water without added chemicals used as drugs.

If additional legal information is required to prove that fluosilicic acid requires a new drug application NDA since the grandfather clause for older drugs has been discontinued and does not apply for this agent, then please do not hesitate to ask and this will also be forwarded to FDA.

November 21, 2001

U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

Dear Reviewers,

This brief letter provides additional information, not forwarded earlier, in support of FDA petition FDA-2007-P- 0346 (originally assigned 2007P-0400/CP1).

The FDA has technically been indirectly involved in water fluoridation for many years, by virtue of prescription drug labeling. The prescription drug Luride has labeling and dosage instructions required for this prescription drug. The Physician’s Desk Reference, America’s first and only compendium of official FDA-approved prescription drug labeling, lists Luride (sodium fluoride) as a still-legal prescription drug. The specific dosage instructions allowed by the FDA, include the following statement:

“Fluoride oral supplements are contra-indicated when drinking water is above 0.7 ppm fluoride” (Physician’s Desk
Reference, p. 838, 48th edition, Medical Economics Data Production Company, Montvale, NJ, 1994).

In spite of recommendations issued January, 2011 from the U.S. Health and Human Services to not exceed 0.7 ppm, San Diego city water is mostly treated to 0.8 ppm fluoride and Los Angeles public water is titrated to 1.0 ppm of the free fluoride ion. Water districts who inject synthetic fluoride compounds for human ingestion are in violation of FDA regulations, by either 1) dispensing a non-FDA approved drug (fluosilicic acid), or 2) in some cities dispensing an FDA allowed prescription drug (sodium fluoride) without a prescription, and 3) by not providing necessary FDA dosage information to consumers (i.e. as listed in the PDR above). FDA existing dosage instructions are being ignored.

Fluosilicic acid is not an FDA approved drug by either prescription or over the counter and is not listed in the PDR. Its dispensation for oral ingestion is a violation of the FD&C Act that requires, for any substance used as a drug to treat disease, a new drug application and FDA approval.

Because we are asking for a ban on fluosilicic acid in public water supplies, I should buffer perhaps this request with an additional statement. Any city with customers who wish to fluoridate their bloodstream through oral ingestion of synthetic fluorides, if the FDA were to ban the injections, may be advised to obtain prescriptions from their physicians who can prescribe Luride that is FDA allowed, as long as water fluoride is less than 0.7 ppm.

If you require the CFR regulations again that specifically apply to the violations listed above, I will be most happy to forward them.

November 22, 2011
U.S. food and Drug Administration

Center for Drug Evaluation and Research
Rockville, MD 20857

Dear Reviewers,

Information here, not submitted earlier, is in support of the petition submitted to the FDA in 2007, FDA-2007-P- 0346 (originally assigned 2007P-0400/CP1).

Preparations used by public water districts to treat water are obtained from various suppliers as a 23% fluosilicic acid solution. Because of the chemistry of aqueous fluorides, these solutions typically contain about 1.0 % HF (as assayed and published by Lucier Chemicals for the Metropolitan Water District, Los Angeles, CA). This is 23 grams of H2SiF6 and 1.0 grams HF per 100 grams of solution. This represents 18 grams of fluoride from H2SiF6 and therefore 5.3% of all fluoride present in the solution is in the form of HF.

The Code of Federal Regulations specifically and explicitly prohibits the marketing, interstate transport, or ingestion of any anti-caries agent that contains HF without a new drug application NDA FDA regulations provide that any anti-caries drug that includes hydrogen fluoride (HF) requires an NDA [21 CFR31O.545(a)(2) and (b).]
Fluosilicic acid hazardous waste preparations are currently diluted into nearly 70% of all U.S. water supplies without FDA approval and without a prescription, to intentionally achieve 0.21 ppm anionic fluorine (National
Research Council, Fluoride In Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C., 2006) in human blood, and such action requires an FDA ban, or an approved NDA.

The concentration of HF that would be present in a solution that is buffered to pH 7 with 1 ppm total fluoride (i.e. a public water system) is about 0.14 ppb of this corrosive substance HF. This may be un-impressive to those promoting fluoride ingestion form water, but nevertheless HF is the most corrosive substance known and is the active ingredient for industrial uses of synthetic fluorides acting on glass, ceramics, computer chips, and concrete when conditions are not buffered.
In water, HF as a weak acid partially ionizes as HF • H+ and F- with dissociation constant Ka = 7.2 x 10-4 (CRC Handbook for Chemistry and Physics). The calculated HF concentration that would be present in the stomach if one were thirsty and drank significant volume of 1 ppm fluoride water without food may be calculated from the equilibrium expression:

7.2 x 10-4 = [H+][F-]/[HF] where [F-] is the molar concentration of free fluoride ion after combining with stomach acid H+ and equals 5.2 x 10-5M – X {which is 1 ppm in molarity units minus the unknown molarity X that forms HF). Rearranging, 7.2 x 10-4X = [10-3][5.2 x 10-5 – X] and 0.00172X = 5.26 x 10-8 Solving, X = 3 x 10-5 M HF in stomach acid, which is 0.6 ppm HF.

This calculated value is in good agreement with experimental observations with a fluoride ion specific electrode at pH 3 (Sauerheber, R., Chemical Analysis of Poisoning from a Fluoridated Water Supply, submitted for publication to J. Env. Health, 2011), where 1 ppm fluoride water is detected by the electrode at only approximately 0.6-0.7 ppm because the remaining fluoride is bound as HF at that acidity, which cannot be detected by the electrode (attached data). This level of HF is a significant concentration of this uncharged tissue-penetrating corrosive, even for acid- resistant stomach mucosa and explains the ready assimilation of fluoride into the bloodstream where it does not belong, from the gastrointestinal tract. Water treated with industrial synthetic fluoride must not be used in cases of gastric ulcer or other GI abnormality. Indeed 1% of all consumers feel gastric discomfort drinking 1 ppm fluoridated water in controlled volunteer human trials (NRC, 2006).

We now know that all synthetic fluorides are fully water soluble and form HF in the stomach that freely passes through biological membranes. Ingested fluoride without sufficient antidote dietary calcium crosses the blood brain barrier and also enters the fetus from placental circulation. This has always been the case in man and animals, but only recently has the mechanism been unraveled by which the ionic charged fluoride can cross biological membranes. It does not itself cross the membrane freely, but the associated HF (in the stomach at 0.5 ppm, in blood at 0.01 ppb and inside cells at 0.04 ppb) is nearly identical in size to the water molecule and is also uncharged, freely permeable through the lipid bilayer as is water. The membrane acts like a permeable polymer to the ultra small sized water and HF molecules, even though these polar substances do not have a significant lipid partition coefficient. The bilayer presents a barrier to most charged ions. Fluoride ion then re-dissociates from HF after it passes through the membrane. The HF concentration my be computed with the Henderson Hasselbach equation, where pH = pKa + log [F-]/[HF]. So 7.4 = -log (7.2 x 10-4) + log [1.1 x 10-5]/[HF]. Solving, [HF] = 6.1 x 10-10 M =
10 ppt. HF however is essentially freely membrane permeable. At pH 8.2 as in the intestines, the HF concentration would be 8.2 = -log(7.2 x 10-4) + log[5.2 x 10-5]/[HF]. ]HF] = 0.009 ppb.

Fluoride and Hydrofluoric Acid Levels in Various Bodily Fluids

pH F- HF Bodily Location

3 0.5 ppm 0.5 ppm Stomach

6.9 .21 ppm 0.04 ppb Intracellular Fluid

7.4 0.21 ppm 0.01 ppb Blood/Extracellular Fluid

8.2 0.21 ppm 0.009 ppb Intestine

#5.

November 24, 2011

U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857

Dear Reviewers,

Information is presented here in support of the 2007 petition FDA-2007-P-0346 (originally assigned 2007P-
0400/CP1) and the Petition for Reconsideration submitted in 2010. I apologize for having submitted a fourth letter to the FDA in one week, but 140 million American citizens, who more often than not vote against ingesting
fluorides that are not FDA approved, yet now consume daily public water supplies that are injected with diluted fluoride compounds obtained from industrial synthetic unnatural hazardous waste sources (see original petition).
Although acute toxicity is normally minimized so as to be unnoticed, chronic toxicity from long term continuous consumption has been well-documented in previous submitted materials.

Industrial Synthetic Fluoride in Public Water Supplies Breaks Federal Law

The purposeful injection of synthetic industrial fluoride, an EPA-recognized water contaminant, into public water supplies, with the intent to treat bacterial-induced dental caries, violates the Safe Drinking Water Act, the Water Pollution Control Act, and the Food Drug and Cosmetic Act [1]. Previous information in great detail proves that ingested fluoride from water supplies cannot decrease dental caries at continuous topical 0.02 ppm in saliva or 1 ppm in water [2], and that systemic blood fluoride is useless for this purpose (see original petition). In support of these facts, this letter summarizes the mechanism by which Federal officials have escaped regulation by the above- listed Congressional Statutes.

Water Pollution Control Act (requested and initiated by the honorable President John Fitzgerald Kennedy).

The mission of the Water Pollution Control Act (section 101a) is to maintain the natural chemistry of U.S. waterways. Pristine fresh drinking water is devoid of fluoride. Purposeful addition of fluosilicic acid or sodium fluoride to elevate fluoride content in water has escaped Federal correction under this Act in part because proponents of ingested fluoride have argued that fluoride is added at a level no higher than what is present naturally in some waters in the U.S. The Act however does not distinguish that one natural water supply is deficient compared to another. Since most (not necessarily all) water is devoid of sodium, fluoride and silicates, the injection of sodium fluoride or fluosilicic acid, plus sodium hydroxide required to neutralize acidity, violates the above mission of the Act. Furthermore, fluoride in drinking water, regardless of source, is correctly officially listed as a contaminant by the U.S. EPA. By perpetrating the opinion as ‘fact’, that fluorides could be part of the natural chemistry of any or all drinking waters (which is false), fluoride injections violate the WPCA without giving the appearance of such a violation of the Act. This constitutes deceptive practice.

Federal Safe Drinking Water Act.

The Safe Drinking Water Act provides that no Federal standard that may require that any substance be added to drinking water other than that required to sanitize the water, and that States can be no less restrictive than the SDWA. Federal officials in the Oral Health Division office within the Centers for Disease Control haves stated in writing their desire that virtually all water in the U.S. be treated with fluoride compounds to 1 ppm. To avoid liability in this action, CDC officials ask the States to accept responsibility for the decision to add fluoride into water, which sidesteps the SDWA by attempting to make the final action a State or water district decision and not a Federal decision. Although one could mistakenly accept this assertion at face value, a rational person understands that the actual definition of the term ‘require’ includes ‘request by authority’ [3]. State, city and water district operators believe there is little higher authority on dental issues than the CDC, and they regard recommendations from the CDC regarding fluoridation as synonymous with issuance of a requirement. This is so, because of the implied authority of any recommendation from an authoritative Federal office. Since the SDWA prohibits any Federal requirement, industrial fluorides injected into public water supplies as presently orchestrated violates this Congressional legislation.

Although all liability is accepted by cities, rather than by the Federal CDC, city managers routinely inject synthetic fluorides only under the auspices of State Health Departments and, in the case of California, State regulations passed which are not in keeping with the intent of the original Congressional SDWA Statute. This fact has been verified in personal communications in writing from San Diego Mayor Jerry Sanders and from Los Angeles Metropolitan Water District President Jeffrey Kightlinger, and personal discussions with Jim Barrett, former Public Utilities Director, San Diego Water and Dale Mason, former Vallecitos Water District Board member, all who uniformly have stated that “California State law requires the injections” and that all questions of safety and effectiveness be answered by the California DPH. Sadly, DPH officials have routinely requested in turn, in writing, that all questions for proof of safety and effectiveness be directed to offices of the Federal CDC. In this way, the OHD achieves its objective, in violation of the SDWA, while giving the appearance of not being in violation of the Act. This is deceptive practice.

U.S. Food Drug and Cosmetic Act.

The Food Drug and Cosmetic Act specifically requires that any chemical substance proposed to be used to prevent or treat disease in humans must submit a new drug application for FDA approval. FDA also now has authority to require approval for substances that had been used for long periods before the Act was passed (Petition for Reconsideration, 2010). Further, treatment of disease in humans with any chemical substance approved by the FDA requires detailed dosage instructions, as have been written for sodium fluoride (see Luride letter sent to FDA,
11/22/11). The FDA correctly ruled in 1963 that fluorides added intentionally into water to treat dental caries would be an uncontrolled use of a drug where dosage cannot be controlled (see original Petition), and it is well accepted
that blood fluoride levels coming from fluoride ingestion do not decrease caries and in fact can induce abnormal tooth fluorosis. Topical fluoride in the form of toothpaste and fluoride dental gels that contain high concentrations
of fluoride does not alter teeth enamel but merely briefly coats it with re-soluble calcium fluoride globules (see original petition).

Neither the CDC nor the EPA assume liability or responsibility for fluoride injections into public water supplies [1]. A 1988 Federal Register article (submitted previously) states that EPA is terminating its water additive program in 1990 which it did. EPA Region 10 in a letter States, “EPA does not provide recommendations for the addition of any substance, including fluoride, to drinking water for preventive e health care purposes and is prohibited by SDWA from setting such requirements. So, neither the EPA nor the FDA have banned the injections, and the FDA has not requested NDA’s or dosage instructions from water districts that disseminate fluoridation materials, nor from the manufacturers that supply them. In this manner it is made to appear that State Public Health Departments and water districts are not violating the FD&CA. In fact fluoridation materials—which meet the definition of drugs—are added to drinking water for the purpose of treating without either a prescription or dosage instructions, in violation of the Act. This is deceptive drug practice.

It is necessary to obtain from the FDA a new drug application NDA for any proposed anti-caries substance that contains hydrofluoric acid HF. Hydrogen fluoride HF is labeled as fluoride by the FDA CDER but, as pointed out in 21 CFR 310.545(a)(2) and (b), an NDA is required for any over the counter anti-caries product that includes HF as an active ingredient. This Federal regulation, considered a Federal law, should prevent most or all fluosilicic acid fluoridation chemicals, and fluoridated waters with these chemicals, from being approved as OTC drugs except with an NDA. This is because HF is an active fluoride ingredient in fluosilicic acid preparations, typically present in fluosilicic supplied to water districts at 1.0%, or 1 gram HF per 100 grams of solution (see Lucier chemical data sheet previously submitted). Further, in a previous letter it was made clear that all synthetic fluorides in drinking water convert about 50% into HF in the acidic stomach after swallowing. In the case of fluosilicic acid, material safety data sheets are mailed to water districts that list the 1% HF, but the content is not revealed to the public, by either the chemical supplier, or by the water district, or by the Public Health Departments that are under the authoritative recommendation from the OHD of the CDC. This is deceptive drug practice.

Fluosilicic Acid Spreads across the Golden State and from Sea to Shining Sea.
San Francisco, CA and our Nation’s Capital, Washington, D.C. began artificial fluoride injections decades ago. The greater Los Angeles basin recently began in 2007. San Diego just began in 2011. Sacramento, the State
Capital, began in 2008. San Jose citizens are soon to be forced to accept water treated with non-FDA-approved fluosilicic acid for ‘prevention of caries’ via systemic ingestion. San Diego had opposed the injections in two city elections. The FDA should be aware that there is a chief fluoridation engineer, a Federal employee, working at the
CDC and identifying himself and that he provides information on synthetic fluoride injection techniques to water

districts. He apparently does not understand that any Federal requirement to treat U.S. citizens, particularly against their will, with substances for any disease violates the Safe Drinking Water Act. The SDWA applies broadly and covers the intentional injection of chemicals such as sodium fluoride and fluosilicic acid into water It applies to added foods or other materials that do not sanitize water, regardless of whether the agents are considered legal or illegal.

We humbly request that the FDA take a public stand on this issue, that it ban injections of fluoride into drinking water, and that it buffer that ban by providing information on oral synthetic fluorides, still widely available by prescription (Luride) for those who insist on systemic blood fluoride treatment through ingestion.

Permanent chemicalization of general public water supplies with chlorines sanitizes water to be bacteria free. Additional treatment of water with fluoridation materials which purportedly prevent bacterial-induced caries is mischief initiated and individuals, educational institutions and chemical companies which are misinformed or who are defending profitable vested interests.

Federal regulations mentioned in this letter, with verbatim wording, will be provided upon request if necessary. The intent of this letter is to clarify how injections of toxic waste fluoridation materials into U.S. public water supplies, allegedly to treat humans and done so without first obtaining their informed consent, and done so in spite of the discredited malpractice it represents [1], have escaped Federal regulation.

It is anticipated that these deceptive practices will one day end. A recent objective review conducted at the London School of Hygiene and Tropical Medicine, published by Taylor & Francis, concluded that water fluoridation is ineffective and harmful and recommended its discontinuation [4]. Personal thanks go to the honorable Dr. Albert W. Burgstahler, editor of Fluoride (U.S.), for providing that reference free of charge (frontispiece attached).

References:
[1] Connett, P., Beck, J., and Micklem, The Case Against Fluoride, How Hazardous Waste ended up in our Drinking Water and the Bad Science and Powerful Politics that Keep it There, Chelsea Green Publishing, White River Junction, Vermont, 2010.
[2] National Research Council, Fluoride in Drinking Water, a Scientific Review of EPA’s Standards, Washington, D.C., 2006.
[3] Webster’s Ninth New Collegiate Dictionary, Merriam-Webster, Inc., Springfield, MA, 1983.
[4] Peckham, Stephen, Slaying sacred cows: is it time to pull the plug on water fluoridation? Critical Public Health, November 15, 2011, pp. 1-19 DOI:10.1080/09581596.2011.596818 To link to this article: http://dx.doi.org/10.1080/09581596.2011.596818

The following material is excerpted from a recent letter written jointly by Dr. Johns, MD and Dr. Osmunson, DDS. State Boards of Pharmacy confirmed fluoride for ingestion is a prescription drug. Pharmacists will not sell fluoride for ingestion without a prescription. The FDA CDER has confirmed fluoride is an unapproved drug and unapproved drugs are actually illegal.

EPA scientists through their Union say fluoridation boarders on a criminal act of governments. There is not one single prospective, double blind randomized controlled clinical trial for either the efficacy or safety of fluoridation of public water supplies in the treatment of dental caries. In fact, the massive data of Ziegelbecker (Connett, The Case Against Fluoride, 2010) statistically confirm beyond doubt that ingested fluoride does not reduce dental caries, and the NRC 2006 report indicates biochemically why this is so, where fluoride in saliva is only 0.02 ppm, unable to exert topical action on teeth.

Dental caries are not the result of inadequate fluoride ingestion, and infants on fluoride free mother’s milk actually have lower dental caries. On the other side of the coin, tooth damage of dental fluorosis occurs while the teeth are developing under the gums. Fluorosis repairs can cost over $100,000 in life time expenses if one wants to re-attain a normal healthy appearing smile. Other adverse effects of long term fluoride incorporation into blood at 0.21 ppm are very well documented, where the normal structure and function of bone and brain are far more important than teeth.

Sincerely, David Johns MD, Mercer Island, WA and Bill Osmunson DDS, MPH, Bellevue, WA

Note from petitioner: Effective anti-caries practices have been confirmed in personal communications with Dr. Grant Layton DDS, Encinitas, CA and in particular the WWII Battle of the Bulge survivor Victor E. Sauerheber,

Veteran 101st Airborne, U.S. Army, among countless others. That is, daily direct application of moist baking soda (50 cents per month for a family) to teeth prevents caries by neutralizing acids produced by Streptococcus mutans that metabolize food residues in the oral cavity. This method supercedes the outdated false practice of contaminating massive volumes of public water supplies with fluosilicic acid, hauled in 20,000 gallon rail car or truck loads to cities, which costs over a billion dollars annually in the U.S. The injections also require expensive sophisticated electronic metering to help prevent acute poisoning [as has occurred on multiple occasions, including Hooper Bay, AK with loss of life (see opening information in original petition 2007), the subject of a research article currently under review submitted to Journal of Environmental Health, 2011] and also requires the addition of massive quantities of sodium hydroxide (Drano) to neutralize acidity in a treated city, but which does not prevent the formation of hydrofluoric acid in the acidic stomach by protonation of fluoride ion after swallowing (see previous letter on HF).

Critical Public Health
Slaying sacred cows: is it time to pull the plug on water fluoridation?

Stephen Peckham
Department of Health Services Research and Policy, London
School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK Available online: 15 Nov 2011
(Received 19 March 2010; final version received 27 April 2011) Water fluoridation continues to be a contentious public health policy.
Recent moves to introduce schemes in England raise important questions about the use of evidence in public policy. Of particular concern is how evidence is used for public health policy-making purposes. This article
reviews some of the key debates about water fluoridation and examines the way evidence has been promoted and used. The background to water fluoridation is discussed and also key ideas about how evidence influences policy. While traditionally the problem of evidence is characterized as one where policy makers either accept or ignore evidence, a central concern of this article is where poor evidence is promoted by professionals and accepted by policy makers. The article then examines the evidence on the effects of water fluoridation. Drawing on the idea of the ‘Gold Effect’, the article shows how deeply held beliefs about public health actions shape not just policy but also the application of evidence itself by professionals and
researchers. Keywords: evidence; healthy public policy; population health; water fluoridation.

In his first major speech at the National Health Service (NHS) Confederation Conference in June 2009, the then United Kingdom (UK) Secretary of State for Health, Andy Burnham MP, argued that ‘We’ve been too timid at times on the
public health agenda. Let’s press ahead with fluoridation of water supplies, given the clear evidence that it can improve children’s dental health’. While a welcome emphasis on public health, the choice of water fluoridation as an example is of particular interest as despite the Department of Health’s long-standing commitment to extending water fluoridation,1 there is no scientific consensus that water fluoridation is either safe or effective. Despite this uncertainty, the UK
Government and the NHS in England, along with governments in Australia and the USA are committed to extending community water fluoridation. However,
proposals for water fluoridation remain contentious and lead to strong opposition.
This article explores why water fluoridation policy is controversial within the context of how evidence is used in public health policy making. This article reviews the evidence on water fluoridation and questions whether uncritical support for this

public health policy should be continued.

*Email: Stephen.peckham@lshtm.ac.uk ISSN 0958–1596 print/ISSN 1469–3682 online
2011 Taylor & Francis http://dx.doi.org/10.1080/09581596.2011.596818 http://www.tandfonline.com

[cid:image122.png@01D47B9C.4AC11730]Excerpted from this article:

Figure 3. Comparison of decline in dental caries in fluoridated and non-fluoridated countries. Source: Neurath, C. (personal communication) amended from Neurath C., 2005. Tooth decay trends for 12 year olds in non-fluoridated and fluoridated countries. Fluoride, 38 (4), 324–325.

#6.

November 25, 2011

U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857

Dear FDA petition reviewers,

Any FDA petition, whether requesting a ban or regulation of a substance, requires that the petitioner explain significant opposing statements claimed by proponents for the use of the substance. To further address this need, the following material is submitted in support of the Petition for Reconsideration, 2010 and the original petition FDA-2007-P-0346 (originally assigned 2007P-0400/CP1). Deceptive statements on synthetic fluoride ingestion have been made by Federal dental officials within the U.S. Centers for Disease Control and Prevention. Scientists and other officials in the CDC appear uninvolved, inasmuch as all questions forwarded to CDC on fluorides in public water supplies are always deferred to the Oral Health Division, regardless of requests otherwise. Statements published by the OHD are henceforth referred to here as being from the CDC.

CDC claims fluoridation should be extended, awards those cities sustaining optimal levels, and trains city officials to fluoridate.

The U.S. Safe Drinking Water Act (SDWA) prohibits any national requirement for substances in drinking water other than required to sanitize the water. This legislative Congressional Statute prohibits the addition into public water of foods, natural or processed, supplements, natural or synthetic, minerals, natural or processed, or drugs, FDA approved or non FDA approved. Specifically, 42 U.S.C. §300g-1(b)(11) states

“No national primary drinking water regulation may require the addition of any substance for preventative health care purposes unrelated to contamination of drinking water.”

As published by Graham and Morin (Highlights in North American Litigation during the Twentieth Century of Artificial Fluoridation of Public Water Supplies, JOHN REMINGTON GRAHAM AND PIERRE MORIN) (http://www.keepersofthewell.org/Highlights_Litigation.pdf), this provision was intended by Congress to prohibit the use of the Safe Drinking Water Act as a means of imposing artificial fluoridation of public water supplies throughout the United States. Note that unscrupulous individuals have attempted to evade this Statute by inserting amendments providing for exceptions, to allow the intentional injection of synthetic industrial fluorides into public water supplies, but the original Congressionally approved Statute and its intent remain un-repealed at this time.

The current Federal CDC website on water fluoridation claims to follow the SDWA, while making statements that violate this national requirement clause by describing techniques and target water concentrations for cities to follow in order to fluoridate public water supplies, and by urging, in a Federal official capacity, that cities do so:

“CDC has recognized water fluoridation as one of 10 great public health achievements of the 20th century. The CDC promotes effective public health practices, such as community water fluoridation. CDC considers comprehensive reviews by the NRC and other systematic scientific studies in its recommendation that community water fluoridation is a safe, effective, and inexpensive method to reduce tooth decay among populations with access to public water systems. Water fluoridation should be continued in communities currently fluoridating and extended to those without fluoridation.”

Awards for outstanding fluoridation efforts

[cid:image124.png@01D47B9C.4AC11730]“CDC recognizes water systems that achieve optimal fluoridation levels for all 12 months each
year with the annual Quality Award. Water systems that adjust the water fluoride level within the optimum range in a sustained manner are eligible for this award if their state documents the performance in the
CDC Water Fluoridation Reporting System.”

Water fluoridation training programs

[cid:image126.png@01D47B9C.4AC11730]“CDC provides water fluoridation training designed to build the capability of state fluoridation programs and to help water treatment professionals develop and refine their skills related to operations. Courses include a 3-day annual training on the Principles and Practice of Water Fluoridation and a newly developed 6-hour water plant operator training course template designed for use by state fluoridation programs. More information on these training programs may be found at the CDC-sponsored training page.”

CDC avoids liability and SDWA requirement clause, while requesting and regulating fluoridation.

To attempt to avoid responsibility and any liability for synthetic fluoride injections, and to claim the SDWA is not violated, the CDC fluoridation website makes the following statement:

“It is not CDC’s task to determine what levels of fluoride in water are safe.”

This of course flatly contradicts their following statements:

“CDC monitors the progress of the United States and individual states toward meeting the Healthy People
2010 objective on community water fluoridation—that 75% of people on public water systems will receive water that has the optimum level of fluoride recommended for preventing tooth decay.” And “My Water’s
Fluoride (MWF) helps consumers in participating states to learn basic information about their water system,
including the number of people served by the system and the target fluoridation level. Engineering and Administrative Recommendations for Water Fluoridation, MMWR, September 29, 1995;44(RR–13):1–40 (PDF–338KB) provides specific recommendations for water fluoridation, including administration, monitoring and surveillance, technical requirements, and safety procedures for community public water supply systems. CDC provides technical assistance to state programs regarding engineering support, facility management, and operational support and also provides responses to public health-related questions on community water fluoridation.”

In another attempt to avoid responsibility, the fluoridation site claims that the EPA is in charge of regulating water fluoridation:

“Under SDWA, the U.S. Environmental Protection Agency (EPA) sets standards for drinking water quality
and oversees the states, localities, and water suppliers that implement those standards.”

It is well established that the EPA relinquished all regulatory control of water fluoridation in 1988, as published in the Code of Federal Regulations (see previous letter to FDA).

Federal Oral Health Division within CDC provides false information on fluoridation.

Information provided to the general public on fluoridation by dental officials within the CDC is false, as proven by the fact that serious adverse biologic effects such as allergy, lethal accidental overfeeds and huge levels of fluoride incorporated into bone (NRC, 2006) are dismissed from the entire fluoridation site. The only adverse effect that is acknowledged is tooth fluorosis, and CDC now pleads lack of understanding of this with the statement:

“Recent studies have raised the possibility that mixing infant formula with fluoridated water, particularly for infants exclusively on a formula diet during the first year of life, may play a more important role in dental fluorosis development than was previously understood.”

To further avoid responsibility for the current U.S. endemic of tooth fluorosis, discovered in 2004 to be at a massive 41% of all U.S. children aged 12-15, CDC provides contradictory, unintelligible information on fluoride consumption safety listed below. Here the confused CDC leaves the responsibility to parents and physicians, instead of the CDC itself who urges fluoride ingestion and argues regularly that it is “safe and natural” and a “great health achievement”:

“For children aged less than 6 years, the dentist, physician, or other health care provider should weigh the risk for tooth decay without fluoride supplements, the decay prevention offered by supplements, and the potential for dental fluorosis. Consideration of the child’s other sources of fluoride, especially drinking water, is essential in determining this balance. Parents and caregivers should be informed of both the benefit of protection against
tooth decay and the possibility of dental fluorosis. All fluoride supplements must be prescribed by a dentist or

physician. The prescription should be consistent with the 2010 dosage schedule [cid:image006.gif@01D47B9B.C7E22160] (PDF–756K) developed by the
American Dental Association (ADA). Fluoride supplements can be prescribed for children at high risk for tooth decay and whose primary drinking water has a low fluoride concentration.”

What, pray tell, is a “low concentration” of fluoride in drinking water? Since fluoride must be given by prescription, why do CDC dental officials urge fluorides be added into drinking water, where dosage cannot be controlled? And how can any rational parent determine a dosage for a substance that could help, rather than harm, teeth, considering that CDC dental officials state elsewhere that fluoride in infant fluorosis is not understood?

The fluoridation site also argues that fluoride “strengthens bone”, “decreases caries” and exerts “no adverse biologic effects on man or animals” as follows:

“Scientists have found a lack of evidence to show an association between water fluoridation and a negative impact on people, plants, or animals.”

Not addressed are the known adverse mental effects of fluoride [2] and the well documented fact that 1% of all humans are allergic to synthetic fluorides with severe rashes on bathing in 1 ppm synthetically fluoridated water and who can have severe painful face swelling and redness upon exposure to sodium fluoride in dental gels. Not mentioned are the findings of the U.S. FDA that fluoride in bone does not strengthen bone and that fluoride is not a mineral nutrient (see petition). Not mentioned is the well established fact that lifetime fluoride water consumption leads to massive unnatural fluoride levels in bone and that common levels of 3-4,000 mg/kg weakens bone, making bone more subject to fracture [3].

CDC claim disproven, that synthetic fluorides are identical to natural calcium fluoride.
It is true that anionic fluorine is the fluoride ion, whether found in solid form in natural minerals such as
tourmaline aluminum fluoride and fluorite calcium fluoride, or rather in synthetic industrial compounds such as fluosilicic acid, sodium fluoride, arsenic fluoride, lead fluoride among others. The ion is identical in all substances
in which it is found, even in bone hydroxyapatite and in blood where it does not belong naturally. Ionized fluoride,
dis-attached from its mineral source, in the ocean at 1 ppm, surrounded by thousands of ppm calcium and magnesium, and ionized fluoride found in some waters in the Southwest detached from its mineral source at 1 ppm with several hundred ppm calcium and magnesium, is identical in form to industrial fluoride ion dissolved in pure water detached from its source compounds, including dissolved fluosilicic acid or sodium fluoride. The fluoridation website statement on this fact is accurate.

The gross deception however is in the remaining description that attempts to deceive the public into the thought that ionized fluoride from natural calcium fluoride behaves biologically and chemically no differently than ionized fluoride from industrial fluosilicic acid or sodium fluoride.

“Three additives—sodium fluoride, sodium fluorosilicate, and fluorosilicic acid—may be used to adjust the natural fluoride levels in water to concentrations that prevent or control tooth decay.”

Therein lies the mistake and the deception. The lethal acute dose in experimental animals for industrial fluorides without calcium caused all to be listed on poisons registries and use as insecticides and rodenticides with high intrinsic toxicity. This is due to the fact that the fluoride ion is soluble to an infinite degree from industrial compounds, but not from natural calcium fluoride, and that fluoride in the absence of calcium is assimilated well after ingestion. Calcium fluoride, with the same fluoride ion as for any compound with fluoride, has no acute intrinsic lethal toxicity because fluoride is not assimilated well into the bloodstream when accompanied with significant calcium ion. Calcium is the world-recognized antidote to poisoning from synthetic industrial fluorides, as occur in toothpastes, dental gels and drinking water. Deaths caused by soluble fluoride, that is well assimilated into the blood where it alters calcium metabolism and homeostasis, have never been found in the case of ingestion of calcium fluoride. For synthetic fluorides, children have had lethal heart attack after swallowing sodium fluoride in dental gels, and overfeeds in some cities have caused death from synthetic injected sodium fluoride that is fully water soluble, as in Hooper Bay, Alaska, and in kidney patients in Illinois and Maryland during overfeeds with synthetic industrial fluoride.

The claim that addition of synthetic fluosilicic acid or sodium fluoride to water duplicates natural calcium fluoride and thus that “fluoridation is natural”, even from toxic hazardous diluted waste fluosilicic acid, is disproven by the fact that fluosilicic acid always contains appreciable hydrofluoric acid HF and always requires

massive amounts of sodium hydroxide soda ash (‘Drano’) to neutralize acidity in the water. Sodium does not belong in fresh drinking water. Sodium reduces productivity of many crops.

The claim that industrial synthetic fluoride from unnatural compounds is identical to natural calcium fluoride fails to explain that synthetic fluoride biological effects are entirely dependent on the materials in the surrounding medium when ingested. Arsenic fluoride and fluosilicic acid and sodium fluoride have the exact same fluoride anion that calcium fluoride also contains, but the toxicity, whether acute lethal or chronic after long-term consumption, is widely different. Arsenic fluoride is more toxic than fluosilicic acid and sodium fluoride, which are both far more toxic than natural calcium fluoride, which is not a registered poison on any poisons registry. Calcium fluoride is water soluble to only 8 ppm maximum.

CDC explicitly exaggerates further by claiming that salmon are not harmed by 1 ppm fluoride naturally present in the ocean. This statement by itself is entirely accurate. Salmon are not adversely affected by 1 ppm fluoride ion in the ocean where calcium and magnesium are present at thousands of ppm levels as antidote. The CDC website however does not explain the entire picture. The salmon collapse in the 1970’s on the Columbia River due to industrial synthetic fluoride emissions from an aluminum smelter into the fresh, calcium-deficient water at only 0.3 ppm fluoride narcotizes salmon brain and prevents navigation upstream to spawn. These data have been confirmed in prospective experiments at the University of Oregon and led the State of Oregon to pass legislation against any synthetic fluoride compounds from being injected into state water supplies. This is necessary to protect the salmon because indeed industrial fluorides in the absence of calcium allow substantial fluoride assimilation into an organism.

CDC claim, that ingested fluoride decreases caries, is explained.

The notion that swallowed fluoride decreases dental caries is a false correlation. Children in Deaf Smith County had whitish teeth with fewer cavities that were ascribed to the 1 ppm fluoride present in drinking water, without mention of the fact that the water contained 205 ppm calcium, in ionized form and as calcium bicarbonate and calcium carbonate, and also contained 123 ppm magnesium as the free ion or bicarbonate and sulfate for a total of
328 ppm divalent cation to minimize fluoride assimilation into the citizens living there. We all know the claims made in 1942 broadly published in public literature that those coming to Deaf Smith County would be assured of having cavities disappear and that babies born there had perfect white teeth with zero cavities. Hereford, Texas was referred to as the “town without a toothache” in Collier’s Magazine, the Readers’ Digest and also the Saturday Evening Post (A. W. Erickson, Field Notes Crop Reporting Service, Minneapolis, MN 1945, with quotes from dentist Dr. G.W. Heard).

The CDC does not acknowledge that 1 ppm fluoride in the water was accompanied with high levels of calcium, and that calcium builds strong teeth. Instead the OHD dental officials insist that the effect on teeth was due entirely to the 1 ppm fluoride alone and that all waters in the U.S. need to adjust their natural chemistry to 1 ppm synthetic fluoride, which is in violation of the Water Pollution Control Act, having the express mission that the chemistry of waters in the U.S. be maintained in their natural state.

Ironically, Dr. Heard, who first believed the false correlation, eventually after following children raised on the water concluded that fluoride incorporated into teeth dentyne make teeth interiors crumbly that required more costly dental procedures in those children in later years. Heard deplored the idea of using synthetic fluorides in public water supplies (see Buck, the Grim Truth About Fluoridation, 1965 in original petition) and wrote a detailed letter to that effect to the U.S. Public Health Service (see attached letter in original petition).
The Public Health Service believed Heard and others with the false correlation, but later did not believe Heard and others when refutations were written, likely because of ignorance, greed, stubbornness or other worse principle. The
exhaustive data of Ziegelbecker [2], that eliminates false correlation due to ‘cherrypicking’ data, proves dramatically that ingested fluoride does not decrease cavities.

CDC promotes assimilation through ingestion of hydrofluoric acid HF.

Ingested fluoride in the stomach mostly becomes protonated at pH 3-4 to hydrofluoric acid HF (see graph in previous letter of pH dependence of ionic fluoride ppm level). It is the HF molecule that is assimilated through the cell membrane over 1,000 times more efficiently than is free ionic fluoride (Buzalaf and Whitford, 2011, see attached abstract). The fluoride ion, ionized as the free ion from synthetic sources in the absence of sufficient

calcium, produces HF quantitatively in the stomach, which is assimilated well into the bloodstream. The fluoride then returns to the free fluoride ion again at blood pH of 7.4.

The Food Drug &Cosmetic Act requires that any substance used as an anti-caries treatment that contains HF must require a new drug application NDA. The Code of Federal Regulations specifically prohibits the marketing, interstate transport, or ingestion of any anti-caries agent that contains HF without a NDA [21 CFR31O.545(a)(2) and (b).]

The CDC does not seem to notice that the FD&CA is violated with any industrial fluoride compound added into water to treat caries, not simply because all fluosilicic acid preparations contain appreciable HF (to 10 grams per Liter), but also because all synthetic fluorides produce HF in the stomach anyway. This is the mechanism by which gastrointestinal distress is associated with all synthetic fluoride overfeeds; here the HF irritation of the stomach is painful.

Even at 1 ppm fluoride in water, 1% of all consumers have stomach irritation after drinking [3]. And there are
1% on average of people in a population who are allergic to the free ion from unnatural synthetic sources without calcium. Dental gels applied to teeth, even in the absence of intentional swallowing in adults, cause severe swelling and rash and redness on the face in those allergic to synthetic fluoride (personal communication). Since fluoride tends to associate with calcium ions in solution, calcium fluoride is not a known allergen, and the presence of calcium in the GI tract minimizes fluoride assimilation as stated earlier.

CDC recommends various synthetic fluorides with dosage instructions contradictory to FDA.

The current CDC public website provides information on other sources of fluoride treatments with recommended dosage instructions, which often contradict FDA dosages, all of which is contrary to the mission of the Federal CDC, which is not to provide information on supplements or minerals for consumption or other uses, but is to monitor and protect citizens from serious lethal contagious disease.

CDC writes: “Concentrations of fluoride in toothpaste sold in the United States range from 1,000–1,500 ppm. Over-the-counter solutions of 0.05% sodium fluoride (230 ppm fluoride) for daily rinsing are available for use by persons older than 6 years of age. Solutions of 0.20% sodium fluoride (920 ppm fluoride) are used in supervised, school-based weekly rinsing programs. Fluoride gel is often formulated to be highly acidic (pH of approximately 3.0). Products available in the United States include gel of acidulated phosphate fluoride (1.23% [12,300 ppm] fluoride), gel or foam of sodium fluoride (0.9% [9,040 ppm] fluoride), and self-applied (i.e., home use) gel of sodium fluoride (0.5% [5,000 ppm] fluoride) or stannous fluoride (0.15% [1,000 ppm] fluoride). Varnishes are available as sodium fluoride (2.26% [22,600 ppm] fluoride) or difluorsilane (0.1% [1,000 ppm] fluoride) preparations. Proper application technique reduces the possibility that a patient will swallow varnish during its application and limits the total amount of fluoride swallowed as the varnish wears off the teeth over several hours, although it is not currently cleared for marketing by the Food and Drug Administration (FDA) as an anti-caries agent.”

The reference below indicates that fluoride assimilation into blood differs for various brands of fluoride dental gels. Providing dosage instructions to citizens for something as minor as tooth decay is not in keeping with the original mission of the CDC, but is within the purview of the FDA.

Summary.

It is clear that Federal dental officials in the Oral Health Division offices within the U.S. Centers for Disease Control and Prevention are not acting in good faith to honor the U.S. Safe Drinking Water Act that all Americans are to follow. Federal officials who openly promote, train and award State Health Departments and cities for the addition of synthetic industrial fluorides into public human drinking water supplies to treat or prevent disease, from a Federal authority, is equivalent to a national requirement, expressly forbidden by the U.S. Safe Drinking Water Act. Statements that the SDWA is being followed constitute deceptive practice.

The U.S. FDA has been here petitioned to ban fluosilicic acid and/or sodium fluoride injections into U.S. public water supplies–or in lieu of a ban to request data providing human controlled clinical trials proving safety and effectiveness for long term consumption of these materials and to prevent nevertheless their use in public water supplies where dosage cannot be regulated. Statements that Luride or any prescription fluoride must be discontinued in any city that adds synthetic fluoride, which is the current instruction to physicians who still

prescribe oral Luride (Physician’s Desk Reference), and statements that infants must not be given fluoridated water are minimal essential requirements.

As the truth is marching on, may you all at the FDA have a very Merry Christmas,

Fluoride Ion Concentration (ppm) as a function of pH,
in the Presence (squares) and Absence (diamonds) of Calcium
[cid:image127.jpg@01D47B9C.4AC11730]

This graph demonstrates the effect of acidity on the free fluoride ion level measured with an ion specific electrode that cannot sense either HF or calcium fluoride. A sodium fluoride solution in distilled water, initially at pH 7 was divided into two samples. The first sample represented by the diamonds was measured for free fluoride ion as a function of changes in pH from 7 to 2.5 in the absence of calcium ion. The squares are the fluoride ion readings of the second sample as a function of changes in pH after addition of 120 ppm calcium and 20 ppm magnesium as phosphates. There is no doubt that the progressively decreasing free fluoride ion levels occurring in the absence of calcium are caused by protonation of the fluoride ion to form HF, where F- + H+ → HF as the acidity increases and pH decreases. At stomach pH of 3-4, the level of free fluoride ion at 0.6-0.7 ppm indicates that about 0.6 ppm HF is present in this solution. This is the mechanism by which synthetic fluorides in the absence of calcium are efficiently assimilated in the stomach from the uncharged small HF molecule that penetrates cell membranes 1,000 times more efficiently than does the free fluoride ion [1]. These experimental observations are fully consistent with chemical calculations of the HF concentration that would form from sodium fluoride in distilled water in the absence of calcium at gastric pH determined mathematically from the known dissociation constant for HF (see previous letter to FDA).

Although fluoride does not combine with phosphate, calcium or magnesium at these cation physiologic concentrations, notice that fluoride ion concentrations are lower in the calcium solution at all pH values. Calcium prevents the assimilation of fluoride from the gastrointestinal tract into the bloodstream, and these data may indicate one possible reason. The levels of free fluoride ion are lower in the presence of calcium and magnesium, independent of pH, because the activity of the free fluoride ion is reduced by the presence of these divalent cations (Moore, Physical Chemistry, 1963). Not only does this impair the fluoride electrode from detecting the free fluoride ion, but also this is the likely explanation for how calcium minimizes fluoride assimilation into the bloodstream after ingestion. The drastically lower free fluoride ion readings at acidic pH in the presence of calcium and magnesium are due in part to formation of HF but also are due to decreased activity of the fluoride ion caused by these cations, where at lower pH the calcium and magnesium phosphates are expected to be fully ionized, which would then interfere more dramatically with fluoride mobility in solution.

As is evident, the interaction of fluoride ion with various foodstuffs during ingestion are complex and are likely to be responsible for the variable effects on those consuming fluoridated water. For example, although tooth fluorosis is increased without exception in any fluoridated city, nevertheless not all children succumb to this permanent adulterated abnormal enamel that produces its unsightly smile [2]. Such differences may be due to variation in diet, as much as to variation in overall fluoride uptake. The fact that the toxicology of the free fluoride ion is dependent on the chemical makeup of its surroundings is well known. Fluoride at 1 ppm in ocean water, accompanied with thousands of ppm calcium that prevents assimilation, does not affect salmon, while only 0.3 ppm fluoride in water devoid of calcium causes narcotic effects on salmon brain.

Regulation of dosage is impossible with fluoride in water, not only because water consumption is variable depending on physical activity, but also because foods alter the extent of assimilation of the agent as shown here. Ingestion of synthetic fluoride without calcium has been legalized in the past by prescription, with accompanying dosage instructions to not be used in a fluoride-treated city. However, all synthetic fluorides quantitatively form hydrofluoric acid HF in the stomach, so Federal recommendations to permanently fluoridate consumers through drinking water to treat/prevent bacteria-induced dental caries, without a prescription, dosage instructions, or consultation with individual consumers, is not only unconscionable, but remains entirely illegal. References:
[1] Buzalaf, MA; Whitford, GM, Fluoride metabolism, Monographs in oral science 2011;22:20-36.
[2] Connett, Micklem and Beck, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, Vermont, 2010.
[3] National Research Council, Fluoride in Drinking Water, a Scientific Review of EPA’s Standards, Washington, D.C., 2006.

Abstracts of references cited in the letter:

Buzalaf, MA; Whitford, GM, Fluoride metabolism, Monographs in oral science 2011;22:20-36. Knowledge of all aspects of fluoride metabolism is essential for comprehending the biological effects of this ion
in humans as well as to drive the prevention (and treatment) of fluoride toxicity. Several aspects of fluoride metabolism – including gastric absorption, distribution and renal excretion – are pH-dependent because the coefficient of permeability of lipid bilayer membranes to hydrogen fluoride (HF) is 1 million times higher than that
of F-. This means that fluoride readily crosses cell membranes as HF, in response to a pH gradient between adjacent body fluid compartments. After ingestion, plasma fluoride levels increase rapidly due to the rapid absorption from
the stomach, an event that is pH-dependent and distinguishes fluoride from other halogens and most other substances. The majority of fluoride not absorbed from the stomach will be absorbed from the small intestine. In this case, absorption is not pH-dependent. Fluoride not absorbed will be excreted in feces. Peak plasma fluoride
concentrations are reached within 20-60 min following ingestion. The levels start declining thereafter due to two main reasons: uptake in calcified tissues and excretion in urine. Plasma fluoride levels are not homeostatically
regulated and vary according to the levels of intake, deposition in hard tissues and excretion of fluoride. Many factors can modify the metabolism and effects of fluoride in the organism, such as chronic and acute acid-base disturbances, hematocrit, altitude, physical activity, circadian rhythm and hormones, nutritional status, diet, and genetic predisposition. These will be discussed in detail in this review.

Whitford, GM, Acute toxicity of ingested fluoride, Monographs in oral science 2011;22:66-80.

This chapter discusses the characteristics and treatment of acute fluoride toxicity as well as the most common sources of overexposure, the doses that cause acute toxicity, and factors that can influence the clinical outcome. Cases of serious systemic toxicity and fatalities due to acute exposures are now rare, but overexposures causing toxic signs and symptoms are not. The clinical course of systemic toxicity from ingested fluoride begins with gastric signs and symptoms, and can develop with alarming rapidity. Treatment involves minimizing absorption by administering a solution containing calcium, monitoring and managing plasma calcium and potassium concentrations, acid-base status, and supporting vital functions. Approximately 30,000 calls to US poison control centers concerning acute exposures in children are made each year, most of which involve temporary gastrointestinal effects, but others require medical treatment. The most common sources of acute overexposures today are dental products – particularly dentifrices because of their relatively high fluoride concentrations, pleasant flavors, and their presence in non-secure locations in most homes. For example, ingestion of only 1.8 ounces of a standard fluoridated dentifrice (900-1,100 mg/kg) by a 10-kg child delivers enough fluoride to reach the ‘probably toxic dose’ (5 mg/kg body weight). Factors that may influence the clinical course of an overexposure include the chemical compound (e.g. NaF, MFP, etc.), the age and acid-base status of the individual, and the elapsed time between exposure and the initiation of treatment. While fluoride has well-established beneficial dental effects and cases of serious toxicity are now rare, the potential for toxicity requires that fluoride-containing materials be handled and stored with the respect they deserve.

Kobayashi, CA; Belini, MR; Italiani, Fde M; Pauleto, AR; Araújo, JJ; Tessarolli, V; Grizzo, LT; Pessan, JP; Machado, MA; Buzalaf, MA, Factors influencing fluoride ingestion from dentifrice by children, Community dentistry and oral epidemiology 2011;39(5):426-32.

OBJECTIVE: This study assessed the percentage of the amount of dentifrice loaded onto the toothbrush that is ingested by children, taking into account age, the amount of dentifrice used during toothbrushing, and the dentifrice flavor. METHODS: The sample consisted of 155 children of both genders attending public kindergartens and schools in Bauru, Brazil, divided into 5 groups (n = 30-32) of children aged 2, 3, 4, 5 and 6 years old. The dentifrices used were Sorriso™ (1219 ppm F, peppermint-flavored) and Tandy™ (959 ppm F, tutti-frutti- flavored). The assessment of fluoride intake from dentifrices was carried out six times for each child, using 0.3, 0.6, and 1.2 g of each dentifrice, following a random, crossover distribution. Brushing was performed by the children or their parents/caregivers according to the home habits and under the observation of the examiner. Fluoride present in the expectorant and on toothbrush was analyzed with an ion-specific electrode after HMDS-facilitated diffusion. Fluoride ingestion was indirectly derived. Results were analyzed by 3-way repeated-measures anova and Tukey’s tests (P < 0.05) using the percent dentifrice ingested as response variable. RESULTS: Age and percent dentifrice ingested for both dentifrices, and the three amounts used were inversely related (P < 0.0001). Percent dentifrice ingested was significantly higher after the use of Tandy™ under all conditions of the study when compared with Sorriso™ (P < 0.0001). Significant differences were observed when brushing with 0.3 g when compared with 1.2 g, for both dentifrices tested (P < 0.05). CONCLUSIONS: The results indicate that all variables tested must be considered in preventive measures aiming to reduce the amount of fluoride ingested by young children.

  • The pharmacokinetics of ingested fluoride was studied by a 2008 study (G.M. Whitford, F.C. Sampaio, C.S. Pinto, A.G. Maria, V.E.S. Cardoso, M.A.R. Buzalaf, Pharmacokinetics of ingested fluoride: Lack of effect of chemical compound, Archives of Oral Biology, 53 (2008) 1037–1041).

Acknowledgments: I am grateful for those kind individuals, especially my students at Palomar College, who have contributed to this series of letters submitted to the FDA. Letter #1 on EPA retraction of the 1979 MOU, letter #2 on the dosage instructions for Luride by prescription only, letter #3 on the extent of conversion of fluoride to HF and the Federal regulations on HF use as an anti-caries agent, letter #4 summarizing violations of the SDWA, the WPCA and the FD&CA, and letter #5 on deceptive practices by the OHD of the CDC on the contaminant fluoride used as though it has Federal approval in public water supplies. My students understand fluoride chemistry well and the Congressional Statutes that protect public water supplies from its intentional injection or its accidental spillage, but do not understand failure to enforce these Statutes.

#7.

December 3, 2011

U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

Dear Reviewer,

The following information is provided in support of the petition sent to the FDA in 2007, FDA 2007-P-0346 (formerly 2007P-0400/CP1) and its Petition for Reconsideration submitted 2011.

I was asked by a legal group to provide information that would clarify questions regarding the chemistry of the fluosilicic acid that is used to influence teeth through ingestion in public water supplies. The information had to be presented in the form of a numbered paragraph legal affidavit, following their required format for litigation. A copy of this affidavit, that is strictly confidential for FDA use only, is enclosed. It specifically clarifies the unusual chemistry of this synthetic fluoride compound and its associated hydrofluoric acid HF, from which fluosilicic acid is synthesized in industry.

A related letter sent earlier (11/11/2011) to the FDA presented chemical calculations of the HF content in fluoridation materials and in the stomach after ingestion, along with a copy of the CFR regulations indicating that any substance proposed to be used as an anti-caries agent containing HF requires a new drug application to the FDA.

No one in the U.S. has the right to adulterate natural water supplies with the intent to treat humans. And yet humans are being so treated, even though one of the foremost texts to advance this policy written by 5 dentists (Newbrun, E., Fluorides and Dental Caries, Thomas Books, Springfield, ILL, 1972) admits glaring adversity associated with the practice. For example, fluoride allergy in anyone should prevent water fluoridation on a mass scale to prevent such harm, as described extensively by Waldbott in several texts (see peitition). Newbrun attempts to discount fluoride allergy but admits that the association of fluoride with albumin (a known mechanism by which small molecules can become large enough to trigger immune reactions) is cause for ‘further exploration’, all while presenting 170 pages of text to convince the country to fluoridate public water supplies anyway (p. 154). The text also admits that kidney patients accumulate bone fluoride to much higher levels, and no investigation at all was made on the brain effects from the consumption of fluoride in public water supplies that has now been documented in 30 scientific publications (Connett, et.al. The Case Against Fluoride, 2010). The CDC admits infants should not use fluoride water because the risk of permanent abnormal enamel fluorosis is too significant. Newbrun admits fluoride at blood levels of 0.2 ppm inhibit sensitive metabolic enzymes. But rather than discussing the pathologic impact of this in vivo, the text turns the long discussion into how this might be beneficial as an antimicrobial.

We must all ask, who in our free country has the right to prevent access to regular public water, without added artificial perturbants documented to adversely affect many classes of people, including the infirmed, infants, and the elderly? And to also expect people in our strained economy to pay into the billions spent yearly to implement that treatment?

Affidavit enclosed.
I, Dr. Richard D. Sauerheber,
home address 1826 Redwing St., San Marcos, CA 92078
solidly and sincerely affirm and declare in this affidavit on this date November 30, 2011, that:

  1. I am a graduate of the University of California, San Diego with a Bachelor of Arts degree in Biology (1971), a graduate of the Department of Chemistry at the University of California, San Diego (1976) and hold a Doctorate in Chemistry, studying biochemistry and inorganic chemistry with emphases at the UCSD School of Medicine in physiology, pathology, cardiovascular science, neurochemistry, histology and pharmacology. My thesis research,

under the supervision of the honorable diabetologist Dr. Arne N. Wick (Scripps Clinic, La Jolla, CA) and world class insulin researcher Dr. Otto Walaas (University of Oslo, Oslo, Norway) led to published articles on diabetes mellitus, insulin action and the physical biochemistry of cell surface membranes and their interactions with calcium and magnesium.

  1. I am of legal age and competent to testify.
  • As a Christian and citizen of the United States of America, I have the authority to make the following statements and declarations voluntarily that have been asked of me.

  • I have no commercial affiliations.

  • I completed a postdoctoral research fellowship at Scripps Clinic, La Jolla, CA (1976-1980).

  • As a Federal National Institutes of Health research grant principal investigator I supervised laboratory medical research studies at the Rees Stealy Clinical Research Foundation, San Diego, CA for one decade (1981-1991).

  • As a California Community Colleges lifetime teaching credential holder in the Life Sciences I have since 1991 been an educator in Chemistry, Physics, Biology, and Mathematics.

  • I have approximately 30 research articles published in scientific journals, including the Journal of Biological Chemistry, Biochemistry, Science, and Current Therapeutics.

  • I co-authored a review article on the role of divalent cations in the structure and function of biological membranes, published by Taylor & Francis, London in the prestigious CRC Press reference book series, The Role of Calcium in Biological Systems.

  • I received laboratory training at the Scripps Institution of Oceanography, UCSD, from the world re-known Dr. Andrew A. Benson of the Calvin-Benson cycle in plant photosynthesis. Not as widely known for his expertise in fluorine chemistry, Benson received his Ph.D. in 1940 from the University of California, Berkeley on the synthesis of fluoride derivatives of thyroid hormone. I currently meet regularly with Benson who at age 94 still runs a laboratory at the SIO.

  • I wrote textbooks entitled The Calculus, Biology Introduction, The Nature of Light, the Truth Behind Relativity, and The Toxicity of Fluoridated Water. I co-authored with my Pearl Harbor survivor father Pearl Harbor, December 7th and 8th. Each of these texts have been accepted for copyright by the Library of Congress, Washington, D.C. (www.lulu.com.)

  • I completed a chemical analysis of the Hooper Bay fluoridated water poisoning disaster, and this article has been published at www.nofluoride.com. A more extensive version is a submitted manuscript now under review at the Journal of Environmental Health.

  • I submitted a petition to ban the un-natural injection of synthetic industrial fluoride diluted fluosilicic acid hazardous waste into public water supplies in the United States. The petition was formally accepted for review by the U.S. Food and Drug Administration in 2007 (FDA2007-P-0346) and remains under consideration.

  • I had the honor of being interviewed, on three separate occasions by Dr. Stanley Monteith, orthopedic surgeon and now National radio broadcaster at www.radioliberty.com, on various aspects of the toxicology of fluoride- treated public water.

  • I am a voluntary science advisor for Washington Action for Safe Water (www.wasw.org) and for San Diegans for Safe Drinking Water (www.sdsdw.org).

  • I support clean water management practices and recognize the sanctity of U.S. waterways. I honor the mission of the U.S. Water Pollution Control Act as originally conceived by President John F. Kennedy, with the stated goal of maintaining the natural chemistry of U.S. public water supplies.

  • I honor the original mission of the U.S. Safe Drinking Water Act and the chemical meaning of its Federal requirement clause designed to prohibit the injection of any substance into water other than necessary to sanitize water.

  • Fluoride chemistry is introduced here, along with an overview of evidence that demonstrates that fluoride ion does not belong in the bloodstream or tissues of man or animal. Central is the observation that pristine fresh drinking waters, naturally formed from ocean evaporates by the sun as the essential feature of the world’s hydrologic cycle (Created to provide the world’s drinking water for man and animals), contain no fluoride. Moreover, several laboratories confirm this, using well controlled caged research animals raised for generations on zero fluoride water and food and proved that fluoride ion is not a mineral nutrient, as correctly decreed by the U.S. FDA in 1963 [1], and as reviewed in 1986 [1a].

  • Anionic fluorine, the fluoride ion, belongs and is present naturally in selected minerals on land [2], and as the free ion at 1 ppm in salt water of the world’s oceans where it is accompanied with thousands of ppm calcium and magnesium that prevent toxicity intrinsic to the ion. Salmon for example are acutely sensitive to, and narcotized by, dilute fluoride in fresh soft river water, but are not affected by fluoride in saline ocean water [2a].

  • It is widely known that fluorine F2 is the most electron–withdrawing of all elements on earth and thus does not exist in nature [3]. On the contrary, not widely understood is the fact that anionic fluorine, the fluoride ion F-, has no electronegativity and in fact is electropositive, where fluoride naturally binds electrostatically to positive ions, most commonly to calcium ion in nature. Fluorine oxidizes virtually every chemical substance (listed as the most
    extreme oxidizing agent in all oxidation/reduction tables), but is reduced by nothing. Fluoride however can neither be oxidized (to fluorine) nor reduced (further than F-) by any known substance and is thus indestructible, a permanent resident on earth. (For an introduction to the chemistry of fluoride one may consult the Agency for Toxic Substances and Disease Registry, 2003) [2] and for an introduction to the chemistry of fluorine, consult the CRC Press Handbook of Physics and Chemistry [3].

  • [cid:image129.png@01D47B9C.4AC11730]21. Fluoride ion is a sphere with a 267 picometer material diameter, comparable in size to a water molecule with length 275 and width 260 picometers (pictorially represented below).

    Fluoride ion H2O molecule

    22.Reaction of fluoride containing minerals, also containing silicates, with the strong acid sulfuric acid H2SO4 produces synthetic substances, silicon tetrafluoride SiF4 and the toxic corrosive hydrofluoric acid HF. In acidic water these combine to quantitatively form inorganic fluosilicic acid*, H2SiF6. This molecule only exists when in water at low pH, because as a complex of HF with SiF4, when water is evaporated, the molecule quickly returns to SiF4 + 2 HF [3,4], and it ionizes at neutral pH. H2SiF6 cannot be stored in glass due to the constant presence of finite amounts of HF which etches glass, or in concrete which is also destroyed by HF, so water districts typically hold the substance in large rubber-lined steel or iron tanks. Large tanks of sodium hydroxide (Drano) are also on- site for neutralization of the treated water.

    1. Fluosilicic acid is a recognized toxic industrial synthetic compound that does not exist in nature. The molecule must not be labeled simply as ‘fluoride’, but does contain the fluoride F- ion within it. This is true for all fluoride compounds, including sodium, aluminum, calcium, stannous, and arsenic fluorides. Only natural calcium fluoride CaF2 has such low intrinsic toxicity that it is not a recognized acute toxic compound (lethal 50% single dose LD50 >
      3,500-5,000 mg/kg); all other fluoride compounds are artificial synthetics of industrial importance and ARE listed
      toxics (LD50 ≈ 125 mg/kg) [4], comparable to the known acute toxicity that is intrinsic to arsenic and lead.
  • Solubility calculations mathematically demonstrate that calcium fluoride is soluble in pure water to 8 ppm fluoride maximum at 25oC with calcium also at 8 ppm (Ksp for CaF2 = 2 x 10-11) [3]. This finite solubility is the mechanism by which calcium interferes with fluoride poisoning in acute toxicity studies in animals, and why calcium is the recognized antidote to fluoride poisoning from ingestion. The presence of calcium ion minimizes the assimilation of ingested fluoride during residence time in the GI tract. The synthetic compounds fluosilicic acid and sodium fluoride however are fully water soluble (to 6,700 ppm and 40,000 ppm respectively) [3], and a lethal fluoride concentration in blood may be achieved experimentally as above, or accidentally after oral ingestion of these compounds in man and animals [4].

  • Acute lethal poisoning with synthetic fluorides, all lacking calcium, is typically reported to occur at a blood and tissue concentration of 5 ppm [5] (whether by ingestion of 120 mg per kg synthetic fluoride without antidote calcium, or would occur by direct injection into the bloodstream at 5 ppm fluoride). This observation is remarkably consistent with solubility calculations for the concentration of fluoride that would precipitate calcium to 1 mM, a calcium level known to interfere dramatically with normal heart function. The concentration of fluoride that would coexist with 1 mM calcium ion is indeed [F-] = {Ksp/[Ca2+]}1/2 = {2 x 10-11/(0.001 M)}1/2 = 2.6 x 10-4 M or 5 ppm fluoride ion. This chemically verifies the lethal mechanism by which fluoride from synthetic compounds can poison, due to hypocalcemia-induced heart attack, in its use as a rodenticide and also in accidental lethal human poisoning as in the infamous fluoridated public water overfeed disaster in Hooper Bay, Alaska in 1994 [6,7,8].

  • Fluosilicic acid dissociates in water above pH 2-3 to form hydrofluoric acid (HF), silicic acid hydrate -2

  • (H2SiO3H2O), fluoride ion and various silicofluorides (i.e. SiF6

    , etc.) in proportions depending on water acidity.

    Acidic conditions cause hydrofluoric acid and silicofluorides to predominate. Since HF is an extreme corrosive that dissolves many metals and frosts glass, to avoid damaging water district plumbing valves, and to avoid acidifying drinking water, fluosilicic acid is mixed with caustic soda sodium hydroxide (NaOH) or soda ash, the active ingredient in Drano drain cleaner.

    The dissociation reaction when injected into neutralized water described by the National Research Council [9] is: H2SiF6 + 4 NaOH → 2HF + Si(OH)4 + 4F- + 4Na+ + heat
    fluosilicic acid caustic soda hydrofluoric acid silicic acid hydrate fluoride sodium

    1. In most all cases of public water supply fluoride treatment, sufficient sodium hydroxide is added to form a basic pH solution, and since the dissociation constant for HF is moderate at 7.2 x10-4 [3] the free fluoride ion predominates and is titrated electronically to 1 ppm, while silicic acid with a small dissociation constant 1 x 10-10 [3] remains as the intact acid. The balanced reaction, with final concentrations used after dilution, may then be written:

    H2SiF6 + 6 NaOH → H2SiO3 + 6F- + 6Na+ + 3H2O + heat

    (0.6 ppm) (1.0 ppm) (0.9 ppm)

    Thus for every say 30 tons of ‘fluoridation’ chemicals employed, about 50 tons each of silicic acid, fluoride ion, and sodium ion are injected into the public water supply. Natural calcium fluoride addition into water, at one time a suggested source for water fluoridation by the CDC, does not require neutralization with sodium hydroxide.

    1. The chemistry entirely changes abruptly after ingestion, as fluoridation materials arrive in the acidic stomach. Fluoride plus silicic acid in part re-form silicofluorides, and also unfortunately fluoride plus hydrogen ions (H+), from gastric strong hydrochloric acid HCl, form hydrofluoric acid HF. Although F- at 1 ppm in neutral water forms HF at approximately 10 ppb = 0.01 ppm, in the stomach the concentration of HF corrosive is far higher. Theoretical mathematical calculations agree precisely with direct experimental measurements. The HF concentration that would occur in the acidic stomach at pH 3, computed from [HF] = [H+][F-]/Ka = (1 x 10-3 M H+)(0.001 ppm/19 grams/mole F-)/(7.2 x 10-4) = 3 x 10-5 M or 0.6 ppm HF. Measurements made with an electronic readout ion specific fluoride electrode (La Motte Industries, MD), that cannot detect complexed fluorides, only the free fluoride ion, have been submitted to the U.S. FDA and for publication. The data indicate that the concentration of free fluoride ion, in a solution of 1 ppm free fluoride in pure water measured at pH 7, reads, after the solution is adjusted to pH
      3, only 0.5 ppm. Thus, the HF concentration that forms from the free fluoride ion is indeed 1.0 – 0.5 = 0.5 ppm HF while residing at a pH present in the stomach and the duodenum until pancreatic bicarbonate re-neutralizes gastric chyme. The importance of this is that the uncharged electrically neutral HF molecule is assimilated through the gastric cell membrane, in the absence of antidote calcium, 1,000 times more efficiently than is the free fluoride ion [10]. Assimilation of the free fluoride ion in the lower intestine is only significant because of the long length of the GI tract.
  • Synonyms for hydrofluoric acid HF are fluohydric acid and hydrogen fluoride. HF is a catalyst in the petroleum and aluminum industries, and is used to separate isotopes of uranium and in dye chemistry. Concentrated HF cannot be stored in glass because HF etches glass and forms frosted glass for light bulbs, carves computer chips, makes ceramics porous, and dissolves concrete, brick and various metals. Unknown to many biochemists however is that HF is a weak acid, since it does not dissociate well in pure water. Its destructive power is not in its acidity, but rather lies in the fact that the uncharged molecule is extremely tiny and able to penetrate solid structures with great ease. In the intestine where fluoride levels from ingested water can range from 0.21 ppm in blood to 1 ppm in ingested treated water, a fluoride gradient would exist where at pH 6.9 inside cells a calculatable level of HF may be the most likely reason that damaged goblet cells that function to assimilate dietary iron is an early morphologic alteration in humans consuming fluoride water. Dr. Susheela, world expert on fluoride-induced pathology and executive director of the Fluorosis Research and Rural Development Foundation, India, found detectable iron deficiency anemia to correlate with such cellular damage within 1 year of consuming fluoridated water [11].

  • It is evident that chemical manufacturers have perceived that HF could have an oral use in dentistry, because the U.S. FDA passed an explicit notice that any proposed anti-caries agent containing HF must submit to the FDA a new drug application. The Food Drug & Cosmetic Act requires that any substance used as an anti-caries treatment that contains HF must require a NDA. The Code of Federal Regulations specifically prohibits the marketing, interstate transport, or ingestion of any anti-caries agent that contains HF without a NDA [21 CFR31O.545(a)(2) and (b).]

  • The CDC does not seem to notice that the FD&CA is violated with any industrial fluoride compound added into water to treat caries. This is not simply because all fluosilicic acid preparations contain appreciable HF to 10 grams per liter from the equilibrium decomposition H2SiF6 → SiF4 + 2HF, but also because all synthetic fluorides form HF in the stomach anyway. These facts are sufficient grounds alone to abolish ‘water fluoridation’ in the United States. Indeed the one controlled human clinical trial type of data set that exists is that reviewed in the NRC report [9] which proved that 1% of all people on average have gastric discomfort immediately after swallowing water containing only 1 ppm fluoride from a synthetic source (i.e. sodium fluoride NaF). This is also the mechanism by

  • which severe GI distress is an initial symptom of synthetic fluoride overfeeds; here the HF irritation of the stomach is painful and was a chief presenting symptom, along with severe chest pain, prompting life flights to a hospital in the Hooper Bay overfeed [6].

    1. Obviously from the above information, the pathologic and toxicologic behavior of a given concentration of fluoride ion is determined by prevailing conditions, such as water hardness. Soft water States in the U.S., deficient in divalent cations, have higher chemical activity or chemical potential of any added fluoride ion due to greater Brownian motion of the ion in solution. The ratio of calcium ion molarity (around 0.12 mM) to added fluoride molarity (0.05 mM) in treated soft water States, particularly in cities of the Pacific Northwest, is a low unsafe 2 to
      1 or lower ratio. In hard water States the ratio is typically about 20 to one, but insufficient to prevent blood levels from reaching 0.21 ppm, the published average for consumers in cities with water fluoride regulated to 1 ppm (NRC p. 70) [9]. Hard water States are thus more protected from fluoride ion than soft water states in the U.S., since assimilation of fluoride is more marked in the latter. The mid-range for calcium ion in U.S. waters is 50 ppm.
  • Much of my research as an NIH investigator centered on the structural/functional properties of cell surface membranes, and the role of calcium in the maintenance of normal membrane properties, one being defense from extracellular toxic materials [12]. The overall biologic effect of fluoride ion in living organisms is determined by the calcium content of the water and also dietary factors that affect assimilation from the gastrointestinal tract. Fluoride tends to remain in a solution containing calcium ion, even at levels below that required for binding calcium as a precipitate. The higher the calcium concentration of a region, the less fluoride is able to diffuse away from it. This electrical attractive force is also responsible for the fact that fluoride, even at levels far below the known solubility constant Ksp for forming calcium fluoride, is trapped into bone, with an ion exchange mechanism due to simple substitution of fluoride for hydroxide during random collisions.

  • In contrast, fluoride accompanied in solution with Group I metal cations, such as sodium or potassium, exhibit little decline in activity over a broad range of cation concentration, because these ions are only monovalent in charge. A 1 ppm fluoride solution in pure water has only a slight activity decline as a function of added potassium ion, where electrode activity is not significantly decreased until 200 mM, a concentration at which fluoride activity would be already reduced a massive 50% by calcium ion alone [7]. Calcium and magnesium together, found in natural U.S. waters at widely varying concentrations, decreases fluoride mobility even more efficiently.

  • The actual Biologic and pathologic importance of the chemical differences between synthetic industrial fluosilicic acid (and sodium fluoride) vs. calcium fluoride are amply demonstrated: the measured dose at which lethal fluoride poisoning occurs in 50% of a tested animal group, the LD50, for calcium fluoride is a safe 3,750 mg/kg single dose, whereas lethality for sodium fluoride or fluosilicic acid, as expected, compares to that for arsenic at 125 mg/kg single dose [4].

  • Toxicity during continuous chronic consumption at sub-acute levels also differs between synthetic industrial fluorides versus natural calcium fluoride. It is well publicized [13] that horses were killed in Pagosa Springs, Colorado after only 9 years drinking artificial silicofluoridated SOFT water, deficient in calcium and magnesium from nearby snowmelt. These animals drink their body weight in water every few days and all suffered severe skin reactions, crumbled hooves and browned, pitted, cracked, destroyed teeth, muscle weakness, and were eventually killed by skeletal fluorosis with severe associated tumors. A finite percentage of horses have severe allergy to synthetic fluorides.

  • Understand, if natural calcium fluoride had been the agent employed, the above lethal reaction could not have happened because the natural mineral is solubility-limited in water to only 8-13 ppm fluoride depending on water temperature. Levels of natural fluoride cannot exceed this amount. Such high water fluoride levels of approximately
    10 ppm from natural sources exist in areas in India and Turkey. Natural fluorides are always accompanied with

  • other calcium and magnesium salts in addition to calcium fluorides. This hardness prevents acute lethality, and instead these people, with lifelong drinking, exhibit bone deformities. Prolonged continuous consumption of synthetic industrial fluorides lacking calcium at such levels in water can cause heart muscle pathology and other toxic sequelae [2].

    1. Artificial fluoride, but not natural calcium fluoride, during water district overfeeds have severely poisoned and killed Americans in the U.S. In Hooper Bay, Alaska 302 people were life-flighted to a hospital after being poisoned, with one fatality by heart attack, due to fluoride assimilation into blood sufficient to decrease calcium ion concentration to block heart function [6]. Although the water fluoridation system functioned for a time at 1 ppm fluoride, metal plumbing valves and parts are no match for long-term continuous exposure to the corrosive HF molecule in un-buffered water. Natural calcium fluoride is unable to corrode metals as do artificial fluorides due to hydrolysis in neutral soft water to form HF. The net ionic reaction in the absence of calcium in soft water is F- + H2O → HF + OH-.
  • Fluoride ion from artificial fluorides are NOT biologically or physico-chemically the same as fluoride ion from natural calcium fluoride, at otherwise identical concentrations of the free fluoride ion. Inexperienced or amateur chemists often believe and proclaim that there is no difference between ‘fluoride ion from calcium fluoride vs. fluoride ion from fluosilicic acid’ because the ion is indeed identical in structure in both compounds, which has misled the CDC to claim the actions of fluoride from both compounds are the same on their current public fluoridation website, providing a false defense to continue artificial fluoridation with synthetic industrial fluorides. As stated earlier, salmon narcotized in 0.3 ppm free fluoride ion in fresh water are completely unaffected by 1 ppm free fluoride ion in the calcium-rich ocean. It is the environment in which fluoride resides that determines whether the intrinsic toxicity of the fluoride ion is expressed or not and determines that all synthetic fluorides are recognized poisons, while calcium fluoride is of low intrinsic acute toxicity.

  • The National Research Council review [9] clearly proved that 1 ppm fluoride in water on average accumulates to about 4,500 mg/kg fluoride in bone lifetime (p. 94 shows 2 year uptake), and far higher levels are expected for higher water-volume-consuming diabetics, reaching levels associated with severe bone pain requiring hospitalization (p. 35, 179) and of course with weakened bone that resist healing after fracture. Nature recently published that the U.S. currently has a well-recognized epidemic of hip fractures in the elderly. Synthetic industrial fluorides, used in over 9,000 U.S. water systems [15] to fluoridate the bloodstream of 140 million Americans permanently over lifetime consumption, are involved since fluoride accumulates and resides in bone permanently. Bone weakening is significantly detectable at levels above 3-4,000 mg/kg [9] and progresses with increasing accumulation. Accumulation below 3,000 also perturbs bone abnormally, but subtly enough to not be necessarily detected experimentally.

  • At ‘low’ 1 ppm fluoride in the absence of any accidental overfeed, the 0.03 mg/kg body weight fluoride ingested daily [9] would mathematically lead after 60 years, with half known to remain in bone, to 4,000 mg/kg permanently stored in the bone as a non-mobilizable fraction. As above, measurements of deceased bone from such regions contain fluoride in this calculated range. ‘Low’ is a very loose but nevertheless common term in toxicology. It must be made clear that even at 1 ppm, there are 30 million trillion fluoride ions in every liter of water, which contains 30 trillion trillion molecules of water (at 55.5 molar). Bone cells respond early to the perturbation from 1 ppm in drinking water by undergoing cell division [9], since a critical function of bone is to provide ionized calcium into the blood to maintain a normal heart beat [7]. Calcium ion is the exclusive agent that couples mechanical contraction of the heart with electrical excitation of the cell membrane during the plateau phase of the cardiac action potential.

  • Forcing any alteration of the chemistry of natural waters of the United States is outside the mission and scope of the United States Centers for Disease Control and in fact is in violation of the Federal Water Pollution Control

  • Act, section 101a, which explicitly mandates the maintenance and protection of the natural chemistry of all U.S. waterways. Fluosilicic acid, H2SiF6, is not present in, and is not a source for any substance present in, any natural water supply and has nothing to do with natural water chemistry–yet its use is widespread in the U.S. U.S. Food and Drug Administration spokesmen have correctly stated in writing that fluorides added into public drinking water constitutes an uncontrolled use of an unapproved drug [1]. Fluoride is not added to sterilize water, but rather to treat or prevent caries, whether a consumer has caries or not, and whether a consumer will ever develop caries or not.

    1. A further complication occurs in aluminum-treated cities, where 0.05 ppm residual aluminum ion typically occurs in the water. Substantial aluminum fluoride AlF3 forms in acidic conditions in the stomach which enhances assimilation of aluminum. Uncharged AlF3, like uncharged HF, is assimilated more readily than ionic aluminum, and HF and AlF3 are also expected to assimilate from a foot long section of the duodenum before acid pH is re- neutralized from pancreatic bicarbonate secretions.
  • The studies of Varner and coworkers, published in Brain Research and in Fluoride [16], summarized at www.fluoridealert.org, prove that the presence of aluminum ion and fluoride ion together in water, given chronically to experimental animals, leads to substantial accumulation of aluminum into brain and symptoms similar to human Alzheimer’s disease. Consistent with the higher rate of assimilation for the complex, separately added aluminum ion without added fluoride ion at the same levels were not rapidly effective. Although aluminum lowers the amount of fluoride ion uptake (i.e. some fluoride that would form HF instead binds to aluminum), nevertheless aluminum is assimilated better because of the fluoride.

  • The CDC Oral Health Division, who are advocates for silicofluoridation, challenged the relevance of the above data. In a written response, CDC stated that fluoride and aluminum levels used in city water supplies are lower than those required to induce pathology [17]. It must be emphasized however that chemists reported in the CDC study that aluminum fluoride molecules preferentially do form at pH 5 for ion concentrations currently employed to fluoridate aluminum-treated public water supplies. The biological significance of this startling admission was apparently not understood by the study authors. Their idea defends the CDC claim that artificial fluorides biologically are ‘no different’ than natural calcium fluoride, but this claim is based only on chemical properties in neutral or alkaline water. No animal testing of any kind prompted these statements. Understand that the acidity of stomach contents at pH 3-4 causes (by admission of Jackson, et.al. [17]) formation of stoichometric levels of aluminum fluoride compounds that are not present in the treated water. After submitting this information to OHD CDC officials, there was no further reply. Neither has CDC commented on the fact that ingested fluoride quantitatively forms HF at stomach pH.

  • The sophisticated and systematic arguments, by vested interests at the Oral Health Division, attempt to reduce significant problems to be ‘insignificant’. Continued claims that fluoride ion in hard water is the same as fluoride in soft water, and that fluoride plus aluminum behaves no differently than in the absence of aluminum because the ions remain dissociated in city water while at pH 7) is unethical misuse of chemistry. The intended implication is that the water data ‘proves’ biological safety after ingestion of synthetic fluoride. Sadly, after assimilation, compartmentalization of fluoride in tissue and cellular regions are well known. After assimilation in the acidic stomach, the free fluoride ion in the alkaline buffered bloodstream incorporates into calcium-rich bone and forms irreversible insoluble precipitates at extracellular fluid fluoride concentrations far below those causing precipitation of calcium fluoride from solution. Fluoride accumulates during lifelong consumption in a pathologic manner that is not saturable and not reversible (p. 94 in [9]). This alone proves to a biochemist beyond doubt that fluoride is not a mineral nutrient. All physiologic required mineral ions act in a saturable and fully reversible manner as a function of concentration present. Extracellular fluid is alkaline at pH 7.4, and since calcium fluoride is only soluble at acidic pH, fluoride is a permanent bone perturbant.

  • Ingested calcium, not ingested fluoride, can build strong teeth. 1) The statistical analysis of extensive data sets by Ziegelbecker as reviewed in Connett [18] eliminated the accidental tendency to ‘cherry pick’ data in favor of a particular bias and confirms that fluoride in drinking water has nothing to do with incidence of tooth decay. 2) Consistent with these observations, the original theory that water fluoride correlated with teeth health in Hereford, Texas, the storied ‘town without a tooth ache’, failed to include the fact that high levels of calcium and magnesium totaling 203 ppm accompany the fluoride [19]. 3) Although consumption of water with 1 ppm fluoride causes 0.21 ppm average levels in blood (which can harm teeth by commonly forming abnormal fluoridated hydroxyapetite permanent teeth enamel fluorosis, as well as other adverse pathology) [18], the U.S. CDC has published that systemic fluoride from the bloodstream after consumption from water does not reduce dental caries. 4) CDC presently argues then that fluoride must benefit teeth through a surface, direct topical mechanism. However, biochemical measurements definitively confirm the fact that ingested fluoride likewise cannot topically affect formed teeth structure– since ingested fluoride from 1 ppm water reaches an average of only 0.02 ppm in saliva [9], a concentration that is useless in affecting teeth topically. Even at extremely high fluoride levels of 1,500 in pastes or 10-12,000 in gels and varnishes, fluoride is unable to penetrate into crystalline, rock-hard normal teeth enamel. The phenomenon known as ‘remineralization’ appears to be the simple formation of calcium fluoride globules on tooth surfaces [8], which are readily soluble in foods/beverages having slight acidity. 5) Finally, research animal studies, where confounding variables are fully controlled, proved that 1 ppm fluoride water does not decrease incidence of spontaneous dental decay in mammals [see 1a for review of those data].

  • The reliance, by those who promote the ingestion of diluted industrial fluorides, on data collected from innocent citizens in the city of Newburgh, N.Y. is particularly appalling. At a time of American jubilance for the U.S. military in finishing WWII, this entire city public water supply was treated with industrial synthetic sodium fluoride without obtaining permission from consumers for human experimentation. The twisted rationale for these experiments has been amply described recently [20]. In spite of many variables being un-controlled because the subjects were not volunteers who regulated their diet, etc., expert statisticians were able to demonstrate later that delayed teeth eruption occurred in children compared to the control city of Kingston and that exuberant officials falsely interpreted this as ‘prevention’ of caries. Other adverse biologic sequelae, summarized by several reviewers [18], were downplayed as ‘minimal’. Experiments with human volunteers who agree to regulate diet and other variables, to study long term safety of ingested synthetic fluorides as required by the Food Drug & Cosmetic Act for any substance to be ingested to treat humans in the U.S., have never been published.

  • Fluosilicic acid [registry number CASRN 16961-83-4] is produced as a 23% solution from phosphate fertilizer scrubbers labeled as either technical (impure, suitable for industrial use) or CP grade (for general uses other than ingestion) [14, 15]. There is no such thing as a “pharmaceutical” U.S.P. grade of this industrial chemical, chiefly used historically as an insecticide and now in industry. A pharmaceutical grade cannot exist because fluosilicic acid is not FDA approved for oral ingestion, and a USP grade is a chemical intended to be ingested that is manufactured under current manufacturing practices which meet the requirements of the U.S. Pharmacopeia. Fluosilicic acid is instead specifically listed (on p. 85) in the EPA Toxic Substances Control Act registry for its traditional use as a pesticide/insecticide. Note however that all allowed use of this hazardous material as an insecticide has been discontinued. Its industrial uses are broad, in the electrolytic refining of lead, the removal of lime from hides during
    tanning, removal of molds, and as preservative for timber [3,4]. The dissociation constant Ka has not been

  • – + -1.2 2 –

    published, but a 1% solution (0.069 M) has pH 1.2 [4], so Ka = [H+][HSiF6 ]/{[H2SiF6] – [H ]} = (10

    ) /(0.069-10

    1.2) = 0.7, indeed a relatively strong acid that would initially fully ionize, at any water or bodily pH, to SiF6- + H+.

    1. Fluoride treatment of the bloodstream and every organ from heart to brain, in an attempt to decrease teeth caries, is one of the greatest public promotional mistakes of the Century. Indeed, cities who halt expensive water fluoridation operations do not report increased incidence of caries [18]. On the contrary, all cities that inject synthetic industrial fluorides into public water supplies experience increased incidence of tooth fluorosis without

    exception as reported even in pro fluoridation literature. The fact that pathologic alterations caused by chronic low level continuous consumption of industrial fluoride from drinking water (i.e. bone cell division with altered calcium homeostasis, and intestinal inhibition of iron assimilation) are not readily sensed or felt by the average consumer does not defend the practice. Instead, these findings demonstrate that deceptive practices are involved when a single Federal office, the Oral Health Division within the Centers for Disease Control and Prevention, continues to recommend the widespread ingestion of diluted toxic fluosilicic acid by citizens in the United States.

    1. The intentional injection into public water supplies of diluted synthetic industrial fluorides, in particular fluosilicic acid which is not FDA approved for ingestion, at levels that avoid acute toxic symptoms is in strict violation of:

    the WPCA (fluosilicic acid and its dissociation products are not part of the normal chemistry of regular fresh drinking water);

    the SDWA (fluosilicic acid is added with the intent to treat dental caries in humans, not to sanitize the water); and

    the FD&CA (no controlled human clinical trials data for either safety or effectiveness have been submitted to the FDA; HF is not permitted by the FDA in any substance intended for
    human ingestion; fluosilicic acid is not an approved over the counter ingestible and is not an approved prescription drug, mineral nutrient or supplement).

    All citizens, government and private agencies must honor these Federal Statutes for the protection of citizens of our country.

    1. Violations of Federal water and drug law routinely escape regulation through distracting claims from parties with vested interests. For example, fluoride from hazardous waste is perceived by the OHD at CDC to become a useful ‘water additive’ or ‘supplement’ upon dilution, argued to not be the contaminant EPA lists it to be. Many at the FDA argue that the EPA, not the FDA, should regulate the injections as contaminants, rather than supplements or drugs, being non-FDA-approved for ingestion (see petition for reconsideration of FDA2007-P-0346, 2010). Some at the EPA argue it is not a spilled contaminant and thus fluoride is an intentional additive, and EPA defers to the private National Sanitation Foundation for ‘certification’. NSF lists fluoride as both a contaminant and as an additive and defers questions of safety to the OHD, even though sodium fluoride (Luride) is intended to treat human caries through ingestion and is subject to regulations by the FDA through prescriptions with dosage instructions required by law. Congress ruled fluoride is not a drug, in agreement with the fact that fluorides are not FDA approved for human ingestion, but nevertheless the ingestion of this substance, which is not a food with calories or a mineral nutrient, is intended to treat human tissue, which is the legal Congressional definition of a drug, albeit an unapproved one.
  • Waters with contaminants such as fluoride or arsenic, either naturally or from accidental spillage, are subject to EPA regulation (water is not considered potable with fluoride ion alone at 4 ppm and warnings must be issued for drinking water that contains fluoride levels above 2 ppm), but EPA does not regulate, monitor or supervise in any way substances intentionally added into water to treat disease, particularly when requested or recommended by Federal officials. The OHD at CDC requests all U.S. waters to be fluoridated at 1 ppm. The U.S. Health and Human Services recently provisionally requested added fluoride not exceed 0.7 ppm, while attempting to analyze the National Research Council conclusion that current allowances for fluoride in drinking water are not protective of human health [9]. This was made because of the CDC admission that, as of 2004, 41% of U.S. children aged 12-
    15 have permanent abnormal tooth fluorosis (that is not a cosmetic effect these consumers requested). The Associated Press reported that toothpaste manufacturers have suggested blame for this endemic on fluoride consumption from water, since toothpaste fluoride is not designed to be swallowed. Water fluoride promoters blame toothpaste manufacturers for the endemic, because water fluoride injections began before fluoride toothpaste

  • was ever marketed. The NRC [9, p. 60] truthfully describes the shared blame on both, by revealing studies finding that about 45% of the fluoride in blood in a 1 ppm treated city comes from water consumption and about 20% comes from assimilation from toothpaste use in the oral cavity in 12 year olds. At the present time there is no official Federal agency that has ever supervised, tested or regulated industrial fluoride materials and their addition into public water supplies, in spite of the strong requests made by Federal officials at the OHD of the CDC that cities continue the practice [18]. The FDA ban petition, accepted for review by the FDA in 2007, remains pending as of the date of writing this affidavit.

    1. References
      [1] Lovering, Edna, Consumer Inquiries, U.S. Food and Drug Administration, letter dated 1963. [1a] Yiamouyiannis, J., Fluoride, the Aging Factor, Health Action Press, 1986.
      [2] Agency for Toxic Substances and Disease Registry, Fluorine, Hydrogen Fluoride, and Fluorides U.S. CDC, 2003.
      [2a] Evidence for Fluoride Effects on Salmon Passage at the John Jay dam, Columbia River, 1982-1986 North American Journal of Fisheries Management, vol. 9, 1989, p. 154.
      [3] CRC Press Handbook of Physics and Chemistry, Chemical Rubber Co., Taylor & Francis, London, U.K.
      [4] The Merck Index, an Encyclopedia of Chemicals and Drugs, Ninth Edition, Merck and Co., Inc., Rahway,N.J., 1976.
      [5] Teitz, N., Clinical Chemistry, W.B. Saunders, Philadelphia, PA, 1976.
      [6] Gessner, B. Beller, M., Middaugh, J, and Whitford, G., Acute Fluoride Poisoning from a Public Water System, New England Journal of Medicine, 330:95.
      [7] Sauerheber, R., Chemical Analysis of Poisoning from a Fluoridated Water Supply, submitted for publication, Journal of Environmental Health.
      [8] Sauerheber, R., FDA ban petition, accepted for review, U.S. Food and Drug Administration (2007) FDA2007-P-0346, formerly 2007P-0400/CP1.
      [9] National Research Council, Fluoride in Drinking Water, A Scientific Reveiw of EPA’s Standards, Washington, D.C., 2006.
      [10] Whitford, G.M., Sampaio, F.C., Pinto, C.S., Maria, A.G., Cardoso, V.. Buzalaf, M.,
      Pharmacokinetics of ingested fluoride: Lack of effect of chemical compound, Archives of Oral Biology, 53 (2008) 1037–1041)
      [11] Susheela, A., Kumar, A., Bhaltnagar, M., et.al., Prevalence of Endemic Fluorosis with
      Gastrointestinal Manifestations in People Living in Some North Indian Villages, Fluoride 26, 1993: 97-104.
      [12] Gordon, L. and Sauerheber, R., Calcium and Membrane Stability, Calcium in Biological Systems, Vol. II, Anghileri, L., Tuffet-Anghileri, A. eds., CRC Press, Inc., Boca Raton FL 1982:3–16.
      [13] Justus, C. and Krook, L., Allergy in Horses from Artificially Fluoridated Water, Fluoride 39, 2006, p. 89-94.
      [14] Haneke, K and Carson, B., Sodium Hexafluorosilicate and Fluorosilicic Acid, Review of
      Toxciological Literature, 2001, prepared for the National Institute of Environmental Health Sciences, 2001.
      [15] Masten, S., National Institute of Environmental Health Sciences, “Sodium Hexafluorosilicate
      (CASRN 16893-85-9) Review of Toxicological Literature”, Research Triangle Park, North Carolina, 2001, available at www.fluoridealert.org).
      [16] Varner, J., Jensen, K., Horvath, W., Isaacson, R., Chronic Administration of Aluminum fluoride and
      Sodium fluoride to Rats in Drinking Water: Alteration in Neuronal and Cerebrovascular Integrity, Brain Research 784, 1988.
      [17] Jackson, P., Harvey, P. and Young, W., Chemistry and Bioavailability Aspects of Fluoride in
      Drinking Water, WRc-NSF Ltd, 2002; http://www.bfsweb.org/ducoments/wcreport.pdf.
      [18] Connett, P., Micklem, H. and Beck, J., The Case Against Fluoride, Chelsea Green Publishing, White River Junction, VT, 2010.
      [19] Ericksson, A. W., Field Notes Crop Reporting Service, Minneapolis, MN, 1945. [20] Bryson, C., The Fluoride Deception, Seven Stories Press, N.Y., 2004.

    *Synonyms for sodium fluorosilicate include: Destruxol, Ens-em weevil bait, ENT 1501, Ortho earwig bait, Ortho weevil bait, Prodan Pesticide, Safsan, Salufur, UN2674. Fluosilicic acid is also referred to as: FKS, UN1778, hexafluorosilicic acid, silicofluoric acid, and others.

    Acknowledgments.

    I dedicate this affidavit to my father, the great American patriot and survivor of the attack on Pearl Harbor, Hawaii,
    who later told me to “stay in school.” This is the 50 year anniversary of the University of California, San Diego. .

    #8.

    December 17, 2011

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This information is sent in support of the 2007 ban petition 2007FDA-P-0346, formerly 2007P-0400/CP1, and its Petition for Reconsideration, submitted 2010. There is now no doubt that synthetic fluoride without calcium, from ingested industrial compounds sodium fluoride or fluosilicic acid, crosses the blood-brain barrier. In mammals, ingested fluoride, from blood where it does not belong, enters the acidic environment of cells at pH 6.9 to form small amounts of hydrofluoric acid HF [2] (H+ + F- → HF) and in brain degrades intracellular structures and decreases protein synthesis [3, 4]. In humans, blood fluoride levels correlate with lowered intelligence and IQ [5].

    In a very dramatic recent published study by Reddy [4] (see enclosed copy), synthetic fluoridated drinking water was provided to rodent mammals that produced fluoride blood levels similar to that in humans (0.21 ppm blood fluoride) when drinking 1 ppm fluoridated water [1]. A higher water concentration is required for animals that resist fluoride assimilation compared to human [6]. Mullenix found blood levels of 0.15 ppm fluoride during consumption of 100 ppm fluoride in water in these animals [6]. The Reddy study used 20 ppm water fluoride. After months of consumption, brain weights diminished 16%, and multiple types of brain and nerve cell lesions were observed with transmission electron microscopy at 3,000X magnification, not previously able to be seen by light microscopy in other fluoride brain-damaging studies. The cellular degeneration was attributed directly to fluoride ion that incorporated into tissue to 0.8 ppm [4], a level similar to that measured biochemically in brain tissue of humans in U.S. fluoridated cities [7].

    Therefore, we now know that the extremely tiny fluoride ion is not simply trapped in regions of the brain that are outside brain cells, such as does occur when fluoride binds to hydroxyapetite structures in the pineal gland [5]. The ion ALSO physically crosses the blood-brain barrier, enters inside brain cells to deform intracellular structures, and inhibits metabolism in these sensitive and important cells. In those consuming fluoride lifetime, fluoride entry into brain cells would occur from infancy, when the blood-brain barrier is not developed, through adulthood, accumulating chronic bits of damage lifetime. It must be noted that in the Varner study, rodents were given water containing only 1 ppm fluoride, which after one year also produced microscopic cellular brain damage [3]. In the Reddy study, fluoride caused myelin sheath degeneration and axon deterioration in the spinal cord as well.

    It is fortunate that the human brain is very large and with such capacity can withstand much chronic degeneration for very long time periods. For example, the chronic brain degeneration and volume reduction associated with alcoholism are well-documented. Further, calcium in water and foods can minimize assimilation of fluoride for many, depending on diet. Most unfortunate however is that subtle effects on brain function such as memory are not necessarily recognized by those affected. No internal control would be present to compare to mental capacity that would have existed if fluoride had never been consumed. Thus, mental adversity can be unnoticed by the consumer of the toxin, and effects that might be perceived by observers may take many decades to be significant, where fluoride logically but wrongly escapes as suspected cause. Much careful epidemiologic published work indicates there are fewer brilliant high IQ individuals and more with lower IQ in cities with higher fluoride in water supplies, as reported in numerous International studies [1, 5].

    It must also be emphasized that damaged brain tissue cannot regenerate. Since fluoride ion crosses the blood- brain barrier and causes chronic brain cell damage that may not be reparable, it is imperative that public utilities again provide regular water to its citizens. Water with added chemicals used to treat people must be avoided, no matter how well-intentioned State or Federal officials may be who request water be treated. In the case of fluoride, the ion does not belong in, and has no function for, any living cell. Dosage cannot be regulated in public water, where the infirmed have higher blood fluoride levels at any given water concentration present, including kidney patients with impaired fluoride elimination, and those with diabetes where water consumption rate is high [5].

    It is illegal for Federal officials to require the addition of alcohol, vitamins, foods, supplements, minerals, drugs or any ingredient into water supplies in the U.S. other than specifically to sanitize the water. Requests by Federal Centers for Disease Control officials, that the State of California ‘fluoridate’ water supplies, is in contrast with Federal law. No State has legal authority to require industrial fluoride treatment of public water, since the U.S. Safe Drinking Water Act covers all public water supplies in the Nation and prohibits any less-restrictive State requirements. And yet, many states have legislation, never open to public vote, with a written requirement for fluoride injections into public water supplies. San Diego, California and San Jose, California city officials this year succumbed to such sham legislation, in opposition to Federal law, and agreed (by emphatic request from Public Health officials guided by the Oral Health Division office of the U.S. CDC) to fluoridate its own citizens, who voted against such treatment.

    Fluosilicic acid H2SiF6 is a chemical complex of silicon fluoride SiF4 and hydrofluoric acid HF that only forms in water. The substance itself cannot be purified, since at low water content it re-dissociates to hydrofluoric acid, where H2SiF6 → SiF4 + 2HF. The Code of Federal Regulations of the Food Drug & Cosmetic Act specifically prohibits the marketing, interstate transport, or ingestion of any anti-caries agent that contains hydrofluoric acid HF without a new drug application NDA [21 CFR31O.545(a)(2) and (b)]. Incredibly, half of all synthetic fluoride in the acidic stomach forms HF, which is fully assimilated [2] (see sworn affidavit sent to FDA November, 2011).

    The treatment of citizens with industrial synthetic fluoride with high intrinsic toxicity (125 mg/kg acute lethal single oral dose, or 5 ppm acute lethal in blood plasma [8]) is a violation of human rights to access clean safe drinking water–and violates the U.S. Water Pollution Control Act mission, to maintain the normal natural chemistry of the Nation’s water supplies, as conceived originally by the honorable former President John F. Kennedy (WPCA, Section 101a). As a known brain degenerative agent, it is imperative, for the success of our country, that the citizens of these United States be protected from further harm of fluoride incorporation. The false deduction from a mere anecdotal correlation, that led to claims that fluoride is a ‘health achievement’, must be overcome. It is necessary for the FDA to join with us citizens to ban the treatment of people with intentional ingestion of industrial synthetic fluoride.

    References
    1. National Research Council, Fluoride in Drinking Water, A Review of EPA’s Standards, Washington, D.C., 2006.
    2. Sauerheber, R. Chemical Analysis of Poisoning from a Fluoridated Water Supply, submitted to Journal of Environmental Health.
    3. Varner,J., Jensen, K., Horvath, W., Isaacson, R., Chronic Administration of Aluminum Fluoride or Sodium
    Fluoride to Rats in Drinking Water: Alterations in Neuronal and Cerebrovascular Integrity, Brain Research 784, no 1-2 pps. 284-28, 1998.
    4. Reddy, P., Reddy, K., Kumar, K., Neurodegenerative Changes in Different Regions of Brain, Spinal Cord and Sciatic Nerve of Rats Treated with Sodium Fluoride, Journal of Medical and Allied Sciences 1(1),
    pp. 30-35, 2011. http://static.infowars.com/2011/12/i/general/2011_study-
    neurodegenerative_changes_from_fluoride_of_brain_spinal_cord_and_sciatic_nerve.pdf (enclosed).
    5. Connett, P., Beck, and Micklem, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, Vermont, 2010. (Chapter 15, Fluoride and the Brain, enclosed)
    6. Mullenix, P., Denbesten, P., Shunior, A., Kernan, W., Neurotoxicity of Sodium Fluoride in Rats, Neurotoxicology and Teratology 17(2) pp. 169-177, 1995.
    7. Yiamouyiannis, J., Fluoride the Aging Factor, Health Action Press, 1985 (see original petition).
    8. The Merck Index, An Encyclopedia of Chemicals, Drugs, and Biologicals, Twelfth Edition, Merck and
    Co., Inc., Whitehouse Station, New Jersey, 1996. Attached news releases on Reddy, et.al. study enclosed.

    #9.

    December 22, 2011

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewer,

    The assimilation from the GI tract into the blood, of both hydrofluoric acid HF and silicofluorides, should no longer be argued by anyone as a useful method to fight bacterial tooth decay. HF is 1,000 times more permeable to cell membranes than the fluoride ion from which it forms in the acidic stomach [1]. Silicofluorides may be tolerated in man, but alligators with a high water turnover rate develop silicosis of the liver and premature death when living in silicofluoridated water [2].

    If we examine pictures of victims of tooth fluorosis, caused by blood fluoride after ingesting fluoridated water during infancy, there can be destroyed areas of teeth, and even in more mild cases fluorosis is a permanent abnormality that prevents a healthy normal smile [3].

    [cid:image130.jpg@01D47B9C.4AC11730]

    The U.S. Oral Health Division, CDC finally disputes that systemic fluoride fights teeth decay, but nevertheless still promotes fluoridation of water as a useful method to fight caries [4]. The argument has long been made that the teeth structure that remains in fluorotic victims is more resistant to decay because the hydroxyapatite normal enamel has been converted into an altered form [5]. Furthermore, locations where fluorotic teeth have worn away do not have cavities, because there is no teeth structure there. This bizarre argument was used to rationalize the lack of effect on decay rate in fluoridated Newburgh, where teeth erupted one year late due to systemic fluoride ingestion in the treated city [6]. Decay rates were identical for both cities’ children after teeth grew into the mouth.

    In other words, let’s consider that indeed fluoride in this severely fluorotic victim has done its job in decreasing incidence of tooth decay. The fact that teeth portions are ruined is considered of lesser importance. The fact that decay rates in teeth after growing into the mouth were identical in Newburgh is not considered by OHD.

    It must be emphasized to those who hold those views, that people who desire fewer teeth caries also prefer to retain their teeth and to have a healthy normal smile while cavities are being fought. Since water fluoridation always increases incidence of tooth fluorosis in every city without exception, please fight teeth decay by brushing after eating sugar, or avoiding sugar, and treatment of gums to inhibit Streptococcus mutans which produces acids causing cavities.

    The CDC now argues that fluoride acts topically on teeth to reduce caries. But fluoride in saliva at 0.02 ppm [7] or water at 1 ppm cannot penetrate teeth enamel with significance, nor decrease bacterial growth [9]. This is consistent with the lack of incorporation of fluoride into teeth enamel interiors when treated with 12,000 ppm fluoride, proven

    by detailed electron microscopic examination [10]. Toothpaste contains 1,500 ppm fluoride, a level that does not slow bacterial growth unless the medium were acidic, where sufficient corrosive HF could form.

    Water fluoridation causes assimilation of HF and silicofluorides into blood that reform fluoride ion which crosses the blood brain barrier, degrades brain tissue chronically observed in mammals [8] and decreases mental IQ in humans [5]. Water fluoridation in U.S. cities requested by the U.S. CDC in violation of the U.S. Safe Drinking Water Act is slowly but surely harming millions of Americans.

    References
    [1] Whitford, G.M., Sampaio, F.C., Pinto, C.S., Maria, A.G., Cardoso, V., Buzalaf, M., Pharmacokinetics of ingested fluoride: Lack of effect of chemical compound, Archives of Oral Biology, 53 (2008) 1037–1041)
    [2] Burgstahler, A., Freeman, R., Jacobs, P., Toxic Effects of Silicofluoridated Water on Chinchillas, Alligators and
    Rats Held in Captivity, Fluoride 41(1), 2008 pp. 83-88. [3] www.spotsonmyteeth.com (the Lillie Center).
    [4] U.S. CDC in: MMWR, Morbidity and Mortality Weekly Report, August 17,2001. [5] Newbrun, E., Fluorides and Dental Caries, Thomas Books, Springfield, ILL, 1972
    [6[ Connett, P., Micklem, Beck, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, VT, 2011.
    [7] National Research Council, Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, D.C. 2006.
    [8] Reddy, P., Reddy, K., Kumar, K., Neurodegenerative Changes in Different Regions of Brain, Spinal Cord and
    Sciatic Nerve of Rats Treated with Sodium Fluoride, Journal of Medical and Allied Sciences 1(1), pp. 30-35,
    2011. http://static.infowars.com/2011/12/i/general/2011_study- neurodegenerative_changes_from_fluoride_of_brain_spinal_cord_and_sciatic_nerve.pdf
    [9] Meiers, P., Fluoride and Dental Caries: Second Thoughts in View of Recent Evidence from Germany, Fluoride 44(1) pp. 1-6, 2011.
    [10]. Department of Pedodontics, Faculty of Dentistry, Hacettepe University, Ankara, Türkiye, S. Ölmez, B. Yuksel, H. Çelik, Scanning Electron Microscope Study of Human Enamel Surfaces Treated with Topical Fluoride Agents, J. Islamic Academy of Sciences 6(2), p. 133, 1993.

    Acute Intrinsic Toxicity of Synthetic Industrial Fluoride

    It is not possible or ethical to conduct direct experiments to determine the precise single oral dose that would be lethal for synthetic fluosilicic acid in humans. However, Material Safety Data Sheets (sent to the FDA, Dec. 21,
    2011) for fluosilicic acid from Brenntag Chemicals with mammalian data sheds light on this issue. Brenntag
    supplies the massive quantities of this material to the city of San Diego to inject continuously and indefinitely into drinking, agricultural and all public water supplies to treat consumers with the fluoride ion by ingestion. It is now clear that there is no further discrepancy regarding the true intrinsic toxicity of synthetic fluorides lacking calcium used in public water supplies.

    The Merck Index lists the acute oral lethal dose LD50 in mammals at 125 mg/kg for sodium fluoride. Since 45% of sodium fluoride is the fluoride ion, this puts the lethal single oral dose at 56 mg/kg body weight of the fluoride ion itself. The Merck Index lists the LD50 for sodium fluosilicate at 125 mg/kg, which produces 76 mg/kg fluoride ion. The Brenntag fluosilicic acid sheets however list the LD100 in guinea pigs at only 80 mg/kg, which amounts to 63 mg/kg fluoride ion from the Brenntag fluosilicic preparation in a single lethal oral dose. Guinea pigs may be more sensitive than other rodents, but notice this dose exerts a full 100% lethal effect in guinea pigs, not just a 50% LD50 lethality as reported for rats and mice in Merck.

    When the 302 people were poisoned like guinea pigs, with one fatality in Hooper Bay, Alaska during a fluoride overfeed, it was thought by estimate that the water level had reached an accidental high of perhaps 150 ppm (see original petition). This number now may be re-estimated. Lethality may actually occur at lower concentrations than this during accidental overfeeds in fluoridated cities. In fact, humans assimilate ingested fluoride far more efficiently than do rodents. Typically it takes 9 ppm fluoride from sodium fluoride in water to achieve 0.2 ppm fluoride ion in blood for rats and mice. The Reddy, 2011 study used 20 ppm sodium fluoride which contains 9 ppm fluoride ion to approximate the human blood level found in humans in cities treated with 1 ppm fluoridated water (NRC, 2006). Part of this is the fact that humans also have a significant % of blood fluoride that comes from fluoridated toothpaste use, but nevertheless it is widely accepted that rodents are more resistant to fluoride

    assimilation. Roughly it appears that only 100 ppm fluoride in water is the level that may have killed Dominic Smith in Hooper Bay assuming he may have been using fluoridated toothpaste and is the typical 9 fold higher sensitivity than rodents. A 70 kg person who drank a gallon of this within a few hours (as Smith was reported to have done) matches the expected lethal single oral dose in a human if the 63 mg/kg LD100 of guinea pigs were more applicable to human. If the human were 9 times more sensitive than this, then 7 mg/kg would be an expected lethal single LD100 dose. Indeed, 100 ppm is 400 mg in 4 liters, which for a 70 kg person is 5.7 mg/kg. The LD50 would be predicted to be in such a range.

    Another way to estimate the lethal acute oral dose is the known fact that 5 ppm in body fluids causes death in both humans and mammals. There is good agreement on this because this is the fluoride level reached after it has been already assimilated. A 70 kg person with a 47 liter fluid volume would require 233 mg assimilated fluoride to be killed. Since half of ingested fluoride in man is typically assimilated, then 466 mg fluoride would be a single lethal oral dose. 466 mg of fluoride is contained in about 1 gram of sodium fluoride, and one edition of the Merck Index indeed reported a person was killed after ingesting an estimated 1 gram of sodium fluoride. And for a one gallon volume, this amounts to a concentration in water of 117 ppm fluoride, comparable to the above estimate.

    Remember that in Madison, Wisconsin when an overfeed reached 50 ppm, the water operator told the newspaper (I now paraphrase) ‘don’t worry about it, it’s not a dose that would seriously poison anyone because it makes you throw up the water you drink, while we get the leak repaired’ (www.fluoridealert.org). It is now common knowledge that people have been killed from fluoride overfeeds because so many millions of people have been misled by CDC statements that ‘fluoride is a great public health achievement’ and ‘fluoride is safe and natural’. The term fluoride has been publicly sanitized to protect its vested use and this has led water district employees, normally in charge of keeping contaminants out of water, to put a contaminant into water that by reason of use by such individuals has become an illegal non FDA-approved drug. Congress defines a drug as a synthetic chemical substance administered to treat or prevent disease. Congress does not recognize synthetic fluorides as drugs since fluorides are not FDA approved. Fluoride however follows the stated definition of a drug, and thus fluorides are illegal drugs, or are being used as though they are drugs, specifically without FDA approval.

    #10.

    December 23, 2011

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 02587

    This information is to support the fluosilicic acid in water ban petition, FDA2007-P-0346, formerly 2007P-
    0400/CP1, and its Petition for Reconsideration, submitted 2010. This is the tenth letter in a late 2011 series to the FDA.

    Presented is an update on the intrinsic toxicity of synthetic fluoride compounds (acute, moderate, and chronic) that are specifically administered to humans internally for drug-like actions without a prescription. The letter is dedicated to the late American great Nobel Prize scientist Dr. Albert Schatz, who devoted his life to protect human health, discovered the recognized cure for tuberculosis that closed TB sanitariums around the world, and fought to protect the poor and malnourished from the toxic effects of synthetic fluorides taken internally. The letter is divided into two parts, one on the intrinsic toxicity of industrial synthetic fluorides and the second on fluoride-induced infant mortality in subpopulation groups.

    I. Synthetic Industrial Fluoride Taken Internally Increases Infant Mortality in Population Groups

    A North County Times newspaper article correctly states that U.S. infant death rates exceed those in Europe. The U.S. has dropped to 34th in the world. The article identifies Sweden, Japan, Finland, Norway being low, and Iceland having the lowest infant mortality in the world. Not mentioned is the fact that none of these countries inject the diluted toxic hazardous waste fluosilicic acid into public water supplies for its fluoride; and not mentioned is the arduous superior work of Dr Schatz who proved for any typical population group that fluoride ingestion from treated water is responsible for high infant mortality rates.

    We now know that all synthetic fluorides are fully water soluble and form HF in the stomach that freely passes through biological membranes. Ingested fluoride without sufficient antidote dietary calcium enters the fetus from placental circulation and crosses the blood brain barrier. This has always been the case in man and animals, but only recently has the mechanism been unraveled by which the ionic charged fluoride can cross biological membranes. It does not itself cross the membrane freely, but the associated HF (in the stomach at 0.6 ppm, in blood at 0.01 ppb and inside cells at 0.04 ppb) is nearly identical in size to the water molecule and is also uncharged, freely permeable through the lipid bilayer as is water. The membrane acts like a permeable polymer to the ultra small sized water and HF molecules, even though these polar substances do not have a significant lipid partition coefficient. The bilayer presents a barrier to most charged ions. Fluoride ion then re-dissociates from HF after it passes through the membrane. The HF concentration may be computed with the Henderson Hasselbach equation, where pH = pKa + log [F-]/[HF]. So 7.4 = -log (7.2 x 10-4) +log [1.1 x 10-5]/[HF]. Solving, [HF] = 6.1 x 10-10 M = 10 ppt. HF however is essentially freely membrane permeable.

    The U.S. is now very widely fluoridated (in some cities for 60 years now), with an infant mortality worse even than Cuba at 5.1 (World Health Organization latest statistics). U.S. standing in this category has progressively worsened since WWII, along with increasing prevalence of water fluoridation. Evidence this correlation is causative is presented here.

    Dr. Bill Osmunson found infant mortality in the 50 U.S. states parallels the percentage of their water districts that fluoridate. Dr. Packington found that towns in England that fluoridate have 75% higher infant mortality than non- fluoridated towns (http://www.oehha.org/prop65/public_meetings/052909coms/fluoride/IPackington.pdf). Dr. Schatz, originally discovered that infant mortality in Chile increased after fluoridation began, and then declined after President Allende stopped it at the request of Schatz (www.fluoridealert.org). Schatz first presented to the U.S. Congress why many miss the connection of fluoride as cause of increased infant mortality. The reason is that fluoride ingestion harms poor undernourished people far more significantly than those with sufficient healthy food who can withstand the toxic material. When examining a total population group, a high percentage of successful births can easily overshadow the fact that a population’s undernourished can be decimated by fluoride in utero.

    A poor section of Memphis, fluoridated for generations, has infant deaths every 43 hours and a graveyard for 1 year olds (http://tv.nytimes.com/2008/08/22/arts/television/22infa.html. Health professionals do not recognize that toxic artificial fluoride is involved, even though animal studies show it increases stillbirth rates and in humans blood fluoride shortens red cell lifespan. The original textbook that promotes water fluoridation [1] does not discuss infant mortality. Successful births for the Memphis population in total remain a high normal-appearing percentage.

    Since an unborn fetus cannot breathe air and depends entirely on placenta blood for oxygen, it is not surprising then that, as has long been known (Himworth, H.E., Am. J. Phys. 135, 387, 1942), higher rates of spontaneous abortions can occur in pregnant animals given fluoridated water. It is important to consider in such studies whether a balanced diet with plentiful calcium is present since abundant calcium minimizes fluoride assimilation and also is protective in overall calcium metabolism that is affected adversely be fluoride uptake as a permanent resident perturbant in the bony skeleton.

    Although U.S. infant mortality at 6.3 deaths per 1,000 means that 99.37% of births are successful, nevertheless, according to Packington in full agreement with Schatz, the premature born infant with low body weight has been found to be 70% more likely to perish in fluoridated water areas compared to non-fluoride drugged areas. The lifelong fluoride toxicology research scientist expert Dr. Susheela reported that de-fluoridation of otherwise potable water sources routinely leads to decreased infant mortality and reduced incidence of spontaneous abortion in man (see enclosed excerpts of sworn affidavit testimony for court litigation in Pennsylvania of a water supply treated with industrial flouride).

    The U.S. has a reported 6.3 deaths per thousand births, worse even than Cuba at 5.1. Fluoridated Ireland is 4.9, fluoridated Canada 4.8, fluoridated Australia 4.4, somewhat better but are also less fluoridated as a % of the country’s water supplies than is the U.S. Non-fluoridated Japan and Sweden are tied for 2nd best countries in the world at 3.2, behind only non-fluoridated Iceland at 2.9. There may be many causes in addition to pollutants that contribute to this, but as Schatz discovered, a country’s relative population living in poverty (or overpopulation or during war) are most significant. Other levels for example are: Mexico 16.7, Vietnam, 19.5, India 55, Iraq 82, Afghanistan 157 deaths per thousand births. References:
    http://www.nytimes.com/2009/04/07/health/07stat.html (11 in 1960, 29 in 2009 http://tv.nytimes.com/2008/08/22/arts/television/22infa.html_(Memphis dead infant every 43 hours

    II. Intrinsic Toxicity of Fluoride from Synthetic Industrial Fluoride Compounds

    A. NRC vs. OHD/ CDC

    The Oral Health Division of the U.S. CDC requests that synthetic diluted industrial fluoride compounds be taken internally by virtually all residents of the U.S. through mass treatment of the Nation’s water supplies. The National Research Council 2006 Report, officially commissioned by the U.S. Environmental Protection Agency at taxpayer expense, challenges this by stating that current allowed fluoride levels in drinking water are not protective of human health [1]. OHD officials quickly disregarded the NRC findings in part because the NRC report examined cities that were both artificially fluoridated with synthetic industrial fluorides and cities that naturally had fluoride in water (from calcium fluoride) as well. The rationale for the disregard was that OHD supports adding industrial synthetic fluoride only, not natural fluoride, so all the data could be conveniently dismissed in their opinion. This contradicts earlier statements by OHD officials to public news agencies and on the CDC fluoridation website, that fluoridation with synthetic fluosilicic acid is identical to natural calcium fluoride and is thus ‘safe and natural.’ Asking in person a NRC coauthor, Dr. Kathleen Thiessen why CDC officials made this claim, she quickly responded that “they lied about the report” (direct, in-person communication, at Metropolitan Water District headquarters, Los Angeles, CA, August, 2007). The NRC text did not endorse fluoridation of water, but challenged it. The CDC interpreted however the lack of a NRC request to halt fluoridation as an official NRC allowance or endorsement to continue it. Adverse effects reported by the NRC on human health from water fluoride were presumed related to high natural fluoride in all cases within 3 days of the release of the lengthy detailed report, while the CDC explained they only request use of synthetic industrial fluoride in water, without realizing most of the U.S. has fluoride in water because of artificial injection that the NRC analyzed. Sadly, ingrained vested interests and acceptance of false deductions and theories can exert powerful influence.

    B. Toxicity of Fluoridated Drinking Water

    Dr. Paul Connett, Professor Emeritus, New York University visited us in San Diego, CA and kindly presented information on industrial synthetic fluorides in drinking water taken internally used for its drug-like properties. He spoke to the pharmacology class of a former colleague scientist of mine at San Diego State University. That scientist informed me that she lived as a child in fluoridated Evansville, Indiana and presumed that her low teeth caries incidence rate resulted from such treatment with synthetic industrial fluoride. I informed her that the absence of fluoride ion does not cause cavities, but instead allows normal teeth enamel to develop, so she graciously allowed Dr. Connett to speak to update us out West on the latest research as reviewed in a recent text [2].
    A key summary of that talk is that any perceived caries reduction associated with fluoride taken internally is so exceedingly small as to be of no useful importance, especially considering that ingested fluoride crosses the blood brain barrier and is a permanent resident of bone in a consumer lifetime where it accumulates. Paul reviewed 26 studies that show decreased Intelligence Quotient (IQ) in humans as a direct function of extent of internal fluoride exposure from water supplies. Also, fluoride at first exposure can bind to high affinity sites in bone that can cause an increase in bone density, thereby deceiving those who promote fluoride as an aid to bone. The effect however is pathologic, particularly in that incorporated bone fluoride abnormally affects overall calcium homeostasis. This of course at a minimum places the heart at risk of incomplete strength or force of contraction when under extreme stress, known as high workload. Additional binding of fluoride in bone (possibly to binding sites of lower affinity) to 2,000 mg/kg causes detectable loss in bone strength and bone thickening due to bone cell division in an attempt to respond to the fluoride as a perturbant, which renders bone at that point more subject to fracture. There is now a strong known relationship between bone fracture incidence and tooth fluorosis, both caused by ingested fluoride in the affected victims [2].

    C. Oral Toxicity of Synthetic Industrial Fluorides in Man and Animal

    The original textbook that attempted to establish fluoride ingestion as an acceptable practice for all humans regardless of diet, genetic composition, lifestyle, or infirmed condition [3] nevertheless presented a rudimentary table on the admitted toxicology of ingested synthetic industrial fluoride at acute, moderate and chronic levels. That table of information may be presented here, updated with recently available published data. It is not possible or ethical to conduct direct experiments to determine the precise single oral dose that would be lethal for synthetic fluosilicic acid or other industrial fluoride by ingestion in humans. Animals are routinely used as guides for this purpose, and accidental human poisonings are now common enough to present a relatively accurate picture for the acute case [4]. Intermediate levels not immediately lethal are the least understood in the human but are available in mammals [5]. Chronic toxicity in man and animals [6] is better understood today than when the practice of ‘water fluoridation’, to internalize the fluoride ion in the human, was first begun.

    Toxic Effects of Synthetic Industrial Fluoride Compounds Taken Internally in Man and Animals (adapted from an earlier version [3])
    Level: Acute Intermediate Low Level Chronic
    76 mg/kg from sodium fluosilicatea 10-25 ppm fluoride in waterc Intentional Fluoridated water
    56 mg/kg from sodium fluoridea (sodium fluoride or fluosilicic acid) (sodium fluoride or fluosilicic acid) 36 mg/kg from fluosilicic acidb
    Outcome: Death within hours Heart failure within months dWithin years: fluorosis, anemia, IQ reduction, bone weakness, brain cell degeneration, increased cancer, mental retardation, heart disease, obesity, infant
    mortality, 1% allergy, 1% GI discomfort
    aThe Merck Index, An Encyclopedia of Chemicals, Drugs, and Biologicals, Twelfth Edition, Merck & Co., Inc., Whitehouse Station, NJ, 1996 for mammals [4].
    b Solvay chemicals fluosilicic acid Materials Safety Data Sheet (80 mg/kg H2SiF6 or 36 mg/kg fluoride ion for guinea pig).
    cAgency for Toxic Substances and Disease Registry, U.S. Centers for Disease Control, Fluorides and HF, 2003 [5].
    dVarious sources, including but not limited to: NRC, 2006 [1], Connett, 2010 [2], Ziegelbecker reviewed in [2], Reddy [6], Yiamouyiannis [7], Osmunsen [12], Waldbott, Burgstahler [10], Schatz [13], Varner [11], Mullenix [9], Spittle [8], Susheela: in Spittle [14].

    Data in this table are taken from multiple sources on mammals including man. In all cases it is synthetic industrial fluoride compounds widely used to treat U.S. water supplies that were used as fluoride source. Values for humans are all estimates because humans exhibit very wide biologic variability. Those with kidney disease and impaired fluoride elimination, or diabetes with excess water consumption are more readily harmed from internal industrial fluoride. Moreover, there now exists in the U.S. a population subset that never existed prior to 1950, and that is people who have consumed water treated with industrial fluorides for decades of time. Fluoride bone loading in to high affinity sites interferes with fluoride removal from plasma and causes higher time average fluoride blood levels for any given assimilated dose. Such individuals are expected to be significantly more susceptible to ingested industrial fluoride than before bone loading ever took place. Effects of fluoride on autism and Alzheimer’s disease patients are not listed because fluoride exacerbates these conditions without being a recognized cause.

    As a medical research scientist who mainly researched laboratory animals bred for that purpose, I have not conducted research on infant mortality and industrial fluorides taken internally in animals, and instead must rely on other research experts in that field. Neither I, nor proponents of industrial fluoride consumption, can disprove the published discoveries of those experts, namely Drs. Susheela (animal and human), Schatz (human), Yiamouyiannis (animal and human), Himworth (animals) and Packington (humans) in this area. These findings are most serious, and the burden of disproof of their work lies on those who continue the willful dissemination of industrial fluorides into water to be taken internally by the unknowing, and trusting, general public.

    According to my Pearl Harbor survivor father, the United States military was sucker-punched by the Empire of Japan who attacked us at Pearl while negotiating peace with President Franklin Roosevelt in person in Washington, D.C. Notice that the country overall has now been sucker-punched with industrial fluorides in drinking water, while given the argument that it is the ‘greatest health achievement of the Century’, now ignoring the explicit conclusion of the EPA-commissioned NRC that current levels of fluoride in public water supplies (70% treated with industrial fluoride compounds) is not protective of human health, and the CDC itself acknowledges that tooth fluorosis is endemic in U.S. children. We citizens, and the U.S. government we support, must end this adversity.

    I must acknowledge that guiding me through this arduous task, with the original FDA Petition 2007 and its supplements, the Petition for Reconsideration 2010 and its supplements, culminating with the last of this 10-letter series, has been a most important statement:

    “Make sure you are right, and then go ahead” (former Congressman David Crockett, Tennessee).

    These words mean explicitly that we only proceed after studying all the facts in detail, discern the consequences of those facts, acknowledge the difference between correlation and causation, and basically know in truth whether something is either right or wrong, before we act. That is what I have here done, and I most assuredly testify that fluoridation must be halted, not simply because it does not work, not simply because the material taken internally harms many, especially the poor and undernourished or calcium-deficient, but for the precise reason that the act itself is wrong. A ban on the injection of industrial fluorides into public drinking water is necessary, but if not instituted, then at the very least fluoride by aqueous solution administration to be taken internally must be limited by prescription only, where an individual’s health status can be assessed before, not after, the agent is administered.

    References:
    [1] National Research Council, Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, D.C. 2006.
    [2] Connett, P., Micklem, Beck, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, VT, 2011.
    [3] Newbrun, E., Fluorides and Dental Caries, Thomas Books, Springfield, ILL, 1972. [4] Solvay Chemicals, Houston, TX, Fluosilicic Acid, Materials Safety Data Sheet.
    [5] U.S. Centers for Disease Control, Agency for Toxic Substances and Disease Registry, Fluorides and HF, 2003.
    [6] Reddy, P., Reddy, K., Kumar, K., Neurodegenerative Changes in Different Regions of Brain, Spinal Cord and
    Sciatic Nerve of Rats Treated with Sodium Fluoride, Journal of Medical and Allied Sciences 1(1), pp. 30-35,
    2011http://static.infowars.com/2011/12/i/general/2011_study- neurodegenerative_changes_from_fluoride_of_brain_spinal_cord_and_sciatic_nerve.pdf. [7] Yiamouyiannis J. Fluoride, the Aging Factor, Health Action Press, 1985.

    [8] Spittle, B., Psychopharmacology of Fluoride:A Review, International Clinical Psychopharmacology 9, 79-82, 1994.
    [9]Mullenix,P., et.al. Neurotoxicology and Teratology 17, 1995:169-177.
    [10] Waldbott, G., Burgstahler,A., McKiney, H. Fluoridation: the Great Dilemma, Lawrence, Kansas, Coronado Press,1978.
    [11] Varner,J, Jensen,K, Horvath,W.,Isaacson,R., Brain Research 784, 1998;284-98.
    [12] Osmunson, B., personal communication (see materials submitted in original petition).
    [13] Schatz,A., Low Level Fluoridation and Low Level Radiation, Two Case Histories of Misconduct in Science,
    1996 http://www.fluoridation.com/schatz.htm taken from: Schatz, A. Increased death rates in Chile associated with artificial fluoridation of drinking water, with implications for other countries. Journal of Arts, Science, and
    Humanities 2:1-17, 1976; Sworn affidavit: http://www.fluorideinbeds.org/FIB/albertschatz.asp
    [14] Spittle, B., Fluoride Fatigue, Is Fluoride in Your Drinking Water—and from other sources—Making you Sick?, Paua Press, Dunedin, New Zealand, 2008 http://www.pauapress.com/fluoride/files/1418.pdf.

    Circuit Court Fond Du Lac County SAFE WATER ASSOCIATION, INC.

    Plaintiff, vs.
    CITY OF FOND DU LAC,
    Defendant.

    Case No. 92 CV 579

    AFFIDAVIT OF ALBERT SCHATZ, Ph.D.
    IN SUPPORT OF MOTION FOR SUMMARY JUDGMENT

    State of Pennsylvania
    City of Philadelphia
    Albert Schatz, Ph.D., being first duly sworn on oath and with personal knowledge of the information contained herein, respectfully states to the Court as follows: BACKGROUND
    1. I received my B.Sc. in 1942 in Soil Chemistry, and my Ph.D. in 1946 in Soil Microbiology, each from Rutgers University.
    2. I have held numerous academic positions. Since 1980, I have been a Senior Professor at Temple University.
    3. At the age of 23, I discovered the antibiotic Streptomycin. This compound was the first effective drug for the treatment of human tuberculosis.
    4. I have been awarded honorary degrees and titles by the University of Chile, the Autonomous University of Santo Domingo, the Federal University of Espirito Santo in Brazil, the National University of San Antonio Abad del Cuzco in Peru, and the University of Bogota in Colombia.
    5. I have been named an honorary member of the Scientific Society of Chile, the Chilean Society of
    Pediatrics, The Academy of Oral Dynamics (USA), the Stomatological Society of Greece, and many others. 6. I am also a Fellow of the Royal Society of Health in Great Britain.
    7. I have published three books, and more than 500 articles in scientific and professional journals, and in popular magazines and newspapers.
    8. On the subject of fluoridation, I have published numerous articles, including: a. The Failure of Fluoridation in Chile, Pakistan Dental Review, 1967; 15:83.
    b. Failure of Fluoridation in the United Kingdom. Pakistan Dental Review, 1972; 22:3. c. The failure of fluoridation in England. Manchester Union Leader, Jan 27, 1973.
    d. Censorship suppresses information unfavorable to fluoridation. Divulgacion Cultural Odontologica, 1975; 110:32.
    e. Increased death rates in Chile associated with artificial fluoridation of drinking water. Journal of Arts, Sciences and Humanities. 1976; 2:1.

    1. From 1962 to 1965 I lived in Chile. During that time I served as a Professor at the University of Chile, and worked in the Faculty of Medicine, the Faculty of Dentistry, the Faculty of Agriculture, and the Faculty of Philosophy and Education. I was also associated with numerous projects in the Ministry of Health, Ministry of Agriculture and the Ministry of Education. EXPERIENCE CONCERNING THE DANGERS OF FLUORIDATION
    2. Chile began to experiment with artificial fluoridation in 1953. By the 1960s, it became clear to me that fluoridation was causing serious harm, and I undertook a study which showed increased death rates in Chile
      associated with artificial fluoridation. My dramatic findings were later published. (Exhibit ).
    3. My first finding is perhaps the most disturbing. Those authorized to study and review the safety and effectiveness of fluoridation consistently distorted the data to achieve the desired results.
    4. When the data for the three “test” cities in Chile were examined, Curico, F 1 ppm, San Fernando F 0.0 ppm, and La Serena 0.67 ppm, the only possible conclusion was that fluoridation was causing significant numbers of deaths.
    5. Consider, for example, the deaths resulting from congenital malformations as a percent of the total number of deaths. Curico has 244% more such deaths than San Fernando, and 94% more than La Serena.

    (Exhibit

    , table 1).

    1. Infant mortality rates in Curico were 69% greater than in San Fernando and La Serena. (Id, table 2).
    2. For a fuller understanding of some of the harmful effects caused by fluoridation, read exhibit

    . Chile

    abandoned artificial fluoridation shortly after I sent copies of my report to all dental and medical officers in the Pan American Health Organization.
    16. In Chile, with widespread malnutrition and high infant mortality, it was not necessary to observe a
    generation of people throughout their entire life-span in order to determine whether artificial fluoridation is or is not harmful. One could see the lethal effect of fluoridation within the first year of life in terms of increased infant mortality due to acute toxicity of fluoride. Some other adverse effects, like congenital malformations, may or may not cause death.
    17. In the US, the harmful effects of artificial fluoridation are not so clearly revealed by large-scale, comparative studies of the total populations of fluoridated and control cities, because Americans as a whole are in a considerably better state of nutrition than Chileans.
    18. Nonetheless, artificial fluoridation of drinking water may well dwarf the thalidomide tragedy, which was dramatic because it produced crippled children who are living testimonials to what that drug has done.
    Many victims of artificial fluoridation, on the other hand, die quietly during the first year of their lives, or
    at a later age under conditions where their deaths are attributed to some other cause. EFFECTIVENESS OF FLUORIDATION
    19. In 1969, the British Committee on Research into Fluoridation reported the fluoridation of water supplies is
    a highly effective way of reducing caries. My published analysis of the data, with Dr. Joseph Martin, shows that fluoridation does not protect against tooth decay. (Exhibit ).
    20. The data clearly showed that fluoridation only delays the appearance of caries. For example, 10-year-old fluoridated and 8.8-year-old control children had about the same DMFT. A comparison of other corresponding age groups shows a similar delay of approximately 1.2 years in the appearance of caries.

    (Exhibit

    , figure 2).

    1. Fluoridation merely postpones the appearance of caries. Fluoridated children develop the same amount of tooth decay as their non-fluoridated counter-parts over their lifetime. The only difference is that caries start developing approximately 1.2 years later.
    2. There is no economic benefit for such actions. Since fluoride does not reduce caries, fluoridated and control children will develop the same amount of tooth decay. Both groups will therefore require the same amount of dental treatment. People in fluoridated areas therefore pay for the same amount of dental treatment plus the added cost of fluoridation. REFUSAL TO CONSIDER ADVERSE EVIDENCE
    3. On the strength of the data I had analyzed in Chile, I wrote L.C. Hendershot, editor of the Journal of the American Dental Association. I asked him if he would be interested in seeing my report of increased death rates, and if he would consider it for publication in JAMA.
    4. When he did not reply to that letter of inquiry, I sent him three copies of the report in January, February, and March of 1965. Dr. Hendershot refused to accept all three communications, which were therefore
      returned to me, unopened. Copies of the certified envelopes, marked refused, are figure 3, exhibit .
  • Such a response is typical of the proponents of fluoridation. The professional sanctions for opposing fluoridation can be severe, and it is best not to even acknowledge evidence of harm or ineffectiveness. CONCLUSION

  • Artificial fluoridation has not been as widely accepted as its proponents imply. Many cities in the US have discontinued fluoridation after starting it. Virtually all of Europe has considered and abandoned fluoridation.
  • Because artificial fluoridation causes deaths among individuals who are for one reason or another more sensitive to fluoride toxicity than the total population taken as a whole, the controversy over whether
    fluoridation does or does not reduce caries is purely academic. It is criminal to implement a so-called
    public health measure which kills certain people even if it does reduce tooth decay in some of the survivors. As noted, the evidence is that it merely delays decay.
  • It is my best judgment, reached with a high degree of scientific certainty, that fluoridation is invalid in
    theory and ineffective in practice as a preventive of dental caries. It is dangerous to the health of consumers.
  • I make this Affidavit in support of the Plaintiff’s Motion for Summary Judgment.
  • The following articles were previously submitted and are here for context. Memphis’s Bad News: The Infant Mortality Rate
    By NEIL GENZLINGER Published: August 21, 2008
    Every war has them: a few searing images caught on film that come to epitomize the conflict. There’s a war going on in Memphis right now, and a third of the way into “Babyland,” Friday’s installment of “20/20” on ABC, there is such an image: workers with a steam shovel burying tiny coffins in a mass grave.
    The program is about infant mortality. The United States, we are told, fares poorly among industrialized nations in
    its survival rate for infants, and the problem is particularly acute in Memphis. “A baby dies in Memphis every 43 hours,” Elizabeth Vargas, who reports the segment, says.
    This program provides fuel for several fires. The mortality rate, attributable primarily to premature births, is
    especially high among low-income blacks. (That mass grave, the burial of last resort, is in a public cemetery whose nickname gives the program its title.) Many of the women who lose babies are young and unmarried, and you can guess the resulting lines of argument.
    But rather than dwell on these familiar and polarizing debates, the program commendably focuses on grass-roots efforts to address the problem.
    There is Terry Drumwright, a white woman from the wealthy suburbs who, through a program at her church, is trying to make a difference (and walk that fine line between assistance and condescension) by working one on one with a pregnant black teenager. There is Dr. Linda Moses, who is from these poor neighborhoods and has now come back to practice there.
    “How much of your job is basic education?” Ms. Vargas asks her. She answers bluntly, “All of my job is basic education.”
    The program alludes to a bigger picture — of poverty, of race-based government indifference — that makes these
    personal crusades feel like lost causes. But the mere fact that someone is making them is wonderful to see.

    Vital Statistics
    U.S. Still Struggling With Infant Mortality
    By NICHOLAS BAKALAR
    Published: April 6, 2009
    Infant mortality has been declining slightly in the United States. But 28,000 children under the age of 1 still die every year. Multimedia

    Graphic Infant Mortality Rates World Wide Times Topics: Infant Mortality
    The main reason for the high rate is preterm delivery, and there was a 10 percent increase in such births from 2000 to 2006, according to recent figures from the Centers for Disease Control and Prevention. (In 2007, according to
    preliminary data just published by the C.D.C. , that rate declined by 1 percent, mainly among late preterm infants.) In 2004, the latest year for which worldwide data are available, the United States had a higher rate than 28
    countries, including Singapore, Japan, Cuba and Hungary. In 1960, the United States had a higher rate than only 11 countries.
    There are large differences by race and ethnicity. Non-Hispanic black, American Indian, Alaska Native and Puerto
    Rican women have the highest rates of infant mortality, while Asian and Pacific Islanders, Central and South Americans, Mexicans and Cubans have the lowest.
    “We think the increase in preterm birth and preterm-related causes of death are major factors inhibiting further declines in infant mortality,” said Marian F. MacDorman, the lead author of the report and a statistician at the C.D.C. “Infant mortality is a major public health problem, and it’s not improving.”
    The following statements were excerpted from the sworn affidavit of Dr. A. Susheela, in support of litigation against the city of Fond du Lac,WI using controlled dosing of industrial fluoride in the water supply at levels recommend by the OHD. Specific fluoride levels used in her studies are not listed in the testimony, but the specific comments were intended to be relevant for water fluoridation as conducted in the United States. Susheela was first to report that consumption of 1 ppm industrial fluoride in water presents anemia as the most significant early event that is also morphologically concurrent with microscopically visible damaged cells in the intestinal villi that are known to be essential for normal assimilation of iron required for red blood cell function and prevention of anemia. State Of Wisconsin
    Circuit Court
    Fond Du Lac County
    SAFE WATER ASSOCIATION, INC., Plaintiff, vs.
    CITY OF FOND DU LAC, Defendant.
    Case No. 92 CV 579

    AFFIDAVIT OF A.K. SUSHEELA, Ph.D.
    IN SUPPORT OF MOTION FOR SUMMARY JUDGMENT

    Nation of India
    City of New Dehli
    A. K. Susheela, Ph.D., being first duly sworn on oath, under penalty of perjury, and with personal knowledge of the information contained herein, respectfully states to the Court as follows:
    1. I, Dr. A. K. Susheela, have spent more than 20 years doing scientific research in the field of Fluoride Toxicity and Fluorosis.
    2. I am a full Professor of Anatomy (Histocytochemistry) and Chief of the Fluoride and Fluorosis Research Laboratories, at the All India Institute of Medical Sciences, New Delhi. 3. I have held Faculty positions at the same Institute since 1969.
    4. I am a Ph.D from India, with Post-doctoral training under LORD WALTON (Neurologist) of U.K. and Dr. Ade Milhorut of the Muscle Institute, New York, USA, (which no longer exists).
    5. I was a Visiting Professor at the Allan Hancock Fnd. at the University of Southern California during 1974- 76.

    1. I am a Fellow of the Indian Academy of Sciences and the National Academy of Medical Sciences.
    2. I have won the prestigious Ran Baxy Research Foundation Award (Cash Prize) for outstanding research in medical sciences.
    3. I have been involved in teaching medical students of all levels and carrying out research and guiding research in the field of muscle diseases and Fluorosis for more than 20 years.
    4. My field of interest for the last 20 years has been Fluoride and Health Hazards.
    5. Numerous funding organizations have been calling upon me during that time for evaluating projects for funding in the field of Biomedical Research.
    6. I have been a member of several National Committees since the early 1970s, where issues related to Fluoride are debated and discussed.
    7. I have convened an International Conference on Fluoride and Fluorosis research in India in 1983. I edited a book on Fluoride Toxicity in 1985.
    8. I have been invited to speak on my experience in the field of Fluoride Research at various scientific meetings held in: (1) Japan; (2) Denmark; (3) Switzerland; (4) Kenya; (5) U.S.A. (several times); and (6) Hungary.
    9. I have guided 6 Ph.D theses in the subject of Fluoride and Health Hazards. A 7th Project is ongoing.
    10. I have more than 80 scientific publications in leading Western and Indian Journals. SAFETY OF FLUORIDATION
    11. From my extensive experience, I state without hesitation and with a high degree of scientific certainty, the following evaluation of fluoridation.
    12. India launched a Technology Mission on “Safe Drinking Water” in 1986 (now re-designated after the late
      Prime Minister Sh. Rajiv Gandhi, as Rajiv Gandhi National Drinking Water Mission) in which every drinking water source in the rural sector is checked for water quality, especially for Fluoride.
    13. People are keen to defluoridate the water due to gastrointestinal problems and are adopting indigenous technology for obtaining potable (defluoridated) water.
    14. Results include reduced abortions (as Fluoride is known to induce calcification of blood vessels of the fetus).
    15. Reduced still births (as Fluoride is known to induce calcification of blood vessels of the fetus).
    16. I am absolutely certain that large numbers of persons all around the world are suffering from Fluoride Toxicity, to one degree or another.
    17. The various and frequent health complaints, caused by fluoride ingestion, are often (or invariably) over- looked due to unawareness at all levels, which include the health professionals or, perhaps, due to the prevailing ill conceived, unscientific notion that “fluoride is good for teeth.”
    18. Fluoride is potentially a dangerous chemical and a poisonous substance, which does no good to the human body.
    19. With a high degree of scientific accuracy and certainty, I conclude that artificial fluoridation of drinking
      water is an ineffective means of improving dental health, and is in fact quite dangerous to those forced to consume it.
    20. I make this Affidavit in support of the Plaintiff’s Motion for Summary Judgment.
    21. Studies on human teeth have shown that fluoride alters a chemical substance in the matrix of the tooth. The mineralization process is abnormal, leading to changes in mineral content, and cavities or pitting are known to occur.
      In other words, Fluoride induces cavity formation, as well as discoloration of teeth. It is also evident that use of fluoride can lead to loss of teeth at an early age and one becomes edentulous. See The Status of Sulphated Isomers of Glycosaminoglycans in Fluorosed Human Teeth. (Exhibit ).

    #11.

    May, 2011

    Department of Health and Human Services Center for Drug Evaluation and Research U.S. Food and Drug Administration Office of Regulatory Policy
    Rockville, MD 20857

    Dear Petition Reviewers,

    It is necessary to send additional information regarding the petition to ban industrial fluoride injections into human water supplies, FDA 2007-P-0346, formerly 2007P-0400.
    It has come to my attention that the FDA has taken a stern measure in warning a public broadcaster regarding
    claims of arsenic levels in apple juice. I commend the FDA for this action to clarify the truth, that is, when to be concerned about contaminants and when it is not necessary to be concerned, for various foods and beverages.

    Along this line, it is important now also for the FDA to similarly interact with U.S. water districts and/or chemical suppliers that claim water supplies are safe to use as a vehicle to disseminate fluosilicic acid, for its fluoride to treat people without obtaining FDA approval for the ingestion of the synthetic compound employed. Total arsenic levels in water quality reports are not distinguished between methylated organic (nontoxic) or inorganic (Type Class IA certain human carcinogenic) arsenic, which is the very reason the FDA presented its stern warning mentioned above. We realize that FDA does not regulate contaminants in public water supplies. However the problem here is overlap with fluosilicic acid compounds that are indeed added to specifically elevate blood fluoride levels in consumers through water supplies as vehicle of choice.

    Fluosilicic acid plus required caustic soda is injected to elevate the fluoride content of the bloodstream of citizens to 0.21 ppm (see original petition). As stated to FDA previously, in our present society this is a contraindication to human health merely for the reason that waters now in the U.S. are widely contaminated with materials that do not belong in fresh drinking water that are not tolerated particularly by the unhealthy and those with kidney and other diseases. The water quality report enclosed here from the North San Diego County region 2011 reports that industrial fluoride is added to top off the fluoride ion level to 1.0 ppm that also elevates the sodium ion level to 85 ppm, while the silicic acid level is not reported or tested. The HHS request to not exceed 0.7 ppm fluoride was honored for about one month here, but the level is now readjusted back to 1.0 ppm for intended permanent consumption without FDA approval.

    The specific problem with adding blood treatment chemicals without FDA approval, and without an FDA new drug application, is that the vehicle used for this drug itself contains numerous cancer-causing agents at levels that have now exceeded that allowed by the state of CA as a Public Health Goal, and for arsenic the level in the Twin Oaks plant exceeds even Federal allowed levels at a listed maximum massive 120 ppb (allowed at 10 ppb Federal, with a non-enforced state PHG of 0.004 ppb). The number of days and the date at which these levels are reached are not reported. Many people particularly with health conditions who debate whether to drink public water in the presence of carcinogens are thus sent mixed messages, where fluoride that is perceived to be of benefit would be
    ‘missed’ if the water were not consumed, thus convincing many to consume it, regardless of other contaminants also present.

    Please understand that the EPA who is in charge of water contaminants does not provide or have guidelines for water supplies that are contaminated with multiple regulated carcinogens all present in the same water at the same time, or for water treated with aluminum and fluoride intentionally for different purposes that interact in the stomach (see original petition). Lead binds to protein sulfhydryls as does arsenic, and both are present in the same water above their respective PHG’s and as mentioned arsenic alone routinely exceeds Federal limits. Fluoride is a known mutagen and teratogen and a cancer promoter (see original petition) and is able to induce bone cancer when ingested for very long time periods in the genetically susceptible. (For this reason fluoride salts are now under review by the CA EPA).

    Sadly, chromium Vl is here also present at more than 5 times the PHG (0.16 ppb for which no Federal level has yet been established in spite of efforts by the famous Erin Brockovich). Also lead (listed here as ‘local’) has been reported in excess of the Federal allowed limit of 10 ppb, depending on the local neighborhood tested, aluminum (no longer listed) is typically 0.05 ppm, arsenic (1.9 ppb average, 120 ppb highest reading, which are 400-30,000 times the PHG and 0.2-20 times the Federal allowed maximum), strontium 90 and uranium total 7.5 pCi/L (below the allowed Federal level for each as separates, but 4.7 and 7 times the PHG respectively) and halogenated hydrocarbons at a gross total of 258 ppb, 3 times the Federal allowed level for any one as a separate.

    This water system is unfit to use as a vehicle to treat citizens with industrial fluoride compounds, for better or for worse. The petition has formally requested that FDA either 1) ban the dissemination of industrial synthetic fluoride compounds intended for human ingestion, or 2) announce the requirement to apply for a new drug application for synthetic fluoride compounds proposed to be ingested (that will require controlled human clinical trials data using city water as vehicle to disseminate the compound for ingestion). It is also advisable to write letters of inquiry to one or more chemical suppliers of fluosilicic acid (Cargill, Lucier, Solvay Chemicals, etc.) requesting any available data to be presented for FDA records that demonstrate efficacy and safety for the ingestion of fluosilicic acid in humans.

    #12.

    January 5, 2012

    U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857 Dear Reviewers,

    This information is provided in support of the petition to ban the intentional dissemination and ingestion of the industrial synthetic fluoride compounds fluosilicic acid and sodium fluoride, petition FDA-2007-P-0346, formerly 2007P-0400.

    Definitions of Ingested Synthetic Industrial Fluoride.

    Federal dental officials within the U.S. Centers for Disease Control request the injection of synthetic industrial fluoride compounds into public water supplies and claim that fluoride is not a drug and could escape the Food Drug and Cosmetic Act. Also fluoride is argued to be a ‘supplement’ and since it ‘belongs in water’ it could escape the Safe Drinking Water Act. Finally, since some waters in the U.S. contain fluoride naturally (as the nontoxic natural calcium fluoride), it is argued to escape control by the Water Pollution Control Act either.

    Fluoride in proponents’ opinion is basically a mineral in the diet that is believed by them to prevent or mitigate teeth caries and is given special honor to inject into virtually all U.S. public water supplies to treat humans. Not being a food (agreeable, since it has no calories) and not being a mineral nutrient (agreeable to the FDA, see original petition and Petition for Reconsideration), fluoride is presumed a ‘supplement’ that ‘mitigates bacterial- induced teeth caries’.

    Putative Rationale for Mass Injection of Industrial Fluorides into U.S. Public Water Supplies.

    On one hand, teeth caries are argued to be non-communicable and thus not a serious condition. This attempts to avoid regulation of fluoride as a disease-treating agent and instead purports to merely present an innocent, unregulated ‘health claim’. In contradiction to this, the CDC goal to mass inject 70% of all U.S. water supplies with industrial synthetic fluoride compounds is justified by their alternative argument that dental caries are a serious disease that can lead to crippling conditions. Which is it? If the latter is true, then claims made to justify fluoride taken internally are more than mere ‘health claims’ and are claims to prevent or mitigate disease. In this case fluoride is being used as a drug for drug-like properties, albeit one that is not FDA approved, that thus requires an FDA ban because it is widely used with claims of disease mitigation without controlled clinical trials or data in proof for that claim.

    On the other hand, if one takes the view that caries are not a serious disease and that fluoride is a supplement that merely deserves a ‘health claim’, then FDA is in charge of the wording used by water districts that claim it is a teeth-improving and safe-to-consume agent. Changes in teeth structure induced by the agent taken internally by ingesting water must go through an FDA approval process with data supplied to demonstrate those claims, and obviously the purchase and use of the materials must be optional, not requested for mass dissemination through all public water supplies for such a mere health claim.

    Fluoride Interactions with FDA-Approved Drugs.

    A key point that has not been considered (whether one considers industrial fluorides taken internally to be drugs or not, or supplements or not) is that fluoride is known to interfere with common FDA-approved drugs that are in wide use in the U.S. Most of these drugs are designed to enhance calcium uptake and bone strength, but some are blood clot preventives and blood thinning agents. Fluoride minimizes calcium uptake from the gastrointestinal tract, just as fluoride assimilation is likewise inhibited by the presence of calcium ion. (This is the reason calcium is the antidote to fluoride poisoning, due to the affinity of fluoride for the double positive charged calcium ion). Fluoride inhibits the actions of drugs designed to enhance calcium uptake and to strengthen bone. Fluoride however

    potentiates the effects of blood clot inhibiting drugs by virtue of its high affinity for association with calcium, restricting the chemical potential, mobility and general physiologic action of the calcium ion.

    In order to protect FDA-approved drug effectiveness and use, it is necessary to ban fluoride injections into public water supplies on the mass scale currently employed in the U.S., no matter what definition(s) one might choose to use for the fluoride ion intended to be ingested. A partial list of FDA-approved drugs that are in common use that are NOT to be used in fluoridated cities, or in conjunction with Luride tablets, or with vitamins in which fluoride is added, are:

    http://www.drugs.com/drug-interactions/multivitamin-with-fluoride.htmlMultivitamin with fluoride Drug Interactions

    Drug Interactions. A total of 8 drugs (18 brand and generic names) interact with multivitamins with fluoride.

    • 3 major drug interactions, 4 moderate drug interactions, 1 minor drug interaction
    Medications known to interact with multivitamins with fluoride include but are not limited to:

    • Alli (orlistat)
    • anisindione
    • Calcijex (calcitriol)
    • calcitriol
    • colesevelam
    • Coumadin (warfarin)
    • dicumarol
    • doxercalciferol
    • Hectorol (doxercalciferol)
    • Jantoven (warfarin)
    • Miradon (anisindione)
    • orlistat
    • paricalcitol
    • Rocaltrol (calcitriol)
    • warfarin
    • Welchol (colesevelam)
    • Xenical (orlistat)
    • Zemplar (parical)

    Dosage instructions with fluoride-containing vitamins or with Luride tablets state that ingested fluoride is only available by prescription and are not to be taken by women intending to become pregnant and are not to be taken in cities with fluoridated water supplies. Some dosage instructions state that it is not known whether fluoride enters breast milk, while other prescription labels indicate fluoride does enter breast milk. In both cases, women are directed to consult with their doctor before taking these agents that contain fluoride.

    It again must be emphasized that fluoride is not listed in the U.S. Pharmacopeia as a Congressionally-recognized legal drug, or an official FDA-approved drug. There are no human controlled clinical trials data or a drug application with the FDA that has ever been approved for any synthetic fluoride to be taken internally by ingestion. Fluoride formulations in waters (which vary from city to city in water contaminants and hardness) are being used with constantly changing suggested levels (which have recently varied from 0.7 to 1.2 ppm), rendering fluoride ingested from water an unapproved and thus illegal drug, and its intentional dissemination for ingestion must be banned.

    If fluoride is defined however as a supplement or mineral allowed in the human diet, taken internally to affect teeth caries in the general population as a mass-disseminated substance for ingestion, then it must be banned as well to protect the safety and effectiveness of the above-listed FDA-approved drugs now in common use in the U.S. It is then appropriate to refer to ingested industrial synthetic fluoride as an ‘anti-drug’, because of known interactions with legal FDA-approved drugs that are recognized in the U.S. Pharmacopoeia, while fluoride is not.

    Although synthetic industrial fluoride added into water supplies to be ingested by U.S. citizens, in an attempt to treat or prevent dental caries, may not be necessarily precisely legally defined by the FDA, as a final note please

    understand that the actual chemical definition of synthetic fluoride compounds, as provide in the original FDA petition, has never wavered at any time, and that is:

    “Synthetic fluoride compounds lacking calcium are toxic calcium chelators” (see original petition).

    Through reason of use, when these compounds at dilute concentrations of 1 ppm are considered putative anti- caries agents, it is legitimate to refer to these toxic materials as either illegal drugs, or as putative supplements that are known not to be mineral nutrients, that do not have FDA approval, and in either case require a ban by the U.S. Food and Drug Administration for intentional ingestion by citizens in the U.S.

    No Regulations or Statutes Exist that Block the FDA from Issuing a Ban for the Dissemination of Synthetic Fluorides Intended for Human Ingestion.

    If information is required by the FDA on Federal regulations that apply to statements made in this letter, that information will be forwarded. If the FDA argues or believes that the requested ban is ‘disallowed’ by Federal law, though no such legislation exists, then please issue a moratorium, injunction, or temporary cessation of the intentional dissemination of synthetic industrial fluorides for human ingestion. This is legal and required, because no clinical trials data exist, no new drug application has been filed and approved by the FDA, and no information has been provided that proves consumption of injected fluorides from synthetic compounds is a dietary supplement with benefit and that is safe for human consumption, for those using the above listed medications, or the infirmed, or even the general population for permanent lifetime ingestion that fluoridation involves. The moratorium is justified by the widespread dissemination and ingestion of synthetic fluorides that still continues in spite of lack of FDA approval or oversight.

    Cessation by the FDA of the dissemination of synthetic industrial fluorides for human ingestion is additionally justified by the fact that normal drinking water is a REQUIRED consumable by all people. If fluoride were an optional purchase, such as in Luride, vitamins with fluoride, or in bottled fluoride water, then this petition would never have been submitted. It was submitted because synthetic fluorides continues to be ingested daily, without FDA approval or oversight, by most of the entire U.S. population and also continues to spread to new cities.

    The interaction of fluoride, consumed from that injected into drinking water, with drugs cannot be argued to be insignificant. The dosage instructions on Luride or vitamins with fluoride clearly indicate these are contraindicated in cases where fluoride is consumed from water at 0.7 ppm or higher. In other words, the amount of fluoride from drinking water supplants that which would have been assimilated from these prescription items. Indeed, the National Research Council 2006 (Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C.) proves that the blood level of fluoride in residents of cities treated to 1 ppm fluoride averages
    0.21 ppm, which is the specific concentration that fluoride proponents target to achieve through either Luride tablets, vitamins with fluoride, or fluoride treated drinking water (personal communication, Donald Nelson, Chief
    Fluoridation Officer, CA Department of Health Services, Sacramento; see original petition court testimony).
    Luride and vitamins with fluoride are listed as contraindicated for patients taking the above-listed medications, so drug interactions with fluoride from drinking water are also obviously significant.

    Concluding Remarks.

    Luride, and fluoride with vitamins, are contraindicated in children under four and in pregnancy, and for good reason always require prescription and use only under a doctor’s oversight. Such restrictions do not exist and are not provided from either water districts, chemical suppliers of fluoridation materials, or Oral Health Division dental officials within the Centers for Disease Control who request the mass dissemination of fluoride into public water supplies to be taken internally. Taken together, all the data provided to the FDA, in the original petition and its supplements, the Petition for Reconsideration and its supplements, and the recent 12 letter series, clearly demonstrate that it is essential that the FDA stop the willful continued permanent ingestion of mass-injected industrial synthetic fluoride compounds by U.S. citizens as quickly as possible.

    #13.

    January 14, 2012

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This information is in support of the FDA petition 2007-P-0346.

    I mailed the following letter to local city officials who recently were forced by State officials, at the request of Federal officials from the OHD of the CDC, to begin industrial fluosilicic acid injections into all San Diego city water supplies in spite of two city elections voting otherwise. The CA state law, that the officials claim forces them to overturn city-wide elections, does not mention fluosilicic acid or any fluoride source compound, nor mentions the water level to inject or the procedure to use, nor requires monitoring blood fluoride to check for treatment target level success, nor requires tooth decay or tooth fluorosis incidence monitoring. The language in the State bill presumes without proof that caries would decrease and that no mentionable adverse health effects would exist in any group regardless of health status or ethnicity, and regardless of calcium content of the treated water. Understand that CA Department of Health officials wrote that the State assumes zero liability for the water fluoridation it requests and that city officials freely decide whether to fluoridate and thus assume all liability. Further, the U.S. Centers for Disease Control formally wrote that States and cities take full responsibility and full liability to fluoridate public water supplies that the CDC recommends.a

    Dear San Diego City Council and Public Utilities Officials,

    As you know, the intent of the U.S. Safe Drinking Water Act is to prohibit any requirement for the addition of substances into water other than to sanitize it. You are now adding fluosilicic acid diluted hazardous waste into water to treat teeth, and you say CA State law forces you to do so in spite of wording in the SDWA.

    Could you then at the very least honor the mission of that State law, to improve teeth, by considering getting at the root of the problem of cavity causation, for example by providing calcium nutrition and counseling for residents with any calcium deficiency and high dental caries incidence (see graph below) — instead of broadly treating everyone with synthetic industrial fluoride through public water? This way calcium can be provided to help build strong teeth where it is actually needed.

    Fluoride has side effects including tooth fluorosis and bone weakening that calcium does not cause. After 30 years of detailed studies on four hundred thousand children [1] it was published that dental caries increase a massive 16 times higher in incidence in children with calcium-deficient diets, which occurs whether water contains appreciable fluoride or not. The authors concluded:

    “The only practical and effective public health measure for the prevention and control of dental caries is the limitation of the fluoride content of drinking water to < 0.5 ppm, and adequate calcium nutrition (dietary calcium > 1 g/day).”

    [1] S P S Teotia and M Teotia, Dental Caries: A Disorder of High Fluoride and Low Dietary Calcium Interactions (30 Years of Personal Research), Fluoride 1994; 27(2): 59-66.

    Caries Incidence % vs. Low or Normal Calcium and Low or 1 ppm Fluoride

    [cid:image137.jpg@01D47B9C.4AC11730]

    The percentage of dental caries are graphed as a function of the presence of dietary calcium deficiency (blue bars), accompanied with either low fluoride (left) or approximately 1 ppm fluoride levels in drinking water (right), and normal dietary calcium (red bars) accompanied with either low fluoride (left) or 1 ppm fluoride in drinking water (right). The data are from Teotia and Teotia for a 30 year study of 400,000 children. Notice that the highest incidence of caries was found in children with a calcium deficient diet where water was approximately 1 ppm fluoride. The lowest caries incidence was found in children with low fluoride water while also having adequate dietary calcium.

    The reason for these results are obvious. Calcium is the chief ingredient in normal teeth enamel, and normal crystalline hard enamel that resists cavities can only form in children in the absence of fluoride-induced enamel fluorosis. Fluoride is unable to counter increased caries incidence from calcium dietary deficiency, and in fact fluoride contributes to caries incidence in this case. Fluoride also causes tooth fluorosis in children, whether on calcium-deficient or normal calcium diets (not shown for brevity).

    Doesn’t it make sense to use the best available mineral to help teeth? If you are planning to continue disseminating a substance to be taken internally to affect teeth, then shouldn’t it be a substance like calcium, that is a normal dietary component, has a daily dietary requirement, is a mineral nutrient and an essential body component required for teeth enamel formation, and its deficiency causes conditions favorable to formation of caries? Fluoride is not a mineral nutrient according to the U.S. Food and Drug Administration, has no daily dietary requirement, from the bloodstream can cause tooth fluorosis, and after ingestion produces only 0.02 ppm fluoride ion in saliva [2] unable to affect teeth topically.

    [2] National Research Council Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C., 2006.

    Calcium supplementation corrects calcium deficiency, that causes inadequate enamel formation and conditions that lead to dental caries. Let’s treat the causes, insufficiently developed enamel and not brushing after eating sugary foods, rather than after-the-fact attempts to treat the symptom, cavities, with fluoride in drinking water where dosage cannot be controlled, and that is of no significant value as observed in large numbers of studies [3], where the absence of fluoride in drinking water does not itself cause dental caries. Caries are caused by acid secretions from S. mutans metabolizing sugars, where insufficient enamel covering teeth dentyne is the most readily breeched.

    [3] Connett, P., et.al., The Case Against Fluoride, How Hazardous Waste Ended up in our Drinking Water and the
    Politics that Keep it There, Chelsea Green Publishing, White River Junction, Vermont, 2010.

    Although we hope for the FDA to ban fluoride water injections, or to prevent its use until a new drug application is sent to the FDA, a very useful action would be for the FDA to prohibit Federal and State officials from requesting that cities inject synthetic fluoride compounds into public water supplies. This would be a great help for the country.

    afootnote. Letters will be forwarded on request from the CA Department of Health Services and from the U.S. Centers for Disease Control that contain these signed statements.

    Enclosure on calcium deficiency and enamel hypoplasia:

    http://www.identalhub.com/article_enamel-hypoplasia-370.aspx

    Hypocalcaemia is a specific cause of tooth enamel hypoplasia. Recently evidence has suggested that the etiology of enamel hypoplasia is highly specific. Enamel hypoplasia is seen in children having disorders of calcium homeostasis. Low calcium level in serum is one of the major causes of enamel hypoplasia.

    Enamel Hypoplasia and Caries. Enamel hypoplasia is clinically significant not only because it is disfiguring and the restorative treatment costly, but because it may affect caries susceptibility. There was a strong correlation between hypoplasia in the teeth of British schoolchildren and caries susceptibility. Out of a collection of 1,500 extracted teeth, 74% of very hypoplastic teeth were carious, whereas 80% of the nonhypoplastic teeth were caries– free. Caries has also been associated with hypoplasia in many parts of the Third World. There is no information about the chemical composition of hypoplasia enamel so the exact reason for its greater proneness to caries is uncertain, but it is possible that its irregularity and pits may favor the development of more plaque compared with smooth well-formed enamel.

    Enamel hypoplasia is due to many causes. It can be due to high fluoride level or due to some medicines or if the child becomes ill when the teeth which are affected by enamel hypoplasia are being formed. The treatment depends on degree of hypoplasia. Intially the composite restorations are done and if it is more (i.e. whole of enamel is hypoplastic) then veneers or crowns are indicated in later age when the teeth are fully formed.

    14.

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    The following information should be of help in evaluating the fluoride water ban petition, FDA2007-P-0346.

    As provided to the FDA earlier, detailed statistical analyses by Ziegelbecker [12] indicate a wide variation in teeth caries incidence among people in a large U.S. population that is unrelated to fluoride levels in drinking water. Vitamin D and calcium, rather than fluoride, is important for normal teeth health and development. Variation in caries incidence found among people may be explained by variation in vitamin D and dietary calcium.

    It has long been known that vitamin D, necessary for the proper assimilation of dietary calcium through the intestines, decreases dental caries. [Dr. Anthony Norman, world expert on the mechanism of action of vitamin D, is a former colleague.] The late Dr. Linus Pauling, a former mentor, founded the Orthomolecular Medicine organization, and the following description is paraphrased from a published article by that organization. The U.S. Public Health Service in 1950 ignored well-published data and accepted the idea that fluoride added to water might fight tooth decay.

    Orthomolecular Medicine News Service, February 19, 2009

    Vitamin Deficiency Underlies Tooth Decay

    There is especially strong evidence for a relationship between vitamin D deficiency and cavities. Dozens of studies were conducted in the 1930’s and 1940’s [1-11] that concluded that supplementing children with vitamin D prevents cavities. Between 5,000 and 15,000 IU of vitamin D may be obtained from modest exposure to sunshine in the middle of the day. Recommending that people regularly use the capacity of their skin to make vitamin D is common sense. 1,000 to 2,000 IU per day of vitamin D in supplemental form is safe to help prevent tooth decay.

    References:

    [1] Tisdall, F.F. The effect of nutrition on the primary teeth. Child Development (1937) 8(1), 102-4.
    [2] McBeath, E.C. Nutrition and diet in relation to preventive dentistry. NY J. Dentistry (1938) 8; 17-21.
    [3] McBeath, E.C.; Zucker, T.F. Role of vitamin D in the control of dental caries in children. Journal of Nutrition (1938) 15; 547-64.
    [4] East, B. R. Nutrition and dental caries. American Journal of Public Health 1938. 28; 72-6. [20] Mellanby, M. The role of nutrition as a factor in resistance to dental caries. British Dental Journal (1937), 62; 241-52.
    [5] His Majesty’s Stationery Office, London. The influence of diet on caries in children’s teeth. Report of the Committee for t he Investigation of Dental Disease (1936).
    [6] McBeath, F.C. Vitamin D studies, 1933-1934. American Journal of Public Health (1934), 24 1028-30.
    [7] Anderson, P. G.; Williams, C. H. M.; Halderson, H.; Summerfeldt, C.; Agnew, R. Influence of vitamin D in the prevention of dental caries. Journal of the American Dental Association (1934) 21; 1349-66.
    [8] Day, C. D.; Sedwick, H. J. Fat-soluble vitamins and dental caries in children. Journal of Nutrition (1934) 8; 309.
    [9] Agnew, M. C.; Agnew, R. G.; Tisdall, F. F. The production and prevention of dental caries. Journal of the American Dental Association, JADA (1933) 20; 193-212.
    [10] Bennett, N. G.; et al. The influence of diet on caries in children’s teeth. Special Report Series – Medical Research Council, UK (1931) No. 159, 19.
    [11] Mellanby, M.; Pattison, C. L. The influence of a cereal-free diet rich in vitamin D and calcium on dental caries in children. British Medical Journal (1932) I 507-10.
    12] Connett, P., et.al., The Case Against Fluoride, How Hazardous Waste Ended up in our Drinking Water and the
    Politics that Keep it There, Chelsea Green Publishing, White River Junction, Vermont, 2010.

    15.
    January 26, 2012

    U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857 Dear Reviewers,

    This information is provided in support of the petition to ban the intentional dissemination and ingestion of the industrial synthetic fluoride compounds fluosilicic acid and sodium fluoride, petition FDA-2007-P-0346, formerly 2007P-0400.

    The U.S. Centers for Disease Control and Prevention, Oral Health Division desires that water fluoridation be conducted in most all U.S. water supplies, as described on the CDC fluoridation website. State Public Health Departments under the authority of the CDC promote and require fluoridation of city water supplies. City administrators instruct water districts to fluoridate under the authority of their State Health Departments.

    However, questions regarding proof of safety and effectiveness of the ingestion of industrial fluorides from water, or procedures used to monitor the injections to determine effectiveness for a given water supply containing various local contaminants and differing water hardness, all the above groups deny authority and responsibility and do not provide answers to such questions. The CDC and State Health Departments go so far as to deny liability and responsibility for the injection of fluorides into public water supplies that they themselves request! CDC lays liability on State Health Departments, which officially give liability to city officials, who themselves claim are required to do so by State Health Departments, who defer authority and all questions to the CDC.

    Enclosed as proof of this endless circle are letters from the Metropolitan Water District, Los Angeles, CA the CA State Department of Public Health, and the U.S. Centers for Disease Control and Prevention. Each were asked for data they possess that demonstrates that ingested industrial fluoride, from public water supplies, decreases caries and exerts no adverse health effects in consumers long-term and without such data to please halt its use. In response, the MWD President denied any authority or knowledge of either safety or effectiveness of fluosilicic acid injections into Los Angeles water supplies and wrote that MWD completely relies on the authority of the CA Department of Public Health for answers to questions of safety and effectiveness of the injections that DPH officials request of them. On the contrary, in the same segment in time, the CA Department of Public Health denied liability or responsibility for the injections, and writes that all liability and responsibility lies with city officials themselves whether to inject fluoride compounds or not into public water.

    Further, in an e-mail from the CA Department of Public Health chief fluoridation officer I was told that it is the CDC who decides what the State Health Department requests and how to inject fluoride compounds into water and answers all questions of safety and effectiveness. Finally, notice however the letter from the CDC, which clearly contradicts this and states that CDC is a non-enforceable, non-regulatory investigative agency, and thus accepts no responsibility or liability for fluoride injections into water supplies. My request to the CDC for data demonstrating the safety and effectiveness of the ingestion of fluoride compounds from water supplies was thus denied when I was told to write to the CA State Health Department (who had already told me to write to the CDC!). The only response to questions of effectiveness was the usual endorsement by the Surgeon General that it is a great ‘public health achievement’. The CDC denies liability and responsibility and gives such to the States, which in turn insist on being accepted by the cities, which in turn give authority back to the States, which give such to the CDC……

    The fruit of this deceptive practice, where fluoridation is not being regulated or monitored (for accuracy among various types of water supplies) by any Federal agency, is well documented. Illness and adversity caused by fluoride ingestion. When proven and brought to suit, requires lengthy trials, where routinely cities claim the State has liability for requiring the injections, while the State claims cities have full liability because the cities decided to fluoridate. The lawsuit is still ongoing now for years for the tragic death of Dominic Smith during the Hooper Bay, AK fluoride water overfeed poisoning disaster (the first topic discussed in this original FDA 2007 petition).

    When will this endless circle be broken? Only when the HHS and FDA order that CDC and State officials cease and desist in requesting or endorsing the injection of fluoride compounds into public drinking water supplies in the U.S. The order is necessary because industrial fluoride compounds, disseminated into public water supplies for ingestion to treat humans, is an uncontrolled use of an un-approved drug or drug-like substance. Fluorides have never been formally approved for ingestion in the U.S. for any purpose, and have been allowed by prescription only but only in cities that do NOT fluoridate public water supplies to 0.7 ppm fluoride or higher. It is necessary for the CDC, the U.S. Surgeon General, and all State Health Departments to withdraw public endorsement of industrial fluoride injections into public drinking water to treat humans with its internal ingestion. It will require the Center for Drug Evaluation and Research, U.S. FDA to achieve this withdrawal of endorsement by the OHD of the CDC, being another agency now part of Health and Human Services.

    Copies of letters in response to request for data demonstrating long-term consumption safety and effectiveness of industrial fluoride compounds added into public drinking water and to halt such additions in the absence of such data (letters are in sequential series according to date of receipt and reflect communication from local, to State, to Federal level in succession). Original signed letters can be forwarded if necessary.

    :

    Letter from Chief Donald Lyman, CA Department of Public Health, 2007.

    Letter from President Jeff Kightlinger, Metropolitan Water District, Los Angeles, CA, 2009.

    Letter from Associate Director for Communication, U.S. Centers for Disease Control and Prevention, 2010.

    #16.

    January 26, 2012

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This information is sent in support of the 2007 ban petition 2007FDA-P-0346, formerly 2007P-0400/CP1, and its
    Petition for Reconsideration, submitted 2010. Scientific facts are now clear today that were not known in the
    1940’s, 50’s, 60’s or 70’s when fluoride injections into public water supplies began and spread to many U.S. cities. One of the most significant new findings is, as stated in an earlier letter, there is now no doubt that synthetic fluoride from ingested industrial compounds sodium fluoride or fluosilicic acid, crosses the blood-brain barrier [1,2,3,4,5].

    This letter provides additional supporting data that indicate the absolute urgency for the FDA to halt water fluoridation in the U.S. or at the very least to request that Federal officials withdraw all endorsements for fluoride injections into water to treat people through internal ingestion. A widely employed American Water Works Association procedure is to add aluminum-based alum into raw water as a flocculant to remove dissolved solids. Unfortunately, this treatment chemically always leaves behind detectable levels of aluminum ion in the product water due to aluminum intrinsic finite chemical solubility. A typical residual level reportted by many water districts is 0.05 ppm aluminum ion. In the presence of added fluoride ion at 0.7 ppm, it is well accepted that aluminum fluoride complexes form in the acidic stomach, enhancing aluminum uptake into the blood after ingestion.

    Aluminum loading in the brain is twice as high in rodents given aluminum fluoride water at concentrations comparable to the above, compared to aluminum water alone since aluminum ion itself is not assimilated well. The effect is due to formation of uncharged aluminum fluoride complexes at acidic pH. Although fluoride assimilation is somewhat reduced in the presence of substantial aluminum ion, sadly aluminum uptake is far greater as a result. Mammals given aluminum fluoride water develop abnormal brain function, and the abnormal brain tau proteins in human Alzheimer’s disease bind aluminum ion efficiently to exacerbate the condition.

    Please understand that of all the leading causes of death due to disease in the United States, only Alzheimer’s disease has neither a cure nor an effective treatment. Moreover, of the top 6 leading caues of death, only Alzheimer’s continues to rapidly rise in incidence while all others are either declining or holding steady. Notice below the graph of U.S. data on incidence of lethal diseases as a function of year in the U.S. The incidence of Alzheimer’s continues to escalate exponentially since first recording in 1978. These data have been confirmed in publications printed by the Alzheimer’s Association. Presently, California leads the nation in per capita incidence of Alzheimer’s disease, and San Diego County leads CA in its incidence. Southern CA aluminum treatment of water supplies is now coupled with fluoride injections, in Los Angeles since 2007 and in San Diego since 2011.

    In non-fluoridated cities that treat drinking water with aluminum, where aluminum assimilation is minimal, industrial fluoride injections must be blocked, and use of Luride, particularly in the elderly, is contraindicated on first principles. There are in fact no valid reasons to excuse and allow the continuous internal ingestion of any industrial fluoride by citizens of the United States. It is necessary for government agencies to immediately stop requesting industrial fluoride injections into U.S. water suplies and to withdraw all endorsements for the internal ingestion of fluoride.

    References:

    1. Varner,J., Jensen, K., Horvath, W., Isaacson, R., Chronic Administration of Aluminum Fluoride or Sodium Fluoride to Rats in Drinking Water: Alterations in Neuronal and Cerebrovascular Integrity, Brain Research 784, no 1-2 pps. 284-28, 1998.
    2. Reddy, P., Reddy, K., Kumar, K., Neurodegenerative Changes in Different Regions of Brain, Spinal Cord and Sciatic Nerve of Rats Treated with Sodium Fluoride, Journal of Medical and Allied Sciences 1(1), pp. 30-35, 2011. http://static.infowars.com/2011/12/i/general/2011_study- neurodegenerative_changes_from_fluoride_of_brain_spinal_cord_and_sciatic_nerve.pdf (enclosed).
    3. Connett, P., Beck, and Micklem, The Case Against Fluoride, Chelsea Green Publishing, White River Junction, Vermont, 2010. (Chapter 15, Fluoride and the Brain, enclosed)
    4. Mullenix, P., Denbesten, P., Shunior, A., Kernan, W., Neurotoxicity of Sodium Fluoride in Rats, Neurotoxicology and Teratology 17(2) pp. 169-177, 1995.
    5. National Research Council, Fluoride in Drinking Water, A Review of EPA’s Standards, Washington, D.C., 2006. [cid:image138.jpg@01D47B9C.4AC11730]

    (Chart taken from CDC National Vital Statistics 2000 report page 9)

    ALZHEIMER’S DISEASE AND DEMENTIA – IMPORTANT NEW STUDY SHOWS GRAVE IMPLICATIONS FROM INTERACTION OF ALUMINUM AND LOW DOSE FLUORIDE

    The latest edition of the peer-reviewed medical journal, Brain Research, (vol.784:l998), reveals that aluminum- induced neural degeneration in rats is greatly enhanced when the animals were fed low doses of fluoride. The presence of fluoride enhanced the bio-availability of aluminum (Al) causing more aluminum to cross the blood-

    brain barrier and become deposited in the brain. The aluminum level in the brains of the fluoride-treated group was double that of the controls. http://www.actionpa.org/fluoride/aluminum.html

    Acknowledgments:
    Much appreciation is here extended to Moms Against Fluoridation (www.momsagainstfluoridation.org) for providing careful data analysis and for extensive letter writing to the U.S. Surgeon General to ban industrial fluoride treatment of public drinking water. Thanks also to San Diegans for Safe Drinking Water (www.SDSDW.org) for the graph employed in this letter.

    p.s. Although the FDA may be officially un-interested in animal welfare, the following letters regarding the famous
    Wild Animal Park show elephants, living on aluminum fluoride water since 2005, are included for context.

    ZOO ELEPHANTS WERE EUTHANIZED AFTER 6 YEARS OF ALUMINUM FLUORIDE WATER CONSUMPTION

    Dear Anthony Young, San Diego City Council,

    As a concerned San Diego native I write again to help you understand your rights regarding the use of substances in water to treat citizens of the city. All Water Districts in the U.S. who treat people with industrial fluorides for any putative effect on teeth via the bloodstream after ingestion are responsible for measuring the fluoride level in the blood of citizens they decide to treat. The burden of quality control is on the utilities that administer the agent, not the consumer who is forced to ingest it. The target blood level stated by the Oral Health Division dental officials within the CDC is 0.2 ppm fluoride [1], but neither the OHD dentists nor most city utilities understand that blood fluoride levels depend on water hardness. People consuming Seattle ultra-soft water (10 ppm calcium) have levels above 0.2 ppm in blood, and water chemists there add calcium chloride along with the fluoridation chemicals to help minimize assimilation [2]. In hard water Texas (safe 300 ppm calcium antidote), where the idea of ‘water fluoridation’ first began, the blood level is below 0.2 ppm. San Diego water (labeled ‘soft’ by water districts) has a calcium to fluoride ratio of only about 60 mg calcium per 0.8 mg fluoride. Animal studies show the blood level of fluoride was lowered 4 fold when calcium was administered along with sodium fluoride, compared to sodium fluoride alone.

    Those who believe the false claim, that fluoride consumption is harmless long-term, regardless of all the published human and animal studies proving otherwise, do not explain how fluoride, that crosses the blood brain barrier [3] and accumulates in bone permanently [4], somehow magically avoids having any effect on systemic biologic functions. How does this happen? The answer of course is that fluoride indeed causes harm. Look at the
    41% of 12-15 year olds in the U.S. having permanent abnormal tooth fluorosis that prevents a normal smile [4]. They are not smiling, and neither are San Diego residents voting against the injections who know the truth, that industrial fluorides are all toxic calcium chelators [5].

    Unfortunately after 6 years of consuming aluminum fluoride treated municipal water, the former show elephants of the Wild Animal Park were finally euthanized at the San Diego Zoo this week [6]. One was unable to walk and the other had also deteriorated after both became mentally unstable and unable to follow tasks in the shows that were canceled a few years after the Park began accepting treated municipal water in 2005. The Park was told in
    2005 they would not receive the treated water, but the Park’s utility, the San Pasqual Water District, arranged for the city of Escondido to provide the water that is treated with aluminum and with industrial fluoride [7], thinking without evidence that the water would be healthy for elephants, not realizing their large body to brain volume ratio.

    Show elephants consume copious amounts of water because of their daily activity level, over 60 gallons daily, and do not have kidneys designed to remove aluminum fluoride at an intake rate that high. They developed mental aberrations that are known to occur in laboratory animals given aluminum fluoride water at such levels for long time periods [3, 4], including inability to walk from motor brain degeneration. The problem is that aluminum and fluoride together in the acidic stomach form complexes that are assimilated into the bloodstream, causing aluminum accumulation in brain [4]. Aluminum in water without industrial fluoride is not assimilated. The elephants were transferred to the San Diego Zoo and have been treated with industrial fluoride water again since January of last year. The elephants’ mental deficiencies, being unable to wander around freely in the enclosure, never improved

    until they were euthanized. Zoo veterinarians do not acknowledge the role played by aluminum fluoride in these animals’ demise, nor are they trained in fluoride toxicology, and neither has a satisfactory explanation for this been found by them.

    It is necessary for city officials to request blood testing of citizens in San Diego that are under your care to verify that the target fluoride blood level is maintained with this new radical water district treatment. Remember that the CA law, that requests ‘fluoridation,’ does not mention the fluoride source of choice nor does it provide protocols for our local water, having only 60 ppm calcium, to achieve a desired blood level of 0.2 ppm fluoride. The CA Dept. of Health merely suggests what the OHD suggests, to use synthetic industrial hazardous waste fluosilicic acid diluted to ‘1 ppm’ free fluoride, making no mention of adjustments for water calcium or aluminum content! It must be emphasized again that both the CDC and the CA Dept. of Health, in detailed letters to me, made it perfectly clear that the city itself bears all responsibility and all liability for the injections designed to treat citizens in San Diego; and monitoring the health effects of animals by either agency is out of the question.

    Is it time to halt these injections? Of course it is. The FDA has never approved ingestion of fluoride because it is not a mineral nutrient and in water is an uncontrolled use of a non FDA-approved drug. When added intentionally into water, the FDA decreed fluoride is an unapproved drug. When accidentally or naturally found in water, both the FDA and EPA rule fluoride is a contaminant. We expect the FDA to ban the intentional injection of fluorides, or to bar the OHD from requesting the injections, soon. But nevertheless in the meantime, cities bear all liability for the injection of fluoride into citizens through public water supplies and because of that fact alone have full legal authority to halt the injections.

    References:
    [1] Personal communication and e-mail from David Nelson, while chief fluoridation officer, CA Department of Health, Sacramento, CA.

    [2] Online statements of chemists at the Seattle Water District.
    [3] Varner, Brain Research, 1986; Mullenix, Journal of Neurology and Teratology, 1995; Reddy, Journal of
    Medical and Allied Sciences, 2011; most data are reviewed in [4]. [4] Connett, P., et.al.,The Case Against Fluoride, 2010. [5] Yiamouyiannis, J., Fluoride, the Aging Factor, Health Action Press, 1986.
    [6] Perry, T., Zoo Euthanizes Zoo Elephants, North County Times, reprinted from Los Angeles Times, Jan. 7, 2012. [7] Freedom of Information Act request answered by the Escondido Public Works Department, 2010.

    Dear San Diego City Council,

    Continuing, we have data from the 50 U.S. states that rank disease incidence as a function of percent of water districts that fluoridate. The data indicate yet again that water fluoridation does not influence teeth decay, but has significant associations with increased tooth fluorosis, mental retardation, cancer and cardiovascular deaths [1]. There was no correlation of increased incidence of Alzheimer’s disease with fluoridation, but cities were not separated between those that treat water also with aluminum from those that do not.

    Please let me be clear. It is possible that the elephants from the Wild Animal Park that were mentally degraded and euthanized at the Zoo this week may have presented with some form of dementia independent of aluminum and fluoride in their water. However, there is little doubt that the massive amounts of aluminum and fluoride, ingested together that causes uptake into brain, hastened their complete demise. The abnormal tau proteins synthesized in brain in human dementia for unknown reasons have very high affinity for aluminum. Many Alzheimer’s victims have aluminum in large concentrations in brain at time of death.

    The Alzheimer’s Association is currently confused and does not know the cause of the high incidence of Alzheimer’s in the U.S. or why San Diego leads the nation in this category of death per capita. It is no longer assumed by this organization that aluminum is the causative agent. San Diego Water facilities indeed do not inject their own aluminum but report levels on water quality reports. Metropolitan Water, Los Angeles has injected aluminum as a clarifying agent long before fluoride injections were begun that enhance aluminum assimilation, and this water is imported to North San Diego County. However, the city of San Diego and Escondido are fully culpable for contributing to the demise of these prize animals by providing no option other than water treated with fluoride that also contained aluminum. There is little doubt that aluminum uptake in brain enhanced the mental condition the animals suffered. Aluminum taken up into the brain where it does not belong cannot hide to exert zero

    effects on structure and function. Numerous studies by Varner and coworkers over the last many decades [2] prove fluoride plus aluminum forms AlF3 complexes that are assimilated into brain that cause microscopically observed brain degeneration during long term chronic consumption. The question is why is this seemingly not more dramatic in the human population than what seems to exist, but remember the human brain is of very high capacity (200 billion cells per brain). Further, lack of effect is merely an impression, not a fact, since Alzheimer’s now is the 6th leading cause of death in the U.S. [3] and in San Diego County is now astoundingly 3rd [4]!! The time to death after Alzheimer’s first appears is relatively quick in many cases and there remains no cure.

    It is time to halt the inane practice of injecting industrial synthetic fluoride compounds into human drinking water in an attempt to find a child’s cavity, when nonfluoridated Europe has experienced the same rate of decline in caries incidence that the U.S. has seen during this water ingested fluoride program [5]. Understand again that CA AB733 was based on a false assumption, that swallowed fluoride was assumed to decrease caries, when biochemical measurements prove it cannot–it is present from swallowing in the saliva at only 0.02 ppm [6], unable to affect teeth topically though CA dental officials with vested interests attempt to ignore this [7]. And again, no protocols are provided in CA AB733; it merely asserts basically to ‘go forth and fluoridate’, without details of any kind, as though it were some sort of higher proclamation, when it is a corrupt order that violates the Safe Drinking Water Act (which prohibits any Federal requirement for drugs, supplements, or any chemicals added other than to sanitize water), the Food Drug and Cosmetic Act (requires FDA approval for any substance used as a putative treatment in humans) and the Water Pollution Control Act (section 101a). No State law can be legally binding that attempts to supercede these and other Federal laws covering public waterways that are Federal property. The Colorado River originates as far North as Western Wyoming (Wind River Mountain Range), and CA aqueduct water originates as far North as creek drainage in Southern Oregon. The Oregon State legislature barred any State requirement for fluoride in Oregon waterways, to protect salmon from the known gross mental narcotic effect fluoride exerts that causes salmon run collapse.

    As a medical research scientist and native San Diegan, I request that you order the Public Utilities Director, San Diego to stop titrating this illegal, unapproved, useless, harmful industrial substance lacking calcium into the water supply that is ingested by the innocent animals and people who reside here in our otherwise fair city. My brother was offered the position of head computer systems operator by the San Diego Padres. However, due to concerns over water fluoride (my brother has slight tooth fluorosis from a one-time Luride dose) he has chosen to remain in his home in Morgan Hill, CA. Morgan Hill is listed as a ‘fluoridated city’ but this is false. The water district chemists there stopped ordering drums of fluosilicic acid hazardous waste decades ago and refuse to inject synthetic fluorides into innocent people that, as a toxic calcium chelator, accumulates into bone permanently lifetime. Many people can remain rational about this, and I think you can also.

    References:
    [1] Dr. Osmunson, presenter, International Fluoride Conference, Toronto,Canada, 2008.
    [2] Varner, Brain Research,1986 reviewed at www.fluoridealert.org. [3] North County Times, Jan 12, 2012. [4] Signon San Diego News, 2010.
    [5] Connett, et.al., The Case Against Fluoride, Chelsea Green Publishing, White River Junction, Vermont, 2010. [6] National Research Council, Report on Fluoride in Drinking Water, a Scientific Review of EPA’s Standards,Washington, D.C., 2006.
    [7] personal communication with Dr. Kathleen Thiessen, co-author of reference [6].

    #17.

    February 10, 2012

    Department of Health and Human Services
    Public Health Service
    U.S. Food and Drug Administration Center for Drug Evaluation and Research Office of Regulatory Policy Rockville, MD 20857

    Dear FDA Project Reviewers,

    This letter is in support of the petition to ban the addition of synthetic industrial fluoride compounds into public drinking water supplies, original petition FDA-2007-P-0346, formerly 2007P-0400. The letter contains three principle sections: I. Cardiovascular effects of ingested industrial fluorides and the recent data from the Veterans’ Administration Healthcare System, Los Angeles indicating fluoride preferentially incorporates into atherosclerotic plaque and diseased heart tissue. II. A discussion of the withdrawal of a fluosilicic acid chemical supplier from the city of Selmer, Tennessee that could not provide data demonstrating either caries reduction or safety of use in the infirmed for consumers who ingest the chemical they provided. III. Direct communications with the U.S. EPA Office of Drinking Water, Region 9, San Francisco proving that EPA has no intention of regulating the procedures or chemicals used to treat humans with industrial fluoride compounds to be taken internally through public water supplies, which confirms the Petition for Reconsideration 2010 that the FDA, not the EPA, is exclusively in charge of regulating/prohibiting the dissemination of fluoride compounds to be taken internally through ingestion by citizens in the U.S. I.Cardiovascular Effects of Systemic Industrial Fluoride.
    The National Research Council 2006 Report [1] avoided discussion of the effects of industrial fluoride ingestion on cardiovascular function because comparatively so much more data existed for review on other organ systems
    (personal communication with Dr. K. Thiessen, coauthor of NRC Report). This is most unfortunate, since the mechanism of acute high level fluoride toxicity is known to be heart block due to inhibition of calcium ion mobility
    and related sequelae [2], the cause of death in the Nation’s worst water fluoride disaster in Hooper Bay, Alaska (see original petition). Further, at lower, intermediate blood levels of fluoride, research animals during long-term consumption develop heart muscle degradation and weakening [3]. Finally, for ‘low’ fluoride levels in consumers
    in U.S. treated cities, 0.2 ppm in blood, it has been long known that heart attack incidence increases in fluoridated cities. In Newburg, N.Y., heart attack incidence increased 1.7 fold after fluoridation began, which exceed the
    National average for the first time in city history, far in excess of incidence in the control city of non-fluoridated Kingston [5].
    Fluoride in soft water is assimilated more than from hard water, and a clear correlation between percent of fluoridated water districts and heart attack incidence for the 50 U.S. States [4] is even more significant for those
    States in soft water regions [2]. Dr. A.L. Miller submitted data to the U.S. Congress regarding the increased
    incidence of cardiovascular deaths after fluoridation of Newburgh, N.Y. and Antigo, Wisconsin [5]. Electrocardiogram abnormal heart rhythms and reduced myocardial function are found in an unusually large percentage of patients having dental tooth fluorosis [6]. This is supported by recent studies indicating that patients with chronic fluorosis have detectably decreased aortic elasticity and left ventricular function [7, 8].
    Although I do not support the injection of any fluoride compound into humans for any purpose, note that the study enclosed below, approved and conducted on heart disease victims for various assessment purposes, proves
    fluoride preferentially incorporates into damaged heart tissue and into coronary and femoral arteries and aorta in
    patients with cardiovascular disease. The study was conducted at the VA Health Care System in Los Angeles, CA, published in Nuclear Medicine Communications, 2011 [9]. There is no doubt that the fluoride ion when present
    systemically incorporates directly and selectively into heart tissue and various major arteries of patients who had
    suffered previous heart conditions, including coronary arteries, the aorta and the leg femoral artery where calcium has long been known to accumulate during atherosclerosis. The incorporation of fluoride, fully expected as a toxic

    calcium chelator, was directly observed by Positron Emission Tomography (PET) scans after injection of radioactive fluoride as sodium fluoride.
    The precise concentration in the bloodstream during the incorporation was not listed, but could be calculated by contacting the authors to determine the specific activity of the isotope employed. Acute heart attack was obviously
    not induced by the injections, so the concentration was a tolerable level that did not exceed the known solubility for calcium fluoride. At such concentrations that compare to that in U.S. citizens in fluoridated cities, the incorporation must occur by an ion exchange mechanism, similar to that in bone where fluoride binds permanently to calcium
    even when below the Ksp for the formed precipitate. The composition of the calcium ingredient in atherosclerosis remains unknown but is most likely calcium carbonate or phosphate, or a lipid complex. The ion exchange mechanism in bone is not opposed by fluoridation proponents (see attached graph from Newbrun, Fluoride and Dental Caries, 1975, indicating in England long before fluoridated pastes, gels and rinses, and before widespread fluoridation corrupted foods and beverages, that bone calcium levels in fluoridated cities accumulate lifetime to levels causing weakening by age 40-50 for water fluoride between 0.8 and 1.9 ppm). Predictably though, fluoridation proponents have claimed without experimental data to back it up, that fluoride as a perennially-excused substance might clean or prevent atherosclerotic plaque buildup. The VA study however indicates that any such claim by proponents must land on deaf ears, since plaque is not removed by fluoride but rather fluoride incorporates so efficiently into tissue that it is detected as solids on the PET scan.
    Fluoride is a toxic calcium chelator and thus incorporates into tissue where calcium is enriched, including calcium-rich atherosclerotic plaque. The authors of the VA study suggested that blood fluoride is expected to
    increase pathologic risk in patients with cardiovascular disease and that fluoride is a component feature of atherosclerosis. To be more accurate, fluoride itself is not a normal body component and its presence is thus an
    aberration. Atherosclerosis in the absence of fluoride is composed chiefly of cholesterol, calcium and fatty acids in the original fatty streak. These are normal constituents of the bloodstream and are always components of atherosclerotic plaque. Fluoride when present, not a normal body component, incorporates as an abnormal ingredient.
    These charges are extremely serious. The presumption that ‘fluoridation’ is safe is based on the fact that
    populations with normal health, regularly drinking fluoridated water in the U.S., can live full lives to a reasonably long age. However, Dr. Albert Schatz cautioned against this mistaken assertion, since it is not the healthy with good nutrition who are noticeably most susceptible to ingestion of industrial fluorides, but rather the undernourished and infirmed who are. Specifically, the population of American citizens who suffer with atherosclerosis or cardiovascular disease are at increased risk from continuous exposure to industrial fluoride taken internally to elevate the blood fluoride level to 0.2 ppm (or higher in soft water cities). Unusual stress in heart patients is expected to be more dangerous when all organs are invested with continuous levels of the fluoride ion where it does not belong.
    Atherosclerosis is still considered to be the most common underlying cause of heart disease in the U.S., particularly in cases of angina pectoris substernal chest pain due to coronary artery reduced blood flow and ischemia. Incorporation of fluoride into atherosclerotic plaque is an insidious and unnecessary abnormality that complicates atherosclerosis, the most widespread disease entity in the U.S. Consumption of industrial fluorides from public drinking water is contraindicated in humans afflicted with either atheroscelerosis or cardiovascular disease. Much recent data, not known when the idea of ‘systemic fluoridation’ was unveiled, now prompts the elimination of industrial fluoride compounds from being intentionally and indiscriminately injected further into public water supplies without a prescription. Cardiovascular disease remains the Nation’s leading killer, and regulation and enforcement is regarded as immediately necessary. As Buck pointed out long ago, indiscriminate dissemination of fluoride compounds into public water supplies is an act of violence, and today we must add that it is nothing short of elder abuse, with the known widespread prevalence of atherosclerosis, and the bone weakening that occurs after lifetime fluoride consumption, in the U.S. elderly.
    The widespread treatment of water with industrial fluoride compounds, in a worthless attempt to decrease dental caries through internal ingestion of fluoride ion, is not the fault of the U.S. FDA. FDA decreed in 1963 that fluoride is not a mineral nutrient and that its addition into public water supplies constitutes an uncontrolled use of a non-FDA-approved drug where dosage could not ever be regulated. Fluoridation is the fault of zealots who have routinely and completely ignored FDA statements on the matter, and the FDA is commended for not approving the ingestion of fluoride compounds and for only allowing ingestion by prescription in non-fluoridated cities. It is now time to impose regulations since currently no Federal agency assumes responsibility for the dissemination into public water supplies.

    Please understand that there is no such action that can be simply called ‘fluoridation.’ Fluoride cannot exist without the presence of other elements. Since 1939 when the original false correlation was made that fluoride, rather than the accompanying, responsible calcium ion, reduced teeth caries, fluoridation proponents have switched from using calcium fluoride (originally promoted as a fluoridation agent by the CDC) to sodium fluoride and then to the cheaper hazardous waste fluosilicic acid fluoride. The Safe Drinking Water Act was written to prevent using public water supplies as a medium in which to disseminate any fluorides for human ingestion, but yet fluoridation promoters have sidestepped the Act by adding tacked-on regulations along the way since 1974, designed to make allowances for ill-defined ‘fluoridation’. Fluosilicic acid supplies have now become depleted, and the next fluoride compound to be proposed to be used as source material will again be fully expected by promoters to go unnoticed and unregulated by any Federal agency.
    It is simple to claim that ‘fluoridation’ is natural—simply use an agent that is known to be a natural ingredient in
    the earth’s crust, such as sodium, silicon, lithium, aluminum or arsenic. The first two ingredients have already been
    in use for ‘fluoridation’, the former for over 69 years in the U.S. Any proposed use of lithium fluoride, aluminum fluoride or arsenic fluoride for water ‘fluoridation’ could also again be argued to be ‘natural’, fully expecting complete lack of Federal agency repudiation or a ban as long as the MCL for the extra component is not exceeded. The U.S has already entered down this slippery slope by ‘fluoridating’ water supplies with toxic industrial sodium fluoride and then with toxic hazardous waste fluosilicic acid, marketed to water districts and State public health departments as a water purifying agent with dental caries benefit as an ingestible. The industrial fluoride compounds are argued by the CDC as being ‘identical’ to natural calcium fluoride and thus deserving of the continued support and proclamation from the U.S. Surgeon General as the ‘greatest public health achievement of the 20th century’. How long this scheme continues is entirely up to the FDA, and no one else. We beg the FDA to oversee these injections, and if a ban is not instituted, then it should be possible to request that all fluoride compounds proposed to be ingested must be given by prescription only, rather than by forced injection into public water supplies used by everyone, having caries or not.

    References:
    1. National Research Council, Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C., 2006.
    2. Sauerheber, R., Chemical Analysis of Fluoride Poisoning from a Public Water Supply, submitted for publication in the Journal of Environmental Health, 2010.
    3. U.S. Centers for Disease Control and Prevention, Fluoride and Hydrogen Fluoride, Agency for Toxic Substances and Disease Registry, 2003.
    4. Osmunsen, B., presentation to the International Fluoride Conference, Toronto, Canada, 2007.
    5. Hardy, L., Mass harm from fluoridation, National Health Federation Bulletin, October, 1974.
    6. Xu, R. and Xu,R., Electrocardiogram analysis of patients with skeletal fluorosis, Fluoride, vol. 30, No 1, 16-18, 1997.
    7. Varol, S., et.al., Impact of Chronic Fluorosis on Left Ventricular Diastolic and Global Functions, The Science of the Total Environment, 408, No. 11, 2295-98, 2010.
    8. Varol, S., et.al., Aortic Elasticity is Impaired in Patients with Endemic Fluorosis, Biological Trace Element Research, 133, No. 2, 121-27, 2010.
    9. Yuxin, L., et.al., Association of vascular fluoride uptake with vascular calcification and coronary artery disease, Nuclear Medicine Communications: January 2012 – Volume 33 – Issue 1 – p 14–20
    http://journals.lww.com/nuclearmedicinecomm/Fulltext/2012/01000/Association_of_vascular_fluoride_uptake _with.3.aspx

    Nuclear Medicine Communications:
    January 2012 – Volume 33 – Issue 1 – p 14–20 doi: 10.1097/MNM.0b013e32834c187e Original Articles

    Association of vascular fluoride uptake with vascular calcification and coronary artery disease

    Li, Yuxina; Berenji, Gholam R.a; Shaba, Wisam F.a; Tafti, Bashira; Yevdayev, Ellaa; Dadparvar, Siminb

    Author Information
    aVA Greater Los Angeles Healthcare System, Los Angeles, California bUniversity PA Health System, Philadelphia, Pennsylvania, USA
    Correspondence to Dr Gholam R. Berenji, MD, VA Greater Los Angeles Healthcare System, Nuclear Medicine
    Service (115), 11301 Wilshire Blvd. Los Angeles, CA 90073, USA Tel: +1 310 268 3583; fax: +1 310 268 4916; e- mail: Gholam.Berenji@va.gov Received June 21, 2011
    Accepted August 18, 2011

    Abstract

    Objective: The feasibility of a fluoride positron emission tomography/computed tomography (PET/CT) scan for imaging atherosclerosis has not been well documented. The purpose of this study was to assess fluoride uptake of vascular calcification in various major arteries, including coronary arteries.

    Methods: We retrospectively reviewed the imaging data and cardiovascular history of 61 patients who received whole-body sodium [18F]fluoride PET/CT studies at our institution from 2009 to 2010. Fluoride uptake and calcification in major arteries, including coronary arteries, were analyzed by both visual assessment and standardized uptake value measurement.

    Results: Fluoride uptake in vascular walls was demonstrated in 361 sites of 54 (96%) patients, whereas calcification was observed in 317 sites of 49 (88%) patients. Significant correlation between fluoride uptake and calcification was observed in most of the arterial walls, except in those of the abdominal aorta. Fluoride uptake in coronary arteries was demonstrated in 28 (46%) patients and coronary calcifications were observed in 34 (56%) patients. There was significant correlation between history of cardiovascular events and presence of fluoride uptake in coronary arteries. The coronary fluoride uptake value in patients with cardiovascular events was significantly higher than in patients without cardiovascular events.

    Conclusion: sodium [18F]fluoride PET/CT might be useful in the evaluation of the atherosclerotic process in major arteries, including coronary arteries. An increased fluoride uptake in coronary arteries may be associated with an increased cardiovascular risk.

    Introduction

    Cardiovascular disease remains the leading cause of morbidity and mortality in the world 1. The major pathophysiologic change of cardiovascular disease is atherosclerosis in critical arteries. Atherosclerosis is a slow,

    progressive, and cumulative process that results in atheromatous plaque formation in vascular walls and eventually leads to narrowing of the arterial lumen, occlusion, or aneurysm formation. The development of atherosclerotic plaque is characterized by subendothelial fatty material accumulation, a chronic inflammatory process, and vascular calcification 2,3. To predict and prevent any deadly cardiovascular events, extensive studies have been conducted to evaluate the risk of cardiovascular disease. Over the past decade, many cardiovascular studies focused on the calcification process in atherosclerosis 4–7.

    Calcification in atherosclerosis occurs through an active process that resembles bone formation and is controlled by complex enzymatic and cellular pathways 8,9. Coronary artery calcification parallels atherosclerosis progress and is strongly and linearly correlated with the total atherosclerotic burden 10. Coronary calcification can be measured by computed tomography (CT) studies and is one of the most important predictors of future cardiovascular events. The level of coronary artery calcium can also help to reclassify asymptomatic individuals into high-risk or low-risk categories 4. Currently, sodium [18F]fluoride positron emission tomography (PET)/CT is the most sensitive imaging modality to detect active bone formation 11. Recently, Derlin et al. 12 reported the feasibility of sodium [18F]fluoride PET/CT for imaging atherosclerotic calcification in major arteries, including carotid, aorta, iliac, and femoral arteries. They also found that the mineral deposition in the carotid plaque detected by sodium [18F]fluoride PET/CT significantly correlates with atherogenic risk factors 13. Although atherosclerosis is a systemic disease, and evaluation of vascular calcification may potentially predict cardiovascular events, studies have shown that direct assessment of coronary arteries is superior to surrogate imaging for evaluating the risk of cardiovascular events 14. Some recent studies have demonstrated that evaluation of coronary arteries by PET is feasible 15–22. Most of these studies investigated fluorodeoxyglucose (FDG) uptake in coronary arteries. However, the clinical significance of [18F]fluoride uptake in coronary arteries has not been documented.

    In this study, we evaluated sodium [18F]fluoride uptake in major arteries, including coronary arteries, in 61 patients. The relationship between [18F]fluoride uptake and cardiovascular history and/or multiple risk factors was also evaluated.

    Materials and methods

    This study has been approved by the institutional review board of the Greater Los Angeles VA Healthcare System.

    Patients

    We retrospectively reviewed sodium [18F]fluoride PET/CT bone studies conducted at Veterans Affairs Greater Los Angeles Healthcare System from April 2009 to June 2010. There were 58 male patients and three female patients. Detailed clinical histories and the presence of cardiovascular risk factors, such as hypertension, diabetes, hypercholesterolemia, smoking history, obesity, and history of cardiovascular events, were obtained for all patients. The clinical characteristics of the patients are summarized in Table 1.

    Table 1 Image Tools

    Positron emission tomography/computed tomography protocols and imaging reconstruction

    PET/CT scans were performed using a Philips Gemini TF 64-channel time-of-flight PET/CT scanner (Philips Healthcare, Andover, Massachusetts, USA) with spatial resolution of 4.5 mm at West Los Angeles VA Medical Center. Sodium [18F]fluoride was injected intravenously at a dose of 10±2 mCi (370±74 MBq). Participants were comfortably seated in a private, quiet, cozy room. Forty minutes after the injection, patients were subjected to a low-dose CT scan of the whole body without contrast at 50 mA, 120 kVp, 0.5 s/rotation, a pitch of covering 0.83 mm, and a slice thickness of 5 mm 23,24. The subsequent PET data were acquired continuously for 90 s and at 180
    mm per bed position with 50% overlap between consecutive bed positions using a matrix of 140×140, followed by reconstruction corrected for attenuation using low-dose CT scans. No cardiac or respiratory gating was performed.

    Imaging and statistical analyses

    CT and PET images were coregistered by the Philips Extended Brilliance workstation (Philips Healthcare). CT, PET, and fused PET/CT images were evaluated visually and semiquantitatively simultaneously using the same workstation. All images were analyzed by two independent nuclear medicine physicians blinded to all patients’ clinical information. Inter-reader reproducibility was excellent and was evaluated using an intraclass correlation coefficient (0.89). Vascular calcification was identified as positive on CT images if the target was visually detectable with a greater than 130 Hounsfield units. CT-attenuated PET images were evaluated for fluoride uptake in major arteries. Background activity was based on the standardized uptake value (SUV) of the blood pool, which was calculated from the mean SUVs of three circular regions of interest (ROIs) placed in the left atrium, mid lumen of the aortic arch, and abdominal aorta at the level of the celiac trunk on axial images. The sizes of ROIs were 2 cm in diameter for the left atrium and 1 cm for the aortic arch and the abdominal aorta. Maximum SUVs (SUVmax) from target arteries were obtained by manually placing an individual circular ROI of 1 cm diameter in the target artery wall. All three orthogonal images were assessed for focal lesions in major arteries with an increased fluoride uptake. Positive fluoride uptake was identified if the target lesion was visually detectable with a greater than or equal to 1.5 target-to-background ratio in all three orthogonal image planes. For either CT or PET evaluation, the arterial territory was categorized as positive if at least one lesion was detected and agreed upon by both readers. The percentages of positive studies on both CT and PET of each arterial territory were calculated. Correlation between fluoride uptake and CT calcification was analyzed by Fisher’s exact test. Correlation of PET results and the number of cardiovascular risk factors were analyzed by the Wilcoxon rank-sum test. Significance was defined as P value of less than 0.05 in two-tailed studies.

    Results

    Patients’ age and reasons for sodium [18F]fluoride PET/CT imaging are summarized in Table 1. Most patients were men with a median age of 66 years (27–91 years). The majority of patients (69%) had more than one risk factor for coronary artery disease.

    Arterial sodium [18F]fluoride uptake and calcification

    Arterial wall sodium [18F]fluoride uptake and calcification were evaluated in major arteries, including carotid arteries, the thoracic ascending (including aortic arch) aorta, the thoracic descending aorta, the abdominal aorta, femoral arteries, and major branches of coronary arteries. Iliac arteries were not evaluated because of frequently observed urinary and occasional bowel uptake in the pelvis, which interferes with the accurate assessment of iliac vessels. For coronary arteries, four major branches were evaluated. An example of fluoride uptake in femoral arteries is shown in Fig. 1. Orthogonal views of fluoride uptake in the aorta and coronary arteries are shown in Figs 2 and 3.

    [cid:image025.jpg@01D47B9B.C7E22160]
    Fig. 2Fig. 3
    Image ToolsImage Tools

    Fig. 1
    Image Tools

    Both fluoride uptake and calcification were common in major arteries as summarized in Table 2. In general, fluoride uptakes in vascular walls were observed in 361 vascular territories of 59 (97%) patients, and calcifications were observed in 317 vascular territories of 49 (88%) patients. Only two patients did not demonstrate fluoride uptake in any of the vasculatures (one patient aged 27 and one aged 61). In thoracic aortas, the abdominal aorta, and femoral arteries, fluoride uptake was observed more frequently compared with calcification. In contrast, calcification was more common than fluoride uptake in carotid and coronary arteries (Table 2). Except for the abdominal aorta, fluoride uptake and calcification were significantly correlated in the same vascular territories, as evaluated by Fisher’s exact test. It should be noted that the fluoride uptake and calcification were not necessarily overlapped in the exact same anatomic locations. At calcification sites that did not demonstrate prominent overlapping fluoride uptake, fluoride uptake was frequently observed in the adjacent area within the same arterial territories (Fig. 2).

    Table 2 Image Tools

    Relationship between coronary fluoride uptake and cardiovascular risk factors

    The coronary arteries were also investigated for fluoride uptake. Four major branches of coronary arteries, including left main artery (LMA), left anterior descending (LAD), left circumflex (LCA), and right coronary arteriy (RCA) were evaluated. Fluoride uptake was more frequently observed in the LAD and LCAs. A similar pattern was also identified in coronary artery calcification. In each individual coronary branch, calcification was more frequently observed than fluoride uptake (Table 2). Among 10 patients who had significant three-vessel coronary calcifications, 80% demonstrated fluoride uptake in at least one coronary branch (data not shown).

    Cardiovascular risk factors including hypertension, obesity, diabetes, hypercholesterolemia, smoking history, and history of coronary artery disease were reviewed in all patients (Table 3). The majority of the patients (69%) had more than one cardiovascular risk factor; however, neither the individual cardiovascular risk factor nor the number of risk factors was significantly correlated with coronary fluoride uptake (Table 3). Nine patients had a history of cardiovascular events. Among them, eight demonstrated identifiable coronary fluoride uptake. There was significant correlation between coronary calcification and fluoride uptake in this group evaluated by Fisher’s exact

    test (Table 3). All nine patients also demonstrated coronary calcification on CT images. We also compared the SUVmax in coronary arteries between patients with and without a history of cardiovascular events. The average coronary SUVmax in patients with a history of cardiovascular events was 1.70, significantly higher than 1.39 for patients without a history of cardiovascular events (P=0.029, two-tailed Student’s t-test). No correlation was observed between cardiovascular risk factors and fluoride uptake in other vascular territories (noncoronary).

    Table 3 Image Tools

    Discussion

    Vascular calcification, in particular coronary calcification, has been shown to predict vascular events 25–27. Recent utilization of multidetector CT has made the assessment of coronary calcium feasible and reproducible 7,28. However, CT can only evaluate structural change, which usually represents later stages of the disease’s process. Given the assumption that fluoride uptake represents dynamic atherosclerotic calcification, we would expect that fluoride uptake occurs at the stage before the formation of detectable calcium deposition. Consistent with this theory, Derlin et al. 12 reported that only 12% of the calcification sites demonstrated prominent overlapping fluoride uptake, whereas 12% of fluoride-positive lesions did not show concordant calcification. In our study, fluoride uptake and CT calcification are significantly correlated in the same arterial territories, except in the abdominal aorta. This is because of the extremely high positive rate (97%, only one patient demonstrated negative uptake) for fluoride uptake in the abdominal aorta. Fluoride uptake either overlaps with calcification or locates adjacent to the detectable calcium deposits, suggesting that fluoride uptake and detectable calcification represent different stages of the atherosclerotic process.

    In large arteries, such as the thoracic aorta, abdominal aorta, and femoral arteries, fluoride uptake is more commonly observed than calcification. This finding is different from results published by Derlin et al. 12, which demonstrated that fluoride uptake is less frequently observed than calcification in all major arteries. The discrepancy may be due to different PET/CT scanners. In our study, we used a time-of-flight PET/CT scanner with better spatial resolution (4.5 mm vs. 8 mm) and higher sensitivity. In addition, differences in patient populations may also contribute to the discrepancy. Most of our patients were older male veterans with multiple cardiovascular risk factors. Consistent with this, our data demonstrated notably higher incidents of calcification compared with the data published by Derlin et al. 12. Recently, they also reported that fluoride uptake in carotid arteries significantly correlated with cardiovascular risk factors. We found that 43 (right) and 48% (left) of patients have carotid calcifications, whereas 34 (right) and 38% (left) of patients have fluoride uptake, compared with 32 (right) and 37% (left) with calcification and 25 (right) and 28% (left) with fluoride uptake according to the results from Derlin et al.
    13. However, we did not observe any correlation between carotid fluoride uptake and cardiovascular risk factors, probably because of the limited number of patients in our study.

    In contrast to the results of the aorta and femoral arteries, fluoride uptake was less commonly observed than calcification in coronary arteries. This phenomenon could be due to the following reasons: (a) the limited spatial resolution of PET reduces the sensitivity to detect fluoride uptake in smaller arteries; (b) the combination of cardiac and respiratory motions further reduces the sensitivity of PET in the evaluation of coronary arteries; (c) the proximal coronary arteries are surrounded by vascular structures that are highly susceptible to calcification. These include aorta, pulmonary artery, and heart valves. All these structures may affect the interpretation of fluoride uptake in coronary arteries; and (d) the partial volume effect on the small size of the ROIs is also a possible reason.

    Coronary motion is greatest in the RCA, followed by circumflex coronary artery, LAD, and LMA in descending order 29. Our study demonstrated that fluoride uptake was more frequently observed in LAD and circumflex coronary artery than in the RCA and LMA. Motion artifact reduces the sensitivity to detect fluoride uptake in the RCA. The short length of LMA and its short distance to the aorta, which frequently demonstrates fluoride uptake, may attribute to the low frequency of fluoride uptake in the LMA. Despite the feasibility of fluoride PET evaluation of coronary calcification, coronary imaging with fluoride PET/CT remains challenging because of small artery size, motion artifact, and interference of surrounding vasculature calcifications. All of these factors will potentially cause either false-negative or false-positive results. The recent development of cardiac–respiratory gating technology in PET scans may increase the accuracy of coronary imaging 30–32. In addition to the technical difficulties in evaluating coronary arteries, the limited number of patients and the unvarying nature of the patient population in this study may be skewed and may not apply to the general population.

    We found that fluoride uptake in coronary arteries is significantly correlated with a patient’s history of cardiovascular events, and the uptake value in patients with cardiovascular events was significantly higher than that in patients without cardiovascular events. These results further support the fact that higher fluoride uptake in coronary arteries indicates increased cardiovascular risk. Recently, several studies have demonstrated the feasibility of FDG-PET/CT in detecting plaque inflammation in coronary arteries 15–22. Nevertheless, fluoride PET/CT detects active mineral deposition, which represents the distinct pathophysiologic process of atherosclerosis. Derlin et al. 33 reported that uptake of FDG and sodium fluoride in vessel wall alterations was rarely coincident, supporting the suggestion that these two studies evaluate different functional and morphologic changes of the atherosclerotic process. The FDG uptake and fluoride uptake of atherosclerotic plaques could have complementary roles in evaluating the cardiovascular risk of patients. The combination of sodium [18F]fluoride PET and CT is a promising imaging modality that provides both metabolic and anatomic information in evaluating vascular calcification. However, large-scale studies are needed to evaluate the clinical significance of fluoride PET/CT for imaging atherosclerosis.

    Conclusion

    Our study demonstrates that vascular calcification and fluoride uptake are significantly correlated in the same arterial territory, although not necessarily overlapping in the same anatomic locations. An increased fluoride uptake in coronary arteries may be associated with an increased cardiovascular risk. Combined anatomic and metabolic imaging with sodium [18F]fluoride PET/CT offers a promising, noninvasive method to evaluate atherosclerosis.

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    II.Fluosilicic Acid Industrial Fluoride Removed from Fluoridated Selmer, Tennessee.

    The letter below was sent to San Diego Mayor Sanders, in an attempt to appease San Diego citizens, and myself, by asking the Mayor a favor that is not unreasonable. David Robinson, the Mayor of Selmer, Tennessee asked a few questions of the fluosilicic acid suppliers for his city and found the supplier could not provide such answers, and instead ceased to provide any further the specific fluosilicic acid formulation that had been used in Selmer for years, and then removed all fluoridation equipment and chemicals from Selmer (see Robinson letter attached). Mayor Robinson has agreed to send the correspondence he has to Mayor Sanders, if it is requested. Here is an attempt to obtain that information to have on file for the city of San Diego for reference because of use by San Diego of the same fluoridation materials used in Selmer.

    Dear Mayor Sanders,

    I am writing to ask a simple specific favor of you. You are fully aware of my feelings on this, but this request is not related to either the support of, nor the opposition to, water fluoridation and is not dependent on scientific data. David Robinson, the Mayor of Selmer, Tennessee wrote to me that he will provide information he obtained that resolved this issue in Selmer, that is similar to that in San Diego. Selmer City officials in the fully fluoridated state of Tennessee found itself in a position similar to here in San Diego, where citizens opposed a measure that is nevertheless required, as here by the CA State fluoridation bill. It is a great story and I’m certain you will be happy that you contacted him, in particular because in so doing you will have the latest information that will fulfill your obligations of due diligence for duty of care for citizens here.

    Thank you for your consideration of this request, for the benefit of our city.

    Robinson is a good and effective mayor and he wrote that he will be more than happy to forward the brief correspondence he has if you ask. His contact information he sent me is:

    David Robinson

    Mayor, Town of Selmer

    City Hall 731-645-3241

    Cell 731-610-7016

    Fax 731-646-1462

    III.Correspondence with the Office of Drinking Water, U.S. Environmental Protection Agency, Region 9, San Francisco.

    The FDA 2010 response to the 2007 petition stated that “artificial fluoride compounds used to fluoridate public drinking water…is regulated by the U.S. Environmental Protection Agency (EPA) under the Safe Drinking Water Act of 1974 (SDWA).” To clarify for you the actual official belief held by the EPA, enclosed please find letters of communication with Jill Korte, U.S. EPA, Region 9, San Francisco, CA, Office of Drinking Water.

    The following letters were recently exchanged with U.S. EPA Region 9. In summary, the EPA mistakenly proposes that fluoride is a contaminant and as long as the level is not in excess of the MCL of 2 ppm, EPA does not take action. In the letter it was admitted that no Federal requirement is allowed for agents added into water to treat people, but that EPA is not concerned with this because the EPA itself does not recommend or support the injections. Intentional injections, although in violation of the SDWA, will not be enforced until the level exceeds the allowed level for fluoride pollution at 2 ppm. In other words, EPA will do no regulating of the procedures by which fluoride compounds are titrated into water, and EPA basically views the MCL as an invitation to ‘fill ‘er up’ with a substance that is not allowed by the SDWA.

    Notice my response to the EPA indicates that we all need to follow the SDWA and prohibit adding any purported medicaments or other agents into water supplies other than to sterilize the water, and that adding a fluoride compound violates the Act. No industry or private agency or citizen is allowed to add any contaminant or other substance into water simply because the total concentration after dilution is kept below the MCL that EPA has decided to allow for a pollutant. The EPA is using the MCL as though it is a value assigned for an ingestible substance approved with proper regulations required by the Food Drug & Cosmetic Act. Understand though that only proper prospective controlled human clinical trials data may be used to arrive at a daily dose for any purported ingestible compound to be taken internally, as required by the FD&CA.

    I apologize for the unnecessary side topic of arsenic being mistakenly typed in a wrong column on a Water
    District report, rather than being an actual water error, as you will see in the exchange.

    Richard D. Sauerheber, Ph.D.
    Palomar Community College
    1140 W. Mission Rd., San Marcos, CA 92069
    E-mail: richsauerheb@hotmail.com Phone: 760-402-1173

    U.S. Environmental Protection Agency
    Region 9, San Francisco, CA Drinking Water Office

    Dear Jill Korte,

    The U.S. EPA of course is not itself directly violating the U.S. Safe Drinking Water Act. I realize that the EPA is not adding fluosilicic acid and is not recommending its addition either. But what you fail to see is that the State of California is in violation of the SDWA because indeed the State, under the direction of Federal dental officials at the Oral Health Division of the Centers for Disease Control by their request, is indeed adding an agent to treat humans through the public water supply, in violation of the Act.

    You have claimed in your letter that the EPA allows the INTENTIONAL injection of chemical substances to treat humans through drinking water as long as the final dilution level remains below the EPA MCL for fluoride. This is absurd. Understand that the 2 ppm MCL you mention is the allowed level for fluoride as an accidental or naturally- present contaminant. It is NOT an invitation to ‘fill ‘er up’ with fluoride on purpose, as long as it remains below 2 ppm when you are done. Intentionally adding a contaminant violates the SDWA just as much as intentionally adding a substance to treat humans violates the Act. Remaining below 2 ppm does not give one the right to willfully place any substance into public water supplies.

    If you as a public servant feel this way and interpret the original Congressionally-approved statutes of the SDWA that way, then please consider this:

    The next time someone dumps barrels of pure arsenic into a public water supply, you have no right whatsoever to arrest him or prohibit his actions, as long as he carefully titrates it in so that the final level does not exceed the MCL for these materials that is allowed by the EPA.

    Do you understand how absurd your thinking is? EPA Region 9 is a basically useless entity in helping spare the people of this country and our State from the intentional treatment of the human blood supply with industrial fluoride through drinking water. Why do you support such nonsense? EPA scientists are currently in litigation over this very matter (Connett, et.al., The Case Against Fluoride, 2010). EPA has every right to order the halt of intentionally-injected contaminants into public water supplies because the EPA is entrained to follow and enforce the SDWA as much as public citizens and anyone else in this country is obligated to honor. Indeed, as you may know, EPA scientists have published that we must stop using our Nation’s water supplies as a vehicle to dispose of toxic hazardous waste fluosilicic acid. How long does the public need to wait for help from EPA administrators?

    Finally, as a chemist who is fully aware of methodology required to eliminate fluoride contamination from drinking water, please understand that the CA Department of Public Health routinely ‘certifies’ reverse osmosis units as ‘reducing fluoride by 90%.’ This is a deceptive and evil practice. In detailed interviews, chemists who perform the tests admitted that this type of reduction cannot be obtained when starting with fluoride concentrations present by intent in public water supplies. 90% reduction is only obtained when starting with fluoride levels in excess of the Ksp solubility for calcium fluoride. In other words, at 8-9 ppm fluoride where calcium fluoride precipitates as particles, of course RO easily removes them. The same instrument however is incapable of but a mere 30% or less reduction when the input water is 1-2 ppm fluoride. Fluoride removal from treated public water under conditions of current use is an expensive and non-trivial issue. Engineers have recently developed special ultra tiny pore size membranes that under high pressure can separate water from fluoride by forcing the oblong water molecule through a pore that tiny fluoride ion cannot enter, but only recently have these become available retail. Also animal bone char (Brimac), only available from facilities in Scotland, is capable of eliminating fluoride by ion exchange much like live bone can, so one’s own bones do not incorporate it. These are the only two methods that work for drinking water, and only the latter method is usable for whole house use for those who cannot shower with fluosilicic acid water due to fluoride allergy. RO wastes far too much water for every gallon produced. And whole house bone char is very expensive to maintain, particularly with Brimac shortages that already exist.

    It would greatly benefit you if you could please examine the above Connett text and also the National Research
    Council Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C.,
    2006 that the EPA commissioned to investigate this specific issue. The NRC concluded without reservation that the current allowed EPA MCL for fluoride is not protective of human health. This is consistent with the current CDC- documented epidemic of tooth fluorosis we now have in 41% of American children aged 12-15 as of 2001 that prompted the U.S. Health and Human Services to request water levels not exceed 0.7 ppm as an interim measure until the issue of ‘water fluoridation’ is resolved. FDA has never approved ingestion of fluoride compounds from public water supplies and has never allowed sale of fluoride compounds to be taken internally without a prescription. The petition to ban fluosilicic acid injections into water supplies in the U.S., accepted for review by the FDA in 2007 (FDA-2007-P-0346), is still pending.

    We again ask the EPA to enforce the SDWA in the meantime, in particular for us here in Carlsbad, CA. The National Sanitation Foundation private organization Standard 60 ‘certification’ mark is devoid of controlled human clinical trials data to back it up, as the FDA recognizes. EPA has a long way to go to catch up on this National abuse of a substance that continues without regulation by any Federal office that agrees to accept liability or responsibility for the treatments.

    You might also want to contact Mayor David Robinson of Selmer, Tennessee who will provide letters indicating that fluosilicic acid suppliers do not have any data demonstrating caries reduction in those who consume their product and have no evidence of safety for long-term consumption, particularly in the infirmed. An EPA MCL is not an allowance to ingest a substance intentionally for its drug-like effects. Food Drug and Cosmetic Act regulations must be satisfied for any such substance used as an ingestible. If you seek, you will find that the FDA ruled fluoride in water is an uncontrolled use of an un-approved drug and is not a mineral nutrient.

    The FDA is not in an as easy a position as is the EPA to ban the injections or to prohibit them for selected locations in honor of the SDWA. And this is why we are asking you to act on this request instead of dismissing it on paper.

    To: richsauerheb@hotmail.com

    CC: Jones.Joel@epamail.epa.gov; Pringle.Everett@epamail.epa.gov; Sylls.Gene@epamail.epa.gov

    Subject: Fw: (SDWA – FY12-91141-3715-CV) Referred to Region – California

    From: Korte.Jill@epamail.epa.gov

    Date: Wed, 8 Feb 2012 09:22:55 -0800

    Dear Dr. Sauerheber,

    Thank you for your e-mails of 1/10/2012 regarding the Metropolitan Water’s (MWD) treated drinking water supply that is provided to Carlsbad Water District. You asked that EPA request that Carlsbad water not be treated with fluoridation materials by MWD due to your health concerns about fluoride and potential impurities in hydrofluosilicic acid, such as arsenic. The drinking water supplied by Carlsbad Water District is in compliance with the federal and state standards for both fluoride and arsenic. Furthermore, the State of California meets its obligations under the Safe Drinking Water Act for the delegation of primary enforcement authority for the public water supply supervision program with respect to the fluoride standard. The U.S. EPA cannot request that MWD stop fluoridation of its water supply.

    The Safe Drinking Water Act (SDWA), 42 USC §300g-1(b)(11), does prohibit the federal government from adopting any national primary drinking water regulations that “require the addition of any substance for preventive health care purposes unrelated to contamination of drinking water.” The U.S. EPA has not adopted any national regulations requiring the addition of fluoride or any other substance for preventive health care.

    The SDWA, 42 USC §300g-2(a)(1), requires states such as California that have been granted primacy enforcement responsibility for public water systems to “adopt drinking water regulations that are no less stringent than the national primary drinking water regulations.” With respect to fluoride, the U.S. EPA has adopted a health- based, enforceable, primary standard of 4.0 mg/l and a secondary standard of 2.0 mg/l that is based on the cosmetic effects of dental fluorosis. Under federal regulations, public water systems with fluoride levels greater than 2.0 mg/l but less than 4.0 mg/l are subject to specific public notification requirements, but are not required to treat to levels 2.0 mg/l or less. California’s enforceable, primary standard for fluoride is 2.0 mg/l, making the state regulation more stringent than the federal regulation. Although California does require its larger public water systems to fluoridate, they are assigned an optimal fluoride level and must operate within a control range, the upper limit of which is less than the more stringent, state enforceable maximum contaminant level (MCL) of 2.0 mg/l.

    Metropolitan Water District’s Skinner Water Treatment Plant provides water to Carlsbad Water District and consistently produces water that is well below the MCLs for both the state and federal fluoride and arsenic MCLs. Arsenic is not detected in the MWD supply from the Skinner Treatment Plant. In addition, treated water provided to Carlsbad Water District by the San Diego County Water Authority also meets both federal and state standards for fluoride and arsenic.

    Any questions you have on fluoridation or home treatment units for fluoride removal should be directed to the
    California Department of Public Health in Sacramento at (916) 449-5600. Thank you for your interest in this topic. Sincerely,

    Jill Korte, P.E.

    Environmental Engineer CA PWSS Project Officer U.S. EPA Region 9 Drinking Water Office
    75 Hawthorne St. (WTR-6) San Francisco, CA 94105
    (415) 972-3562 (415) 947-3549 (fax)
    01/10/2012
    SUBJECT: FWD: (SDWA – FY12-91141-3715-CV) Referred to Region – California FROM: sylls.gene@epa.gov
    TO: jones.joel@epa.gov
    CC:
    See complaint #91144. The following tip is from the National Tips Database. This information is being provided to you for whatever action you deem appropriate. Please follow up or notify the appropriate agency.

    1/4/2012 8:46 PM
    HQ LEAD NUMBER: FY12-91141-3715-CV SUBJECT: Referred to Region – California FROM: richsauerheb@hotmail.com TO:
    Name: Dr. Richard Sauerheber Address: 1826 Redwing. St. City: San Marcos State: California
    Zip: 92078
    Phone: 760-744-2547

    Alleged Violator’s Name: Carlsbad Water District Alleged Violator’s Address: 5950 El Camino Real Alleged Violator’s City: Carlsbad Alleged Violator’s State: California
    Alleged Violator’s Zip: 92008
    Tip or Complaint:
    I here raise a formal complaint against the Carlsbad Water District, San Diego County for its use of water with high arsenic levels, and for not reporting this clearly. A value of 120 ppb arsenic detected was listed on their water
    quality report 2011 with an average of 1.9 ppb. As you know, the EPA allowed MCL for arsenic since Jan., 2011 has been 10 – 50 ppb. The CA State MCL is 10 ppb and the State Public Health Goal is zero. A small amount of
    arsenic is diluted into water from added fluosilicic acid crude preparations that use the excuse of fighting cavities with the fluoride contained in it. Again, the As PHG is zero. Further, it is a violation of the Safe Drinking Water Act for any State to be less restrictive than its clause that prohibits any National requirement for any substance
    added into water other than to sanitize the water. This makes it illegal to add arsenic, fluoride, or any substance other than to kill bacteria, into water and yet the practice of adding both has now spread even here to Southern CA

    recently against the voting will of the public. These were the typed data in the Carlsbad Water Quality Report,
    2011. Arsenic: CA MCL 10 ppb; PHG .004 Sample 1.9 Range ND – 120 I was told by an employee of CWD that the 120 number was not a reading, but an ‘allowed range’. But again the Fed and State allowed ranges do not include a number as high as 120 ppb. I told him that and he said he wasn’t sure and that I need to talk with the supervisor who is not available. The 120 number was printed in the report in the column in which measurements were reported, not in the column which lists the allowed MCL’s, as shown above.
    If you could look into this we would appreciate it here in Carlsbad. We have had a terrible history with elementary school children perishing with cancers of various types and we are aware of the problem with schoolhouses being built on farms (as here) where arsenic pesticides had been used and that allowed arsenic emissions are detected from the Carlsbad emission stacks from a utility. The last thing Carlsbad children need is an extra dose of arsenic from their local water supply and yet that is what they are getting, from fluosilicic acid diluted waste and obviously additional unknown sources responsible for these readings. Carlsbad should be placed on a moratorium for the addition of crude hazardous diluted fluosilicic acid waste, out of sheer courtesy to the parents of these children as well as for the safety of the children themselves.
    We in So CA have had enough of fluosilicic acid waste that actually adds, for every 30 tons of added materials,
    10 tons of sodium in fresh water where it does not belong, 10 tons of fluoride unwanted by the citizens, and 10 tons of silicic acid, all labeled as ‘water fluoridation.’ When does drugging the people of a city end, and who has
    the right to alter the bone density of citizens with fluoride that we now know crosses the blood brain barrier and
    injects arsenic when we are trying to remove it under our specific problematic circumstances? Violation Still Occurring? Yes State DEP/DEQ/DEM Notified? No

    01/10/2012
    SUBJECT: FWD: (SDWA – FY12-91144-3715-CV) Referred to Region – California FROM: sylls.gene@epa.gov
    TO: jones.joel@epa.gov
    CC:
    See complaint #91141. The following tip is from the National Tips Database. This information is being provided to you for whatever action you deem appropriate. Please follow up or notify the appropriate agency. 1/4/2012 11:10 PM
    HQ LEAD NUMBER: FY12-91144-3715-CV SUBJECT: Referred to Region – California FROM: richsauerheb@hotmail.com TO:
    Name: Dr. Richard Sauerheber Address: 1826 Redwing St. City: San Marcos State: California
    Zip: 92078
    Phone: 760-744-2547

    Alleged Violator’s Name: Metropolitan Water District
    Alleged Violator’s Address: Alameda St. Alleged Violator’s City: Los Angeles Alleged Violator’s State: California Alleged Violator’s Zip: 90054 Tip or Complaint:
    I earlier submitted a complaint against Carlsbad Water District, CA on behalf of children in that city. Upon reading the Vallecitos Water Report that shares the same water source, it became clear that the Carlsbad Water

    Quality Report made a simple clerical error and typed in a value of 120 ppb for arsenic that was actually that for barium, which is an acceptable number. The remaining part of the original complaint then is directed to Metropolitan Water, Los Angeles, because Carlsbad does not inject the fluosilicic acid materials, but rather MWD does. MWD is unaware of the arsenic issue in Carlsbad, where arsenic in schoolyard soils and from the city power plant stack parents believe is causing the high incidence of childhood cancers here. The type and class IA human carcinogen arsenic is present in small amounts in the fluosilicic acid injected for its fluoride by MWD and we ask the EPA to request that Carlsbad water not be treated with fluoridation materials by MWD, particularly inasmuch as fluoride in blood at 0.2 ppm inhibits DNA repair enzymes involved in cancer cell removal (Yiamouyiannis, Fluoride, The Aging Factor, 1985; National Research Council, Report on Fluoride in Drinking Water, 2006; Connett, The Case Against Fluoride, 2010) and because Carlsbad Water has arsenic and lead at levels approaching their respective MCL’s both at the same time.
    Fluosilicic acid waste injections are requested by Federal dentists at the CDC, which is prohibited by the Safe Drinking Water Act since no National requirement may be made for any substance added into water other than to sanitize the water, and States can be no less restrictive. Ingested fluoride is not FDA approved, and States cannot require consumption by citizens of a substance that is not FDA approved. Carlsbad citizens are being disserved by EPA allowance of fluosilicic acid hazardous waste injections into city water supplies that violates the SDWA. The National Sanitation Foundation is a private agency that ‘certifies’ the injection materials without having data demonstrating it is effective at caries reduction or that it causes no harm to anyone upon long term consumption. The chemical supplier Lucier Chemicals and Brenntag Chemicals likewise have no such data demonstrating safety or effectiveness of the materials they sell and deliver to MWD and to San Diego (personal communication, Brenntag CEO, water chemicals division).
    Carlsbad water also contains injected aluminum at 0.05 ppm which forms complexes with fluoride in stomach acid. Fluoride crosses the blood brain barrier, affects calcium homeostasis and induces bone cell division as a result. These children with high incidence of various lethal cancers in Carlsbad are being subject to unnecessary risk with fluoridation waste materials that is inconsistent with current conditions here. Thank you for your attention. Violation Still Occurring? Yes
    State DEP/DEQ/DEM Notified? Yes

    #18.

    March 24, 2012

    Department of Health and Human Services
    Public Health Service
    U.S. Food and Drug Administration Center for Drug Evaluation and Research Office of Regulatory Policy Rockville, MD 20857

    Dear FDA Project Reviewers,

    This letter is in support of the petition to ban the addition of synthetic industrial fluoride compounds into public drinking water supplies, original petition FDA-2007-P-0346, formerly 2007P-0400. It has come to my attention that Metropolitan Water District, Los Angeles has been conferring with and advised by officials from the U.S. Environmental Protection Agency to determine dosages in public water supplies for the treatment of consumers with fluoride to be taken internally.

    This treatment has nothing to do with environmental protection, but is instead a medical health procedure with the goal of treating the bloodstream of consumers to 0.2 ppm fluoride in an attempt to affect dental tissue through systemic ingestion. This medical procedure has been labeled a dietary supplement (CDC) or as an unapproved drug (FDA) where nevertheless the EPA has no Congressional authority to set dosages for any substance to be taken internally by man in the U.S. That is the sole role of the FDA. Below is correspondence from the President of MWD indicating the role EPA officials are playing in determining dosages. Unfortunately, the EPA MCL’s of 4 and 2 ppm fluoride for water are to indicate when water is not to be consumed (4 ppm) and when citizens are to be warned to avoid it (2 ppm) because of known adverse effects on bone during long-term consumption at these levels. Sadly, using these levels as though they were guidelines from volunteer, prospective controlled human clinical trials is a miscarriage of justice that has given MWD board members the false impression that such trials have been conducted, when in fact they have not. FDA ruled in 1963 that fluoride in drinking water is an uncontrolled use of a drug and in 1993 that taking fluoride internally through intentional ingestion is an unapproved drug.

    I understand the former claim (2010) by the FDA regarding the 1979 MOU, that has since been repealed, where the EPA was asked to regulate water fluoridation chemicals and procedures, but that memo never intended for the EPA to be responsible for determining or contributing to decisions regarding dosages to be given to consumers for fluoride to be taken internally under conditions with purported benefit but without adverse effect in consumers. The EPA has no such data of safety or effectiveness, or has expertise to determine such dosage in human consumers, particularly in patients who are missing kidneys and rely on dialysis equipment for survival, and in diabetics who typically consume twice as much water daily as similar-weight non-diabetics, and mental retardation victims now that it is certain fluoride crosses the blood brain barrier where it alters brain cell calcium metabolism. The EPA is unaware of such sequelea from fluoride taken internally and is unaware of fluoride-drug interactions, fluoride allergies, or fluoride and HF effects on those with stomach ulceration, Crohn’s and other digestive diseases. As a case in point as to how uninformed the EPA and the general public is on fluoride toxicology, the following is a description of a museum display on fluorotic bone vs. normal bone that may be used as an instructional tool. It is intended to introduce the fact that fluoride is both an acute poison (lethal at 5 ppm in blood) and an insidious chronic poison when present at blood levels long-term that are sub-acute, with widely different deleterious effects.

    The Associated Press recently reported that hip, knee and elbow replacement surgeries have risen dramatically in the U.S.in recent years. It is inexcusable under these conditions, knowing that fluoride accumulates pathologically into bone permanently during lifetime ingestion, for any human public drinking water to be treated with industrial

    fluoride compounds to be taken internally. The treatment is an attempt to solve one problem, tooth caries, but instead introduces other problems, including bone weakening, impaired brain cell calcium metabolism, incorporation into atherosclerotic plaque in cardiovascular disease patients, and in fact ingested synthetic fluoride does not decrease teeth caries systemically at 0.2 ppm in blood and 0.02 ppm in saliva (see previous letters).

    Sincerely, Richard Sauerheber, Ph.D.

    Dear Mayor Sanders,

    March 22, 2012

    I understand this is the final year for you as Mayor of San Diego. I believe it would be good if you could examine the correspondence below with Jeff Kightlinger, President of Metropolitan Water, Los Angeles. Kightlinger informed me that no State official ever forced MWD to inject fluosilicic acid, but that the MWD Board itself made that choice. This means that the fluoride treatment of San Diego will be one of the legacies of your administration, if left as is.

    The fluosilicic acid chemical suppliers have no data demonstrating caries reduction when the product is ingested. I am certain you would be a virtual hero to the people of San Diego (and elsehwere) by looking into this and fulfilling the voting will of San Diegans. I fully expect that Kightlinger will correct this, now that we have data, unknown when the practice started in 1945, that proves fluoride crosses the blood brain barrier and incorporates into atherosclerotic plaque in cardiovascular disease patients (found on PET scans by physicians at the VA hospital, Los Angeles, published in: Yuxin, Nuclear Medicine Communications, Jan., 2012).

    As you will see below, MWD has been relying on advice from the EPA for fluoride dosage instructions. EPA regulates contaminant, not supplements or medicaments, for which only the FDA has Congressional authority. In fact it was for this reason that litigation was filed this year against MWD in Federal court.

    Richard Sauerheber, Ph.D.

    Correspondence (arranged in order for simpler reading):

    Dear Jeff Kightlinger, Metropolitan Water, Los Angeles,

    Thank you for the editorial you submitted to the North County Times. I do not condone the claims of North
    County Supervisors that San Diego water is being more unfairly charged for water delivery than other cities are.

    On the other hand, one of the sources of unnecessary costs that all overlook is fluosilicic acid/caustic soda injections that treat people, rather than sanitize water. I must inform you that an MWD spokesman incorrectly told a news reporter (France 24 television) that MWD has ‘authority to inject fluosilicic acid from the EPA’. I have a letter from EPA Region IX San Francisco, Office of Drinking Water, Jill Korte, that states the opposite! EPA does not authorize the injection of fluosilicic acid for its fluoride in public water supplies. That is fully the responsibility of the city itself who chooses to do so. EPA only limits the amount present as a hazardous waste in water to 4 ppm for acute safety concerns. EPA has no ability to regulate procedures or ingredients used to treat people, as fluoride is used. The EPA MCL is not a license to fill up water supplies to that known hazardous level as though it were a value from human clinical trials–that, it is not.

    The CA Department of Public health also wrote to me that they do not take any responsibility for, or force fluoride injections–all liability belongs to the cities alone. Further, the FDA has never given approval for any fluoride compound to be ingested, taken internally. The FDA ruled fluoride in water is an uncontrolled use of a drug in
    1963 and is an unapproved drug in 1993. Although FDA has not yet banned the injections, it does not approve them and an FDA petition to ban the injections is still pending.

    A recent study from the Veterans Administration Health Care Center, Los Angeles is particularly disturbing, that fluoride from the blood incorporates into atherosclerotic plaque in coronary arteries in cardiovascular disease patients, observed directly in PET scans (Yuxin, Nuclear Medicine Communications, Jan, 2012). This information has been forwarded to the FDA. Inasmuch as the ban petition is still under consideration, it advisable for you to reprimand the MWD official who is making false statements to public reporters regarding the EPA on

    fluosilicic acid. The statement is not only false but also projects a blatant disregard of the public welfare and lack of due diligence in duty of care by MWD.

    These unlawful, wasteful, harmful injections will one day end, with or without the blessing of MWD.

    Richard Sauerheber, Ph.D.

    From: jkightlinger@mwdh2o.com

    To: richsauerheb@hotmail.com

    Date: Tue, 20 Mar 2012 14:57:15 -0700

    Subject: Re: questions from reporters

    Dr. Sauerheber

    Thank you for your email. I’m glad you understand the real issues on rates.

    I will speak with my staff so we are very clear on the fluoride issue so that we communicate clearly that MWD was never mandated or required to fluoridate its water supply. Rather our Board voted to take the action at the urging of numerous medical, county and state officials. There were also many that spoke in opposition as well. That vote was years ago and has been the Board direction to staff since that time. Since that vote staff has worked with the U.S. EPA and health officials on how best to set the right dosage levels and on various technical issues.

    Thank you for your continued interest. Jeffrey Kightlinger

    Dear President Kightlinger,

    Thank you for your quick response. I want you to know that the EPA does not have data or expertise on what water or blood level of any substance to use to induce a biologic effect in humans while also preventing any associated adverse symptoms, especially in the infirmed (and when other exposures are prevalent for that substance, as true for fluoride). Such regulation of dosage for any chemical to be taken internally is the exclusive jurisdiction of the U.S. FDA. The EPA deals with preventing contaminants from being too high in water, which is a completely unrelated issue. Officials from the EPA who are advising you have no authority to regulate substances that treat consumers internally through oral ingestion as a supplement.

    In short, for the fluoridation of the bloodstream of millions of Southern Californians, MWD is placing its trust in officials who are advising you to treat people with a substance ruled by the FDA as an unapproved drug (where dosage is uncontrolled for this substance ruled to be not a mineral nutrient in 1963). The material has no volunteer controlled human clinical trials data for safety or effectiveness and thus has never been FDA approved. Industrial synthetic fluoride is scientifically un-tested for either safety or effectiveness. An EPA MCL is not a dosage–it is a level not to exceed to help minimize adverse bodily effects known to occur on long term exposure when other sources are absent. The current MCL allowed by the EPA was deemed unprotective of human health by the National Research Council in 2006 in their study requested by the EPA. NRC is expecting a full lowering of this level from the EPA as soon as possible since fluoride exposure from other sources coupled with that in water has resulted in the current endemic of fluorotic abnormal teeth in 40% of U.S. teens as of 2004. This amounts to 9 million U.S. teens who now in 2012 are in their 20’s with permanent fluorotic enamel. The next crop of 9 million more are already now being so treated.

    MWD has entered into a fray that is completely unnecessary and again the Board should re-vote to halt the injections, not simply to cut out unnecessary expenses that eventually will be paid by consumers, but also because the treatments are harming our youth. There is no excuse for officials who continue to avoid understanding the data we now have and to encourage you to violate the Safe Drinking Water Act that prohibits using public waters as a vehicle to treat consumers of broad and varying need or lack thereof.

    You need not feel you have to respond if you do not wish to do so. Sincerely, Richard Sauerheber, Ph.D.

    Dear Mr. Kightlinger,

    I am requesting that you write a brief letter to Mayor Robinson of Selmer, Tennessee who has agreed to supply information to you regarding fluosilicic acid chemicals used by cities in public water supplies. This letter to Mayor Sanders I now address to you also. Mayor Robinson asked a few questions of the fluosilicic acid suppliers for his city and found they could not provide such answers, and instead ceased to provide their specific fluosilicic acid formulation and then removed all fluoridation equipment and chemicals from Selmer. Robinson agreed to send the correspondence he has to anyone who asks for it. This is an attempt to collect that information to have on file for reference because we at MWD use the same materials as Selmer did (our supplier for fluosilicic acid as you know is Lucier Chemicals, which like the Brenntag supplier for San Diego has no data demonstrating caries reduction after the material is ingested (personal communications from two Brenntag officials, water additives division).

    Dear Mayor Sanders,

    January 8, 2012

    I am writing to ask a simple specific favor of you. You are fully aware of my feelings on this, but this request is not related to either the support of, nor the opposition to, water fluoridation and is not dependent on scientific data. David Robinson, the Mayor of Selmer, Tennessee wrote to me that he will provide information he obtained that resolved the issue in Selmer, that is similar to that in San Diego and in Los Angeles. Selmer City officials in the fully fluoridated state of Tennessee found itself in a position similar to here in San Diego, where citizens opposed a measure that is nevertheless required (here by the CA State fluoridation bill). It is a great story and I’m certain you will be happy that you contacted him, in particular because in so doing you will have the latest information that will fulfill obligations of due diligence for duty of care for citizens here.

    Thank you for your consideration of this request, for the benefit of our city.

    Robinson is a good and effective mayor and he wrote that he will be more than happy to forward the brief correspondence he has if you ask. His contact information he sent me is:

    David Robinson

    Mayor, Town of Selmer

    City Hall 731-645-3241

    Cell 731-610-7016

    Fax 731-646-1462

    Email david.robinson@selmercityhall.com website www.townofselmer.com From: jkightlinger@mwdh2o.com

    To: richsauerheb@hotmail.com

    Wed 21, Mar 2012

    Subject: great information from Mayor David Robinson

    Dr. Sauerheber,

    Thank you. I will have my staff look into this.

    Jeff Kightlinger

    From: Richard Sauerheber To: Mr. Kightlinger

    Thanks, Mr. Kightlinger.

    I really don’t want to be pushy, but there is another item that should be mentioned, now that the Water Board is placing its trust in dosage instructions suggested from EPA officials. The EPA does not have expertise or authority in setting dosage for dietary supplements or medicinal ingredients, in particular for people with diabetes who drink more water daily, or patients with missing kidneys living on dialysis machines that cannot process fluoride taken internally.

    We included a supplement in the FDA petition describing cases where fluoride consumption is a contraindication, for example for patients with stomach ulcers, since HF forms in stomach acid from ingested fluoride and is far too corrosive for these victims. There is a long list of medications that various patients take that cannot be taken with fluoride because fluoride either potentiates or interferes with their intended actions. Attached are two letters sent to the FDA, one on luride that is an unapproved but allowed drug by prescription in cities that are not fluoridated (as per dosage instructions) and the other on drugs that are not to be taken with fluoride.

    The original petition in 2007 is about 80 pages, the Petition for Reconsideration in 2010 another 80 pages, and these are two of 17 supplementary letters relevant to industrial fluoride ingestion from water. We are all hoping the FDA will act and either ban the injections for you or request from chemical suppliers information on 1) what % caries reduction to expect when the material is ingested and 2) that consumption has no adverse side effects for all consumers, even the infirmed. These data do not actually exist. At the very least we expect the FDA to request that Federal officials stop endorsing fluoride ingestion without having controlled volunteer human clinical prospective trials data to back it up.

    Thanks again for your consideration, Richard Sauerheber, Ph.D.

    Normal and Severely Fluorotic Human Leg Bones, Museum of Man, Balboa Park, San Diego, CA

    [cid:image145.jpg@01D47B9C.4AC11730]

    The detailed history or mechanism by which fluorosis occurred in the individual from which these leg bones were obtained is not described. However, it is nevertheless instructive to ask: if one of these were from a victim of acute fluoride poisoning, which set of leg bones would that have been?

    If you guessed the bone with fluorosis damage, you would not be correct! Acute fluoride poisoning does not alter the structure of bone, but instead causes heart block when blood fluoride reaches 5 ppm, which prevents blood calcium from coupling the heart beat with electrical excitation (ATSDR, 2003; Gessner, New England Journal of Medicine, 330, 1994; Sauerheber, J. Environmental Health, submitted 2011). Intermediate blood levels of 1 ppm over a chronic period cause heart muscle weakening

    Leg bone is in part responsible for delivering calcium into the blood to support heart function, where normal bone has a smooth surface. The bones with fluorosis are severely spiculed with calcium fluoride deposits, abnormally thickened due to bone cell replication to help maintain normal whole body calcium homeostasis in response to the poisonous insult of the calcium chelator fluoride. Fluoride accumulates into bone permanently during lifetime consumption only when at levels low enough to not be acutely lethal. Uptake is a linear dependence on concentration (National Research Council, Report on Fluoride in Drinking Water, Washington, D.C., 2006) and is pathologic, not physiologic, and is virtually non-saturable, where human bone in the U.S. has been found with
    12,000 mg/kg fluoride. Two years drinking water with 1 ppm fluoride accumulates 2,000 mg/kg. At 3,000 mg/kg, bone is detectably weakened and more subject to fracture. The extent of incorporation is determined by water hardness that minimizes fluoride assimilation, as well as the fluoride concentration in water.

    The Museum claims that fluorosis results from exposure to ‘high concentrations’ of fluoride, but high is a relative term with little meaning in fluoride toxicology. A ‘high’ concentration of 5 ppm fluoride in blood is acutely lethal within minutes from heart block, without effects on bone. For fluoride to accumulate into bone, lower blood levels of fluoride, not acutely lethal, are necessary so accumulation can occur over many years without killing the individual. A ‘low’ blood level of 0.21 ppm fluoride, the average for 150 million U.S. citizens consuming 1 ppm fluoride water, causes lifetime bone accumulation to 3-4,000 mg/kg (range from 1610 – 4,921 mg/kg) (p.73). The U.S. now has an epidemic of hip fractures in our elderly population (1/3 million cases yearly) while knee, elbow and hip replacements are on the rise, and there is little reason to wonder why. The NRC reported that drinking 2.6 ppm fluoride water lifetime leads to 10,800 mg/kg with bone/joint pain, and 4 ppm water leads to 11,000 ppm associated with immobility, so bone fluorosis is not limited to cryolite and other industrial workers.

    Fluoride is not a mineral nutrient and has no place or function in any living animal or man. Technically any blood fluoride level above zero, where fluoride does not belong, is thus a ‘high’ level. Industrial fluoride from human drinking water in the U.S. is fully assimilated, crosses the blood-brain barrier and lowers IQ in children raised on such water (Connett, The Case Against Fluoride, How hazardous Waste ended up in our Drinking Water and the Politics that Keep it There, Chelsea Green Publishing, White River Junction, VT, 2010), does not decrease dental caries, but instead increases tooth fluorosis in all treated cities, and can incorporates into aorta (ATSDR, CDC, Washington, D.C., 2003) and coronary artery atherosclerotic plaque (Yuxin, Nuclear Medicine Communications, January, 2012).

    #19.

    April 4, 2012

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear reviewers,

    This letter is in support of the petition to ban the addition of synthetic industrial fluoride compounds into public drinking water supplies, original petition FDA-2007-P-0346, formerly 2007P-0400.

    The France 24 international television news broadcast entitled ‘In Deep Water’ (aired March, 2012, http://www.france24.com/en/20120318-2012-in-deep-water-india-california-fluoride-drinking-clean-france- mineral) interviewed Dr. Kennedy, myself, and Mr. Stewart, general manager of Metropolitan Water District, Los Angeles on water treated with industrial fluoride. According to Stewart, the entire Los Angeles basin and also the North San Diego County region of Southern California began injecting fluorosilicic acid/caustic soda into all human drinking water a few years ago because of health agency recommendations that MWD entrusts. Previously, Jeff Kightlinger, MWD President, stated that Federal officials from the EPA instruct MWD on procedures and dosages of industrial fluoride to administer to consumers through public water supplies. Taken together, it is clear that MWD officials and employees themselves do not understand the biologic effects of fluorosilicic acid in humans, and instead rely on Federal agencies other than the FDA to determine treatment protocols with fluorides used as though they are safe and effective when taken internally.

    In fact, the original plan to use toxic hazardous waste fluorosilicic acid, that the EPA classes as hazardous waste, was delineated by Rebecca Hamner of the EPA years ago. She wrote that a solution to the disposal of toxic hazardous waste fluorosilicic acid is to allow it to be injected into public water supplies as a source of fluoride (see petition and Connett, et.al., The Case Against Fluoride, how Hazardous Waste ended up in our Drinking Water and the Bad Science and Politics that Keep it There, Chelsea Green Publishing, White River Junction, VT, 2010).

    The U.S. Safe Drinking Water Act forbids any Federal requirement for any substance added into water other than to sanitize water. The U.S. Surgeon General’s announcement in past years that fluoridation is a public health achievement begs the question of why chemicals that contain fluoride are allowed to violate the SDWA. Placing calcium fluoride, a nontoxic material, into water supplies does not compare with adding hazardous waste industrial fluorides lacking calcium, which the EPA Hamner decision authorized. The CDC recommends the injections, the EPA and CDC overlook SDWA statutes, and both allow hazardous industrial waste injections into public water supplies, advise, encourage and in fact orchestrate dosages and mechanisms.

    It is commendable in the TV interview that Stewart admits that science about fluoridation is changing and that a public discussion of the injections is good to have. Indeed, Dr. Kennedy, D.D.S. was able to point out that the ingestion of industrial fluoride represents a poisoning, where tooth fluorosis permanent abnormal enamel hypoplasia occurs when systemic ingested fluoride is present when teeth develop under the gums at ages 5-8. Abnormal dental fluorosis is exclusively caused by consumption of fluorides, including sodium fluoride and fluorosilic acid fluoride, and the chief source of fluoride in the bloodstream of consumers in a fluoridated water region is from ingestion of fluoride water (National Research Council, 2006, Washington, D.C.). Fluorosis afflicts approximately 5 million teenagers aged 12-15 in the U.S. In 2004, 41% of 12-15 years olds had tooth fluorosis according to published figures from the CDC. Government statistics indicate there are 13 million teens today in the 12-15 year age group. Those teens in 2004 are now in their 20’s, still with the permanent abnormality except for those who have paid large sums for tooth restorations. The next population of children are now

    developing fluorosis, since 70% of all water districts continue to inject fluorosilicic acid (and, as well, toothpaste with industrial fluoride intended for topical treatment only is not declining in use).
    Dosage instructions for, and handling procedures for, hazardous toxic waste fluorosilicic acid is provided to water districts by the CDC and now also the EPA (see previous letters #6 and #18). In the U.S., neither of these Federal
    agencies has authority to regulate, request, recommend, promote, advertise, require or provide dosage and treatment instructions for any substance intended to be taken internally to affect human tissue. Such Federal actions lie only within the purview of the U.S. FDA. For example, the EPA Maximum Contaminant Level for fluoride at which
    water becomes non-potable is not an invitation to inject fluoride on purpose to that level, and certainly is not a
    ‘dosage’ obtained from clinical trials. The MCL does not take into account that people vary widely in daily water consumption and health conditions. Those with tooth fluorosis in particular are not candidates for further,
    continuous lifelong fluoride ingestion, nor individuals who have been fluoride poisoned in industry or through
    intentional ingestion of fluoride toothpaste or other sources. Injection of chemical treatments for internal ingestion on a mass scale are based on a theoretic average, healthy person, when no additional sources of fluoride other than
    from drinking water are available. No person in such a situation in the heavily fluoridated U.S. is known to exist.

    The FDA is commended for requesting recently that fluoride mouthwash advertisers cease from claiming that fluoride taken topically promotes gum health, as there is no evidence in support of this. It is now time to also order water districts, industrial fluorosilicic acid chemical suppliers, and CDC and EPA officials to stop advertising that the ingestion of fluoride from industrial compounds decreases teeth caries, as this gives the impression that no adverse health effects of any kind occur along with its ingestion by all consumers, even diabetics (who drink twice normal water volumes daily) and kidney disease patients with impaired ability to eliminate the fluoride ion. And it further continues the myth that industrial fluoride taken internally can decrease caries, when the CDC published that systemic fluoride does not do so (in: Morbidity and Mortality Weekly Report, August, 2001).

    A disturbing N.Y. Times article last week went so far as to reprimand parents for providing bottled regular water to children who developed cavities, when in fact normal water without fluoride does not cause cavities. Caries are caused by sugars in the mouth that are not brushed away after eating that S. mutans metabolizes to acid that can degrade enamel. Fluoride, in the bloodstream systemically at 0.2 ppm or in saliva at 0.02 ppm, after ingestion from fluoridated water does not prevent caries (see letters #9, #13). The accusation that normal drinking water is suddenly now unhealthy, and that parents using it should be denounced, is false. It is an extension of much incorrect information provided by the Oral Health Division of the CDC (see letter #6) that is also supported by certain officials in the EPA. One is free not to oppose fluoride injections, but no one has a moral right to make false claims of effectiveness or safety of its long-term consumption by humans, particularly the infirmed. Natural God- given pristine drinking water (without injected synthetic industrial fluoride) is not to be denigrated, but in fact must be valued and protected.

    Richard Sauerheber, Ph.D.

    Letter # 6 sent to FDA Nov. 25, 2011
    Letter #8 sent to FDA Dec. 17, 2011
    Letter # 9 sent to FDA Dec. 22, 1011
    Letter #13 sent to FDA Jan. 14, 2012
    Leter #18 sent to FDA March 24, 2012

    #20.
    April 14, 2012
    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This letter is in support of the petition to ban the addition of synthetic industrial fluoride compounds into public drinking water supplies, original petition FDA-2007-P-0346, formerly 2007P-0400.

    Enclosed please find an article submitted for publication entitled Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride. Although it is a privileged communication that is now under review, it is appropriate for the FDA to have a copy. The brief paper describes the interaction of synthetic industrial fluoride with calcium ion at physiologic concentrations and body temperature. The level of fluoride required to induce acute poisoning is computed and agrees favorably with known fluoride levels in tissues of persons with acute fluoride poisoning.

    The calcium fluoride paradox is described, where high calcium levels in the GI tract are able to prevent fluoride toxicity by inhibiting assimilation, but once inside the bloodstream the opposite scenario exists where higher calcium levels are more easily saturated with lower levels of fluoride. An explanation of biologic variability in both chronic and acute fluoride toxicity is indicated, and the significance of the data are briefly presented in context of the treatment of water supplies with industrial fluoride.

    Thank you again and if you have any questions please do not hesitate to contact me preferably by E-mail where thoughtful answers could be best provided as I am able.

    Richard Sauerheber, Ph.D.

    Enclosures (see letters that follow)

    #21.

    April 15, 2012

    U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857 Dear Reviewers,

    This information is provided in support of the petition to ban the intentional dissemination and ingestion of the industrial synthetic fluoride compounds fluorosilicic acid and sodium fluoride, petition FDA-2007-P-0346, formerly 2007P-0400.

    It is important to emphasize that most individuals involved in the treatment of public water supplies with industrial fluorides are not well-versed in the consequences of fluoride ingestion on those with selected illnesses. Conditions that are particularly exacerbated by systemic fluoride from ingestion are briefly mentioned here, where fluoride crosses the blood brain barrier, accumulates irreversibly into bone, and incorporates into atherosclerotic plaque as found in human heart disease patients (Yuxin, Nuclear Communications, January, 2012) and in research animals (Agency for Toxic Substances and Disease Registry, 2003).

    Cardiovascular Disease. According to the Health and Human Services, San Diego there are 4,000 heart disease deaths every year in San Diego, where the leading contributor to the condition is coronary artery atherosclerosis. The known accumulation of systemic fluoride ion into atherosclerotic plaque in coronary arteries in cardiovascular disease victims (Yuxin,) is an unnecessary chemicalization risk, knowing that the chief source of fluoride in the bloodstream in fluoridated cities is fluoride ingested from treated public water supplies (National Research Council, Report on Fluoride in Drinking Water, Washington, D.C., 2006).

    Brain Disease. There are 50,000 victims of Alzheimer’s disease in San Diego County (Alzheimer’s Association). Aluminum and fluoride treated water are contraindicated in this disorder as the aluminum fluoride complex at stomach pH heighten their assimilation and incorporation into brain.

    In California there are typically 10,000 new cases of autism every four years (as found between 1996-2000). With
    44,000 births yearly in San Diego there are 270 new cases annually. Fluoride consumption exacerbates symptoms in these children (personal communication, Washington Action for Safe Water advocate testimony).

    Bone Disease. I was interviewed by Dr. Stanley Monteith on Liberty Radio (www.libertyradio.com) in three one hour segments discussing the adverse effects on human health from long term fluoride ingestion. Dr. Monteith testified as a former orthopedic surgeon that bones are abnormal and chalky in appearance in patients living in fluoridated cities for prolonged periods. 95% of all ingested fluoride that is retained (50% of that ingested) resides permanently lifetime in bone (NRC,2006) where bone becomes significantly weakened and more subject to fracture at 3,000 ppm. There are now 10 million victims of bone weakening due to osteoporosis in the U.S., and in all fluoride consumption is unwarranted and a harmful contributor to additional weakening and calcium metabolic alterations that already plague these victims.

    Sincerely,

    Richad Sauerheber, Ph.D.

    Physicians Group, Sharp Hospital, San Diego description of osteoporosis and its treatments attached

    Thanks go to physicians at Scripps Hospital, San Diego for the following invaluable information on the problems that victims of osteoporosis face, whether caused by calcium deficiency or other unknown reasons, where fluoride consumption is an obvious contraindication. It is important to understand the difficult symptomatology that victims face with this insidious condition.

    Osteoporosis

    Definition

    Osteoporosis is the thinning of bone tissue and loss of bone density over time.

    Alternative Names

    Thin bones

    Causes, incidence, and risk factors

    Osteoporosis is the most common type of bone disease. There are currently an estimated 10 million Americans suffering from osteoporosis, as well as another 18 million who have low bone mass, or osteopenia.

    Osteoporosis occurs when the body fails to form enough new bone, or when too much old bone is reabsorbed by the body, or both.

    Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.

    As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. Both situations can result in brittle, fragile bones that are subject to fractures, even without trauma.

    Usually, the loss occurs gradually over years. Many times, a person will sustain a fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and the damage is severe.

    Researchers estimate that about 20% of American women over the age of 50 have osteoporosis. In addition, another 30% of them have osteopenia, which is abnormally low bone density that may eventually deteriorate into osteoporosis, if not treated.
    About half of all women over the age of 50 will suffer a fracture of the hip, wrist, or vertebra (bones of the spine). Recognized risk factors include smoking, eating disorders, low body weight, too little calcium in the diet, heavy
    alcohol consumption, early menopause, and use of certain medications, such as steroids and anticonvulsants.

    Symptoms

    There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include:
    • Fractures of the vertebrae, wrists, or hips (usually the first indication)
    • Low back pain
    • Neck pain
    • Bone pain or tenderness • Loss of height over time
    • Stooped posture
    Signs and tests

    • Bone mineral density (BMD) testing — as performed in dual-energy x-ray absorptiometry (DEXA) — measures the demineralization of the bones. This has become the gold standard for osteoporosis evaluation.
    • A spine CT can show demineralization. Quantitative computed tomography (QCT) can evaluate bone density, but is less available and is more expensive.
    • A spine or hip x-ray may show fracture or vertebral collapse in severe cases.

    • Measuring the amount of calcium in urine can provide some evidence of increased bone turnover, but is of limited value. Treatment

    Treatments for osteoporosis focus on slowing down or stopping bone loss, preventing bone fractures by minimizing the risk of falls, and controlling pain associated with the disease.

    There are several different kinds of drugs used to treat osteoporosis. They vary in their side effects, benefits, and costs. Bisphosphonates are a type of drug used for both the prevention and treatment of osteoporosis in postmenopausal women. The two bisphosphonates currently approved for osteoporosis — Fosamax and Actonel – help prevent bone loss and reduce the risk of spinal and hip fractures.

    A woman’s body produces less estrogen during and after menopause, which may affect her bone strength. Based on early studies, many physicians used to believe that hormone replacement therapy (HRT) might be beneficial for reducing the risk of heart disease and bone fractures caused by osteoporosis in addition to treating menopausal symptoms. The results of a new study, called the Women’s Health Initiative (WHI), has led physicians to revise their recommendations regarding HRT.

    In July 2002, one component of the WHI, which studied the use of estrogen and progestin in women who had a uterus, was stopped early because the health risks exceeded the health benefits. A second component of the study, which studied estrogen-only therapy in women who no longer had a uterus, was stopped early in March 2004.

    The WHI study showed that women taking HRT had 34% fewer hip fractures and 24% fewer fractures than women not receiving hormones. However, the main reason for stopping the estrogen-progestin study was a 26% increase in breast cancer in women taking HRT, as well as increases in heart attacks, strokes, and blood clots.

    Calcitonin, marketed under Calcimar (injectable), is a medication that slows the rate of bone loss and relieves bone pain. While calcitonin slows bone loss and reduces the risk of fractures, it appears to be less effective than bisphosphonates.

    A diet that includes an adequate amount of calcium, vitamin D, and protein should be maintained. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses for bone formation and maintenance is available.

    Supplemental calcium can be taken as needed to achieve recommended daily calcium dietary intake.

    Response to treatment can be monitored with a series of bone mineral density measurements taken every 1-2 years, though such monitoring is controversial and expensive.

    There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in the spinal column due to osteoporosis. The procedure involves injecting a fast-hardening glue into the regions that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.)

    Expectations (prognosis)

    Progression of the disease can sometimes be slowed or stopped with treatment. Some people become severely disabled, as a result of weakened bones. Hip fractures, which are frequently sustained by people with osteoporosis, leave about 50% of victims unable to walk independently.

    This is one of the major reasons people are admitted to nursing homes.

    Complications

    • Compression fractures of the spine
    • Hip fractures and wrist fractures
    • Disability caused by severely weakened bones • Loss of ability to walk, due to hip fractures

    #22.
    June 8, 2012
    Department of Health and Human Services, Public Health Service
    U.S. Food and Drug Administration Center for Drug Evaluation and Research Office of Regulatory Policy Rockville, MD 20857

    Dear FDA Project Reviewers,

    I write this letter in support of the petition to ban fluoridation, that is adding synthetic industrial fluoride compounds into public drinking water supplies, FDA-2007-P-0346, formerly 2007P-0400.

    The Everett, Washington city council is currently conducting public hearings on water fluoridation. The key witness for the city in favor of fluoridation is a Dr. Goldbaum who presented arguments that fluoride in public water supplies is “safe” and “natural.” Each contention made by Goldbaum is addressed in the letter below for the benefit of the FDA.

    Secondly, the country of Southern Ireland accepted and published a treatise on water fluoridation by Chartered Environmental Scientist Declan Waugh, a 360 page document with 1,216 scientific references that request an immediate halt to water fluoridation. The document was also submitted to the European Union. A health professional offered several arguments against the document that were incorrect. A letter was written to Declan Waugh by request that addresses each point, and a copy is enclosed here for information in support of the ban petition to the FDA.

    Again, if a ban cannot be instituted for any reason, then:

    1) Federal officials must be told to cease requesting or recommending synthetic industrial fluoride compounds be taken internally through ingestion since no such compound has been approved by the FDA for ingestion and only sodium fluoride is allowed as an unapproved drug to be taken internally by prescription only;
    2) a moratorium on synthetic industrial fluoride infusions into public human water supplies may be issued until controlled clinical trials data are submitted on human volunteers to the FDA for a new drug application, particularly for HF-containing fluorosilicic acid;
    3) or letters from the FDA to fluoride chemical suppliers (currently about 49 such suppliers exist in the U.S.) requesting data in their possession demonstrating safety and effectiveness for those ingesting their product;
    4) or FDA could request that fluoride compounds only be added into water that is rich in calcium or magnesium, to maintain the original 160:1 divalent cation to fluoride ion ratio present in Hereford, Texas water, where the idea of water fluoridation first began;
    5) or calcium chloride could be added to water which is known to strengthen teeth and to build strong enamel in childhood growth years, rather than systemic ingested fluoride ion that sidetracks the discussion of healthy diets that fight dental caries. Foods rich in calcium may be suggested, including spinach (595 mg calcium per 100 grams), onions (135 mg per 100 grams) and broccoli (160 mg per 100 grams) [compared to lettuce at 25 mg per 100 grams]. Earlier letters (Jan 14 and Jan 17, 2012) described vitamin D and calcium supplementation as proper dietary methods for building strong teeth enamel and preventing caries-prone teeth enamel hypoplasia, rather than synthetic industrial fluoride taken internally which is ineffective for this purpose and harmful long-term.
    Enclosed: Response letters for Everett City Council to Dr. Goldbaum (https://fluoride-class-action.com/sauerheber- responds-to-goldblum-6-4-12); and for Declan Waugh to Irish Dental Association (http://fluoride-class- action.com/sauerheber-speaks-up-for-declan-waugh

    #23.

    June 4, 2012

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    The information below from Ireland is provided in support of petition FDA-2007-P-0346, formerly 2007P-0400. It is requested that FDA perform all or at least one of the following actions:

    1) ban the intentional infusion of industrial fluoride compounds into water supplies intended to treat humans, because of lack of FDA approval; 2) institute a moratorium on the infusions; 3) contact chemical suppliers of the materials used for the infusions to obtain information in their possession on effectiveness and safety when taken internally by oral ingestion; 4) request all Federal officials halt endorsement of the infusions; 5) request prescriptions be required for the ingestion of the fluoridation chemicals; 6) request that industrial fluoride infusions be limited in the U.S. to water supplies containing a minimum of 302 ppm calcium/magnesium (to minimize HF assimilation from the GI tract) as was present in the original studies used that led to the idea of water fluoridation in 1939.

    These actions are requested from the FDA (rather than the U.S. Environmental Protection Agency) as the sole regulatory Federal agency in charge of chemicals to be taken internally through ingestion intended to treat human tissue in the U.S. The U.S. EPA remains in internal litigation over this issue, with scientists opposed to the infusions (for letter from the EPA Union of scientists see: https://fluoride-class-action.com/epa-scientists).

    We have long-awaited a rigorous analysis of the health consequences associated with the infusion of industrial fluoride compounds into public water supplies in Ireland, treated now for over 40 years. Northern Ireland has never been fluoridated and acts as an excellent control population for any effects observed in Southern Ireland which is fluoridated. Moreover, for the first time we accidentally have an ongoing experiment to compare peoples in the North with its harder calcium-replete water, and people in the South with its soft calcium-deficient water.

    Declan Waugh, a Chartered Environmental Scientist in Ireland, has now published a thorough 360 page analysis with 1,216 references. In summary, the incidence of neurological disease (including epilepsy and Alzheimer’s), cancers of the GI tract (where hydrofluoric acid HF is most concentrated after ingestion of fluoride water) and heart disease are now highest in the world in Southern Ireland, as opposed to Northern Ireland. The detailed report may be read at: http://www.enviro.ie/risk.html

    A radio interview was conducted in Canada with Declan Waugh recently and may be seen at:

    As is typical, those in favor of continuing to fluoridate water claim these data are merely ‘anecdotal correlations’. But the burden of proof lies with those forcing a non-nutrient chemical to be taken internally, rather than on the people themselves to prove with certainty that the action is harmful. Arguments were also claimed by fluoride promoters regarding the increased cancer incidence data published for U.S. cities (that acted as their own controls before fluoridation) by Yiamouyiannis (Fluoride the Aging Factor, see petition), but the fact that fluoride either causes increased cancer incidence, or rather prevents successful cancer control in humans, was proven in no less than three U.S. courts based on these carefully analyzed data.

    In Ireland, cancers of the brain and other parts of the CNS had a strong geographical pattern which was similar for both sexes. The maps of relative risk show a gradient across the whole island, with the highest relative risk in the Southwest, decreasing uniformly to the area of lowest risk in the North-east. The risk in urban areas was similar to that in the surrounding countryside.

    Cancers of the gastrointestinal tract showed similar patterns. Averages for six types of cancer showed increasing incidence from North Ireland, that is not fluoridated, to Southern Ireland that is fluoridated. In regions with little protective calcium, fluoride correlated with a 4 fold increase in six types of cancer.

    I received these comments from DeclanWaugh who submitted my letter to the Irish public:

    Dear Richard, I just sent your letter on this via the web here in Ireland to elected representatives, with your signature:

    Dear RTE, Irish Examiner, Irish Independent, Irish Times, Sunday Times, Sunday Business Post and local and regional newspapers editors:

    This message of public importance has been forwarded to the Minister for Health, elected TD’s, Senators, Councillors as well as City and County Managers:

    “The fact that fluoridated Southern Ireland is experiencing high cancer risk compared to Northern Ireland (non fluoridated) makes it absolutely essential politically and morally to correct any and all unusual known factors that could possibly be involved, and that are feasible to correct. Fluoridation of Southern Ireland could explain the unequal incidence distribution, particularly after considering all published data taken together, including the known mutagenic effects of fluoride in vitro (National Research Council, Report on Fluoride in Drinking Water, 2006), and for this reason must be stopped now, because it is artificial and can be stopped. Continuing to fluoride-treat the people of Ireland, with these data at hand, is inconsistent with the meaning of due diligence in duty of care and also presumes that an unidentified mythical factor is instead responsible, even though it is known with certainty that calcium deficient soft fluoride water ingestion causes 4 fold higher blood fluoride levels, compared to ingestion of calcium-rich fluoride water.” Richard Sauerheber, Ph.D.

    Next I received news that an Irish County has ruled that the fluoridation-cancer association in soft water is so strong that fluoridation will be discontinued. Further, a European Court ruled that fluoride, being present in various foods, is a food. Since foodstuffs are illegal to add into public drinking water in Ireland, Waugh stated that he expects all Ireland will now halt water fluoridation, after 40 years.

    Below is a dialogue with Waugh (Director, Enviro Management Services, 11 Riverview,

    O Doherty’s Rd., Bandon Co., Cork, Ireland), and a U.S. scientist (Chris Neurath, Research Director, American Environmental Health Studies Project) and myself:

    Sauerheber: We in the United States appreciate greatly the recent Declan Waugh report on industrial fluoride infusions into public drinking water supplies. We hope that Southern Ireland can soon be freed of fluoridation chemicals that produce 1 ppm fluoride ion, 1 ppm silicic acid and 2-4 ppm sodium ion in drinking water, none of which belong in, or are found in, pristine fresh clean drinking water, as for example in the American NorthWest.

    I am happy to have been included in the review as reference #137. I here deliver the present version of that original article (attached) that is now under review by the Journal of Toxicology and Pharmacology. The article originally was available as an online publication in various websites, and at least one is available at www.fluorideclassaction.com but as yet is being reviewed by journal editors.

    It seems few write of the cardiovascular impact of systemic fluoride and for that reason in my opinion the Waugh review is very important. Although the focus of my article was the effects of fluoride on calcium metabolism and adverse heart function, one section presented data demonstrating that 50% of ingested fluoride converts in the acidic stomach to hydrofluoric acid HF, a weak acid with small dissociation constant but with extreme corrosivity due to it being uncharged and extremely minute in size, comparable to the dimensions of a water molecule. So I very much appreciate the comment provided in the Waugh review.

    Waugh: For anyone looking for higher resolution figures of the incidence of various cancers in regions of Ireland, you can download the official reports from here:

    http://www.ncri.ie/atlas/Brain%20and%20other%20CNS%20cancers.pdf. All of the maps are on this site.

    Neurath: I briefly looked through the atlas, examining the original high quality maps and reading some of the text. I think it is quite speculative to attribute the lower rates of some cancers in Northern Ireland (NI) than in the Republic of Ireland (RoI) to fluoridation. Many cancers did not show a pattern higher in RoI than in NI, although they showed some quite distinct geographical patterns. For such a small and relatively homogeneous island, it is quite amazing how strong the geographic patterns turned out to be. Almost all maps showed variations in risk by a factor of 4, from an OR=0.5 to OR=2.0. I’m not sure these Odds Ratios translate to actual rates of cancer. That is, although the risk of a cancer might be 4 times higher in one location than in another, I’m not sure the rate of cancer

    is 4 times higher. Hardy brought up sunlight, and the atlas does provide a map of sunlight, but I don’t think any of the cancer types had geographic variation that matched the pattern of sunlight.

    Waugh: Please Neurath, I am not saying that water fluoridation is the known certain cause, I am rather suggesting and asking the Minister when you look at the above two figures and take every other known variable into consideration including sunlight, the only known variable is that across the border in Northern Ireland they do not add silicofluoride to drinking water. Donegal at the top left, it has the same sunlight as Northern Ireland, it’s in the same province Ulster. Remember also Ireland is a very small country, we don’t really get much sun at all, more like dull overcast weather and rain most of the time. 4 seasons in one day so to speak. The incidence for osteosarcoma in Ireland is as follows Republic of Ireland 1:8,250 and Northern Ireland 1:12,964 for childhood population under
    18years of age. A 37% variation similar to that for prostate cancer with Northern Ireland.

    As I mentioned previously genetically the South of Ireland is similar to Northern Ireland. I’m Scot’s Irish myself maybe 10 generations old on my father’s side, my mother’s family was Collins, over 40% of Irish people have Anglo Saxon DNA. In the very South where I live its more like 70%.

    Sauerheber: The notion is possible, that another variable besides industrial fluoride treatment of people may be involved in Ireland cancer risk data between South and North. For this reason no one has said fluoride has been proven to cause the risk, but rather that fluoride correlates with it. Many arguments were put forth to attempt to re- interpret the cancer incidence data described by the late Dr. Yiamouyiannis for U.S. cities, before and after fluoride infusions into public water supplies. However, after intense argument, rebuttal, and scrutiny, the relation between chronic industrial fluoride exposure from drinking water with increased incidence of lethal cancers was accepted in no less than three U.S. courts (see attached summary of the actual data from Fluoride the Aging Factor). The reason is because no other plausible explanation was ever put forth that was better than the notion that fluoride could have caused the effect. Regardless, the correlation is consistently there. The argument that cancer caused people to want to be fluoridated, which if true could explain the data, is of course absurd.

    Industrial fluoride treatment of the people of Southern Ireland should be halted because: 1) there are no valid or logical environmental, behavioral or genetic factors known at the present time that consistently explain all the sequestration of cancer risk mapped in Ireland’s fluoridated regions. Fluoride alone could explain it. 2) The increased incidence of cancers in U.S. cities, discovered in the 1960’s after fluoridation began, has never been explained by any factor other than fluoride. There the cities themselves acted as their own controls in prospective observations and thus represent the best data we have, in the absence of intentional studies with volunteer populations with this synthetic poison, which would be illegal.

    I always say, ‘it is what it is’. In other words, whether fluoride induces cancer or not, or whether fluoride potentiates cancers caused by other factors, etc., the data are what they are: lethal cancer incidence is higher in all carefully examined U.S. cities after fluoridation, compared to before fluoridation. It makes no difference whether the exact mechanism for these correlations is ever known in detail or not, to set environmental or health policy. The fact that Southern Ireland is experiencing high cancer risk compared to Northern Ireland (as well as higher epilepsy rates and heart disease rates) makes it absolutely essential politically and morally to correct any and all unusual known factors that could possibly be involved, and that are feasible to correct. Fluoridation of Southern Ireland could explain the unequal incidence distribution, particularly after considering all the data taken together, including the known mutagenic effects of fluoride in vitro (National Research Council, Report on Fluoride in Drinking Water, 2006), the brain effects published recently and the finding that fluoride incorporates into atherosclerotic plaque (Yuxin, 2012, see previous letter), and for this reason must be stopped now– it is artificial and can be stopped. Continuing to fluoride-treat the people of Ireland, with these data at hand, is inconsistent with the meaning of due diligence in duty of care and also presumes that an unidentified mythical factor is instead responsible, even though it is known with certainty that calcium deficient soft fluoride water ingestion causes 4 fold higher blood fluoride levels, compared to ingestion of calcium-rich fluoride water.

    Waugh: My view on all this is rather simplistic and that is, it is not for us to prove that fluoride is a contributory factor to the increased risk of developing cancer in southern Ireland compared to un-fluoridated Northern Ireland, it’s for the government and health authorities to prove in detailed studies that it is not a contributory factor. That is the basis of environmental law in Europe and the basis of the Medicine Directive, none of which have ever been applied to the use of silicofluorides. The problem is they won’t do the studies. So what do you do in these circumstances?

    Neurath: I agree with Declan’s position: it is the obligation of authorities who promote fluoridation to expend the resources to prove it does not cause cancer … or at least prove that it does not cause more than a di minimis amount of cancer. It is impossible to prove a negative, and we can’t really ask them to do that.

    Sauerheber: It is fair to request well-controlled clinical trials data with human volunteers to see if fluorosilicic acid ingestion for a prolonged period does not increase cancer incidence and other sequelae. Therefore, it is fair to request water fluoridation be halted. The goal of water is to hydrate a person to maintain life. It is not to elevate the blood level of a foreign substance that does not belong in the blood or in any living cell. The actual requirements necessary before adding such a material are vast and do not exist (any foreign substance proposed to be ingested or used to treat any condition requires clinical trials data and FDA approval for safety first; and even if approved, no one is authorized to place any such substance that is not a mineral nutrient into water without a prescription. Such approved substances are intended for temporary use to treat infirmity, not lifetime permanent consumption as though it were a nutrient, which it is not).

    And it is possible to prove a negative, at least beyond reasonable doubt. For example, halt fluoride infusions in Ireland for 20 years and see if the cancer risk remains unaffected. If so, then there would be grounds to claim that fluoride did not cause the higher incidence. Until then, that claim, that it is mere coincidence that soft fluoridated water regions contain higher risk than non-fluoridated merely because of a bizarre anecdotal coincidence, has no basis of support.

    Even if one wrongly believes the idea that water may be used to elevate fluoride in blood, then it is at a minimum necessary to check the blood level of consumers after fluoridation begins. And yet, there are no such measurements by water districts who infuse fluorosilicic acid under a wide variety of conditions (i.e. water hardness). The fluoride in this industrial substance is nearly fully assimilated after ingestion in calcium-deficient water in Southern Ireland (10 pm calcium measured by Waugh). Calcium fluoride in water however is not well-assimilated.

    So, where are the requisite data showing that water districts are titrating the right amount of industrial fluorosilicic acid into water to achieve the actual blood level of fluoride desired by those who infuse it?

    The world waits.

    p.s. Although the recent ruling that fluoride in Europe is a food should prevent the addition of industrial fluoride into drinking water in virtually 100% of all Europe, such a ruling in the U.S. would be disastrous. Many dentists trained to believe that ‘fluoride is good’ have already asked to have fluoride added into bread (personal communication with a local dentist), so a ruling that it is a ‘food’ would imply that fluorosilicic acid could be directly added into foodstuffs in the U.S. Fortunately, much thanks are due the U.S. FDA for the correct ruling in
    1963 that fluoride is not a mineral nutrient and when added into water is an uncontrolled use of an unapproved (1993) drug.

    COPIES Sent to: Vallecitos Water District, San Diego Water District, all San Diego City Council members, the Mayor, all San Diego County Supervisors, San Diego City Attorney, Congressman Bilbray, several CEO’s of fluorosilicic acid chemical supply companies including Brenntag, to Metropolitan Water District, Los Angeles, clean water advocacy groups fighting fluorosilicic acid infusions in New York City, N.Y. and Asheville, N.C., and to city officials now listening to fluoride opponents in Everett, WA and Milwaukee, WI, and to many local citizens.

    #24.

    July 16, 2012

    Dear Fluoride Free Windsor, Windsor, Canada City Officials, and other interested parties,

    As a research scientist and educator with experience in experimental toxicology, I submitted an 80 page petition to the U.S. Food and Drug Administration, calling for a ban on industrial fluoride infusions into public water supplies in the U.S., that was accepted for review in 2007. In 2010 the FDA decided that fluoride is a contaminant and is the responsibility of the EPA. I was allowed to write a Petition for Reconsideration however, another 80 page report proving that the EPA relinquished its control over water additives in 1988, and that only the FDA is responsible for regulating the intentional ingestion of fluoride compounds used to treat humans in the U.S., and the petition is still under consideration. I’ve sent 23 detailed letters of supplemental information in support of the petition since then. One is a sworn private affidavit on the detailed chemistry of fluorosilicic acid, requested by a law firm in Texas for a Court case. I was allowed by the firm to send the manuscript to the FDA.

    I now have an article entitled Physiologic Conditions Affect the Toxicity of Industrial Fluoride that is under review by the Journal of Environmental Toxicology. I regularly submit information to citizen groups and to city officials in Asheville, NC, Milwaukee, WI, San Diego, CA, Los Angeles, CA and in Everett, WA and other cities. Much of what I have written is posted on the website of attorney James Deal, candidate for Lieutenant Governor, in Washington State at: www.fluorideclassaction.com.

    The recent 360 page report by Declan Waugh in Ireland with 1,216 references (I happened to be reference #137) is also referenced on the site (http://www.enviro.ie/risk.html). This treatise is a scathing report on the adverse health consequences experienced by Southern Ireland with soft fluoridated water, compared to non-fluoridated Northern Ireland. It has thus far caused one entire county in Southern Ireland to decide to halt fluoridation. Waugh believes the rest of the country will be fluoride free soon also, rendering virtually all of Europe with regular, non-drugged water.

    If there are specific concerns you would like to see addressed, please do not hesitate to contact me. Calgary, Canada halted water fluoridation in 2011 and this is fortunate because the Calgary Stampede has been plagued of late with horse breakdowns from heart attacks and then bone breaks on the track. In Los Angeles, the Los Alamitos racetrack experienced a steep rise in fatal horse breakdowns after fluoridation in Los Angeles began in 2007, and the numbers remain elevated and rising. Fluoride from the bloodstream has been observed in PET scans, taken of cardiovascular disease patients at the Veterans Administration Health Care Center in Los Angeles, to incorporate into aorta and atherosclerotic plaque present in coronary arteries (Yuxin, Nuclear Medicine Communications, Jan, 2012) and of course accumulates permanently lifetime into bone (National Research Council, Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, Washington, D.C., 2006) where it does not belong and is a cumulative structure-altering substance known to weaken bone at 3,000 mg/kg or above.

    The following information is being sent to the Oral Health Division officials at the CDC who request mass fluoridation, which is prohibited by the U.S. Safe Drinking Water Act:

    Oral Health Division
    U.S. Centers for Disease Control and Prevention
    Atlanta, Georgia

    Dear sirs,

    Toothpaste contains 1,500 ppm fluoride, argued to be an effective decay-preventing dentifice. On the other end of the spectrum, fluoride in saliva from ingested industrial fluoride in treated water supplies is only 0.02 ppm (NRC,

    2006 p.81), which although unable to enter teeth enamel is also claimed by dental officials at OHD to prevent teeth decay by topical means.

    Questions:

    1) If 1,500 ppm fluoride acts topically to prevent teeth decay during teeth brushing, then how does fluoridated water prevent tooth decay when ingested fluoride is present in saliva at 75,000 times lower concentration than in toothpaste? Could you please provide the data that prove 0.02 ppm fluoride bathing teeth is superior to 0.01 ppm or less that is typically found in saliva in non-fluoridated cities, that would justify the U.S. to continue spending over
    300 million dollars annually to adjust fluoride levels in most all U.S. water supplies? On the other hand:
    2) If 1 ppm fluoridated water that produces 0.02 ppm fluoride in saliva can act topically to reduce decay as many dental officials argue, with only 0.02 mg available per 24 hour day, then why does toothpaste need to be 75,000 times more concentrated than this to be effective at treating teeth to prevent decay? Where is the data that proves a need for 1,500 ppm fluoride in toothpaste, when 0.02 ppm for a 24 hour period between brushings contains only
    0.02 mg fluoride total available (1 liter of saliva daily) while a tooth brush would contain 1.5 mg, 75 times more than in 24 hours worth of saliva, a 75 day supply?

    Please respond to these questions at your earliest convenience with data from these studies for all to see and analyze. The usual claim that ‘fluoride is a great public health achievement’ or that ‘fluoride decreases decay’ do not suffice, since no mention is made of the amounts of fluoride required to achieve these claims. Indeed, the CDC publication in Morbidity and Mortality Weekly, August, 2001 stated that systemic fluoride from ingestion does not decrease teeth caries, and fluoride is only believed to act topically (i.e. presumably from toothpaste).

    We have city Council members from many U.S. and Canadian cities needing answers to these questions, before deciding to continue infusing industrial fluorosilicic acid/caustic soda materials into drinking water to treat citizens for the purpose of taking fluoride internally, all without FDA approval for ingestion. Cities infusing industrial fluoride into water to treat citizens are fully liable and know full well that the FDA ruled in 1963 that fluoride is not a mineral nutrient and when injected into water is an uncontrolled use of an unapproved (1993) drug.

    The U.S. Health and Human Services request in 2011, that fluoride in water not exceed 0.7 ppm until updated guidelines are developed, addressed the problem that 41% of U.S. teens as of 2003 have permanent fluorotic teeth with abnormal enamel hypoplasia and ugliness. Colgate toothpaste manufacturers have written that water districts are at fault for this endemic (Los Angeles Times, Jan., 2011) by allowing fluoride to be swallowed– toothpaste is not to be swallowed, but applied directly to teeth. On the other hand, water district officials argue that toothpaste manufacturers are at fault for the endemic, because fluoridated water began in 1945 and toothpaste use followed many years afterward, so water fluoridation was set in place prior to the pervasive use of concentrated toothpastes. The FDA would argue that both contributors are at fault, since the NRC 2006 report clarified that 55% of fluoride in the bloodstream is that ingested from treated water, and 35% is from toothpaste use.

    Currently there are no city officials who obtain measurements of blood fluoride or saliva in treated citizens to ensure that infused industrial fluoride from fluorosilicic acid/caustic soda mixtures is either safe or effective, in spite of vast data indicating that soft water allows blood fluoride levels to accumulate to 4 times higher concentrations than fluoride present from ingesting treated hard water containing sufficient calcium to minimize assimilation of fluoride from the GI tract.

    Richard Sauerheber, Ph.D. Chemistry

    Copy sent to U.S. Food and Drug Administration, Center for Drug Evaluation and Research, Rockville, MD 20857 (in care of petition FDA-2007-P-0346) Additional comments specifically for the U.S. FDA:

    Food and Drug Administration
    Centers for Drug Evaluation and Research
    Rockville, MD 20857

    Dear petition reviewers:

    As you know, the original notion that natural calcium fluoride in drinking water associated with whitish teeth assumed that fluoride was responsible for this effect, even though calcium in the water was extremely high at over
    300 ppm calcium and magnesium. We now know that it is calcium that builds strong teeth, not fluoride: fluoride is
    a general enzyme inhibitor at concentrations known to prevail in human blood and tissues due to ingestion from water supplies, and topical fluoride at miniscule levels does not remineralize or incorporate into enamel (high fluoride concentrations as found in dental gels rather form calcium fluoride globules from salivary calcium which are readily washed away and swallowed after eating a meal) and Ziegelbecker extensively published vast data indicating the wide scatter that first caused the misleading proposed correlation that turns out to be anecdotal, finding no association between caries incidence and blood fluoride over a wide fluoride range, and Teotia and Teotia in the largest international study ever conducted over 30 years with 100,000 subjects reported that highest cavity incidence occurs in fluoridated cities with calcium deficient diets and lowest caries incidence occurs in non- fluoridated regions with typical calcium-sufficient diets (see original petition FDA-P-0346).

    Sadly, there are no controlled prospective clinical trials conducted with human volunteers to eliminate extraneous variables, to help separate anecdotal correlation from cause and effect fact. However, the reason we now have conclusive proof that industrial fluoride ingestion is harmful and ineffective when ingested from 1 ppm treated water is because of the large number of U.S. cities that have been infusing industrial fluoride into water supplies that have acted as a trials data set. The evidence of harm and ineffectiveness have been amply discussed with references in Connett, P., et.al. The Case Against Fluoride, how Hazardous Waste ended up in our Drinking Water and the Politics that Keep it There, Chelsea Green Publishing, White River Junction, VT, ,2010 and recently the 360 page report by the Irish environmental scientist Declan Waugh, 2012 and in the NRC, 2006
    Report, all which present the results of over 1,000 recent studies published on this issue. The original test experiments in cities in 1945 switched from natural calcium fluoride to use of industrial sodium fluoride without FDA approval, and today most water districts use industrial toxic diluted hazardous waste fluorosilicic acid without FDA approval to infuse into municipal drinking water.

    We would appreciate action on the part of the FDA in addition to the correct and excellent former FDA rulings from 1963 to 1993 (that fluoride is not a mineral nutrient, does no strengthen bone, and when added into water is an uncontrolled use of an unapproved drug). We again request that industrial fluoride either be banned from application into public water supplies without a prescription, or that CDC officials be halted from requesting water be treated with industrial (unnatural lacking calcium antidote) fluorides since the SDWA prohibits adding any chemical into to water other than to sanitize it, or that chemical suppliers provide FDA with data demonstrating safety and effectiveness even in the infirmed who consume the water product, or that fluoridation only be allowed in cities with hard water in the 300 ppm calcium range, or that calcium and/or vitamin D infusions into soft water supplies be suggested as a dental aid rather than diluted toxic industrial fluorides, or that any municipality that continues to infuse industrial fluorides into public waters be requested to inform citizens to halt use of Luride sodium fluoride tablets, to halt use of prescription drugs that interact with or are impaired by fluoride, and that citizens afflicted with bone diseases, with cardiovascular disease, kidney disease or diabetics, athletes and laborers who can ingest much more water be warned to consume non-fluoridated water, or other action(s) deemed the FDA CDER deems appropriate. We now have sufficient data available that acts as a substitute for the lack of initial controlled clinical trials with human volunteers (that remains non-existent to this date).

    Thank you very much again for your attention on this matter. Copy sent to U.S. CDC

    #25.

    August 21, 2012

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear reviewers,

    This letter supports the petition to regulate or ban the infusion of industrial fluoride compounds into public water supplies designed to treat humans, FDA 2007-P-0346.

    Longstanding communications with the U.S. Centers for Disease Control Oral Health Division dental officials has revealed a striking lack of understanding of their own water treatment ‘fluoridation program’ that the CDC requests of U.S. cities.

    1) As previously mentioned remember that CDC has written there is no difference between natural calcium fluoride (found in some U.S. waters) vs. treating water supplies artificially with industrial fluorosilicic acid collected from waste scrubbers of the phosphate fertilizer industry designed to minimize fluoride pollution. Calcium fluoride is not a recognized poison, having low solubility to only 8 ppm maximum where calcium minimizes fluoride assimilation after ingestion. However all industrial fluorides are toxic calcium chelator poisons with essentially infinite water solubility since all lack antidote calcium.

    2) CDC has correctly written and fully understands the truth, that fluoridation cannot be required by the CDC, which is a non-regulatory agency (see attached letter from CDC). No Federal agency can do so, because the Safe Drinking Water Act prohibits the infusion of any substance into water other than to sterilize the water, as written by the U.S. EPA (see attached letter from the EPA). And yet, CDC on its fluoridation website strongly recommends industrial dilute fluorosilicic acid infusions into all public water supplies (regardless of calcium content), and cities are forcefully and strongly requested to fluoridate anyway (see previous letter to FDA on deceptive CDC practices, where CDC and EPA officials train water district personnel how to fluoridate).

    3) Finally, a simple question was posted to CDC on the vast discrepancy between salivary fluoride for ingestion and toothpaste fluoride for dental caries mitigation (a copy of this letter was sent to the FDA July 16, 2012). On August 1, 2012 CDC wrote back with no answer to the question. I was told “we will respond to your inquiry when we have additional information” (see attached letter). In other words, CDC personnel who forcefully request cities fluoridate (which is equivalent to a requirement that violates the SDWA) has no immediate answer to the most straightforward question about the program that is necessary to know before embarking on the infusions.

    We urge the FDA to inform the CDC that the OHD is urged to discontinue recommending the infusion of industrial fluoride compounds into U.S. water supplies, since A) no controlled clinical trials have been conducted on either diluted fluorosilicic acid or sodium fluoride for internal consumption that meets FDA requirements for approval to be taken internally in the U.S.; B) a forceful or strong recommendation from Federal officials to infuse a substance to treat humans is comparable to a Federal requirement, which violates the Safe Drinking Water Act; C) vast published data clearly demonstrate that ingested fluoride, taken internally, does not decrease teeth caries (see FDA petition and letters to FDA November 24, 2011; December 3, 2011; January 14, 2012); and D) CDC has not answered the most basic question about the program (FDA letter July 16, 2012), which spends 300 million dollars annually to fluoridate citizens in the U.S. that achieves only 0.02 ppm fluoride to bathe teeth topically, while toothpaste fluoride, with FDA approval as a medical device not to be swallowed, contains 1,500 ppm fluoride, a level argued to mitigate teeth decay, so saliva from fluoridated water ingestion is 75,000 times less concentrated than the level that has FDA approval for mitigation of teeth decay.

    I fully expect the CDC to continue to defend water fluoridation anyway as a Federal program. I will inform you of any additional responses CDC provides to my recent question, and I expect the excuse will be that ‘ingested fluoride from water must work, so it must be that the 75,000 times more concentrated level provides additional help with a different mechanism’–all without any detailed scientific references with research proving the claim. This has

    been the usual procedure that CDC dental officials have followed with any question to date on this illegal Federal program that the OHD of the CDC strongly requests.

    As of this date there have been 25 supplement letters forwarded in support of the FDA petition, so enclosed please find a CD containing reprints of those letters in dated order for your convenience.

    My LDL/HDL cholesterol ratio has been exceedingly high for about 15 years that has been resistant to repair with drugs and diet, and I suffered a heart attack on July 19. The angioplasty was successful and it is believed I can return to normal after an uncertain number of months. In the meantime during recovery, I hope to continue correspondence with you and other agencies in support of this petition. For example, I hope to write the Federal Trade Commission who routinely involves itself in the interstate sale and transport of supplements of suspected quality. Since we now know that in CA and other U.S. locations fluorosilicic acid waste from fertilizer industries in China, that are not monitored for purity, are infused into public water supplies. It might be of interest for the FTC to regulate the sale of these industrial fluoridation materials. A lawyer involved in a lawsuit against Metropolitan Water, Los Angeles informed me that the material is stored in the open in pits that are so toxic that when birds fly over they perish and fall into the materials. When the material arrives in the U.S. it is contaminated with feathers and bird remains. None of this is known by the general public who consume the materials from treated water supplies and it is time to regulate this practice at the Federal level.

    Thank you for your attention, Richard Sauerheber, Ph.D.

    #26.

    October 6, 2012

    U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This information is provided in support of the petition to ban the intentional dissemination and ingestion of the industrial synthetic fluoride compounds, including fluorosilicic acid and sodium fluoride routinely infused into public water supplies in an attempt to mitigate dental caries (petition FDA-2007-P-0346, formerly 2007P-0400).

    The FDA is thanked tremendously for the recent work to halt sales and use of what were thought for 68 years to be safe organic arsenic chemicals added to poultry feed to prevent coccidiosis in chickens. It is also encouraging that the manufacturer of that arsenical, Pfizer, quickly agreed to halt sales for feeds when FDA discovered that the organic arsenic was converted to detectable inorganic arsenic III, a type class IA certain human carcinogen, in chicken liver in the ppb range.

    It is notable that the infusion of industrial fluoride compounds into public water supplies, to be taken internally to adjust blood levels to 0.2 ppm fluoride where it does not belong, to affect teeth, is soon also to be a 68 year old practice (since 1945 in Grand Rapids, MI and Newburgh, NY). We now know that systemic fluoride is responsible for abnormal ugly tooth fluorosis with its enamel hypoplasia that afflicts 41% of U.S. teens aged 12-15 as of 2004, and that fluoride has been argued by CDC to aid teeth only topically, not systemically (see National Research Council, Report on Fluoride in Drinking Water, 2006, p. 16 for seven references for this fact). So ingested fluoride from water cannot decrease teeth caries since fluoride in toothpaste is 75,000 times more concentrated than fluoride in saliva at 0.02 ppm from ingestion of treated water (see previous letters to FDA and NRC, 2006, p. 71).

    Moreover, chemical calculations suggest that it is orthosilicic acid that may be responsible for the increased lead leeching from plumbing in water treated with fluorosilicic acid, but not sodium fluoride. Higher blood lead levels occur in children ingesting this treated water compared to water treated with either sodium fluoride or left untreated. For a typical treated city where industrial fluoride is 0.8 ppm, pH 7.6, the hydrofluoric acid HF level is only 0.5 parts per billion but the intact orthosilicic acid concentration is about 4 ppm, 8,000 times greater (see below). It is not surprising that fluorosilicic acid treatment of water might cause increased lead levels in blood, while sodium fluoride treatment does not. Infusions of industrial fluorosilicic acid typically produces after dilution into municipal water supplies roughly equal amounts of fluoride ion, sodium ion and intact orthosilicic acid (NRC,
    2006, p. 56). For many reasons, it is necessary for the FDA to halt sales of fluorosilicic acid for addition into water, producing orthosilicic acid for human ingestion in the U.S. The substance is not FDA approved to be taken internally.

    Recently, orthosilicic acid is now being sold as an anti-wrinkling oral agent and possible ‘vitamin’ or ‘dietary supplement’, marketed as such under the name Biosil: http://www.amazon.com/Biosil-Orthosilicic-Acid-Veg- Caps/dp/B003WGCK70 even though this is an abnormal contaminant with no purpose in human blood.

    So, treatment of water with fluorosilicic acid provides two substances, both argued by different promoters as being mineral ‘nutrients’ or ‘supplements’, orthosilicic acid and fluoride.

    It is gratifying indeed that the FDA today reported cracking down, with the help of Interpol, on internet pharmacies that sell unapproved drugs. The Associated Press wrote that FDA spokeswoman Sarah Clark-Lynn stated “the door isn’t closed on these cases.”

    One can only hope then that the FDA will logically also crack down on the sale of fluorosilicic acid to water districts for its orthosilicic acid (and fluoride) in public water supplies for internal ingestion without FDA approval. This is even more important than cracking down on suppliers of substances taken voluntary, that can be avoided by

    simply not purchasing them. Chemical substances that treat humans by internal ingestion from public water supplies cannot be avoided by the consumer. Water must be consumed by everyone to remain alive.

    The CDC ignores any possible adverse effect from infusing orthosilicic acid into public water supplies that always accompanies water fluoridation when industrial fluorosilicic acid is used as starting material (see CDC fluoridation website). Indeed, the CA State Chief Fluoridation Officer acting under the auspices of the CDC Oral Health Division, a Donald Nelson, D.D.S., informed me that silicic acid is viewed by the dental industry to be innocuous and argued to be ‘metabolized away’ after ingestion. This of course is a rumor that is not proven. Although silicic acid is fully assimilated and excreted well by normal kidneys, evidence that silicic acid is not always well-excreted exists. Alligators developed lethal silicosis of the liver quickly after fluorosilicic acid infusions began in Kansas City, Kansas (personal communication, Dr. Albert Burgstahler) proven with well-controlled studies at an alligator farm, published in the journal Fluoride. People with kidney disease on dialysis would be expected to have silicic acid excretion difficulties. Also, neither Nelson nor the CDC concede that silicic acid leeches lead from lead-based plumbing. And Nelson wrote to me: “it is not the responsibility of the CDC to make people drink the treated water. CDC only recommends fluoridation and does not force anyone to actually drink the municipal water supplied to their homes. Citizens can purify that water before consumption if they are sensitive to it or want to avoid it.” Really?

    Acknowledgements. Much thanks to James Deal, Attorney, Candidate for Lieutenant Governor, State of Washington, for asking the simple question that CDC refuses to ask: “How does fluorosilicic acid treated water leech lead from plumbing, that water treated with sodium fluoride cannot?”

    Thank you again, Richard Sauerheber, Ph.D.

    p.s. The following letter was sent to Everett, WA by request, answering claims made to the city by a Dr. Goldbaum.

    To the city of Everett, WA,

    Dr. Goldbaum is partly correct, to claim water lead ion levels are not higher after fluorosilicic acid is diluted and infused at the treatment plant, but this statement does not list experimental error; it is not the entire truth. The added fertilizer discard material fluorosilicic acid that contains lead, when diluted properly only increases lead in the delivered water to a level too low to be detected with the instumentation the Everett water district uses. However, notice the Everett water district Water Quality Report 2011 listed that about 2% of household samples had lead so high in the product water that they exceeded the EPA allowed 15 ppb (but without actually listing what the high concentrations were that were measured, see http://www.ci.everett.wa.us/Get_PDF.aspx?pdfID=5924). Here in Southern CA in Carlsbad, fluorosilicic acid treatment of water supplies began in 2007 and quickly caused many household waters to exceed lead ion allowed levels to a very large degree, and necessitated changing plumbing fixtures at one elementary school (Carlsbad Water District Water Quality Report, 2010).

    The Masters and Coplan study

    (http://www.waterloowatch.com/Index_files/Fluorosilicates%20Increase%20Blood%20Lead%20Levels.pdf) that reported higher blood lead levels in children drinking fluorosilicic acid treated water, rather than sodium fluoride treated water (Coplan, et. al., Neurotoxicology, 28(5):1032-42), has often been criticized for not providing a mechanism for this increase. Many ask how does 1 ppm fluoride from fluorosilicic acid leech lead from plumbing even though 1 ppm fluoride from sodium fluoride cannot, since fluoride is the identical ion in both cases? The answer to this is suggested to be that fluorosilicic acid after dilution nevertheless leaves about 1 ppm intact orthosilicic acid (H4SiO4) in the final water (National Research Council, Report on Fluoride in Drinking Water,
    2006 p. 53). This is the orthosilicic acid form that remains the intact acid even at alkaline pH because its dissociation constant Ka is only 2 x 10-10. The intact acid exists appreciably over the pH range 7 to 10 and likely is the reason lead leeches from home plumbing fixtures because the reduction potential for lead is larger than that for hydrogen, where: 2H4SiO4 + Pb(s) → Pb2+ + H2 + 2H3SiO4 . Indeed, it is well known that even the weak organic acids including intact acetic acid (CH3COOH) dissolve lead, which for unknown reasons is resistant to HF (Merck Index, 9th edition, 1976, entry 5242, p. 5235). Orthosilicic acid is a ‘weak’ acid, remaining un-ionized at high pH, but this makes the acid able to react at alkaline pH with lead, or especially lead salts known to typically line old pipe surfaces such as lead carbonate and lead hydroxide, where: 2H4SiO4 + Pb(OH)2 →2H2O + Pb2+ + 2H3SiO4 . Coplan and Masters found that brass fixtures containing lead are most susceptible to fluorosilicic acid treated water.

    The pH at which orthosilicic acid is neutralized (i.e. ionized) by caustic soda, so it would be unable to react with lead or its salts, is very high, above pH 11. Its pKa of 9.7 is the pH at which the acid would only be half- dissociated. The water quality report in Everett indicates in one place that the pH of Everett water is 7.6, but in another it is listed at 8.2, so the pH of Everett water may vary widely, where the acid hydrogen ion content at 7.6 is a 4 times higher than at 8.2. The higher the acid content, the more corrosive the orthosilicic acid can be.

    Neither physicians nor dentists are water quality professionals and have no expertise to advise the State of WA on water quality. HHS requested lowering the fluoride to 0.7 ppm as Goldbaum pointed out while claiming WA State law will not allow a level lower than 0.8 ppm unless HHS makes the 0.7 ppm recommendation ‘official’. But HHS will not make (and cannot make) any fluoride level ‘official’, because the FDA ruled that fluoride is not a mineral nutrient and in water is an uncontrolled use of an unapproved drug and the Safe Drinking Water Act prohibits such permission anyway. FDA has never approved any fluoride compound to be taken internally in the United States. The HHS recommendation was not an allowance or an ‘endorsement recommendation’ as Goldbaum surmises; it was a warning that unless levels are lowered to 0.7, adverse health effects will be found at undesirable significant levels in those who consume it. To help counter the current endemic of abnormal tooth fluorosis in U.S. children, the recommendation was made to minimize fluoride additions to a level that promoters already deem acceptable for themselves. This was a negotiation, a ‘recommendation warning’, that if one is going to fluoridate anyway, at least use the lowest level already promoted. It was not to endorse, promote, request or give license to fluoridate. HHS cannot assign an official allowed level because the Safe Drinking Water Act prohibits any Federal requirement for any amount of any substance in water other than to sanitize the water. HHS knows this, but Dr. Goldbaum apparently does not. One man’s ‘recommendation warning’ to use the least possible amount of a poison (if you’re going to drink it anyway) is another man’s ‘recommendation allowance’ or license to go ahead and consume that poison — whoopee, drink it up, the HHS apparently now says ‘it’s OK.’

    Goldbaum continues to claim that the NRC endorses water fluoridation, by stating that the CDC has ruled that the NRC report is fully consistent with CDC recommendations to fluoridate drinking water. This is false. The NRC did not make that statement; dental officials in offices within the CDC made that claim. The NRC actually concluded unanimously without dissent that current allowed levels for fluoride in drinking water are not protective of human health. Adverse health effects are now widespread in U.S. cities because of fluoride in drinking water. Although Goldbuam claims the NRC only studied fluoride between 2-4 pm, this is also false. The NRC examined published adverse health effects in humans and animals over the full range of fluoride in water from near zero to 2-4 ppm and to 10 ppm.

    And the NRC did not conclude that fluoride ingested from water decreases dental caries. Quite the contrary. The NRC concluded that abnormal tooth enamel fluorosis, caused by ingesting fluoride in water, is accompanied with fluorotic dentin teeth interiors (p. 126) where fluoride levels in dentin even exceed that in bone. Also, significant fluorotic regions in teeth “are structurally weak” so when decay sets in “the result is often disastrous, spreading rapidly so that steps taken to repair the cavities are unsuccessful, the tooth breaking away when attempts are made to anchor the fillings so that extraction is the only course.”

    Yes, moderate dental fluorosis was intended to be kept below 15% incidence by the EPA’s MCL of 2 ppm fluoride in water, but this policy has failed. The NRC (p. 352) requested that the EPA MCLG of 4 ppm be lowered to help minimize significant abnormal bone fluorosis, and that the EPA MCL of 2 ppm be re-considered because moderate (significant) tooth fluorosis (as well as other adverse health effects seen at 1 ppm) exceeds the 15% incidence that the level was supposed to prevent.

    For 0.8 ppm fluoride, as listed in the Everett Water Quality Report, the intact acid HF level would be only 2 ppb when the Everett water is at pH 7.6, and 0.5 ppb HF when Everett water is at pH 8.2. These are calculated from the Henderson-Hasselbach equation, pH = pKa + log [F-]/[HF] where [ ] refers to molarity of the fluoride and the HF and pKa refers to the negative log of the HF dissociation constant which is approximately 5 (Lide, editor, CRC Handbook of Chemistry and Physics, Chemical Rubber Company).

    Fluorosilicic acid treated water dissolves lead from pipes more readily than does sodium fluoride treated water, even though the HF trace concentration is the same at a given fluoride level from either source. Therefore, as expected, it may be the un-ionized orthosilicic acid that is responsible for the dissolved lead from pipes exposed to this acid at about 1 ppm in waters treated with fluorosilicic acid, but which is not present in water treated with sodium fluoride.

    Finally, it should be noted that intact orthosilicic acid bathes teeth enamel topically from drinking treated water. Intact acids readily dissolve weak acid salts, including enamel calcium phosphate, the extent determined by concentration and exposure time. The ‘weak’ organic carbonic acid H2CO3 (Ka = 4.5 x 10-7) eventually dissolves teeth enamel soaked in vitro in large volumes of carbonated beverages. The intact acid concentration, 4 ppm at pH
    5.6, compares with the intact orthosilicic acid concentration in drinking water (4 ppm at pH 7-8). The slow reaction

    with calcium phosphate is: 2H4SiO4 + Ca3(PO4)2 → 2HPO -2

    • 2H3SiO4-
  • 3Ca

  • 2+.

    . Although Material Safety Data

    Sheets on orthosilicic acid indicate it is fully assimilated and well-excreted by normal kidneys, lifelong orthosilicic
    acid from treated drinking water has not been evaluated, and dental effects were not examined. Orthosilicic acid tablets are sold for optional use in solid form for swallowing and would not affect teeth topically. Lifelong orthosilicic acid from industrial sources in drinking water however is completely contraindicated in any topical caries preventive or as an ingestible.

    Please remember, it is correct that neither silicic acid nor fluoride ion are listed as constituents of normal human blood (Teitz, Clinical Chemistry, W.B. Saunders, 1976; the Merck Manual, any edition; Leahy, Foundations of Nursing Practice, W.B. Saunders, 1998; or equivalent Nursing or Clinical Chemistry text with tabulated listings for normal blood constituents). These substances at any concentration are contaminants in blood.

    #27

    October 9, 2012

    U.S. Food and Drug Administration Centers for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    This information is provided in support of the petition to ban the intentional dissemination and ingestion of the industrial synthetic fluoride compounds, including fluorosilicic acid and sodium fluoride routinely infused into public water supplies in an attempt to mitigate dental caries (petition FDA-2007-P-0346, formerly 2007P-0400).

    In an earlier letter sent to FDA June 4, 2012, the recent massive review of the adverse health impact of water fluoridation in Ireland was described with references. Just in case it was not possible for FDA to obtain some of the important raw data from the references, enclosed please find a key component of the 360 page study. It is a map of Ireland showing the borderline in red that separates Northern Ireland from the Southern Republic. Water fluoridation does not exist in Northern Ireland but has been conducted in Southern Ireland for over 4 decades.

    According to Declan Waugh, the award-winning environmental scientist who finished the report, Southern Ireland is now experiencing huge increases in incidence of various adverse health conditions that appear to be related to the fact that fluoride is a toxic calcium chelator, couples with the fact that calcium levels in many areas in the South are deficient in endogenous calcium.

    The scientific fluoride risk assessment study demonstrates the danger of water fluoridation on human health, the environment and animals. It can be downloaded at: www.enviro.ie. It is advised that the FDA, all concerned parents, farmers and government officials look at this document, with 1,200 peer reviewed studies.

    Pay attention to these maps below from this document, showing cancer rates on both sides of the border that separates Northern from Southern Ireland. The Southern Republic has higher incidence of cancers than the North and what is most disturbing is that the cancers follow the imaginary border line closely. There are 18 cancers with higher rates in the South, even though the Irish live on the same piece of land, breathe the same air, and are the same genetic make-up. Waugh concluded that the only definitely known difference at the present time that could explain this is the infusion of industrial fluorosilicic acid into public water supplies that takes place in all Southern Ireland but nowhere across the border in the North.

    The maps are from the National Cancer Registry, Ireland (NCRI) for all Ireland 32 counties. Waugh wrote to the NCRI raising concerns that the only known environmental exposure present in Southern Ireland not present in Northern Ireland to which the population is fully exposed are industrial silicofluoride compounds added into Southern water supplies. Calcium is a known antidote to fluoride chronic poisoning, by minimizing fluoride assimilation after ingestion, and the highest cancer rates indeed occur in those fluoridated Southern Counties with the lowest calcium level in the water. In light of these and other U.S. data (see previous letters to FDA), this must be considered as a risk factor in cancer prevalence.

    Any peoples that are health conscious and who treasure life must oppose the industrial fluorosilicic acid discarded material from the fertilizer industry from being infused into public water supplies. It is expected that Southern Ireland will indeed do so soon.

    [cid:image151.jpg@01D47B9C.4AC11730]

    #28.

    November 4, 2012

    Department of Health and Human Services
    Public Health Service
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Office of Regulatory Policy
    Rockville, MD 20857
    Dear FDA Project Reviewers,

    This letter supports the petition to ban the infusion of industrial fluoride compounds into public water supplies, FDA2007-P-0346, formerly 2007P-0400.

    Materials submitted by a Dr. Goldbaum to the citizens of Everett, WA are comparable to those beliefrs widely promulgated to convince city councils and local and State governments to infuse into public water supplies fluoride compounds that are classified by the FDA as unapproved drugs to treat consumers. His presented data indicate that over 50% of Snohomish County, WA third graders have cavities, and 20-30% of 65 year olds have lost all permanent teeth (slide #2), and yet that Snohomish County waters have been treated with industrial fluoride in Edmonds, Mount Lake Terrace, Lynwood, Everett, and Seattle at concentrations above the level recently requested to not be exceeded by Health and Human Services. This contradiction was not explained, even though the entire 47 slide presentation argues that treating water with diluted industrial fluoride from a fertilizer off-product is believed to reduce tooth decay when taken internally through ingestion.

    The National Research Council 2006 Report on Fluoride in Drinking Water examined vast studies of the health consequences of ingesting water with fluoride from 1 ppm and above and concluded unanimously that current allowed levels of fluoride in public water do not protect human health. In stark contradiction, Goldbaum claimed instead that the Report indicated there were ZERO adverse health effects of ingested fluoride!

    Comments presented below, by request, clarify one of the slides Goldbaum presented August, 2012 entitled “Fluoridation is a Balanced Approach” (slide #16). Two graphed curves were presented without actual data points, attempting to indicate that populations drinking regular water without added fluoride is associated with 2.2 times higher incidence in teeth caries than that associated with fluoridated water at 0.7 ppm. This claim is not referenced and in fact is starkly contradicted by data presented on slide 9, where 14 year old children consuming non- fluoridated water lifetime had only 1 tooth caries incident above that in children consuming 0.7 ppm fluoride water.

    Vast epidemiologic data published in numerous sources prove that tooth caries incidence is unrelated to level of fluoride in drinking water. In fact, ingested fluoride cannot decrease caries because fluoride in saliva from treated water is only 0.02 ppm (NRC, 2006, p. 71), 75,000 times lower than in toothpaste. The fact that fluoride does not work systemically from the bloodstream was described by the Centers for Disease Control (MMWR, Aug., 2001), and yet slide #6 purports without citation that in pregnant mothers, fluoride (which crosses the placental barrier) is somehow perceived as helping teeth which develop years after birth.

    Goldbaum claimed that fluoride consumption from treated water supplies exerts no adverse health effects whatsoever lifetime, but the data he presented in slide #16 disproves that claim, where abnormal tooth fluorosis with its unsightly enamel hypoplasia increases in incidence as a direct function of fluoride level in drinking water. Tooth fluorosis is the first visible sign of fluoride poisoning and is always accompanied with abnormal, permanent fluoride incorporation into bone. Fluoride accumulates in bone during lifelong consumption, weakening bone at
    3,000 mg/kg (NRC), typically reached after decades of consuming water with 1 ppm fluoride (depending on total exposure to fluoride from all sources, and water hardness since calcium minimize fluoride assimilation into the
    bloodstream from the gastrointestinal tract). Published data demonstrating the adverse effects of ingested
    fluoridated water on brain function and morphology in humans and in research animals led the U.S. EPA to list synthetic fluoride as a development neurotoxin

    http://www.epa.gov/ncct/toxcast/files/summit/48P%20Mundy%20TDAS.pdf).

    The idea of drawing these two curves, one showing purported decreases in teeth decay, and the other showing the increased incidence of tooth fluorosis as a function of fluoride levels in water, was first invented in 1939 by Dean. Dean mistakenly attributed a lower teeth caries incidence in Texas children to fluoride, rather than to the calcium present in the natural hard water with 300 ppm calcium and magnesium. Dean apologized years later in a Chicago court for making this correlation graph having no scientific proof, but variants of the graph have nevertheless been used by fluoride promoters for 67 years to argue a purpose for taking fluoride ion internally. Fluoride is not a normal constituent of the bloodstream and no listing for this halogen exists in any detailed tables of blood constituent levels in Clinical Chemistry or Nursing textbooks, or the Merck Manual. There is no recommended daily allowance (RDA) for the ion, where the FDA correctly ruled that fluoride is not a mineral nutrient and in water is an uncontrolled use of an unapproved drug and that fluoride does not strengthen bone (as fluoride promoters had hoped).

    The comprehensive analysis of Ziegelbecker (in Connett, The Case Against Fluoride, 2010), which included the original data misinterpreted by Dean, proved that fluoride levels in water bear no relation to caries incidence, and that scatter in the data led Dean to the false correlation in the first place. What was correct however is the strong correlation that is irrefutable, where tooth fluorosis increases as a function of progressively increasing fluoride water level from 0.3 ppm and above. The two curves taken together were hoped to intersect at a level of choice where fluorosis adverse effects would be minimized, while an effect on caries might be significant, so the idea that
    1 ppm fluoride would be ‘optimal’ was set. Unfortunately, the average water level of calcium, the antidote to
    fluoride poisoning, in the U.S. varies widely, with an average of only 50 ppm. Thus it comes as no surprise that the
    CDC reported the U.S. is suffering from an endemic of abnormal tooth fluorosis, afflicting 41% of children aged
    12-15 as of 2004. Toothpaste manufacturers argue this is the fault of water treated with industrial fluoride, since water is directly swallowed, and produces over 50% of all fluoride ion present in the bloodstream (NRC). Dental
    officials who still promote fluorosilicic acid infusions into public water supplies argue it is the fault of toothpaste,
    since water fluoride use began long before toothpaste fluoride was developed. In reality, both sources are of course at fault in determining total exposure of our children to this unnatural synthetic fluoride. It is necessary to halt the
    infusion of industrial fluoride toxic calcium chelators into public drinking water supplies and to return to a sane
    policy of supplying regular fresh clean drinking water to all U.S. citizens. The world waits.

    Goldbaum made the incredible assertion without reference that there is no known allergy or sensitivity to fluoride in anyone! This is incorrect as reported in several textbooks and in the scientific literature, that documented sensitivity to fluoride occurs in approximately 1% of people (Feltman, R. and Kosel, G., Prenatal and Postnatal Ingestion of Fluoride—Fourteen Years of Investigation—Final Report, Journal of Dental Medicine, 16:190,
    1961). This was confirmed further in the NRC 2006 report that described the controlled clinical trials conducted with human volunteers drinking only 1 ppm fluoride water, where 1% reported GI discomfort immediately after consumption. This author knows three individuals who are sensitive to silicofluoridated water used in ‘water fluoridation’ and one whose face swells each and every time dental fluoride gels are applied to her. The data from Waldbott is comprehensive (Fluoridation the Great Dilemma, Coronado Press, 1978) and includes a large number of references on sensitivity to fluoridated water, many being well controlled double blind studies (such as Grimbergen, A Double Blind Test for Determination of Intolerance to Fluoridated Water, Fluoride 7:146, 1974) and the studies of Petraborg, H., Chronic Fluoride Intoxication from Drinking Water, Fluoride 7:47,1974).

    It is claimed on slide #17 that fluoride is the safest fluoride. Ironically, industrial fluoridation of drinking water is the least safe fluoride compound because 1) it is intended to be taken internally through swallowing, where the ion permeates all organs of the body and averages 0.21 ppm in the blood where it does not belong and where it incorporates permanently into bone and where it causes enamel hypoplasia (fluorosis) in 30% or more of children in 1 ppm treated cities; all other sources of fluoride listed in the slide are not intended to be swallowed. And 2) industrial fluoride lacks antidote calcium and is listed as a toxic substance on poisons registries with a lethal oral dose of 120 mg/g in mammals; calcium fluoride is not a listed toxic.

    Entitled “Fluoridation is Safe”, slide #34 makes astoundingly incorrect claims that are not found in any reference.
    1) ‘There are no negative effects on health in humans or animals from fluoridation’. There have been multiple
    deaths caused by water fluoridation due to accidental overfeeds (Gessner, New England Journal of Medicine,
    330,1994). Longterm effects at lower levels labeled ‘optimal’ are far too numerous to describe thoroughly, but
    include at 1 ppm fluoride, iron deficiency anemia, bone weakening after longterm consumption, mental IQ
    lowering due to blood fluoride above zero, the level it is supposed to be as a non-nutrient ion, and fluoride

    accumulates into atherosclerotic plaque in coronary disease victims. Salmon collapses have occurred on the Columbia River and the Sacramento River after fluoridated water discharges began, where salmon extreme fluoride sensitivity has been documented in fresh soft water. Salmon are unaffected by natural fluoride in the ocean due to its extremely high content of protective calcium, but which of course renders seawater undrinkable by humans.

    2) The statement that there is no measurable increase in lead or arsenic due to fluoridation, and there is no measurable increase in fluoride from water discharges, are incomplete thoughts. After dilution, the added lead and arsenic, is then below that typically detectable with instruments lacking sensitivity to detect the increase that exists. The implication that it does not increase at all is false. Although the arsenic additions that accompany fluorosilicic acid infusion are currently not banned by the EPA, it is nevertheless illegal to add any known carcinogen into human drinking water (Delany clause of the Food Drug and Cosmetic Act), whether it is below the limits of detection by low-sensitive equipment or not. And overfeeds that occasionally occur in U.S. fluoridated cities indeed contain increased arsenic levels that are detectable. Fluoride levels in rivers after discharging fluoridated water also increase in the emission plume that may, after dilution, be again undetectable with insensitive equipment, but salmon can be blocked from navigation at levels 2-3 times lower than already present in discharged waters (at 0.7-1 ppm).

    Goldbaum sates that he ‘is convinced’ that fluoridation is ‘safe, effective and legal’ and consumes it regularly himself and gives it to his family. It is obvious that he is convinced, but why cannot other rational people who remain un-convinced and know the truth, have access to regular fresh clean non-drugged drinking water is they so choose? Free choice to have clean non-drugged drinking water is a right even guaranteed by the United Nations charter for all human beings. It is admirable that Golbaum is concerned about teeth health, but it is also necessary to clarify that caries prevention does not occur because of fluoride ingestion, as is evident in Snohomish County that is largely fluoridated but yet laden with caries incidence as he states. Caries are not caused by lack of fluoride, but by acid secretions from bacteria in the mouth from carbohydrate and free sugar. To prevent caries it is necessary to brush after consumption of any sugar and to have a diet with adequate calcium and vitamin D, necessary for strong teeth enamel in the formative years. Strong enamel indeed lasts a lifetime, but fluoride is a toxic calcium chelator that can interfere with normal enamel formation to cause ugly tooth fluorosis with enamel hypoplasia. Many using fluoridated water are tricked into thinking their healthy teeth were the result of fluoride ingestion, this is no surprise. What is surprising is that vast scientific literature is excluded in the Goldbaum presentation and that the evidence cited for effectiveness is merely anecdotal, where coincidental lower rates of caries in one fluoridated location does not mean fluoride caused it, but rather better dental hygiene, better diet, or less consumption of sugar, were better possible explanations. The largest studies we have prove fluoride ingestion does not decrease caries and in fact fluoride incorporates into dentyne, but not enamel, where long term consumption causes teeth interiors to be crumbly (NRC, 2006). Dr. Heard, D.D.S., Hereford, Texas first presumed fluoride in water caused fewer caries, until years later in those children he followed were found to have crumbly teeth interiors from the fluoride compromised dentyne. Goldbaum is free to continue ingesting this ion, even though it is not a normal constituent of the bloodstream, but lifelong accumulation will be the result in later life that he alone must bear for his choice of action. The rest of society is to be left to choose the risks they wish to take in their own lives, for their own planned futures.

    Everyone agrees that fluoride accumulates into bone during lifelong consumption. At 3,000 mg/kg bone is detectably weakened (NRC), even though fluoride promoters at one time had hoped fluoride would strengthen bone. In Goldbaum’s exuberance to defend fluoride taken internally lifetime, he may be surprised to learn he is risking having later in life muscle and bone pain. This is largely the reason why the FDA has never approved any industrial fluoride for human ingestion in the U.S. and why the FDA in 1989 rejected approval based on controlled human clinical trials with sodium fluoride taken longterm conducted by the National Institutes of Health (Pollner, F., Medical World News, Nov. 13, 1989). Although bone mass increased substantially (and abnormally) in the fluoride treated cohort, no effect on strengthening bone and preventing fractures was found, and in fact more non- vertebral skeletal lesions were reported in the treated group who also had a high incidence of painful lower extremity syndrome. The toxic effects of fluoridated bone may not be manifest for 30 or more years when the bone is unable to accomodate any further fluoride, at which point consumed fluoride is stored in the soft tissues. Decalcification of bone known as osteoporosis is also a fairly common condition past middle age. When it occurs and the bone is fluoridated, the fluoride can be released into soft tissues at a rate exceeding its elimination through the kidneys (Petraborg, H., Fluoride Poisons Enzymes). Perhaps Dr. Goldbaum would be interested in examining the exhibit at the San Diego Museum of Man, Balboa Park, of fluoridated human femur bone with its bizarre

    pathologic calcium fluoride spicules that protrude from the surface, able to cause severe pain when muscle slid along it. The degree of spiculation depends not only on length of consumption of fluoridated water but also on whether the water is soft or not, since calcium minimizes fluoride assimilation after ingestion.

    #29.

    December 17, 2012

    Dear FDA Project Reviewers,

    This letter supports the petition to ban the infusion of industrial fluoride compounds into public water supplies, FDA2007-P-0346, formerly 2007P-0400.

    Summarized in earlier letters, the FDA ruled from 1963 to 1993 that fluoride is not a mineral nutrient and addition of fluoride into water is an uncontrolled use of an unapproved drug, and fluoride has never been approved by the FDA to be taken internally through ingestion, and in 1989 the FDA (see letter dated November 4, 2012) rejected approval based on controlled human clinical trials with sodium fluoride taken longterm conducted by the National Institutes of Health (Pollner, F., Medical World News, Nov. 13, 1989). (Bone mass increased abnormally in the fluoride treated cohort without effect on bone strength and more skeletal lesions were reported in the treated group with high incidence of painful lower extremity syndrome. The toxic effects of fluoridated bone may not be manifest for 30 or more years when the bone is unable to accommodate any further fluoride, at which point fluoride is stored in soft tissues).

    This letter is to also inform and remind the current staff at the FDA that in 1966 the FDA officially banned the sale, by manufacturers, of fluoride compounds for oral administration to pregnant women to affect the developing fetus for dental caries. This was printed in the Federal Register (October 20, 1966, FDA statements of general policy or interpretation, oral prenatal drugs containing fluorides for human use). In the research article in Public Health Reports by Horowitz, H. and Heifitz, S. (April, 82:297-304, 1967), the following quote was published:

    “The FDA, recognizing insufficient evidence existed to support claims of benefits from prenatal use of preparations containing fluoride, banned the marketing by manufacturers of these products offered for prenatal decay prevention” (see online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919981/).

    Please understand that fluoride promoters make the routine first assumption that ‘fluoride is good’ (personal communication, Dr. Donald Lyman, CA Department of Public Health) and have thus become blinded in suggesting that fluoride in bone ‘must strengthen bone’ and in the pregnant mother acting on the fetus ‘must prevent caries’ in developing teeth after birth. Both of these extreme ideas had no data of support and have been overturned carefully by the U.S. FDA. As described in the Petition for Reconsideration submitted to the FDA in 2010, the EPA (in the
    1979 Memorandum of Understanding with the FDA) was never given authority to regulate the use of unapproved drugs. EPA instead was given authority to regulate water additives, all designed to treat water to purify it. Agents
    used to treat people are regulated under the exclusive authority of the FDA, and indeed the FDA has thus far
    properly banned the sale of fluorides for ingestion by pregnant women in the U.S. Thank you.

    It has now been six months since asking the CDC to clarify why fluoride in saliva that bathes teeth topically at
    0.02 ppm is 75,000 times less concentrated than in toothpaste (letter to FDA dated August 21, 2012). The CDC
    after two months responded that they have no answer to the inquiry and would send it to others to try to find an answer. No answer has been provided to date and I have been advised by legal counsel that it is therefore legal and proper to conclude that the CDC, in not providing a timely answer, does not have an answer. The Oral Health Division of the CDC has no legal right to authorize the infusion of industrial fluoride compounds into public water supplies at this useless concentration. The FDA is hence asked on behalf of the citizens of these United States to ban the practice of adding industrial fluorides into public water supplies to treat people for dental caries, when it has not been FDA approved for this purpose. The 1966 ban on fluorides intended for oral ingestion in pregnant women was ordered because of no evidence of effectiveness, and the requested ban on fluorides to be infused into water supplies to treat people is also for this same reason.

    Differences in the consumption of caries-causing sugar were not examined in the original anecdotal studies claiming caries benefit from ingested fluoride water that began this whole belief system that infusing industrial fluorides into water systems was necessary to ‘fortify’ water. More comprehensive studies proved there is no relation between fluoride intake and caries incidence (Ziegelbecker as reviewed in Connett, The Case Against Fluoride, 2010, pp. 50-51). Further, the low topical levels found in saliva are definitive proof that ingested fluoride

    is unable to treat caries topically (even fluoride from toothpaste at 1,500 ppm only produces surface calcium fluoride globules that are easily dissolved through normal eating and are swallowed).

    The false hope that systemic fluoride ingested from water would affect enamel caries fell by the wayside when biochemical proof demonstrated that 1) systemic fluoride accumulates into dentin interiors of teeth (average 394 ppm from 1 ppm treated water) (National Research Council, Report on Fluoride in Drinking Water, 2006, p. 73) that enamel exists to protect (p. 126), and 2) fluoride in the bloodstream from consumed water, treated with industrial fluoride without FDA approval, causes, without exception in any treated city, increased incidence of inefficient enamel formation during teeth development, where ugly enamel fluorosis has reached endemic incidence in U.S. teens( http://www.cdc.gov/nchs/data/databriefs/db53.pdf). The U.S. Health and Human Services requested fluoride treatment of water supplies be reduced for merely this reason alone, and an official decision to ban the infusions is now necessary for the U.S. population, as was properly done in 1966 by the FDA for pregnant women.

    Recent studies confirmed the concerns published by the National Research Council (2006, p. 126) regarding fluoridated dentin fracture and tooth loss (Offenbacher, et.al., Journal of Periodontal Research 27, p. 207, 1992). Because gum tissue and dentin incorporate fluoride both from toothpaste and from ingested water systemically, tooth loss and periodontitis are widely prevalent in the U.S. The state of Kentucky was presented an award by the American Dental Association for its mandatory fluoridation of virtually all public water supplies in the state for 50 years (http://www.skagitcleanwater.com/Fluoridation_concern_%20Brief_%200utline.pdf). But no mention was made of the fact that tooth caries incidence in Kentucky is not lower than that in any other state (personal communication, Dr. Bill Osmunsen) and that the U.S. CDC published that Kentucky leads the nation in tooth loss at a massive 42% (Public Health and Aging: Retention of Natural Teeth Among Older Adults United States, 2002, Centers for Disease Control). There is no life long reduction in dental decay that can be directly attributable to water fluoridation and instead there appears to be an increase in tooth loss associated with fluoridation amongst the older population who have the longest exposure compared to non fluoridated communities. The CDC report findings support this in noting:“The prevalence of edentate persons (i.e., those who have lost all their natural teeth) ranged from 13% in Hawaii to 42% in Kentucky.” The lowest rates of tooth loss in people over 60 years of age occur in the states with the lowest rates of water fluoridation. It is irrational to defend the idea that this is a coincidence, in light of the propensity of fluoride to concentrate into dentin as in skeletal bone, weakening bone.

    The FDA has two avenues to take, placing a ban on the sale of ionic fluoride compounds intended to be ingested by the entire general public (as added into water supplies), or choosing to not do so. The latter will require an explanation one day by the FDA when the public at large fully understands the useless waste of funds on a procedure that does not decrease caries and in fact causes long-term harm, as currently being litigated (see attachments). The former avenue keeps the FDA still in the lead on this massive scale problem and allows the FDA to explain why the ban instituted earlier to protect pregnancy is necessary to extend to the general population– that is, no controlled human clinical trials data have ever been submitted to the FDA for industrial fluorides proposed to be used as though they were drugs or supplements for ingestion, and the FDA ruled that fluorides are unapproved drugs, banned for sale for use during pregnancy, and since widespread use continues without FDA approval (as in treatment of public water supplies) the FDA ban requires an extension to the general public where dosage cannot be regulated and outside sources of fluoride from other foods/beverages cannot be adequately quantified.

    Thank you again for your attention,

    Richard Sauerheber, Ph.D. Addenda:
    1. Gerber foods advertisement for its new line of fluoride-free water for infant formula, with rationale.
    2. Colgate expanded its production of fluoride-free toothpaste, advertised for children as safe if swallowed
    (not shown). An Orajel advertisement for fluoride-free, safe-if-swallowed toothpaste is included.
    3. Article in The Corporate Observer on current litigation in defense of citizens who contract tooth fluorosis.
    4. Summary of Toxic Torts Environmental Law, Nidel Law Refiled Case of Injury from Fluoridated Water.

    #30.
    January 10, 2013
    Department of Health and Human Services
    Public Health Service
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Office of Regulatory Policy
    Rockville, MD 20857

    Dear FDA Project Reviewers,

    This letter supports the petition to ban the infusion of industrial fluoride compounds into public water supplies, FDA2007-P-0346, formerly 2007P-0400.

    The last letter to you (12/7/12) reminded current FDA staff that in 1966 FDA banned sale of industrial fluoride to be ingested by pregnant women in the U.S. It must be emphasized that current sales of industrial fluoride, for the most part fluorosilicic acid enriched material, for this purpose demonstrate that chemical suppliers are in violation of the Food Drug and Cosmetic Act. These materials are sold to water districts as ‘water purifying ingredients for caries benefit’ to be ingested by the general population. The general population includes pregnant women in the U.S. Artificial fluoride ingestion does not have FDA approval, and in fact as mentioned the sale of fluoride for caries treatment through ingestion was banned in 1966 for pregnant women in the U.S. because the material was misbranded by claiming benefit to teeth through exposure of the developing fetus.

    This letter serves to point out that chemical preparations used to ‘fluoridate’ most U.S. water supplies are also misbranded by suppliers in terms of recommended dosage instructions provided. Suppliers are thus subject to reprimand from the U.S. FDA. Enclosed please find a typical data sheet and labeling for fluorosilicic acid used as though it were a water treatment additive to fight dental caries through oral ingestion. Notice that the stated allowed concentration for drinking is listed at 6 ppm. There is no EPA MCL for fluorosilicic acid. Further, the EPA MCLG for fluoride emanating from the acid is 2 ppm, which means that levels must be below this in drinking water or else a warning must be issued to consumers. 6 ppm fluorosilicic acid diluted into water dissociates to produce 4.75 ppm fluoride which is in excess of the EPA MCLG and the MCL of 4 ppm at which EPA declares the water as not potable. Alternatively, if the 6 ppm value listed by the suppliers on the report refers to the intent to dilute the aqueous preparation by a factor of 6 parts per million parts of drinking water, rather than 6 ppm of the contained fluorosilicic acid, then for a 23% solution this produces a fluoride level of 1.3 ppm. This level is still in excess of that recommended by the U.S Health and Human Services of 0.7 ppm maximum. The point is that dosage instructions for this material are vague and inaccurate and not understood by the purchaser intending to infuse it into public water supplies to treat dental caries by ingestion. Misbranding of supplements, drugs or any substance intended to treat any human ailment through ingestion is a violation of the Food Drug and Cosmetic Act, and FDA must contact any chemical supplier of fluorosilicic acid who sells this material for human ingestion.

    Industrial fluoride consumption has been found to be a promoter or supporter of human cancers (Yiamouyiannis, J., Fluoride the Aging Factor; Bessin , S. ) and animal cancers (Marcus, EPA) especially bone cancer and liver cancer (). The failed experiment for water industrial fluoridation in Southern Ireland has recently been found to be associated with massive increases in various human cancers compared to non-fluoridated Northern Ireland. Further, the high heart attack mortality in Scandinavian and Northern European countries is surpassed by fluoridated Southern Ireland. The ability of fluoride to elevate the already high death rate in this region of the world is due to the fact that most water supplies in Southern Ireland have very low levels of antidote calcium to minimize assimilation of fluoride after ingestion. As a result, Southern Ireland holds the highest cardiovascular disease mortality incidence in the entire world (Waugh, D. http://ffwireland.blogspot.ie/2013/01/fluoride-and-cardiovascular-disease_15.html).

    The Irish American Kennedy family, including Senator Ted Kennedy and President John Kennedy, if alive today and aware of these findings, with little doubt would object to artificial fluoridation of public drinking water. Senator Kennedy worked most of his life to develop a U.S. National Health Care system that eventually produced passage of the Affordable Care Act after his death, and President John Kennedy created the U.S. Water Pollution Control

    Act that was eventually passed after his death with the stated mission to maintain the natural chemistry of normal fresh drinking water supplies in the U.S. This was followed by the Safe Drinking Water Act that prohibits any National requirement for any substance added into water other than to sterilize the water. Fluoride does not sterilize water but is added only to attempt to treat dental caries through ingestion. Ted Kennedy nearly lost his son to usually-lethal bone cancer, and fluoride specifically increases the incidence of this extremely rare lethal disease over 5 fold in human males who had been exposed as children to treated drinking water. William Marcus with carefully controlled experiments found bone cancer to be induced in a significant fraction of rats treated with fluoridated water supplies, an astounding achievement in this bone-cancer-resistant species having only a 3 year lifespan in which to attempt to achieve that result

    ().

    In light of these findings, the following news report was sent to the San Diego Union Tribune newspaper. Fluoride is not FDA approved for swallowing.
    Fluoride is not listed as a normal blood constituent in any Clinical Chemistry or Nursing text, but instead
    the EPA lists fluoride as a contaminant when present in drinking water, and the FDA ruled it is not a mineral nutrient and is an unapproved drug. The disturbing recent discovery at the Veterans Administration Healthcare Center in Los Angeles with PET scans is that systemic fluoride incorporates into atherosclerotic plaque in coronary arteries of cardiovascular disease patients. This has been argued to be the reason why water fluoridation is typically associated with increased incidence of cardiovascular disease mortality in treated cities, including Grand Rapids, MI and Newburgh, N.Y. This was thoroughly described recently for the fluoridated country of Southern Ireland in a publication submitted to the European Union by a chartered environmental scientist (http://ffwireland.blogspot.ie/2013/01/fluoride– and-cardiovascular-disease_15.html). It is long past time to halt the infusions of diluted industrial hazardous fluorosilicic acid into U.S. drinking water, ongoing in Escondido since 2005, Los Angeles and North County since 2007, and San Diego since 2011. The CA State AB733 mandate does not mention fluorosilicic acid as a possible source material to be used, and it is fully legal to halt its infusion.

    Special Dedication to the Irish American Kennedy Family
    2013 marks the 50th anniversary of the homestead visit paid by President John Fitzgerald Kennedy and first lady Mrs. Jacqueline Kennedy to New Ross, Wexford County, Ireland in 1963, only months before he was killed in Dallas, Texas (The Irish Herald, Southern California Edition, Volume 10, No. 4, January, 2013, celebrating 51 years from 1962 to 2013). This letter is dedicated to the Irish American Kennedy family for their long and tireless devotion to promote health and clean drinking water. Ireland-U.S. relations are highlighted at the new state of the art Kennedy Homestead Visitor Centre in Dunganstown, Wexford. An official apology and possible reparations are in order to the Republic of Ireland for the false recommendation from U.S. dental administrators to infuse industrial fluoride compounds into calcium-deficient water supplies that led to mandatory fluoridation of Southern Ireland. Northern Ireland is commended for diligent opposition and for the promotion of clean drinking water for her citizens.

    Second, this letter calls your attention to an additional misuse of fluoride added into drinking water to treat human dental caries that now permeates the horse racing industry without FDA approval. The FDA has carefully considered data to award approval for various medications used by horses, but, as with humans, no approval has ever been granted for horses to take soluble inorganic fluoride compounds internally through ingestion.

    I was kindly asked by the journal Fluoride to write an editorial on fluoride exposure in racehorses, and attached here is a privileged copy of the article now under review. It is not to be made public inasmuch as it is being considered for publication, but nevertheless it is appropriate for the FDA to have a copy.

    The key findings are that 80-90% of racehorses have gastric ulcers seen with video endoscopy, largely because of stress and scheduled feedings instead of pasture foraging. The affected pyloric region of the horse stomach has a pH of 2.6 at which 85% of ingested fluoride ion is hydrofluoric acid HF, the corrosive substance used to frost glass and permeate porcelain. The one and only double blind, placebo controlled, human clinical trial data set we have proved that drinking water artificially fluoridated at 1 ppm, from either sodium fluoride or diluted fluorosilicic acid, causes gastrointestinal discomfort in 7% of humans, even in the absence of known ulceration of GI mucosa. Fluoride at human stomach pH is 50% HF, so it is certain that racehorses at pH 2.6 accompanied with stress ulcers are being subjected to significant HF aggravation when consuming water treated artificially with soluble fluorides.

    There are now 3 fatal horse breakdowns in the U.S. every single day (2 breakdowns per 1,000 horse starts National average) and at tracks in CA that are fluoridated and board horses year round, the rate is up to 6-7 fatal breakdowns per 1,000 horse starts. Most fatalities are due to broken bone from a misstep on the track, which can be caused by many factors including chronic pain.

    It is necessary for the FDA to honor the Food Drug and Cosmetic Act requirement of a new drug application for industrial fluoride additives to treat caries through drinking water and to regulate or ban all sales of fluorides intended for ingestion to treat caries in the absence of an approved NDA. FDA reviewed data for the organic fluoride flunixin and approved it for horses to relieve pain, not to allow horses to race while inflammation is extant, and yet this agent is commonly also given during racing and has a well-known side effect of gastric ulceration. HF aggravation of ulcerated tissue is logically a significant factor in horse unplanned mis-steps.

    Also, horses accumulate fluoride in bone, albeit at perhaps lower rates than human. Nevertheless significant structural damage occurs at only 500 mg/kg fluoride in horse leg cannon bone observed on X-ray. Fluoridate bone requires far less force to break than normal bone. FDA ruled in 1989 that fluoride does not strengthen bone.

    Finally, horse teeth do not require fluoride and in fact are harmed by its ingestion or topical use. An inorganic layer of soft pliable cementum is continuously reshaped by the act of chewing feed. Sensitive cells that secrete cementum are immediately under the gums where soluble topical fluoride as a metabolic inhibitor readily penetrates.

    Subjecting these animals intentionally to whole body fluoridation from artificially fluoridated water supplies, particularly when the ion is not a mineral nutrient and has no functional purpose in the horse where significant harm instead occurs, necessitates that the FDA regulate the sale of these chemicals when intended for ingestion by people and animals in an attempt to treat dental caries. Requesting the horse racing industry itself to use water without
    added industrial fluoride in racing is not a viable solution to the problem, where one horse consumes 30 gallons of water daily. Racetracks in CA rely on municipal water supplies for all livestock, and the only corrective measure that is rational is to ban the sale of industrial fluorides intended to be infused intentionally into public water supplies. Horses cannot speak out for themselves and FDA action is necessary to protect them while ensuring the public that vast data prove caries incidence is independent of ingested fluoride and must be fought instead with good dental hygiene.

    Attachment: Sauerheber, R. (2013) “Racehorse Fluoride Exposure; Contrasted with the Human Condition”, invited editorial submitted to Fluoride, January 2, 2013.

    #31
    January 29, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    Information here, not submitted earlier, is in support of the petition submitted to the FDA in 2007, FDA-2007-P-0346 (originally assigned 2007P-0400/CP1). The contention of this petitioner is that use of fluorine and fluorine derivatives presents a massive denegration of the health of citizens in this country. Here requested as a minimum action is a Nationwide ban of the sale of industrial fluorides intended to be taken internally through ingestion. This merely reflects an extension of an earlier 1966 FDA ban on the sale of industrial fluoride that had been intended to be offered for ingestion by pregnant women in the U.S. Elderly Care is in Drastic Need of FDA Assistance.
    Elderly persons in the U.S., typically in their 70’s and 80’s, are routinely placed in convalescent care settings where health decisions are made for them. Many are now treated with fluoridated Lipitor daily for the rest of their lives to lower cholesterol, and at the same time with fluoridated Januvia daily for the rest of their lives to lower blood glucose, and with artificially fluoridated drinking and cooking water without benefit daily for the rest of their lives, and with fluoridated flu vaccines yearly, and with fluoridated Levaquin antibiotic in cases of bacterial infections.
    Fluoride from the ionic compounds fluorosilicic acid or sodium fluoride from treated drinking water, plus that from the fraction of covalent carbon-fluorine molecules that are metabolized, accumulates into elderly bone permanently lifetime, weakening bone and altering whole body calcium homeostasis. In addition, carbon fluorine molecules in the above list incorporate into all biological membranes because of high lipophilicity and high lipid water partition coefficients. The fluorine atom in the polar covalent carbon-fluorine bond is extremely tine in volume (0.0025 nm3) at 84 pm diameter, compared to the 34-fold larger volume (0.084 nm 3) of the fluoride ion with 272 pm diameter. Thus, hydrophobic organic molecules even with fluoride cross the blood brain barrier, incorporate into membranes and some induce mental abnormality that is not simple to quantify. All carbon fluorine molecules are unnatural industrial compounds, prepared under harsh synthetic conditions, and should have no place in medicine except in life-threatening cases. But fluoridated statins, 80-200 times more lipid soluble than pravastatin from natural sources [66], are widely used in humans for cholesterol reduction, with one (cerivastatin) banned by the FDA for its lethality. Many animal species and humans exhibit lowered coenzyme Q and cardiomypopathy from chronic treatment with the more lipophilic statins [67].
    Fluorine, though extremely electronegative that forms polar hydrophilic bonds, is extremely minute in size so that in a nonpolar molecule does not lower its lipophilicity. The rationale put forth by drug companies who synthesize unnatural fluorine compounds and use them as though they were useful drugs, is that the carbon fluorine bond escapes metabolism by the drug destroying enzymes in the liver designed to eliminate poisonous substances. This is argued then to allow less drug to be ingested for efficacy. Please understand however that neither Pravachol without fluoride nor Lipitor with fluoride prescribed at 20 mg daily, or oral diabetic drugs without fluoride nor Januvia with fluoride, are taken any differently than a dose every single day, lifetime. Further, the high membrane incorporation of these carbon fluorine drugs causes accumulation of the C-F bond in virtually every surface and intracellular membrane of every cell in the entire body at levels that cannot be known and sadly have not even been estimated during longterm ingestion of these substances. Mental deterioration is not assessed competently or at all by drug companies in clinical trials and the FDA has no reliable method of assessing brain damage caused by C-F compound accumulation into brain intracellular organelle membranes.
    The fluoride accumulation problem is supremely exaggerated due to the fact that drug manufacturers do not hire competent physiologists to help keep their activities in check. Focus is paid to lowering blood cholesterol at all cost, without realizing the crucial roles cholesterol is necessary to play in overall physiology. It is the ingredient in bran and peripheral nerve myelin, is a necessity in every cell surface membrane from skeletal and heart muscle, fat, liver, brain and other general cell membranes at a cholesterol to phospholipid ratio of 1:4,in red blood cells, intestinal cells at a 1:1 ratio, and in myelin at even high ratios. Patients are typically treated with statin drugs that do not have a true inappropriately high ratio of LDL to HDL and this is likely the cause of a complete absence of any reduction in overall mortality in the large clinical trials with statins that we have where heart attack incidence is reduced. Mortality is usually higher in a miscellaneous category involving tragic accidents due to brain myelin depletion that offsets any gains in heart death reduction. Statins without industrial fluoride may be acceptable but only in those individuals who have very high LDL/HDL ratios to justify longterm use.
    The fluoride accumulation problem is supremely exaggerated due to the fact that drug manufacturers continue to misdiagnose what constitutes type II diabetes mellitus. Type II exists technically only when glucose is present in urine (diabetes mellitus = sweet siphon) at blood glucose levels of 180-200 mg%. The American Diabetes Association correctly identifies patients with ‘prediabetes’, a condition where fasting blood glucose is unusually high but not in excess of the renal threshold where diabetes should be diagnosed, and correctly indicates that blood sugar modeling is not required unless fasting blood glucose exceeds 130 mg%. Today however clinicians nationwide typically do not fast patients for 14 hours to determine the fasting glucose level and also prescribe oral diabetic drugs even in cases when fasting sugar is as low as 101 mg%. Thus the use of diabetic drugs, some of which are now fluoridated is false medical practice.
    The fluoride accumulation problem is supremely exaggerated due to the fact that water is now artificially treated with fluorosilicic acid hazardous waste for its fluoride ion in nearly 75% of all U.S. water districts and the materials yield 1 ppm fluoride, 0.8 ppm silicic acid, and 3 ppm sodium in drinking water that are not normal ingredients of fresh clean drinking water to be consumed now lifetime by most all citizens of the country from now on.
    Fluoride ingestion is a useless act. Please understand that fluoride ingested from fluoridated water is unable to decrease dental caries and in fact is harming the health of U.S. citizens (see proof in original petition, the petition for reconsideration and letters sent to the FDA in last two years for proof). Moreover, fluoridated drugs have gained wide acceptance by the drug industry where junior fluorine chemists (unaware of the significance of their actions) are praised for their skilled handiwork (San Diego Union-Tribune, Jan 28, 2014, business section). Although many of these drugs have already been banned or taken off the market because of deaths that never should have happened, the use of synthetic industrial fluoride drugs continues to grow exponentially. All while no researchers to date have been in a position to measure how much C-F material remains in biologic tissues in individuals treated with these noxious industrial materials.
    Teenagers are now being mistreated with fluorine based antidepressants in massive numbers where again the C-F bond cannot be altered well by drug-metabolizing enzymes in the liver. By bypassing this natural God-given method of eliminating poisonous substances, drug companies have achieved a new world in which fluoridated substances of all shapes and sizes are being ingested without knowing the long term effects on membranes, brain function and other adverse pathology. We now know that mass shootings in the U.S. of late have for the most part been conducted by patients on antidepressants, many of which were fluorine based to ensure long-term strength, effect and adversity. FDA has been warned that these drugs tend to cause depression, suicidal tendencies and aggression in children who take them.
    Personal problem. When I experienced a severe heart attack last year after many years of having an exceptionally high LDL/HDL ratio of 10:1, I was operated on with a stent emplacement in the left anterior descending artery. While in the hospital I was given fluoridated Lipitor daily and was told to take the drug the rest of my life. Also I was given fluoridated Levoquin because of a suspected lung infection that did not exist and the drug caused severe rashes, swelling and itching and was thankfully withdrawn, and I was provided with fluoridated water and fluoridated soups and beverages made with fluoridated water that everyone in Southern California are now forced to consume daily lifetime and I was expected to brush with fluoridated toothpaste twice daily for the rest of my life as well. I was given a flu shot that I also found contained fluoridated derivatives. I had earlier been told to take fluoridated Januvia because my fasting blood sugar was a mere 101mg%, which is a completely normal reading.
    Fluoride in this country is nearly impossible to efficiently avoid no matter how careful one wishes to be, where helpless victims whose care must be dictated by health professionals in fluoridated cities is the rule.
    Unless the FDA takes action and restricts the coincident use of carbon fluorine drugs especially in fluoridated water cities, this country is going to expend massive health care costs in the immediate future. #32

    February 22, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    Information here, not submitted earlier, is in support of the petition submitted to the FDA in 2007, FDA-2007-P-0346 (originally assigned 2007P-0400/CP1).
    Enclosed please find a letter from the U.S. EPA that answers questions posed by Attorney Gerald Steel in Washington State. Clearly spelled out is the fact that the EPA never intended to, and does not now, actually properly regulate the intentional addition of fluoride compounds into public water supplies for the purpose of treating humans. EPA only provides estimated maximum contaminant levels for water additives to help mitigate serious poisoning outcomes and does not evaluate effectiveness of dental, or any other, additives. Recall that in 2010 the FDA officially wrote a decision to the above 2007 petition, that stated that the EPA is in charge of all water contaminants, lists fluoride as a regulated water contaminant, and thus FDA is not responsible for the infusion into water supplies but the EPA is (under the 1979 memorandum of understanding MOU, which has nevertheless been officially discontinued anyway). The Petition for Reconsideration submitted 2010 in response to this FDA decision is thus entirely justified, in establishing that indeed the FDA is the Federal agency in charge of regulating fluoride compounds for safety and effectiveness that are intended to be taken internally to treat humans. Also enclosed are letters from Health and Human Services regarding the MOU that does not list clinical trials would ever have been conducted for effectiveness, and from the FDA that there is no regulation that releases the FDA from Congressional requirement to properly regulate substances used to treat humans even though they might be administered through public water supplies.
    Also please find enclosed a letter from the prestigious group Moms Against Fluoridation. Although I am not a spokesperson for the group, the letter spells out in simple fashion why fluorosilicic acid infusions must be halted. .0The EPA could halt the infusions because fluoride is an EPA-regulated contaminant and it is a violation of Federal water laws to add any contaminant intentionally into public drinking water (Water Pollution Control Act, Toxic Substances Control Act). However, the EPA is currently ineffective at halting the infusions in part because the EPA officially has not studied concentrations below 2 ppm used as a treatment (i.e. assessing therapeutic effectiveness of any substance is not the role of the EPA). In fact the infusions are recommended by dental officials because of a belief of benefit on dental caries, so the EPA would, as we all do, logically expect any such approval for effectiveness and safety to come from the FDA.
    There of course are no benefits on dental caries from swallowed fluoride ion, in spite of belief in an old correlation dating to 1939. This is because fluoride in saliva is only 0.02 ppm to bathe teeth topically when ingested (National Research Council, 2006), 75,000 times less than in toothpaste, and CDC has published that systemic fluoride does not decrease dental caries and in fact is largely responsible for the massive endemic of permanent ugly abnormal tooth fluorosis now affecting 41% of U.S. teens. Enclosed also is an article published in Environmental Engineering News, the most highly regarded water treatment publication in Canada, that confirms the ineffectiveness of ingested fluoride on dental caries.
    We hope you will assist Moms Against Fluoridation with their request, whether that group contacts the FDA, the responsible agency, or not—and to help all other organizations who oppose the ingestion of industrial fluoride compounds that are not FDA-approved. We must halt these useless, harmful, money-wasting, illegal infusions of toxic calcium chelator fluorides into public water supplies that weaken bone and dentyne and cause vast other adversity to the U.S. population. No fluoride compound has ever been FDA approved for ingestion, and the FDA is to be commended for that. But Luride use (in non-fluoridated regions) still lingers on; and 20% of U.S. pharmaceuticals are now fluorinated with full FDA approval, with many more such drugs in planning stages. It is not in keeping with good medicine to allow artificial fluorides in water to act synergistically with these drugs, or with drugs that may be metabolized differently and thus act unexpectedly in fluoridated, rather than non-fluoridated, regions.
    Please help us keep water just water. Dental officials will eventually understand. We understand FDA reluctance to become more involved, particularly when one industrial fluoride compound has been in use in two cities since 1945 attempting to treat dental caries through internal ingestion. Considering all the data taken together though, as described in the last 32 letters to the FDA, there are sufficient explicit reasons why it is necessary now to halt the infusions. Enclosures:
    Letter to Attorney Gerald Steel from the U.S. EPA
    Letters to Bill Osmunsen from HHS and the FDA
    Letter from the President of Moms Against Fluoridation
    Article by Sheldon Thomas, Rethinking the Risks and Benefits of Fluoridation, Environmental Science and Engineering Magazine, Feb. 2013, Canada. Available at: http://cof-cof.ca/wp-content/uploads/2013/02/Sheldon-Thomas-Rethinking-The-Risks-And-Benefits-Of-Fluoridation-Environmental-Science-Engineering-Magazine-Jan-Feb-2013-OCR.pdf

    #33
    March 7, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    Information here is in support of the petition submitted to the FDA in 2007, FDA-2007-P-0346 (originally assigned 2007P-0400/CP1).

    Mother/Fetus and Industrial Synthetic Fluoride. Recall from an earlier letter that the FDA in 1966 banned the sale of industrial fluoride compounds (synthetic fluorides that all lack calcium) intended to be consumed by pregnant women. This was because the belief that ingested fluoride, which incorporates into a developing fetus by passage through the placenta, would lead to teeth more resistant to decay in the offspring was unjustified.

    Today, industrial synthetic fluorides are infused widely into public water supplies as a purported orally-ingested general dental prophylactic. The number of pregnant women ingesting these materials in the U.S. is staggering, while suppliers sell the materials with a typical description being ‘water purifying ingredients’ generally ‘useful for teeth’.

    Unfortunately, the developing fetus is so highly sensitive to the adverse effects of fluoride that, as described in an earlier letter, data collected by Dr. Schatz indicates that infant mortality rises significantly in fluoridated regions for parents that have poor diets with insufficient calcium. All who consume water willingly, or in the case of developing fetuses unwillingly, are then permeated with industrial fluoride from the artificially treated water to a blood level of about 0.21 ppm because of full assimilation, when the water is consumed as intended by suppliers and distributors.

    The FDA has allowed the sale of fluoridated nursery bottled water for newborn infants, but at least this material is entirely optional. This petition concerns the sale of industrial synthetic fluoride for broad dissemination into public drinking water intended for use by all (including mother and fetus) where suppliers claim this material is for internal consumption by everyone.

    Silicic Acid has no EPA MCL but is Argued to be Below One. The switch to using industrial fluorosilicic acid for its fluoride, rather than the natural non-toxic calcium fluoride, causes silicic acid to be present in water at levels comparable to that for fluoride. Silicic acid is the agent that most likely leeches lead from lead-based plumbing, that does not occur with use of sodium fluoride, since the silicic acid remains the intact molecule at alkaline pH of public water. It is important to emphasize that Standard 60 for water additives was developed by private organizations, the American Water Works Association and the National Sanitation Foundation, and their 300 page document correctly lists that the EPA has no MCL for silicic acid. The problem is, NSF proceeded to adopt its own silicic acid maximum level for water at 16 ppm, without reference or testing data required by their own regulations for all other water treatment chemicals (see attached NSF reprint). This is followed with the statement that since silicic acid is 0.8 ppm when fluoride is adjusted to 1 ppm, the silicic acid is below the allowed maximum level This self-serving unscientific procedure signifies that their ‘certification’ of fluorosilicic acid material ingredients to be ingested to treat caries is invalid. NSF is carrying out what only the FDA is authorized to do, to regulate substances orally ingested to mitigate, treat or prevent disease.

    In a letter sent to the Fluoride Information Network group of very influential fluoridators (http://www.fluorideinfo.org/) some of its information not previously sent to the FDA follows:

    Dear Fluoride Information Network,

    1) One claim made on your website is that the FDA has no authority to regulate any substance in water to treat humans (http://fluorideinfo.org/fluoride_claims-vs-facts.html), including fluoride, even though fluoride is added with the intent to elevate the blood level to permeate organs to prevent a health condition. Please understand, the FDA has full Congressional authority to regulate and evaluate the willful public sale and public use of any chemical substance intended to treat humans by any delivered means, including in packages, bottles, spraying in the air, or addition into public drinking water of any purported supplement, mineral nutrient, medicament or other material intended to treat humans in the U.S. Your claim that only the EPA ‘regulates fluoride in water’ is not correct. The EPA has no such authority to determine effectiveness of chemicals designed to treat humans, and instead monitors substances that accidentally contaminate water supplies, not substances added into water intended to treat disease.

    2) Your site makes the claim that the EPA is correct in writing that there is no conclusive evidence of harm from taking fluoride internally from drinking water at levels below 8 ppm! There is no level low enough in water to prevent accumulation into bone. It is generally accepted by fluoridations texts that bone incorporates fluoride during lifelong consumption from drinking water, and at 4 ppm (in 1958 before fluoridated toothpaste was even used) (see NRC Report on Fluoride, 2006) the level lifetime reached over 7,000 mg/kg (see graph in previous letter to FDA Feb 12, 2012). With toothpaste use, where about 1/4 of the fluoride in the bloodstream comes from today, the corresponding levels in bone are even higher, where 1 ppm in water is about the same accumulation as drinking 2 ppm before toothpaste became widely used. Any level above 3,000 mg/kg weakens bone in compression fracture tests and makes bone more subject to fracture.

    3) You claim that the National Research Council does not oppose fluoridation. Their 2006 Report however concluded unanimously, without dissent from any member author, that the current allowed levels of fluoride in water in the U.S. is not protective of human health. Yes, humans in this country are being harmed by the infusion of industrial fluorides into public drinking water supplies.

    4) The CDC has been unable to answer a most simple question–why does CDC still promote water fluoridation when the NRC reported that fluoride in saliva from drinking water bathing teeth is only 0.02 ppm, a level 75,000 times lower than in toothpaste? (since the CDC published that systemic fluoride does not affect caries (MMWR, Aug, 2001) and that any effect must be topical). The CDC has been unable to explain this huge discrepancy for nearly a year now, even though CDC wrote 7 months ago that they would contact someone who should have an explanation. Meanwhile, recent studies indicate that even topical fluoride in toothpaste is ineffective to 500 ppm (see enclosed chart) and that a mere 26% caries reduction is found for 1,500 ppm fluoride toothpaste that is not further improved with 5,000 ppm. This lack of concentration dependent progressive effect suggests that any apparent caries effects may be experimental error. And toothpaste without fluoride is comparably effective, certainly less hazardous, and obviously ingested low-level fluoride from drinking water is absolutely useless. Enclosed: NSF report sheet excerpt on fluoridation chemicals
    Effect of Fluoride in Toothpaste on Relative Caries Incidence (from Prospective Recent Controlled Studies) [cid:image152.png@01D47B9C.4AC11730]
    Experiments conducted on the effects of brushing with toothpaste with varying fluoride content have been recently published in several dental journals. Caries incidence (here assigned as level 4) is unaffected by fluoride in toothpaste up to 500 ppm. A 25% reduction (to level 3) was reported for toothpaste with 1,000-1,500 ppm fluoride, but that effect is not improved with 5,000 ppm fluoride (http://www.health-evidence.ca/articles/show/16301; nhttp://www.fluoridation.com/caries2.htmo).
    The fact that caries have declined worldwide since the 1950’s has been suggested to be due to many possible factors including the wide introduction of antibiotics (since bacteria cause caries) or better brushing habits, but is not from fluoride in drinking water (0.02 ppm in saliva) or toothpaste which became widely available only after a 1958 patent ( http://www.ncbi.nlm.nih.gov/pubmed/2009), and as evidenced here is not particularly effective. #34
    March 7,2013

    U.S. Food and Drug Administration Center for Drug Evaluation and Research Rockville, MD 20857

    Dear Reviewers,

    Information here is in support of the petition submitted to the FDA in 2007, FDA-2007-P-0346 (originally assigned 2007P-0400/CP1).

    Please watch the recent television news clip at:

    where news anchor Abby Martin finally truthfully explained the significance and illegal use of industrial fluorosilicic acid hazardous waste infusions now ongoing in 76% of U.S. water supplies to treat consumers with substances (fluoride ion and silicic acid) without FDA approval. The transcript of the words spoken on the broadcast and references for the statements made are provided.

    Also please understand that in addition to Grand Rapids, the cities of Newburg and Kingston N.Y. were also used to study efficacy of ingested fluoride ion on teeth caries and was negative. The reason though that fluoride proponents thought ingested fluoride reduced caries in Newburg was actually due to the fact that ingested fluoride as a systemic metabolic calcium chelator slows teeth development. After all teeth erupted in the children in Newburg, the dental caries rate from then on was the same as that in the control city of Kingston. Fluoride from treated water, at 75,000 times less concentrated than in toothpaste, is unable to decrease caries. Moreover, the caries reduction data advertised by fluoridated toothpaste manufactures is also now in doubt because fluoride incorporates into the bloodstream from toothpaste since fluoride penetrates gum tissue (NRC,2006). Any slowing of teeth development during a study of effectiveness in children could attribute missing teeth as fewer caries in the mouth, when in fact toothpaste would then be misbranded. Most people assume the advertisements means reducing caries in existing teeth, not that teeth will be blocked from existing in the first place. Since fluoride slows teeth development in children (NRC, 2006) the agent should not be used until at least age 10 when all teeth are fully grown and have all erupted. But of course fluoride has no useful role for any teeth, even in the adult, as demonstrated in earlier letters.

    The country waits on the FDA to ban the sale of industrial fluoride compounds intended for ingestion to mitigate disease, when absence of fluoride does not cause caries in the first place. The FDA does not have to enter into banning the production of the material for sale for other applications, such as in the production of frosted glass or to break down brick and concrete or other industrial uses that are not to be taken internally.

    Transcript of Abby Martin National Fox News broadcast:

    When was the last time you stopped to think about the one thing you can’t live without? No I’m not talking of the Internet. I’m talking about water. Without clean drinking water life couldn’t go on. So it’s probably important that we know what’s in the water we drink. For the past 65 years city governments nationwide have been adding a substance called fluoride to the water supply. The practice of water Fluoridation started a time in history when asbestos PCBs and DDT were all deemed safe and effective. And although all of these chemicals have been banned since fluoridation is still common practice. However it’s uniquely American. The US has more people drinking fluoridated water than the rest of the world combined. in fact most industrialized nations do not fluoridate their water including Japan and 97% of Europe.

    So what exactly is it that we’re ingesting? It’s not the same fluoride that is in your toothpaste. What’s being added to municipal water supplies is a fluorine compound called hydrofluosilicic acid. Ant it is a byproduct from the phosphate fertilizer industry. Yes you heard me right! Let me break this down for you. Gaseous fluoride is produced during fertilizer production. Now it used to go straight in the atmosphere straight from these factories but presently filtration devices are used to contain the toxic chemicals. Then what was extracted from the filters is then condensed into water-based solution which is packaged on unrefined and sold the city governments for the purpose of water fluoridation.

    So how did this all start? Well, interestingly in 1944 the American Dental Association themselves published that it was not worth the health risk to fluoridate public water supplies. To bad no one heeded their warning. Because the very next year Grand Rapids Michigan became the first community to fluoridate. What happened next would not have been possible without without a push from the aluminum industry which was looking for away to safely discard there fluoride pollution and waste. In 1947 Oscar Ewing a paid attorney for Alcoa the biggest aluminum company in the US was picked to oversee the Public Health Service which is now known as the Department of Health and Human Services. He then made clear his lingering ties to the aluminum industry by promoting water fluoridation as one of the first official policies of the department. From there the policy expanded tenfold. With and additional 87 US cities fluoridating within the next three years.

    Fast-forward to today where children are growing up indoctrinated with the notion that fluoridated water is necessary, because it prevents tooth decay. But is that really the case? In 1987 the National Institute of Dental Research examined 39,000 schoolchildren from 84 different fluoridated and non-fluoridated communities. And while the study did find that in fluoridated areas tooth decay declined, the most interesting part is that there was a declining trend in tooth decay in non fluoridated areas too, perhaps because of overall better hygiene. Okay but not only is there no causal link there’s also serious health risks for fluoride overexposure. For one an excess of fluoride causes fluorosis which is an eating away of the enamel on your teeth. This is indicative of what it’s doing your body on a larger scale. You see it does not just eat away at the tooth enamel. Only 50% of the fluoride we consume is excreted. The rest is absorbed throughout our our bodies our pineal glands and our bones. In fact an alarming study by the US Public Health Service which was later confirmed by Harvard Medical School found a deadly type of bone cancer called osteosarcoma was significantly higher in fluoridated communities than non- fluoridated communities. However most distressing findings come from 18 studies done worldwide showing a substantial lowering of IQ in overly fluoridated areas. And there are many more adverse effects than just those. Not to mention that the FDA admits that fluoride is a drug, not a nutrient.

    Multiple ethical codes are being violated here by forcing us to ingest this drug. Look, Lets call it like it is. Water fluoridation has nothing to do with said benefits. Think about it. We are getting or fair share of this substance through the dentist and the tooth paste we use every day. And what about the processed foods were already eating and drinking on a daily basis. We get get more than enough. So the argument that we need to ingest this substance as well is baseless. Look guys no matter what you think of fluoride the real issue here is having a choice. No chemical no matter what its alleged benefits are should be forced upon the public without their consent. Lets not forget as long as corporations are involved our best interest isn’t really the priority. So maybe we should be looking at water fluoridation as a money making scam. A tale that’s is all-too-familiar. Governments and industry colluding to save money – instead of saving lives. William Zimmermann, Consultant
    619-260-0677 Office
    619-917-6995 Mobile

    #35.
    March 16, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    Information here is in support of the petition submitted to the FDA in 2007, FDA-2007-P-0346 (originally assigned 2007P-0400/CP1). In addition to the original petition (2007), its supplements, and the petition for reconsideration (2010) the 35 letters of support now alone total over 140 pages and 81,000 words. I do not know when this petition process will end, but an apology cannot be offered for the cumbersome volume of material because it is the quality of life for hundreds of millions of people who consume and accumulate industrial fluoride daily over a lifetime as a National policy that is at stake.
    Article accepted for Publication. Attached please find my research article that has now been accepted for publication in the Journal of Environmental and Public Health 2013 entitled Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride. The article required many years of work to reach its final form and resembles little the first version sent to the FDA in an earlier letter. Chemical calculations indicate that the mechanism by which acute lethal fluoride poisoning from drinking water overfeeds that occurred in Hooper Bay, Alaska and kidney dialysis wards in Illinois and Maryland were from elevation of plasma fluoride that caused lowering of blood calcium which is necessary for the beating heart. The Hooper Bay incident is what chiefly prompted this original petition.
    Also in the article the pH dependence of the conversion of fluoride into the corrosive uncharged hydrofluoric acid HF molecule is shown over a broad pH range. Theoretic calculations agree closely with free fluoride levels measured experimentally with an ion specific electrode over the range examined. It is clear that at stomach pH most of the fluoride is HF which is the extreme corrosive. Although stomach mucosa is fortunately designed obviously to withstand attack by the strong acid HCl, HF is a weak acid and the intact uncharged molecule freely penetrates any biologic membrane. Most of the fluoride that is assimilated into the bloodstream gains entry as HF, both in the acidic stomach and in the first portion of the small intestine, before being re-neutralized at the Ampulla of Vater.
    Also a section in the article describes the other quantitative ingredients infused into water during ‘fluoridation’ in cities using industrial fluorosilicic acid as starting material. There is no MCL allowed concentration for silicic acid recognized or regulated by the EPA, so NSF invented its own MCL for it (see previous letter). Silicic acid is infused into U.S. drinking waters at 0.6-0.8 ppm where it does not belong. It is not found in natural waters supplies and is an unintended derivative of fluorosilicic acid dilution. Not pointed out in the article, topical silicic acid is contraindicated for caries control because this acid remains the intact molecule even at alkaline pH and is known to degrade calcium phosphate, the chief matrix component of teeth enamel. Long term exposure of teeth to silicic acid renders it certain that fluorosilicic acid is impractical for its intended purpose. Please understand that the initial studies on fluoridated water for teeth caries in Newburgh and Grand Rapids used sodium fluoride, which neither contains nor produces silicic acid that could slowly degrade teeth. Clinical trials as you know have never been conducted with fluorosilicic acid for effectiveness or safety longterm because of presumptions that industrial fluoride ion is the only ingredient of concern. Silicic acid was not mentioned in the letter from Rebecca Hamner, U.S. EPA when it was decided to allow hazardous waste fluorosilicic acid to be used for its fluoride in public water supplies for dental caries (see letter to FDA dated April 4, 2012). EPA Chemical Fact Sheet.
    NSF regulation mis-statement. Enclosed is a chemical fact sheet from the EPA on the properties of fluorosilicic acid intended for use though it is an oral ingestible dental prophylactic. The sheet writes that the AWWA and NSF formed a rule where materials added into public water supplies cannot exceed 10% of an EPA MCL for contaminants. Fluoride is an EPA listed contaminant. The sheet misstates it though to imply that only contaminant metals follow this rule. The rule is made very clear in writing in the NSF 300 page textbook on minimum regulations required before certification can be given to any water additive—not just metals, but any additive. Then, in violation of its own 10% rule, fluoride is without explanation allowed up to 1.2 ppm, as has been added into many water supplies for decades. 1.2 ppm is 60% of the EPA MCLG of 2 ppm for fluoride contaminant and 30% of the MCL of 4 ppm. When added at 0.7 ppm recommended by HHS since 2011, this is still 42% of the MCLG and 21% of the MCL.
    HF False Argument for Safety. The EPA fact sheet also discusses that HF forms quantitatively from fluoride at pH 3 or lower but is the free ion at alkaline pH. This is true, but the important point is that HF therefore forms in the acidic stomach after ingestion. The EPA fact sheet argues that ingestion of fluorosilicic acid treated water causes no harm because there is virtually no HF at water district pH. But it is the HF forming at stomach pH after ingestion that is fully assimilated from the GI tract and is the corrosive irritant. 7% of people experience GI discomfort from drinking 1 ppm fluoridated (with sodium fluoride) water in double blind placebo controlled human trials (see article). The 50% conversion pH is 3.14 (or 3.2 with the EPA listed pKa). The EPA argues improperly that at pH 4.2 HF is substantially reduced compared to pH 3, seeming to suggest that there are no adverse effects from HF after ingestion. The explanation though is that the titration curve for fluoride sharply plummets in the pH 3-4 region forming substantial HF exponentially.
    The normal pH range for stomach contents between meals, with typically 100 ml total volume, is 1.5 to 3.5 (Teitz, N. Clinical Chemistry, W.B. Saunders, Philadelphia, 1976, p. 1072). Stunningly, the pH of parietal HCl secretions from gastric mucosa is 0.9. Fluoride is 100% HF at pH 1.5 or lower (see Figure 2B in article) and consumption of one soda can size of 1 ppm fluoridated water (355 ml) would produce about 1 ppm HF. Therefore the use of fluoridated water is a false practice, particularly when ulcers are present. Moreover, carcinoma of the stomach is rising in the U.S. and the continued unregulated use of industrial fluorosilicic acid in public water supplies consumed by all is unconscionable. Fluoride is a mutagen and genotoxic substance (National Research Council, 2006). Adenocarcinoma of the upper stomach and esophagus have continued to steadily rise in incidence in the U.S. since 1970 (Blot, W. et.al. Rising Incidence of Acenocarcinoma of the Esophagus and Gastric Cardia, J. Amer. Med. Ass. 1991 265(10):1287). (http://www.ncbi.nlm.nih.gov/pubmed/1995976?dopt=Abstract) where the cause is not known widely.
    HF in the acidic stomach must be regulated by the FDA because of the FDA ruling that no substances can be sold for ingestion without a new drug application that contain HF. As seen in the EPA fact sheet, the Table lists the fluorosilicic acid pH at 1.2. Thus, 100% of the free fluoride component in the solution is HF. Routine assays (certified by NSF) contain 1.5% HF, or 1,500 mg/Kg, when sold directly to water districts to disseminate for dental health treatment.
    Silicic Acid False Claims. Also the fact sheet dismisses any consideration without reference that silicic acid (referred to casually as a form of sand) could cause adversity. Ingested silicic acid is assimilated and is known to stimulate collagen formation. In some animal species silicic acid from fluoridated water supplies causes severe silicosis of the liver (see previous letter and publication in Fluoride). The topical chronic effect on teeth enamel mentioned above is not studied by EPA, so EPA has no right to make the claim that lifelong consumption is harmless. Silicic acid is commonly used in agriculture to degrade calcium phosphate.
    Conclusions. It is hoped that the FDA will study the contents of the article in detail to help conclude why water supplies are today an unacceptable vehicle by which to administer any materials intended to be taken internally as drugs. Although the FDA has never authorized use of public water supplies for drug administration, it is now very necessary to confer a final judgment to prevent any substance from being taken internally as either a drug, supplement, nutrient, or food by way of artificial treatment of public water supplies.

    Sincerely,

    Richard Sauerheber, Ph.D. Chemistry

    Enclosures: 1. Article accepted for publication by JEPH
    2. EPA chemical data sheet on fluorosilicic acid

    Journal of Environmental and Public Health, Volume 2013, Article 439490 2013 http://dx.doi.org/10.1155/2013/439490
    Hindawi Publishing Corporation
    Special Issue: Water, Sanitation, and Public Health Research Article
    Physiologic Conditions Affect Toxicity of Ingested Industrial Fluoride Richard Sauerheber1,2
    1Department of Chemistry, University of California, San Diego, La Jolla, CA 92037, USA
    2STAR Tutoring Center, Palomar Community College, San Marcos, CA 92069, USA
    Correspondence should be addressed to Richard Sauerheber: rsauerheber@palomar.edu
    Received 30 September 2012; Revised 13 March 2013; Accepted 3 April 2013 Academic Editor: Stephen Peckham
    Copyright ©2013 Richard Sauerheber. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
    Abstract The effects of calcium ion and broad pH ranges on free fluoride ion aqueous concentrations were measured directly and computed theoretically. Solubility calculations indicate that blood fluoride concentrations that occur in lethal poisonings would decrease calcium below prevailing levels. Acute toxicity and also many of the chronic effects of fluoride involve alterations in the chemical activity of calcium by the fluoride ion. Natural calcium fluoride with low solubility and toxicity from ingestion is distinct from fully soluble toxic industrial fluorides. The toxicity of fluoride is determined by environmental conditions and the positive cations present. At a pH typical of gastric juice, fluoride is largely protonated as hydrofluoric acid HF. Industrial fluoride ingested from treated water enters saliva at levels too low to affect dental caries. Blood levels during lifelong consumption can harm heart, bone, brain, and even developing teeth enamel. The widespread policy known as water fluoridation is discussed in light of these findings.

    1.Introduction
    Synthetic industrial fluoride compounds lack calcium and are listed toxic substances (Buck [1], Gleason [2], Blakiston [3], The Merck Index [4]). Calcium fluoride CaF2 is found in natural minerals and is not labeled a toxic compound because of the comparatively high lethal oral acute dose of the purified compound when tested in mammals (LD50 ~ 3,750 mg/kg). The fluoride compounds, sodium fluoride NaF and fluorosilicic acid H2SiF6, added into municipal water for human ingestion purposes are synthesized artificially by industrial reaction and have been used as rodenticides, insecticides, and pediculicides with acute oral lethal doses in experimental animals comparable to arsenic and lead (LD50 ~ 125 mg/kg) [4] due to the fluoride at ~60-90 mg/kg.
    Waters in the U.S. can contain natural calcium fluoride along with other calcium and magnesium salts (U.S. Centers for Disease Control CDC [5]) but pure pristine fresh drinking water does not contain fluoride. Fluoride is not a normal constituent of the mammalian bloodstream (The Merck Manual for Health Care Professsionals [6]). It has no nutritive value (Lovering [7]) or physiologic function but has been believed by some to be useful for teeth based on an initial correlation with natural calcium

    fluoride in drinking water ([1], Connett [8]). The chief ingredient in normal teeth enamel is hydroxyapatite that contains calcium phosphate not fluoride. After nearly seven decades of adding industrial fluoride compounds into public water supplies in the U.S. plus those countries that have agreed to this policy, the principal documented effects of ingested fluoride on teeth are to increase incidence of abnormal permanent enamel fluorosis during teeth development and to abnormally incorporate into underlying dentin bone (National Research Council NRC [9]). Fluorosis, unsightly at best, afflicts ~5 million U.S. teenagers aged 12-15 as of 2004 [8].
    The reported adverse consequences of adding fluoride lacking calcium into public water supplies include effects on man, animals, and the environment [1, 8-12]. Ingested industrial fluoride incorporates chiefly into bone with an ion exchange process that is irreversible and thus not physiologic. Normal biochemical effects of nutrient minerals are saturable and readily reversible. Fluorine leads all elements in electronegativity and is extremely reactive and not found in nature. But fluoride is permanent because the ion has no electronegativity, cannot be reduced further, or oxidized by any known substance. Fluoride instead associates with positive charged ions in particular aluminum, calcium, and iron. Thus, its toxicity depends on the environment in which it resides.
    Soluble fluoride at 60 mg/kg single oral dose without calcium causes acute heart failure in research animals (CDC [5]) and caused lethal heart failure reported in a child after swallowing concentrated dental gel (NY Times [13]). 25 ppm artificial fluoridated water leads to chronic heart failure in research animals [5] which compares with levels during accidental overfeeds where kidney dialysis patients died (Gessner et al. [14]). At lower concentrations (~1 ppm), artificially fluoridated water supplies are documented to have caused horses, frogs, chinchillas, and alligators to die prematurely that consume treated water continuously for extended periods of time [Spittle 12]. Discharged fluoride into the Columbia River to ~0.3 ppm blocked salmon navigation upstream to spawn (Damkaer and Dey [15]). Even though natural fluoride at 1 ppm is in the world’s oceans with substantial calcium and magnesium salts, this arrangement is normal and harmless to aquatic species.
    Natural calcium fluoride is considered insoluble (to 8-10 ppm fluoride maximum depending on water pH). Industrial synthetic fluorides however are fully soluble and are all toxic calcium chelators. The degree of absorption of any fluoride compound after ingestion is correlated with its solubility (Goodman and Gilman [16]). Industrial fluorides are completely absorbed but natural fluoride minerals cryolite (Na3AlF6) or fluorite (mineral fluorspar with CaF2) are poorly absorbed (see Endnote 1). The dietary cations calcium and iron retard absorption by forming complexes in the GI tract. Although large populations are reported to safely consume 1 ppm fluoride in water for long periods of time, this is when it exists naturally at this level.
    In what was considered unthinkable, in Hooper Bay, Alaska, in 1994 an industrial fluoridation overfeed of calcium-deficient Yukon River drinking water caused fatal heart block in an otherwise healthy 41 year old male. This is the largest known poisoning in the U.S. from a fluoridated water supply. Over 300 people with severe gastrointestinal pain survived the incident (Gessner et al. [14]). Electronic feeding equipment is now employed to prevent overfeeds and acute poisoning. But chronic effects of industrial fluoridation of public water supplies on humans, animals, and the environment require further study if fluoridation of fresh water supplies continues. Many countries require great expenditures to remove endogenous natural fluoride from drinking water that causes skeletal and other pathology at 8-10 ppm even when water contains substantial antidote calcium to minimize assimilation of the ingested fluoride [5]. The present study investigates conditions involved in acute and chronic fluoride toxicity and environmental effects of industrial fluorides added into public water. 2. Methods
    The concentration of the free fluoride ion was mathematically computed at which the solubility of calcium fluoride would be exceeded with calcium concentrations known to be physiologic. [F-] = (Ksp/[Ca2+])1/2 from the definition of the solubility product
    constant for insoluble salts where CaF2 [cid:image154.png@01D47B9C.4AC11730] Ca2+ + 2F- and Ksp = [Ca2+][F-]2. Consideration was made for physiologic temperature by using the published Ksp at 37oC.
    A 0.9 ppm fluoride solution in distilled water was measured for the free fluoride ion concentration over a wide concentration range of added calcium ion from aliquots of a calcium biphosphate solution. In other experiments, a 1.2 ppm fluoride concentration solution was measured for free fluoride ion level as a function of pH. Acidity was adjusted with dilute acetic acid. All readings were made at room temperature with a LaMotte Instruments fluoride ion specific electrode calibrated with a 1.00 ppm fluoride standard solution in distilled deionized water. The electrode was rinsed with the solution to be tested for each measurement. The instrument reported accurate readings for known standard solutions within ± 0.05 ppm fluoride over the temperature range 15-30oC. 3. Results/Discussion
    3.1 Acute Toxicity. Acute fluoride poisoning in man is not rare ([16] p. 804). The concentration of fluoride is here calculated that would cause calcium fluoride precipitates to first form from the known solubility product constant for calcium fluoride (Ksp = 8 x 10-11 at 37oC) and the known concentration of calcium ion in normal human blood (2.2 mM). The Ksp varies slightly with temperature and may be computed at 37oC (310 Kelvin) from the relation ln(Ksp) = – ∆G/(RT) (Lide [17]) for calcium fluoride with the free energy for the dissociation of calcium fluoride ∆G = 59 kJ/mol and Ksp = 3.4 x 10-11, 25oC (298 K).
    The computed fluoride level at which an aqueous solution containing physiologic calcium (3 mM) at physiologic temperature (37oC) is precipitated is 0.11 mM fluoride (2 ppm). The concentration of blood fluoride where the blood calcium level would be lowered to the lethal low level of about 1 mM is 0.2 mM fluoride (3.8 ppm). This also compares with measured blood fluoride levels in man (2-3 ppm) due to acute lethal poisonings after accidental ingestion of soluble fluorides (Teitz [18] p. 1130).
    The calculated calcium levels that would coexist in fluid with a given fluoride level from solubility considerations were compared with actual measurements of blood levels of calcium and fluoride ion in victims of fluoride poisoning [14] in Hooper Bay. The calculated theoretic fluoride levels that would lower prevailing blood calcium ion levels compare closely with the actual ion levels measured in the blood of victims poisoned with fluoridated municipal water. The victim who died of heart failure from fluoride had a measured fluoride level of 0.18 mM while another victim that survived had blood fluoride at 0.48 mM. These concentrations of fluoride from solubility considerations produce calcium ion lowering to levels reported to decrease beat rates in isolated mammalian heart cells (Wang [19]).
    The fact that fluoride lethality occurs at concentrations known to compare with saturation and activity reduction for calcium ion brings forth an aspect of fluoride toxicity that is counter-intuitive. Ionized calcium levels in human plasma can vary in some cases from 1.5 mM in hypocalcemia to 4.5 mM in hypercalcemia (as in hyperparathyroidism or excessive Vitamin D intake) (Davidsohn and Wells [20]). The assimilation of ingested fluoride is drastically minimized by calcium ion in the gastrointestinal tract [5] and calcium is the recognized antidote to oral fluoride poisoning. This would suggest that individuals with higher blood calcium would be more resistant to fluoride toxicity. But Ksp calculations indicate that higher blood calcium levels require less blood fluoride to reduce calcium activity or mobility.
    Figure 1(a) indicates the calcium fluoride precipitation isocurve over a broad concentration range for the two ions. The ions are precipitated when present together at any ordered pair of concentrations indicated along the curve. Lower blood calcium levels require higher fluoride blood levels to begin precipitation. The effect is quite substantial in varying from 2.5 to 5 ppm fluoride lethal levels for subjects with 4.5 and 1.5 mM calcium, respectively. This may help explain the broad variability in reported blood and tissue fluoride levels causing toxicity and why calcium can exist within a normal range during acute fluoride poisoning from ingestion in humans.
    Wang et al. [19] also found the heart cell beat rate in cultured cells in well-controlled experiments progressively slows with increasing fluoride levels in a concentration-dependent manner. Beat rates were slowed 17% by 0.15 mM (2.8 ppm) fluoride, a level that causes precipitation of physiologic calcium concentrations in solution. Unlike skeletal muscle, cardiac muscle requires extracellular calcium ion from the bloodstream to couple electrical excitation of the cell membrane with contraction of cardiac muscle fibers. Each time the heart contracts, calcium fluxes into the heart cells from the extracellular fluid. When the heart relaxes, the calcium is pumped back out of the cell allowing the fibrils to relax. Lowered extracellular calcium ion levels block contraction of the heart.
    Blood with high ionic strength is quite different than aqueous solutions in a laboratory. Precipitates of calcium fluoride generally throughout interstitial fluid have not been found during acute lethal fluoride poisonings. These data together suggest that fluoride ingestion is lethal by causing decreased activity (and not necessarily complete precipitation) of the free calcium ion with blockage of heart contractions. Fluoride acute toxicity has long been known to be accompanied by increased blood potassium levels (Burgstahler [21]) where membrane sodium potassium ATPase is also inhibited by fluoride or low calcium. Thus the detailed sequential mechanism of lethality cannot be precisely stated.
    Fluoride tends to associate with and bind calcium ion. Calcium is concentrated throughout the body including teeth, bones, ligaments, aorta, skeletal muscle, and brain [5,10,16]. But the most crucial physiologic function requiring calcium that is sensitive to industrial fluoride at acute levels is the beating heart. It is well known that extracellular calcium is an obligatory requirement for heart cells to undergo contraction after electrical excitation. Heart cells do not have a well-developed sarcoplasmic reticulum to store calcium for this purpose as does skeletal muscle which does not exhibit this extreme sensitivity to changes in blood calcium. The cellular uptake of calcium occurs during the plateau phase of the cardiac action potential. Extracellular calcium is necessary for the development of contractile force. The strength of contraction (inotropic state) of the heart depends on extracellular calcium with half-maximal contractility at 0.5 mM.

    Calcium (mM) causing precipitation of fluoride (mM) Observed fluoride (ppm) as a function of calcium (mM)
    [cid:image155.png@01D47B9C.4AC11730] [cid:image156.png@01D47B9C.4AC11730]

    1. (b)
      FIGURE 1: (a) Calcium concentrations (mM) that precipitate various fluoride concentrations. From the known solubility product constant Ksp for calcium fluoride, the calculated isocurve for CaF2 precipitation is shown as a function of varying concentrations for the two ions. Calcium levels in normal blood (1 – 3 mM) reach precipitation maximum solubility with 0.1 – 0.18 mM (1.9 – 3.4 ppm) fluoride. For 3 mM calcium, precipitation begins to occur when fluoride is 3% of calcium and for 1 mM at 18%. The Hooper Bay poisoning incident produced a lethal 5 ppm blood fluoride level in one victim. Whether it is a low Ca/F ratio or rather calcium fluoride saturation that is required for acute toxicity is not known.
      (b) Calcium effects on measured fluoride ion concentration. A 0.9 ppm fluoride solution in distilled water was measured for free fluoride ion level with a LaMotte fluoride specific electrode calibrated with 1.00 ppm sodium fluoride in distilled de-ionized water at room temperature. Calcium ion was adjusted over a wide range by addition of aliquots of calcium biphosphate. Fluoride readings progressively decrease with increasing calcium concentration as expected over the range 30 – 650 mM.

    3.2 Chronic Toxicity. Kidney dialysis patients have frequently been killed from fluoridated water during accidental fluoride overfeeds [14] because dialysis units are not equipped to eliminate fluoride from blood [22]. Even more alarming are kidney patient lethal fluoride poisonings with a form of congestive heart failure if hemodialysis units use fluoridated water containing targeted fluoride concentrations. As pointed out by Dr. Ahmad, Medical Director, University of Washington, Seattle, hemodialysis patients receive more than 400 liters of water weekly and fluoride levels above 0.2 ppm if not pre-cleaned cause significant morbidity and mortality [56]. Fluoridated water at 0.7-1 ppm is unsuitable for dialysis and the FDA has published instructions to that effect. Deaths have even occurred because fluoride-removing deionizer resins when full leached fluoride back into the water used for dialysis.
    The mechanism by which blood fluoride, at 0.2 ppm referred to as “optimal”, irreversibly accumulates in bone of all consumers [9] does not involve precipitation of ionized calcium. Fluoride is then below the Ksp for direct precipitation. Instead, an ion exchange mechanism occurs at extremely minute fluoride levels where the fluoride ion merely by diffusion exchanges with hydroxide on bone hydroxyapatite [16]. The precise formula unit of the bone matrix has been variably described as calcium phosphate hydroxide Ca3(PO4)2Ca(OH)2 or pentacalcium monohydroxy orthophosphate, Ca5(OH)(PO4)3, or Ca10(PO4)6(OH)2 [4]. Very different lattice packing and fluoride sensitivities occur among spongy bone, compact bone, teeth dentin and hard enamel.
    A fluoride ion solution made in soft or distilled water has a higher chemical activity or chemical potential compared to the activity of the ion at the same concentration when accompanied with calcium or magnesium in solution. Although much less sensitive and exquisite than an actual biological cell membrane, a fluoride specific electrode senses such a difference. Fluoride electrode measurements of a solution of sodium fluoride fixed at 0.8 mg/L (ppm) (0.042 mM) in de-ionized water were examined at various calcium levels over a wide range. 30 mM calcium and higher cause substantial inter-ionic interactions with fluoride that significantly lower diffusion or Brownian motion of the fluoride ion because of the relatively massive divalent positive charge on the compact calcium ion. Further addition of calcium to 650 mM causes progressive decreases in the free fluoride ion measured level due to precipitation of calcium fluoride particles that the electrode cannot detect. The calcium level theoretically calculated to first begin fluoride precipitation for 0.9 ppm fluoride is approximately 30 mM which is consistent with Figure 1(b) observed data.
    The phenomenon of fluoride-induced decreased chemical activity (i.e. in the absence of precipitation) applies to Group II cations including magnesium ion prevalent in all foods and natural hard waters. In contrast, fluoride accompanied in solution with Group I metal cations, such as sodium or potassium, exhibit no decline in activity over a broad range of cation concentration (data not shown) because these ions are only monovalent in charge.
    Activity coefficients for the fluoride ion are substantially reduced in the presence of calcium and magnesium divalent cations (Moore [23]). This effect may be compared to the phenomenon of attraction between fluoride ion and hydrogen atoms in water known as hydrogen bonding which decreases the Brownian motion and diffusion of the ion. These factors determine the overall biologic effect of fluoride ion in living organisms. Calcium decreases assimilation through the gastrointestinal tract but in the bloodstream lowers the fluoride required for calcium sequestration. Further, membranes exhibit complex structural and functional features that are modulated by calcium and magnesium including region-specific effects on membrane lipid fluidity (Sauerheber and Gordon [24]). Fluoride diffusion from a solution rich in calcium ion may be impaired even though far below the
    level required for binding as calcium fluoride precipitate. This electrical attractive force is also responsible for the fact that fluoride at levels below the Ksp is trapped in bone by ion exchange.
    As shown in Figure 2, changes in pH affect the percent of fluoride that converts to HF. As HF, fluoride gains entry into the bloodstream because HF is a neutral small molecule comparable in size to the water molecule and is freely permeable through the biologic membrane (Whitford et al. [24]). The Ka for HF indicates it is a weak acid. As a small molecule, HF is the most penetrating corrosive. Its assimilation is most efficient at stomach pH in the absence of substantial calcium.
    Industrial fluoride in drinking water can cause GI distress in human subgroups because fluoride converts to HF in the stomach ([9] p. 268). Even at low concentrations, HF can aggravate and prevent healing of ulcerated tissue. Industrial fluoride in drinking water at gastric pH is mostly protonated HF. At pH 2, 96% of fluoride is HF [9] in agreement with calculated levels in Figure 2(b). Structural damage to mucosa is detected at 20 ppm HF in 15 minutes. Lower concentrations cause pain without visible damage. Human case studies proved that abdominal discomfort occurs from drinking 1 ppm artificially fluoridated water (Waldbott [10], Petraborg [26]). In a careful placebo controlled double blind clinical study, 1 ppm fluoridated water caused GI discomfort in 7% of subjects (Grimbergen [27]). Exposing the GI tract to HF from the duodenum to the Ampulla of Vater before re-neutralization is a false practice. The more elderly the person with slower gastric mucosa turnover, the more likely symptoms can develop. In the presence of ulceration or gastric carcinoma, industrial fluoridated water must be avoided. Acute pain requiring hospitalization in Hooper Bay reflected gastric HF at ~50-100 ppm.
    HF at high concentrations dissolves glass and permeates porcelain. This is not due to the hydrogen or the fluoride ions since strong acids do not have this ability and soluble fluoride salts slowly etch glass. Corrosiveness of HF is due to its extremely tiny uncharged covalent structure, intermediate between fluorine F (0.8 Å3, 128 pm diameter) in F2 and the 10-fold larger volume fluoride ion F- (7.9 Å 3, 272 pm diameter) in ionic compounds. As a 2nd Period nonmetal, fluoride at any concentration forms abnormal inter-atomic hydrogen bonding (H+- -F-) and disrupts normal intermolecular hydrogen bonding (H+- -N or H+- -O) in water and macromolecules. It is a general enzyme inhibitor in some cases at 0.2 ppm [11], the targeted blood level which is reported in residents of 1 ppm fluoride water areas ([9] p.70).
    3.3 Natural and Industrial Fluoride in Water. Dental officials report in CDC fluoridation literature that fluoride ion is identical in natural and industrial compounds. This is correct. However the assimilation of ingested fluoride is minimized by calcium in the GI tract ([5], [16]). The conversion of fluoride to HF measured with an electrode is
    also reduced in the presence of calcium at levels far below saturation (data not shown). Natural fluoride is accompanied with antidote calcium to prevent acute lethality and reduce chronic toxicity. Nevertheless, the CDC goes on to argue that the relative safety of water containing calcium fluoride at 1 ppm is sufficient proof that industrial fluoride at 1 ppm will exert no significant pathology. But toxic effects of natural fluoride in water can often be difficult to measure such as widely reported effects on human brain function [8]. Also any effect would not be identical for water treated with an equal level of industrial fluoride which is assimilated more efficiently [5]. Indeed, salmon are unaffected by natural 1 ppm fluoride in ocean water where calcium is extremely high but are narcotized by industrial fluoride in soft water at only 0.3 ppm [15]. Thus, the mere absence of gross observable bone abnormality from natural fluoride at levels below the Environmental Protection Agency Maximum Contaminant Level (EPA MCL) of 4 ppm should never have led to the presumption that lifelong consumption of infused industrial fluoride at any purported concentration (>0) would have no possible pathologic consequence.
    From Figure 1 it is evident that at 30:1 calcium to fluoride, the assimilation from the GI tract, if compared to conditions in a laboratory, would begin to be impaired. Waters in the U.S. average 50 ppm calcium to 0.2 ppm fluoride naturally (250:1). But soft waters allow more efficient absorption. The ratio of calcium ion molarity (around 0.12 mM or 7 ppm) to infused total fluoride molarity (0.05 mM or 1 ppm) in soft water regions in an artificially fluoridated city is very low. Hard water regions are more protected from fluoride assimilation. Fluoride toxicity thus depends on its environment.

    [cid:image159.png@01D47B9C.4AC11730]

    1. (b)
      FIGURE 2: Fluoride protonation depends on prevailing acidity following the equilibrium reaction F- + H+ ↔ HF.
      (a) All measurements of fluoride ion concentration were made with a LaMotte Instruments fluoride ion specific electrode calibrated with a 1.00 ppm fluoride standard solution in distilled deionized water at room temperature. Readings for the 1.2 ppm true concentration solution progressively decrease as pH decreases. Acidity was adjusted with dilute acetic acid. Stomach acid pH normally varies from 1.5-3 ([16] p. 1072) where fluoride is mostly protonated as hydrofluoric acid HF.
      (b) The percent contribution to the total fluoride from the free ion F- (squares) and intact HF (diamonds), calculated theoretically from the Henderson Hasselbach equation pH = pKa + log{[F-]/[HF]} over the pH range 1-10, utilizing the known Ka for HF. HF decreases while F- increases from pH 1 to 5. At pH 3.14 (= pKa = -log 7.2 x 10-4), HF is half dissociated.

    Sources of ingested industrial fluoride are diverse. The fluoride that is absorbed into the bloodstream arises chiefly from public water supplies. But substantial amounts are assimilated also from foods, toothpaste [9], mouth rinses, and some bottled waters. The EPA currently allowed levels in drinking water in the U.S. were found by the NRC to not be protective of human health [9]. The plethora of chronic effects are accompanied with alterations in calcium homeostasis where bone fluoride is retained for an estimated 20 years ([9] p. 133) which affects calcium mobilization into blood. Variations in biologic outcome of course occur because of differences in water hardness, diet, and whether it is natural insoluble fluoride or artificially infused soluble fluoride without calcium.
    Assimilation of industrial fluoride from water into the bloodstream in humans can be seemingly well-tolerated for long time periods because bone efficiently traps the calcium chelator from interstitial fluid to minimize exposure to soft tissues. Bone is the final resting site for 95% of all retained fluoride. Even there, the intrusion causes increased osteoblastic activity [9,16] in response to the intrusion. Fluoride accumulates from consumption in a 1 ppm fluoride water region, in the absence of other known sources, to 2,500 mg/kg in two years and to 3-4,000 mg/kg lifetime [9]. Bone weakening occurs around 3,500 mg/kg. Bone pathology from ingested water fluoride has been widely described consistently in research animals ([9], [8] appendix 2). In spite of variations in water hardness and the fact that man cannot be controlled for variables as can research animals, more human studies correlate 1 ppm fluoride ingestion with bone weakening than studies that do not. Before bone weakening occurs, the abnormal incorporation of fluoride that is irreversible affects calcium whole body metabolism. In the normal cell, a steep calcium concentration gradient varies from millimolar levels outside in interstitial fluid to micromolar levels in cell cytoplasm. Magnesium exists at millimolar concentrations on both sides of the membrane. Fluoride ion has no functional purpose in the cell but being attracted to these ions would affect their chemical activity.
    The chemical characteristics of fluoroapatite in living bone tissue are not clearly understood. But fluoride accumulation, being non-saturable and irreversible, is pathologic not physiologic. Skeletal fluorosis poisoning from long-term uptake involves fluoride sources with concentrations that are obviously below that which would cause acute lethal poisoning. In contrast, there are no fluoride blood levels low enough to prevent incorporation into bone. Since fluoride is not a normal bodily component, there are no endocrine mechanisms to mobilize fluoride from bone after binding. Although calcium fluoride is a weak acid salt because it readily dissolves in acidic media, extracellular fluid is alkaline at pH 7.4. It is thus not surprising that fluoride cannot be removed from bone. As an insidious poison, it can affect calcium homeostasis as it accumulates during lifelong exposure (see endnote 2). The accumulation can slowly progress from bone weakening (at ~3,500 mg/kg) to arthritis-type bone pain (~7,000 mg/kg) and, in some regions of the world with high endemic fluoride in water, to total immobility (~10,000 mg/kg) ([8, 9]). At any stage, there is no cure because fluoroapatite at extracellular pH is insoluble. Before symptoms appear, fluorosis can only be detected by expert X ray analysis and is associated with bone being more subject to fracture.
    Teeth enamel is very much different than hydroxyapatite in dentin and skeletal bone. Fluoride cannot incorporate into translucent crystalline enamel as it efficiently can in the opaque underlying bony dentin. Once fluoride enters the bloodstream and then bone tissue, its chemistry is pathologic since the fluoride has entered the sanctity of a living organism. Stages II and III skeletal fluorosis have historically been considered absent in the U.S. population [9]. There is no reason to believe that this will remain so, as long as more cities require fluoridation and more sources of fluoride exposure continue to expand. Fluoridated drugs containing C-F bonds that are partially metabolized and intended for life-long ingestion, such as some statins, are of concern.
    In elder years with fluoride-loaded bone [8], continuous consumption of fluoride with reduced binding sites available in bone leads to accumulation in soft tissues, including brain [8] and in ligaments, tendons, and aorta [16]. Fluoride from consumption in water can cross the blood-brain barrier in man [11] and is found in all tissues [16] but concentrates in bone, thyroid, aorta, kidney [16], and pineal gland [8]. This is perhaps by passage as trace neutral HF comparable in size to a water molecule. In animal brain (Reddy et al. [28]), this blood level causes direct histopathology observed by electron microscopy.
    Long term exposure appears to decrease IQ in children ([8] pp.148-156) even from natural fluoride in water. Alum used as a clarifying agent in public water systems produces residual aluminum ion (~0.05 mM). Fluoride complexes with aluminum in the acidic stomach and is assimilated. Binding of aluminum to abnormal brain proteins in Alzheimer’s and in mammals that causes pathologic effects (Varner in: [8,9]) indicates caution in consuming aluminum fluoride from water in the presence of brain abnormality. There are no cures for either bone fluorosis or brain damage. Thus, yearly incidence of new cases adds directly to net prevalence for these conditions. The U.S. has 1/3 million hip fractures in the elderly annually [8] and lethal Alzheimer’s cases have been steadily rising for decades (see Endnote 3).
    Systemic fluoride at sub-acute levels incorporates into atherosclerotic plaque in coronary vessels of cardiovascular disease patients directly revealed with PET scans in a study at the Veterans Administration Healthcare Center, Los Angeles (Yuxin et al. [28]). Fluoride is accumulated by the aorta and concentrations increase with age that reflect calcification that occurs in this artery [16]. The extent is determined by water hardness and all sources of fluoride exposure. Chronic ingestion of sub-acute concentrations of fluoride from drinking water weakens heart muscle in animal studies [5] and can cause alterations in heart function in humans (Varol et al. [30, 31]). Per capita cardiovascular deaths increased after Grand Rapids, MI and Newburgh, NY began industrial fluoridation (U.S. Public Health Service (PHS) Congressional Record, Mar 24, 1952). 1,059 heart disease deaths yearly occurred in 1948 in Grand Rapids, MI after 3 years of fluoridation but 585 yearly before fluoridation. The N.Y. News, Jan 27, 1954 reported after 9 years of fluoridation in Newburgh, NY there were 882 heart deaths per 100,000 which was 74% above the National average. Increased incidence of EKG abnormalities were reported to occur in patients having tooth fluorosis in high natural fluoride areas (Xu et al. [32], Takamori et al. [33]).
    Ironically, the level of fluoride in saliva that filters from the bloodstream after swallowing water with 1 ppm fluoride is a miniscule 0.02 ppm average (personal communication K. Theissen re: NRC [9] p. 71). This is unable to influence teeth cavities at 75,000 times lower concentration than in toothpaste at 1,500 ppm. Consistent with this, the largest U.S. epidemiologic studies we have found caries incidence does not correspond to fluoride water level (Hileman [34]). The largest international study we have indicates that caries incidence is lowest in cities with the lowest levels of water fluoride and with calcium-sufficient diets (Teotia and Teotia [35]). The U.S. CDC [36] published findings that high levels of topical fluoride might have a caries effect but systemic blood-borne fluoride from swallowing does not. In fact, systemic fluoride plays the most major role in causing the current U.S. high incidence of tooth fluorosis in children that prompted the U.S Health and Human Services to request in 2011 that added water fluoride be lowered from ~1 ppm to 0.7 ppm. But this is not expected to eliminate the problem.

    Normal teeth enamel is a calcium phosphate matrix that does not contain fluoride. Research animals raised under controlled conditions in the complete absence of any fluoride source, either natural or synthetic, develop normal teeth enamel without increase in incidence of spontaneous dental caries (reviewed in: Yiamouyiannis [11]). These controlled experimental data carefully using the scientific method demonstrated in three separate laboratories that ingested fluoride is not a mineral nutrient. In another animal study, 1 ppm artificial fluoride in drinking water did not decrease incidence of spontaneous dental caries. Thus fluoride does not affect teeth caries by either a systemic mechanism after assimilation or by direct contact with teeth surfaces from either fluoridated saliva or from treated water in the tested animals.
    This enables one to understand the original correlation proposed in the U.S. between natural calcium fluoride in water and human caries incidence that attributed causation to fluoride. The essential minerals calcium, which builds strong teeth and bone, and magnesium totaled 302 ppm in the hard water at the time. Furthermore Ziegelbecker found the original correlation was mere scatter and that no relationship existed between caries incidence and water fluoride concentration when all data are considered (Connett et al. [8] p. 50). Clearly fluoride in drinking water whether natural or unnatural has no functional purpose. In fact, this statement was published in the textbook written by dentist Dr. George Heard who first proposed to the Public Health Service in 1950 the idea that natural fluoride in water might be of benefit for tooth decay. He apologized later for the extrapolation in a letter to the U.S. Health and Human Services (HHS) [37] after finding that children raised on water with fluoride developed crumbly teeth interiors. This is from fluoride incorporation into underlying bony dentin.
    Water districts most commonly now inject unnatural fluoride compounds into water to increase blood fluoride levels in consumers to treat dental caries (personal communication, CA Dept. of Public Health official). The toxic hazardous waste produced from fertilizer manufacturing, fluorosilicic acid H2SiF6, is the most widely used substance ([8], EPA [38]). This was after an EPA official in 1983 described the direct use of this waste as a source of fluoride for drinking water supplies.
    Controlled human clinical trials for safety and effectiveness have never been completed with water treated with either sodium fluoride or fluorosilicic acid.
    The U.S. Food and Drug Administration has never approved fluoride compounds for ingestion in the U.S. The FDA has written that fluoride is not a mineral nutrient and has labeled fluoride in water an uncontrolled use of an unapproved drug (Lovering [7]). In 1966, the FDA banned the sale of fluorides intended for ingestion by pregnant women due to lack of effectiveness on dental health in offspring (Horowitz and Heifitz [39]).
    Early interpretations of data from Newburgh, N.Y. and Grand Rapids, MI where synthetic industrial sodium fluoride was first infused into public water supplies in 1945 were flawed as pointed out by the academic statistician dentist Sutton [40]. Assimilated fluoride in the treated cities caused delayed teeth eruption where missing teeth were scored as absence of cavities. Unbiased double blind methods were not used. Caries incidence in control cities were not assessed synchronously among other unanswered problems. Bone cortical defects were attributed to fluoride assimilation from the treated water supply [8].
    Recent studies indicate that rather than strengthening teeth, fluoride water consumption during teeth development decreases calcium content in teeth with electron microscopic structural abnormality and weakening (Susheela [41]). Ingested fluoride abnormally incorporates substantially into underlying dentin [9]. Ingested fluoride is of course no value to adult teeth [16].
    3.4 Other Fluorosilicic Acid Products in Water. Fluorosilicic acid is not a source for fluoride in any natural water supply. Its infusion quantitatively adds three ingredients: fluoride, sodium, and silicic acid. Fluoride and sodium are not components of pristine fresh drinking waters such as in the Pacific Northwest. Neither fluoride nor silicic acid are listed in the Merck Manual for Health Care Professsionals [6] or in Clinical Chemistry (Teitz [18]) texts as constituents of normal human blood because neither are mineral requirements.
    Silicic acid H4SiO4 from fluorosilicic is typically 0.6 ppm when fluoride is adjusted to 0.8 ppm. Silicic acid with its low dissociation constant remains the intact molecule at alkaline pH and may be the ingredient that leaches lead salts from lead-based plumbing that does not occur with sodium fluoride. The EPA has no MCL for silicic acid because it is usually considered harmless in water supplies. Artificial silicofluoridation of municipal water supplies however caused alligators to develop liver silicosis that did not occur in alligators given water without fluorosilicic acid [12]. NMR studies confirm that fluorosilicic acid fully dissociates into fluoride ion and silicic acid at community water pH but forms a silicofluoride complex at pH 3 (identified as SiF5-) (Finney et al.[42]) as in stomach acid. A positive view has been presented for possible benefits of silicic acid consumption to cause soft fingernails and changes in skin structure (Barel et al. [43]) due to stimulation of collagen formation by fibroblasts. But this effect has not been researched sufficiently to recommend its intentional ingestion and the effect may be nonphysiologic. Long-term topical effects on teeth enamel have not been studied even though silicic acid is used in agriculture to degrade calcium phosphate in soils.
    In Figure 3, note Southern California public drinking water sodium levels increased from an average 80 ppm prior to artificial fluoridation to average 93 ppm after 2007 when fluorosilicic acid injections began that require sodium hydroxide to neutralize acidity. Many plant species that have thrived in this region including the widely cultivated avocado are saline intolerant (Musyimi [44]). Elevated sodium in irrigation water can alter avocado leaf number, chlorophyll content, chloride content, root weight, and transpiration water loss rate. At 345 ppm sodium, chlorophyll content is reduced in leaves by 40%, chloride content by 42% and transpiration rate of water loss 21% after only 7 days with sodium at this level. In January, 2011 when the Health and Human Services recommended that infused fluoride not exceed 0.7 ppm in public water supplies [45], Metropolitan Water followed this request in Southern California and the sodium level dropped back to near 85 ppm.

    [cid:image160.png@01D47B9C.4AC11730]
    FIGURE 3: Data are from public published water quality reports from the Metropolitan Water District, Los Angeles for sodium as a function of year. The concentration increased progressively after 2007 when industrial fluorosilicic acid with caustic soda injections began. Every 24 tons of fluorosilicic acid require 14 tons of sodium hydroxide to maintain pH at 8.4 (two H+ ions from H2SiF6 requires two sodium ions). Sodium at 116 ppm has been found to decrease yields and affect vegetable and fruit quality. Sodium is released into the Colorado River by scores of industries lining the river. The EPA Salt Abatement Program limits releases from companies to one ton daily each but the existence of numerous sites has led to this level. The EPA secondary standard for TDS (500 ppm) is exceeded but is not enforced–plants can tolerate natural TDS from 800-1000 ppm. No MCL standards have been developed by EPA for sodium, since fresh water has historically been low in sodium. Sodium in blood is 3,000 ppm but is 0-10 ppm in pristine fresh drinking water with a national average at 15 ppm. The river winds 900 miles from West Central Wyoming to Southern CA and the Mexico border. The speed of the river flowing at a typical width of 900 ft. is 4.5 ft/sec. with an estimated travel time of 12 days along its course. The source of fluoride along its length that produces the fluoride level of 0.2 ppm is presumably natural but has not been identified.

    3.5 Interpreting Fluoridation Policy. Federal water laws were enacted by the U.S. Congress for the protection of the nation’s waterways that often cross state boundaries. The Water Pollution Control Act conceived by President John F. Kennedy states its mission is to maintain the natural chemistry of the nation’s water. The Safe Drinking Water Act provides an exception that allows additives that sanitize drinking water but otherwise prohibits any national requirement for the intentional incorporation into water of other substances regardless of perceived benefit. This includes foods, supplements, nutrients, drugs, therapeutics, poisonous substances, or pollutants. Together with the WPCA, this also includes ingredients that may be present naturally in one particular water that are absent or at lower levels in other waters. Natural U.S. waterways are a heritage that are under Federal protection. The SDWA also stipulates that States can be no less restrictive.
    In practice, it has proven difficult to follow Federal water law in its entirety because of industrial and other human activities. In the case of “fluoridation”, Oral Health Division officials within the CDC endorse and encourage ingestion of fluoride from water at dictated concentrations. The beliefs are that it is a systemic dental treatment and that natural calcium fluoride contaminant in some waters might suggest it is a desired water ingredient. Unable to mandate a Federal requirement, the CDC encourages states to do so. Some states legislate “mandatory fluoridation.” But this does not consider the requirements of all Federal water law taken together and can thus be argued to be invalid (Balog [46]).
    The Congress assigns to the FDA full authority to regulate use of any oral ingested substance to treat humans including nutrients, approved drugs, unapproved drugs, and substances used as drugs or treatments, regardless of method of dissemination. As mentioned, the FDA banned the sale of fluoride compounds intended to be taken internally by pregnant women. And yet, industrial fluoride is consumed by the general public in those 70% of all districts that artificially fluoridate water.
    No Federal agency accepts liability for the unnatural fluoride infusions [8]. The FDA wrote that added fluoride is a contaminant for regulation by the Environmental Protection Agency [37] and does not require labeling fluoride content of bottled water to avoid public perception that fluoride might be thought to be a normal ingredient in water. The EPA considers intentionally added fluoride a water additive, accepts no authority for its regulation, allows states and cities to fluoridate. Yet, EPA offers assistance in the use of chemicals certified by the private organization the National Sanitation Foundation [8]. The NSF denies liability for use of fluorides [47] and does not publicly disclose all safety or effectiveness data for its use as a water additive. The CDC endorses the practice but shuns liability and regards fluoride in water as a supplement ingredient for teeth. Only the FDA is authorized to regulate dietary supplements.
    Water districts rely on state health departments for safe conditions of use. These departments under the CDC also refuse liability and assign liability to the cities themselves. Litigation over the Hooper Bay incident pitted State vs. city disputing liability. The EPA and CDC advise compliance with NSF Standard 60 requirements for fluoridation chemicals. But NSF neither discloses its detailed composition (for proprietary reasons) nor performs toxicity testing ([8] p. 26-28). NSF labels fluoride in water a contaminant, as does the EPA, except when added purposely as an “additive” (NSF [47]). But additives are chemicals that treat water for sanitation, not to treat humans through internal ingestion. Chemical supplier data sheets also place liability on the end user.
    Standard 60 requires that all water additives be allowed to only 10% of any EPA maximum contaminant level MCL which for the fluoride contaminant developed for natural water containing calcium is 4 ppm. Unnatural fluoride has been infused typically to 1.2 ppm, 30% of the MCL. This evasion of the NSF toxicology rule is allowed in part by considering it as a normal ingredient in water [8]. As evident in the present article, labeling the fluoride anion alone as a water ingredient without consideration of the associated positive ions and its environment is incorrect. Natural fluoride in water is always accompanied with calcium from the dissolved salts. The EPA MCL was based on observations from natural calcium fluoride in water. Additional sources of industrial fluoride have now become considerable and many water sources are very low in calcium content. Thus, the EPA MCL does not apply for industrial added fluoride or for many regions such as the soft water Pacific Northwest. A separate MCL is necessary for fluoride from industrial sources that also considers varying levels of interacting endogenous calcium.
    NSF Standard 60 for water additives is not applicable to chemical agents used to alter human tissue. The purpose of fluoridating water supplies is to affect teeth from ingestion and internal consumption of fluoride. Prescriptions have long been required for those who desire that children ingest sodium fluoride (Luride) tablets for perceived dental effect [48]. Total fluoride exposure from all sources must be monitored by prescription because ingested sodium fluoride rodenticide acts acutely by calcium sequestration and subacute doses taken longterm can cause accumulative pathology. The tablets are not FDA approved to be taken internally but are nevertheless allowed by prescription. Most prescriptions state that the drug is not to be used in areas where water contains 0.7 ppm fluoride or higher [16, 48]. Dosage instructions for fluoride tablets in the Physician’s Desk Reference [48] have varied from 1994-2013 and in 1998 state — Warnings: Do not use Luride 1mg tablets for children under age 3 or use in patients under age 6 when fluoride water content exceeds 0.3 ppm. Luride tablets in any strength are contraindicated for all age groups when the fluoride content of drinking water exceeds 0.6 ppm. The 2013 issue has similar warnings for vitamins with added sodium fluoride. These restrictions attempt to minimize fluorosis and other adverse pathology. However not considered are the endogenous calcium level, other widespread fluoride sources that equal or exceed the prescribed dose even when drinking water is devoid of fluoride (Lee [49]), and that fluoride ingestion is not FDA approved. Cities fluoridate water to 0.7 ppm or higher but do not announce that use of fluoride tablets must be discontinued or that fluoride is a recognized neurotoxin in animals and man that accumulates abnormally and permanently into bone. Thus, officials within the CDC, NSF, and EPA appear to be unaware that these agencies taken together recommend, certify, allow and describe the consumption of industrial fluorides from treated drinking water supplies. This perturbs the prescription process and interferes with public understanding that soluble industrial fluorides are toxics and are not FDA approved for ingestion.
    The SDWA states “No National primary drinking water regulation may require the addition of any substance for preventive health care purposes unrelated to contamination of drinking water” (Graham and Morin [50]). Chlorination is used for sanitation but fluoridation is added to treat humans. This provision was specifically intended by Congress to prohibit the use of the SDWA as a means to impose artificial fluoridation of public water supplies throughout the United States ([50] note 88, p. 213). Yet Federal and state agencies and chemical suppliers assign all liability to cities, which are typically the least informed of the risks. A California law attempts to mandate “fluoride” (see Endnote 1) in public water supplies without listing the specific substance required. Since the toxicity of all compounds containing fluoride is determined by its ionic co-ingredient, the law is neither actionable nor a mandate. Funds for silicofluoridation are typically derived from tobacco tax money, dental insurance premiums, or directly from ratepayers. San Diego citizens voted twice against adding fluoride compounds into water but fluorosilicic acid infusions began there in 2011.
    Silicic acid has no EPA MCL so a standard was created and deemed safe at 16 ppm as an allowed maximum without conducting or soliciting toxicologic studies that NSF documentation requires [47]. This is thus circular reasoning. NSF states that silicic acid infused to 0.8 ppm in fluoridated water is below a safe standard. But NSF helped determine the standard deemed to be safe without toxicity data to back it up. The EPA has authority to prohibit the intentional addition of any contaminant under the authority of the SDWA. Instead, a current EPA fact sheet on hazardous waste fluorosilicic acid describes its use as an ingestible dental prophylactic for use in water supplies (EPA [38]).
    The FDA requires a new drug application for any material containing HF intended for human ingestion [50]. Fluorosilicic acid typically contains 1.5-2% HF. The EPA fact sheet focused on the upper portion of the titration curve in Fig. 2(b) where HF is negligible above pH 4.2 to imply the material is safe for long-term oral ingestion. However, as shown in this article, fluoride converts to HF below pH 4 as in the acidic stomach (pH 1.5 – 3) which is contraindicated as a proposed human treatment.
    The FDA ruled in 1975 that fluoride is not considered safe to add to foods (Sutton [40]). But fluoride drinking water regulations are still being revised by Health and Human Services. The HHS and EPA joint recommendation in 2011 to lower the allowed fluoride level in water was a temporary response to requests made by the NRC. It is not expected that the FDA would approve soluble fluorides for ingestion because controlled human clinical trials data are required for review. It would be unethical to conduct human trials since industrial fluoride at blood levels typically found in residents of fluoridated cities is recognized already as a neurotoxin, a non-physiologic mitogen, a general enzyme inhibitor, and a permanent bone perturbant during chronic consumption [8, 9]. This author submitted a petition to the FDA requesting a general ban on the sale or use of all industrial fluorides intended for internal ingestion by dissemination through public water supplies in the U.S. The petition was accepted for review in 2007 and remains pending (FDA [37]). 4. Conclusions
    This study indicates that industrial fluoride added to drinking water forms intact corrosive hydrofluoric acid under acidic conditions that prevail in the stomach of man (pH 1.5 – 3) and animals. Ingested fluoride from water enters the bloodstream as an artificial component, not a normal constituent, and disrupts inter-molecular hydrogen bonding, forming inter-atomic hydrogen bonding. Fluoride influences calcium homeostasis. Accidental higher levels of fluoride known to cause acute lethality compare with calculated levels that would begin calcium precipitation at physiologic calcium concentrations in blood. The difference between the single oral acute fluoride dose of 60 mg/kg body weight and the lethal blood concentration of 2-3 ppm calculated here and observed clinically in blood after accidental fluoride poisonings may be due in part to fluoride elimination by kidneys and accumulation by bone during assimilation of the ingested oral dose. It is not possible to reach an acute lethal blood level of industrial fluoride from treated water unless there were an accidental overfeed. 1 ppm water leads typically to ~0.2 ppm blood fluoride. But only ~1 ppm blood levels cause a chronic form of congestive heart failure (found after hemodialysis with fluoridated water) and 2-3 ppm causes acute heart block.
    The infusion of industrial fluorosilicic acid with caustic sodium hydroxide into water supplies introduces sodium, that is not a component of fresh drinking water, plus fluoride without calcium. Sodium and fluoride are the ingredients used in rodenticides and in the prescription drug Luride which is not approved by the FDA to be taken internally by ingestion. Ingested sodium fluoride from treated water does not reduce caries either systemically at 0.2 ppm or topically from saliva at 0.02 ppm. Instead it increases the incidence of unsightly abnormal dental fluorosis hypoplasia in all treated cities. The policy adopted by the U.S. Public Health Service in 1950 remains encouraged by the trade organization the American Dental Association, dental insurance providers, and dental officials in the Oral Health Division. But none of these groups has authority to chemically treat public water supplies. The rationale for the infusions remains based on early observations not supported by careful experimentation using the scientific method. When examined in detail this proved to be an anecdotal incorrect correlation.
    Federal law prohibits any requirement for substances added into water other than to sanitize water, regardless of ascribed benefit. And yet, plain water without added industrial fluoride is now scarce in U.S. public supplies. The decision to infuse industrial fluoride compounds into public water supplies to permeate the blood and organs of consumers with fluoride as an ingested dental prophylactic has resulted in serious consequences including loss of life. Although many believe the infusions decrease caries without causing systemic damage, the data reported here along with other published studies do not support the policy [1,7-12,25-35,41,52-54]. Insidious effects that can occur on musculoskeletal, neurologic, reproductive, and endocrine systems from long-term ingestion of fluoride in water [8,9,11] plus cardiovascular effects discussed here emphasize the seriousness of fluoridation especially in soft water regions lacking antidote calcium. Currently fluoride exposure is from diverse sources.
    Adding substances in water that are unnatural, harmful, illegal, and ineffective in stated purpose violates universally accepted consumers’ and patients’ rights of refusal. This is because fluoride at sub-saturation levels is not easily filtered. A legal review described the policy as un-Constitutional (Balog [46]). Enamel hypoplasia and caries are not caused by absence of fluoride. Essentially all European countries do not fluoridate public water supplies but some do offer optional fluoridated salt that is not as extensively consumed as water. Opposition has been widely publicized in the U.S. (Abby Martin of RT News [55] and the documentary film Fluoridegate [56]), Canada, and the U.K. [52, 53, 57]. The National Kidney Foundation recently formally withdrew support. Citizens mostly vote against fluoridation but the SDWA should have been sufficient law to avoid the need for voting. The city of Portland, Oregon recently voted against fluoridation for the fourth time and remains untreated as of now. 61 cities in Nebraska voted against fluoridation over the period 2008-2009, effectively overruling a state mandate. The policy does not accommodate kidney disease patients and those who are normally fluoride-sensitive [12]. For all who object, the policy evades human decency.

    1. Endnotes

    1.Definition of terms fluoride, a fluoride, fluorides, fluoride mineral(s), mineral fluoride(s), fluorine, fluoride compound(s): In chemical nomenclature “ide” refers not only to the nonmetal anions but also to all binary compounds. Fluoride is the ion F-. It can be found naturally in minerals or dissolved from minerals as the free

    ion in water accompanied with cations with which it coexists. “A fluoride” refers to compounds containing fluoride including natural minerals and industrial compounds or to a single fluoride ion. “Fluorides” refer to compounds containing fluoride, natural or otherwise. Fluoride minerals or mineral fluorides are the natural compounds that contain the fluoride ion.

    Fluorine specifically refers only to pure elemental diatomic molecules of the atoms, F2. Even though commonly done in respected reference sources, it is incorrect to state that fluorine has a natural abundance on the earth’s crust. It does not. Elemental fluorine does not exist in nature. It is also incorrect to state that fluoride in the earth’s crust is a mineral. Natural sources that contain the fluoride ion are fluorite or fluorspar, cryolite, and fluorapatite [4]. Fluorite is found in metallurgical, ceramic, and acid grade with CaF2 content ranging from 60-97%. These are natural fluoride minerals or mineral fluorides. But there is no mineral called fluoride even though “a fluoride” can refer to a natural fluoride mineral.

    The difference between industrial fluorides and fluoride minerals is chemically and biologically vast. Natural mineral fluorides are not absorbed well when ingested because of the natural metal cations that accompany the fluoride. Having no biologic similarity at all with natural fluoride minerals, industrial manufactured fluoride compounds have cations that replaced those in the natural

    mineral. Sodium fluoride is an industrial, fully soluble, metal-nonmetal fluoride. Fluorosilicic acid is an industrial,

    fully soluble, metalloid-nonmetal fluoride.

    The CDC website on fluoridation writes extensively that there is “no difference” between natural and industrial “fluoride” since the ion is itself identical in both materials. But the reactivity and toxicity of the fluoride ion is determined by the positive cation company it keeps. Free fluoride ion in some water supplies as a contaminant is naturally present from natural fluoride minerals that exhibit low solubility. The equilibrium double-arrow natural partial dissolution of the insoluble solid into some waters is given by: CaF2(s) ↔ Ca2+(aq) + 2F-(aq). Industrial fluoride stripped from natural mineral cations lacks antidote calcium and is fully assimilated from artificially treated water having insufficient calcium. The artificial industrial fully soluble material reacts to completion, approximated

    as: H2SiF6 + 6NaOH → 6F-(aq) + 6Na+(aq) + H4SiO4(aq) + 2H2O.

    Binary covalent compounds can be labeled fluorides when the fluorine atom is attached to a nonmetal atom as in fluorocarbons. These do not contain either the fluoride charged ion F- or the neutral fluorine F atom. Binary or not, these compounds are often labeled fluorinated substances because of this partial charge separation. The unnatural C-F bond is lipophilic.

    1. The average lifespan for many animal species is reduced significantly by providing 1 ppm fluoridated water their entire lives (Yiamouyiannis [11], Spittle [12]). Alligators died prematurely living in the treated water. Horses turn over whole body water quickly and perished from complications due to continuous exposure to fluorosilicic acid treated soft water over a 9 year period. Recent evidence suggests that silicofluoridated water in Southern California since 2007 appears to be a contributing factor in the increasing incidence of racehorse deaths there (submitted for publication).

    No citizens have yet been exposed to fluoridated water for an entire human average lifetime of 75 years even though retained fluoride accumulates during chronic continuous exposure. Grand Rapids, MI treated since 1945 could have individuals who have consumed fluoridated water for 68 years. It has long been known that lifetime (>60 years) consumption of water with 1 ppm natural fluoride in the absence of fluoride toothpaste causes fluoride to accumulate in bone to 4,000 mg/kg. This level causes weakening of bone, making bone more subject to fracture [9]. In 2000, there were 2.6 million medically treated non-fatal fall-related injuries (Stevens [58]) with medical care costs totaling 19 billion dollars. Consumption of 1 ppm industrial fluoride from drinking water together with fluoride toothpaste and other fluoride sources for 68 years would be expected to cause far larger fluoride incorporation. Besides possible shifts in the IQ of the population to a lower mean, bone fluoride accumulation could be associated with arthritis type pain. The subset of the population with atherosclerosis would have more extensive fluoride incorporation into the aorta which is an inappropriate risk when cardiovascular disease is the nation’s leading lethal disease entity. And 1%. of the people would need to live with fluoride hypersensitivity by avoiding treated water supplies or by moving away from the area.

    Fluorides used as dental treatments in pastes and gels can be avoided. But fluoride added into water supplies is a burden. The ion compares in size to water molecules and is difficult to eliminate except with sophisticated procedures

    including high pressure reverse osmosis (~ 0.27 nm pore size), binding by specially prepared bone char, or distillation. Millions of dollars can be saved for any city by simply not purchasing waste fluorosilicic acid and instead

    treating caries differently with promotion of sufficient dietary calcium phosphate to help maintain strong teeth. Blood calcium homeostasis is a far more important consideration than are dental caries. Fluoridation equipment and engineers can easily become involved in removing EPA contaminants from water instead of adding them into water. The presence of natural calcium fluoride in waters should not be labeled “natural fluoridation.” Fluoridation refers to the intentional addition of fluoride compounds which are mostly soluble industrial synthetic

    fluoride toxic calcium chelators into water supplies to treat humans. Fluoridation needs to be revoked as a general public policy because the actual purpose of drinking water is to hydrate living cellular tissue with H2O. Daily amounts depend on level of physical activity, health conditions (diabetics require more water), personal taste, environmental and other factors.

    1. The prevalence of Alzheimer’s disease in the U.S. is 4-5 million people. The cost of care for Alzheimer’s, chiefly for nursing care facilities, totals 2 billion dollars annually in the U.S. (New England Journal of Medicine, 2013 in press). 75% of Alzheimer’s victims require nursing home care, compared to 5% without Alzheimer’s. It is the 6th leading cause of death. It has no cure or effective treatment. It is the most expensive in costs of care of any disease entity in the U.S. The EPA recently classified fluoride as a neurotoxin but this requires clarification. Fluoride minerals are not neurotoxins, because fluoride is

    not absorbed from ingested minerals. Free fluoride ion in drinking water can be so classified but industrial fluoride sources are assimilated more readily than fluoride from hard water or from natural calcium fluoride. Blood-borne fluoride regardless of source is neurotoxic and should be avoided from any source by individuals with neurologic conditions such as autism and Alzheimer’s disease. Brain pathology produces symptoms that are not necessarily easily quantified but recent studies confirm fluoride levels in blood correlate with reductions in IQ as a direct function

    of fluoride concentration (Xiang [54]).

    Disclosure Conclusions were analyzed on the author’s personal time and do not necessarily reflect any institutional view. Acknowledgements
    The author thanks the late, world-reknowned calcium physiologist Dr. C. Baird Hastings and colleague Andrew A. Benson for discussions 42 years ago on toxic fluoride calcium chelators. Benson discovered the CO2 fixation product in photosynthesis and at age 95 continues work at the Scripps Institution of Oceanography. Thanks for excellent reviewer comments and to both Chemical and Engineering News editors and Declan Waugh (http://www.enviro.ie) for suggesting submission to an environmental journal. Dr. Paul Connett is thanked for scientific public education on this topic and for visiting the Presidio Sentinel and San Diegans for Safe Drinking water. This study began after the Hooper Bay disaster and apologies are given for the years taken to complete it. Peoples of the world are quite grateful to God when drinking water is fresh, pristine, and sufficiently pure for its physiologic purpose.

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    [44] U.S. Health and Human Services, HHS and EPA announce new scientific assessments and actions on fluoride, Jan., 2011. Available at: http://www.hhs.gov/news/press/2011pres/01/20110107a.html.
    [46] Balog, D., Fluoridation of Public Water Systems: Valid Exercise of State Police Power or Constitutional Violation? Pace University Environmental Law Review 14(2):645, 1997. Available at: http://digitalcommons.pace.edu/cgi/viewcontent.cgi?article=1487&context=pelr
    [47] NSF International Standard/American National Standard NSF/ANSI 60 (2009) Drinking Water Treatment Chemicals — Health Effects, Ann Arbor, MI. Brief summary available at: http://www.nsf.org/business/water_distribution/pdf/NSF_Fact_Sheet.pdf.
    [48] Physician’s Desk Reference , 48th ed., R. Arky, M.D. Medical Consultant, Medical Economics Data Production Company, Montvale, NJ USA 1994 (p. 839).
    [49] Lee, J.R., Optimal Fluoridation –the concept and its application to municipal water fluoridation, Western Journal of Medicine 122:431-436, 1975. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1129768/pdf/westjmed00297-0103.pdf
    [50] Graham, J.R. and Morin, P., Highlights in North American Litigation during the Twentieth Century of Artificial Fluoridation of Public Water Supplies, 1999. Available at: http://www.law.fsu.edu/journals/landuse/vol142/graham-final2.pdf. [51] FDA Code of Federal Regulations, 21 CFR31O.545(a)(2) and (b).
    [52] Caulart, P.V., Canadian Water Providers Ceasing Artificial Fluoridation, Environmental Science and Engineering Magazine, July 2008 p. 38-41 see www.esemag.com.
    [53] Thomas, S., Rethinking the Risks and Benefits of Fluoridation, Environmental Science and Engineering Magazine, Canada, Feb. 2013. Available at:
    http://cof-cof.ca/wp-content/uploads/2013/02/Sheldon-Thomas- Rethinking-The-Risks-And-Benefits-Of-Fluoridation-Environmental-Science-Engineering-Magazine-Jan-Feb-2013-OCR.pdf.
    [54] Xiang, Q., Liang, Y., Chen, B., Chen, L., Analysis of Children’s Serum Fluoride Levels in Relation to Intelligence Scores in a High and Low Fluoride Water Village in China Fluoride 44(4) 191-194, 2011.
    [55] Abby Martin, RT News, 2013. Available at:

    [56] Kennedy, David, Fluoridegate, Available at:

    [57] Peckham, Stephen, Slaying sacred cows: is it time to pull the plug on water fluoridation? Critical Public Health, November 15, 2011, pp. 1-19, Available at:

    DOI:10.1080/09581596.2011.596818.
    [58] Stevens, J.A., Corso, P.S., Finkelstein, E.A., Miller, T.R., The costs of fatal and non-fatal falls among older adults, Injury Prevention Oct;12(5):290-5, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC) Atlanta, GA, USA, 2006.

    file:///C:/Users/rsauerheber/Documents/Physiologic%20Conditions%20Affect%20Toxicity%20of%20Ingested%20Industrial%20Fluoride.xht

    1. May 12, 2013 U.S. Food and Drug Administration
      Center for Drug Evaluation and Research
      Rockville, MD 20857
      Dear Reviewers,
      This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346.
      Journal of Environmental and Public Health finalized publication. I am pleased at last to enclose the final research article accepted for publication in the Journal of Environmental and Public Health. The article took 19 years to complete and bears little resemblance to earlier versions submitted to the FDA. It is published in an open access journal and will be available free of charge online at the Journal website. This feature was paid for from public donations in support of the specific content of the article. The main findings are that calcium fluoride found as a natural contaminant in some waters is poorly absorbed and is impossible to cause acute poisoning, while industrial synthetic unnatural fluorides infused into water supplies as presumed dental prophylactics all lack calcium and are toxic calcium chelators that are fully assimilated. During accidental overfeeds treated water can and has caused acute lethal poisonings that are impossible with natural calcium fluoride due to solubility constraints.
      Chronic effects are now extant from consumption of industrial fluoride in treated water, particularly in bone, while being unable to influence teeth caries through ingestion. As noted in the article, dentists introducing the Public Health Service to the idea of “fluoridation of water” based on natural calcium fluoride (which is the basis for historical support by former U.S. Surgeons General) later denounced the infusions of industrial fluoride into water. It was found that long-term ingestion cause fluoride incorporation into dentin and crumbly teeth interiors. The FDA in 1994 approved fluoride varnishes for topical use but has never approved ingestible fluorides that have the purpose of intentionally introducing the fluoride ion into the bloodstream. Fluoridation has caused directly visible unsightly teeth enamel permanent abnormal hypoplasia (dental fluorosis) in a wide swath of the U.S. population (see article).
      Ingested fluoride ion does not decrease caries incidence. The landmark publication that demolished the idea that ingested fluoride ion decreases dental caries is the textbook by Dr. P.R. Sutton (Philip R.N. Sutton, The Greatest Fraud Fluoridation, Karunda Pty. Ltd., Lorne, Australia, 1996). The textbook provides exhaustive details from this academic statistician indicating the gross flaws in all the experiments intended to demonstrate that fluoridation of water supplies could decrease decay. The 334 page textbook has been reviewed and is strongly recommended reading for the FDA. Critics who promote fluoride ingestion submitted rebuttal materials that are included in the book. Detailed answers to those critical comments are also included that were never addressed by promoters of industrial fluoride ingestion. For example the famous fluoridated test city of Newburgh, NY has 5 times higher calcium concentration in drinking water than Kingston used as a control (page 178 enclosed). This helped minimize adverse health effects where bone cortical defects and delayed eruption of teeth occurred in the treated population. And since calcium helps build strong teeth, the interpretation that fluoride affected teeth caries is absurd. A prime precisely worded conclusion is “in the face of these new findings, that fluoridation does not reduce the number of decayed teeth, to now continue to medicate whole populations with uncontrollable doses of this very toxic substance, against the wishes of many people, some of who are very sensitive to fluoride poisoning, and yet are forced to drink this chemically treated water, and all to no purpose, is the height of folly” (p. 276).
      FDA 1975 fluoride ruling. Published in the U.S. Federal Register, the U.S. Food and Drug Administration officially in 1975 ruled that fluoride is not considered generally safe to be taken internally through ingestion and thus its addition into foods would be illegal (Sutton, p. 5 and p. 102). A copy of pages in this textbook that describe this are enclosed. Since fluoride is recognized by the FDA as not safe for ingestion, and the information from Sutton proves complete lack of effectiveness of ingested fluoride for its intended purpose in consumers, it is imperative that FDA ban the sale of industrial fluorides intended to be used as an oral ingested dental prophylactic in all Americans from treated public water supplies.
      Fluoridation Policy. The reviewers of the Journal article specifically requested a full description to be made public of current fluoridation policy in the U.S. in the context of these findings. It will be necessary for FDA reviewers to examine this article entirely in full because the FDA has been involved in the use of fluorides as oral ingestibles either directly or through water “fluoridation” (e.g. the 1966 ban of fluoride sales for internal use by pregnant women; the allowance of fluoride tablets by prescription in regions where water is not fluoridated and levels are below 0.7 ppm; rulings that fluoride in bone does not strengthen bone and that addition of fluoride which is not a mineral nutrient into water is an uncontrolled use of an unapproved drug, etc.).
      U.S. Senators (personal communication from the office of CA Senator Feinstein) are regularly told by influential lobbyists that $38 are saved on dental care for every $1 spent on “water fluoridation”. This is based on the assumption that ingested fluoride from water actually lowers caries incidence, which it unfortunately cannot. Caries reductions are due to factors such as brushing after eating sugary foods, not from swallowed fluoride in saliva at 0.02 ppm or in blood (see article). There are no “savings” from “fluoridation of water” when there are no reduction in caries from it.
      Rationale for FDA ban. When the FDA does ban all infusions of industrial synthetic unnatural fluoride compounds into public water supplies for purported use as a dental prophylactic, then the public will need to be informed why this is now necessary. Reasons include but are not limited to:
    2. Synthetic industrial fluorides lacking calcium are not natural and are fully assimilated and thus not directly comparable to natural calcium fluoride that can be found in some water supplies.
    3. Artificially fluoridated water has been found in well-controlled research animal studies to be unable to influence teeth caries. In humans, the concentration of fluoride in saliva from drinking treated water has been found to be only 0.02 ppm which cannot exert an effective surface action on dental enamel. The blood concentration is rising above 0.21 ppm because total fluoride exposure has risen considerably in recent years from increasingly varied ingestible sources of fluoride.
    4. Addition of industrial fluorides into water supplies that lack sufficient calcium causes full assimilation of the ion with undesired levels of bone loading after lifelong consumption from water in addition to that from other sources. Fortunately no cities in the U.S. have yet to be exposed to artificially fluoridated water for an entire human average lifespan – – the longest treated city has now been 68 years.
    5. Efficient methods of caries prevention are now understood, namely ensuring first and foremost that sufficient calcium phosphate minerals are present in the diet to build healthy enamel during teeth development and to foster proper enamel remineralization in adult teeth.
    6. Since unnatural fluorides are being used as ingestible dental prophylactics, any regulations are outside the jurisdiction of either the U.S. EPA or the U.S. CDC. Former recommendations from these agencies were developed based on natural calcium fluoride found in some water supplies that do not apply to the intentional treatment of water with unnatural industrial fluoride compounds.
      We citizens view the ban as important and immediately necessary, particularly in view of the fact that fluoride promoters do not understand recent data and yet are forcing additional cities to infuse industrial silicofluoride compounds lacking calcium into water supplies. An egregious case is now ongoing in Portland, Oregon where the population is being forced to fluoridate water that is devoid of sufficient endogenous calcium and the action is widely opposed by the citizens themselves.
      This is in the 7th year of supplying information to the FDA on this issue since the original ban petition was filed. We would appreciate from the FDA an approximate expected date at which time the FDA will be able to act on this petition. We thank you very much for your attention,

    Richard Sauerheber, Ph.D. Chemistry
    Enclosures:
    pages 5, 102, and 178 from Sutton, P. (1996) The Greatest Fraud Fluoridation.
    Sauerheber, R. Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, Journal of Environmental and Public Health, May, 2013 (see previous letter).

    37.
    June 10, 2013 U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346.
    Natural vs. Industrial Fluorides. The Oral Health Division, U.S. Centers for Disease Control has written on their fluoridation website that there is no difference whatsoever between use of fluorosilicic acid or natural calcium fluoride for treatment of public water supplies. This claim is false, as described in previous letters to the FDA, the original FDA petition, and a 2013 published article [1]. The data analyzed below confirms the vast difference in toxicology between fluoride from calcium fluoride found in some water supplies naturally versus industrial fluoride added into water artificially.
    The published data were reviewed in the National Research Council 2006 Report on Fluoride in Drinking Water [2] but the authors of that report did not seem to notice the vastly different amounts of fluoride required to cause severe skeletal fluorosis when natural and artificial fluoride sources are used. There is a huge difference in bone accumulation of fluoride for any given total amount of ingested fluoride as shown in the graph. This is undoubtedly due to the fact that calcium impairs fluoride assimilation from the GI tract after ingestion. This directly counters the CDC argument that fluorosilicic acid fluoride is “identical to natural calcium fluoride.” It is of course well known that all synthetic fluorides lacking calcium are listed on poisons registries and have an LD50 of only 120 mg/kg single oral dose in tested animals. Natural calcium fluoride is not a listed toxic substance on any poisons registry. Since questioning the CDC on this point their fluoridation website has been changed to longer stress that the two fluoride sources are effectivelythe same.
    Bone Fluoride (mg/kg) vs. Total Fluoride Consumed (grams) from Natural and Industrial Sources [cid:image169.png@01D47B9C.4AC11730]
    Total fluoride consumed (grams)
    To produce severe bone pain near immobilization stage II-III skeletal fluorosis requires a bone concentration of approximately 6-9,000 mg fluoride per kg bone [2]. Notice this occurs after ingestion of approximately 120 grams of fluoride from natural calcium fluoride in water supplies over many years duration. The squares represent bone accumulation for total natural fluoride consumed by people ranging from 5 to 30 years. The same level of bone accumulation is achieved with only 38 grams of industrial fluoride in clinical trials. The diamonds represent this bone accumulation for total industrial fluoride consumed over a 3-4 year period.
    It is currently difficult to predict any particular bone fluoride concentration that would exist in residents of any particular region of the U.S. because natural and industrial fluoride levels in water supplies vary widely with existing water hardness. Also the amount of fluoride varies from other sources such as foods, beverages, and industrial fluoridated toothpastes. In 1958 before other fluoride sources became prevalent, natural calcium fluoride from a 1 ppm water supply (~2 mg fluoride daily for 30 years) produced a measured bone level of 2,200 mg/kg (Neubrun, [3]). At 2 ppm and 4 mg daily, bone accumulated to 4,000 mg/kg as expected. These are the leftmost squares on the natural fluoride line in the graph. After the development of industrial fluoridation of public water supplies and the introduction of industrial fluoride in toothpaste, the bone accumulation rate became far higher.
    Bone weakening that makes bone more subject to fracture occurs any time that bone has accumulated fluoride irreversibly to 3,000 mg/kg. Bone pain occurs at approximately 6,000 mg/kg, and immobility with eventual lethality at 9,000 mg/kg [2]. As stated before in the original petition and in supplemental letters, approximately 1/3 million hip fractures in the U.S. occur annually. The cost for nonfatal fall broken bone injuries approximates 2 billion dollars for health care annually [1]. Hip, knee, and elbow replacement surgeries are at record highs and increasing in the U.S.
    Obviously soft water regions of the U.S. lacking protective calcium to minimize fluoride assimilation after ingestion are more susceptible to bone accumulation from artificially fluoridated water supplies. These waters are devoid of protective calcium and devoid of natural fluoride. Therefore all the fluoride in the treated water would be from artificially added industrial compounds sodium fluoride or fluorosilicic acid.
    Fluoride by ingestion does not work systemically or topically. The CDC published that ingested fluoride in the blood does not reduce dental caries. This was an astonishing admission since the Public Health Service for decades forced the view that swallowing fluoride would decrease caries by acting from the bloodstream during tooth development. Because dental officials have long held the policy that somehow fluoride “must decrease caries,” the argument that ingested fluoride works topically by filtering into saliva from the bloodstream [4] was promoted. A 14 year old epidemiologic anecdotal study making this claim is currently being cited by U.S. Health and Human Services in defense of its recent recommendation to use fluoridated water at 0.7 ppm.
    However, the NRC conclusively found that ingested fluoride in saliva is only 0.02 ppm from 1 ppm treated water ingestion. This is unable to affect teeth caries at 75,000 times lower concentration than in topical toothpastes. The CDC has been unable for a full year to explain this discrepancy. If 0.02 ppm topical fluoride effectively decreased caries topically from saliva, then why should anyone buy toothpaste when water contains 35 times more concentrated fluoride at 0.7 ppm than saliva does? Teeth could be brushed with fluoridated water for its topical effect. This of course is absurd because such low levels of fluoride cannot influence caries topically. Topical toothpaste with 1,000 ppm fluoride has been reported recently to not decrease caries significantly, so 1,500 ppm is now used in toothpastes (see previous letter to FDA). After this still-unanswered question was posed to the CDC last year, the CDC had changed its fluoride website stating:
    “CDC promotes effective public health practices such as community water fluoridation. It is not CDC’s task to determine what levels of fluoride in water are safe” [5b].
    If it is not the CDC’s role to determine what level is safe (agreeably this is the role of the FDA), then CDC has no right to promote the infusions.
    Also CDC makes unreferenced unproven claims to answer the question on their website #29 regarding need for fluoride from water and from toothpaste at the same time:
    29. If they [toothpaste and water] both contain fluoride, how can they work differently? CDC response: “Both drinking water and toothpaste provide important and complementary benefits. The drinking water provides long low-level protection. …whether in water or toothpaste, fluoride works by slowing the activity of bacteria that cause decay, and by combining with enamel to make it stronger and more resistant to decay. Fluoride in water, although at a lower concentration than in toothpaste, maintains a constant low level of fluoride in the dental plaque and saliva all day. Toothpaste provides a high level of fluoride, but only for 1-2 hours after brushing, so the water exposure during the remainder of the day takes over after that.”
    This of course is utter nonsense since the fluoride level in paste is a massive 75,000 times higher than fluoride in saliva from ingestion of treated water. Fluoride in the ragne 0.02-0.7 ppm does not affect bacteria.
    The above CDC response to question 29 completely contradicts the CDC response to question #16:
    16. Why does HHS think that 0.7 milligrams per liter is appropriate? CDC response: “HHS has reviewed extensively the scientific literature on the relationship between fluoride and oral health. The optimal level of fluoride in drinking water provides enough fluoride to prevent tooth decay in children and adults while limiting the possibility for children to develop dental fluorosis in teeth that are forming under the gums. Analyses of national survey data show a gradual decline in tooth decay as fluoride content in water increases from very low levels to the recommended level of 0.7 milligrams per liter. However, there were limited changes in tooth decay as the level of fluoride in drinking water increased to 1.2 milligrams per liter. In contrast, the percentage of children with dental fluorosis increased as the fluoride concentration in water increased” [5a].
    Notice the argument was made in question #29 that high levels of toothpaste fluoride help reduce tooth decay topically and that drinking water fluoride at lower levels is necessary to maintain fluoride levels throughout the day to maintain the effect, but here the argument is made that increasing water levels from 0.7 to 1.2 is of no effect ! And what happened to the first claim above [5b], that it is not the job of the CDC to determine the effective concentrations to be used?
    Comments/Conclusions. Fluoridated bone is abnormal, weakened, and more subject to fracture when fluoride accumulates to only 3,000 mg/kg. Industrial infused fluoride lacking calcium is fully assimilated and undoubtedly contributes to bone pathology in the elderly in the U.S. Industrial fluoride blood poisoning from treated drinking water has caused an endemic of fluorosis in both teeth enamel and bone. 41% of U.S. teens now have ugly abnormal enamel hypoplasia as a result. In some fluoridated areas it is as high a 50% (Peckham reference [44] in [1]) but depends on calcium content of the water. Severe skeletal fluorosis has been rare in the U.S. but understand that it will be another decade before industrial fluoride use here will have existed for as long as an average human lifespan of 75 years.
    Dentists within the CDC intent on decreasing caries do not comprehend the biochemistry or pathology associated with fluoridation of blood, interstitial fluid, and internal organs. The EPA does not regulate fluoride infusions into public water supplies over any range below 2 ppm. The CDC has no authority to add supplements, drugs, nutrients or other agents into public water supplies. Neither agency has officials capable of evaluating the detailed pathology or effectiveness of ingested industrial fluoride. In fact the EPA MCL of 4 ppm was established to prevent severe stage III skeletal fluorosis from consumption of natural calcium fluoride. This does not apply to the more potent industrial fluoride infused now into public waters. Only the U.S. Food and Drug Administration has authority to regulate the treatment of consumers with oral fluoride compounds. The FDA is here asked to come to the aid of the CDC and EPA which are floundering on this topic while nevertheless still forcefully recommending that fluoridation be expanded nation-wide.
    Knowledgeable citizens of the U.S. request that a ruling be made by the FDA as follows:
    The FDA does not recommend the addition of fluoride compounds into public water supplies from industrial sources sodium fluoride or fluorosilicic acid that lack calcium which coexists with fluoride from natural sources. The FDA has not approved fluoride compounds for ingestion to reduce dental caries in the U.S. Thank you again for your attention,

    Data used in the above graph were from published sources from three different U.S. laboratories and two from the U.K. as presented in table form in the NRC 2006 Report on p. 216 for synthetic industrial fluoride clinical trials over a 3-4 year period and for natural calcium fluoride in water observaitonal studies where conditiosn ranged from 5 years at ~8 ppm fluoride in water to ~30 years with ~4 ppm in water, from NRC p. 91 that was also reviewed in Newbrun [3], p. 125. References
    [1] Sauerheber, R. Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, Journal of Environmental and Public Health 2013 Available at: http://www.hindawi.com/journals/jeph/2013/439490/.
    [2] National Research Council Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, National Academy of Sciences, Washington, D.C. 2006.
    [3] Newbrunn, E. Fluorides and Dental Caries, Contemporary Concepts for Practitioners and Students, 2nd ed., Charles Thomas Publisher, Springfield, ILL, 1975.
    [4] Featherstone, J., Prevention and Reversal of Dental Caries: Role of Low Fluoride, Community Dental Oral Epidemiology 1999 (27):31 Available on the U.S Health and Human Services fluoride website at: http://www.gpo.gov/fdsys/pkg/FR-2011-01-13/pdf/2011-637.pdf
    [5] CDC website on fluoridation a) Available at: http://www.cdc.gov/fluoridation/fact_sheets/cwf_qa.htm#28 b) Available at: http://www.cdc.gov/fluoridation/safety.htm

    38.
    July 8, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857

    Dear Reviewers,

    This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346.
    If it is not possible for the FDA to ban the infusion of fluoride compounds into public drinking water, and if it is not possible for the FDA to request fluoride infusions be halted, then this petitioner asks that the FDA recommend that industrial fluoride infusions into public water supplies be discontinued or at the very least reduced. In addition to the massive volume of information contained in this petition that proves the need for this request, additional important reasons for this are described below:

    1) Nutritionists have found that most people need to consume approximately 4 liters of water daily to maintain optimal hydration and health, which is double the level previously thought to be required (see attached supplement). Studies also demonstrated that increasing water consumption to this level can aid in weight reduction. (It is not known if this is because water may be replacing high calorie beverages, or if it is a direct effect of improved metabolism associated with proper hydration). These findings have profound consequences for the program called “water fluoridation.” The currently employed fluoride level recommended not to be exceeded by Health and Human Services is 0.7 ppm fluoride in treated water supplies in the U.S. This level was set based on the assumption that 2 liters of water on average are consumed daily by adults. This consumption volume also was used by the EPA to determine the important secondary maximum contaminant level SMCL for fluoride contaminant in water of 2 ppm. (The SMCL was set to help minimize severe dental fluorosis. 4 ppm was set as the MCL to minimize stage II – III skeletal fluorosis associated with pain or immobility after lifelong consumption of fluoride). Increasing water consumption by a factor of two, as now recommended by nutritionists, requires that the SMCL and MCL be lowered to 1 ppm and 2 ppm, respectively to avoid these sequelae. To avoid bone weakening (stage I skeletal fluorosis) and significant dental fluorosis, the HHS must now also recommend the level in water not exceed 0.35 ppm instead of the recent provisional suggested level of 0.7 ppm.

    2)Transcripts summarizing a discussion with two dentists that contained 14 pages are attached that were published by the Parkland, WA Tribune at http://www.thenewstribune.com/2013/06/28/2658316/parkland-will-lose-fluoridated.html . Incorrect statements made by fluoridation proponents to force water districts to fluoridate public water supplies are described. A key false claim typically made is that fluoridation is like chlorination and can be thought of as a required “additive” that treats water supplies and does not actually treat humans. But if dental decay did not exist in a population or if a population had false teeth, fluoridation of water would not be conducted. Chlorination on the other hand must be added to sterilize the water to make it potable. It kills organisms that reside in the water before it is consumed. Fluorides are only added into water for the putative effect it has on caries in consumers. Chlorination is not added with the intent to be swallowed by consumers but is a necessary nuisance. Fluoride is intended to be swallowed. According to the U.S. FDA fluoride added into water would be an uncontrolled use of an unapproved drug. Chlorine contaminants in water produced from chlorination are regulated by the EPA, and chlorination is a requirement. Fluoridation is not required, and materials produced in water from fluoridation, including sodium ion, silicic acid, and fluoride ion are not tested at any concentration for safety or effectiveness by any Federal agency. Water is merely prohibited from being consumed by the EPA if fluoride levels exceed the current MCL designed to minimize stage II-II skeletal fluorosis after lifelong consumption.

    3)The small city of Encinitas, CA has been coerced by dental officials to infuse the drug sodium fluoride (Luride) into all public water supplies and the Olivenhain Municipal Water district is set to begin this policy July, 2013. Oral ingestion of Luride requires a prescription. OMWD has not plans to obtain prescriptions and is not listing any side effects of longterm ingestion of Luride and is interfering with the prescription process in Encinitas. A Coast News article states that OMWD has delayed the treatment temporarily which will allow clinicians time to adjust any sodium fluoride Luride prescriptions currently in use. Luride has never been approved by the FDA for ingestion in the U.S. Sodium fluoride topical use that is not to be swallowed is currently FDA approved in dental gels (10,000 ppm) and toothpaste (1,500 ppm). The FDA ruled that sodium fluoride treatment of the public through water supplies is an unapproved drug where dosage cannot be controlled.

    Considering these facts, it is therefore necessary for the FDA to recommend that industrial fluoride infusions into water supplies be halted (or at the very least to not exceed 0.35 ppm). The FDA should recommend that the EPA revise the current SMCL and MCL for natural fluoride to 1 and 2 ppm respectively due to recent recommendations from nutritionists that more water be consumed.

    1) Nutritionists recommend doubling water intake levels by consumers of all ages.
    Recently published guidelines by nutritionists intake that water intake needs are twice as high as previously thought (http://www.utsandiego.com/news/2013/jul/02/water-hydration-sports-drinks/). Men need to drink 4 liters of water daily (about 16 cups) instead of the previously recommended minimum of 2 liters daily (Livestrong.com). Seniors are advised to drink water regularly throughout the day since aging is associated with increased tendency to dehydration (National Institutes of Health). Pregnant women are advised to consume more water than normal to avoid excessive labor contractions according to the American Pregnancy Association. Teens are advised to drink as much water as adults. Teens exercising need water every 20 minutes. Infants need more water than previously thought according to the American Academy of Pediatrics (www.healthychildren.org). Athletes need to drink higher water volumes to avoid muscle cramping and electrolyte loss (Harvard University researchers).

    What is most important however is that any advisory to increase intake of water must state that the water be clean, not loaded with drugs, pollutants, contaminants, or other chemicals. Especially important in the U.S. is the need to recommend using water without added industrial fluoride compounds. The EPA SMCL of 2 ppm fluoride in water was based on the assumption that the average human would consume 2 liters daily, not 4 liters daily. To avoid fluoride overexposure, this means that the SMCL should be thought of as being 1 ppm for all who increase water consumption to levels recommended by nutritionists. Further, the HHS recommendation of January 2011 that water fluoride not exceed 0.7 ppm was also based on the 2 liter consumption assumption. This means that the HHS recommended level should now be no higher than 0.35 ppm fluoride in water for all who follow the new water advisory.

    1. Parkland, Washington halts fluoridation–sparks intense debate (Parkland News Tribune).

    Parkland will lose fluoridated water soon

    Water in Parkland soon will lack a fluoride additive that a local company has been providing customers for 10 years. Board members for Parkland Light & Water voted this month to stop fluoridation, which is used to reduce tooth decay and prevent oral health problems. KARI PLOG; STAFF WRITER
    Published: June 28, 2013 at 10:40 p.m. PDT — Updated: June 28, 2013 at 10:40 p.m. PDT
    114 Comments

    Water in Parkland soon will lack a fluoride additive that a local company has been providing customers for 10 years.

    Board members for Parkland Light & Water, a private cooperative system that serves about 7,500 customers in the unincorporated community south of Tacoma, voted this month to stop fluoridation, which is used to reduce tooth decay and prevent oral health problems.

    The practice will stop after inventory runs out, which general manager Mark Johnson said Friday could be around the end of summer.

    The board was not opposed to fluoridation; the decision was a cost-saving effort, Johnson said.

    “We’re stopping because the process is not cost-effective,” he said.

    An analysis by Parkland Light & Water found it spent about $350,000 to carry out water fluoridation over five years. In that time, Johnson said, an estimated 0.03 percent of the fluoride was consumed by children ages 2 to 14, the target group for fluoride.

    “It doesn’t make sense to use our membership’s money for that kind of return,” he said.

    The decision will primarily affect those from low-income families who don’t have access to dental care, said Mary Jennings, dental director for Parkland’s Lindquist Dental Clinic for Children.

    “It takes away a brick in our safety net,” she said.

    Johnson said he and the board are concerned about low-income families, but he thought it was wasteful to spend $70,000 a year on an ineffective process. Money should instead benefit programs that provide fluoride directly to those who need it, he said.

    That is a difficult goal to achieve, Jennings said.

    “We can’t go into every home like water does,” she said.

    The decision to cease fluoridation came after a contract with the Tacoma-Pierce County Health Department expired in March. The agreement came after the Health Department tried to mandate utilities to fluoridate water in 2002. After lengthy court appeals in 2003, the Washington State Supreme Court sided with the cooperatives.

    By then Parkland Light & Water had entered into a contract that arranged for about $250,000 in infrastructure improvements to accommodate fluoridation. The company would have had to pay back that amount had it terminated the contract, Johnson said.

    Health Department spokeswoman Edie Jeffers said Parkland has been fortunate to receive a critical public health benefit through fluoridation and that the agency is disappointed the practice won’t continue.

    “Fluoridation is one of the most cost-effective ways to enhance oral health,” Jeffers said. “We’re happy they were partners in that for 10 years.”

    The company held public meetings on the issue, Johnson said. No mailers were sent out, he said.

    Pacific Lutheran University, a company member, has about 3,500 students who use the water. The student government passed a resolution urging Parkland Light & Water to continue fluoridation, and many other members, residents and businesses that use the utility sent letters for and against it over several months.

    The Campaign for Dental Health said fluoridated water is available to a growing number of Americans. About 74 percent of homes nationwide are connected to public water systems that receive fluoridated water, according to the organization’s website.

    The group said it is the cheapest way to provide fluoride to communities. The per-person annual cost of fluoride rinse programs is about double the cost of fluoridated water, according to the website.

    Johnson said he doesn’t disagree with the health benefits of fluoridated water, but he thinks there needs to be a more cost-effective, less invasive way to provide it.

    Feedback from members over the years, he said, shows they don’t want fluoride forced on them.

    “(The board members) have to take into account what their members want,” Johnson said.

    Jennings said she doesn’t understand the decision to stop the process.

    “I just want fluoride in the water for everybody,” she said. “I think it’s one of the best ideas we’ve ever had.”

    Kari Plog: 253-597-8682
    kari.plog@thenewstribune.com @KariPlog

    Claims that fluoridation is like chlorination–a necessary water additive, does not treat people but treats water, subject to the EPA not the FDA, and is harmless.
    Steve Slott, D.D.S.: “There is no fluoride treatment of people occurring as a result of water fluoridated at 0.7 ppm. Just as there is no chlorine treatment of people occurring as a result of water chlorination.” Why would anyone think that EPA regulated water additives would be covered as a “treatment”? Medicare is a government sponsored medical assistance program for US citizens at the age considered to be “senior citizens”. It is not a program to pay for water additives. The evidence for the safety and effectiveness of water fluoridation is abundant and clear. It is a shame that the citizens of Parkland will soon be deprived of its proven benefits, presumably due to the unfortunate circumstance of Board members of Parkland Power and Light having fallen prey to antifluoridationist misunderstanding and misinformation such as what you have displayed. Hopefully, those in the healthcare community there will be able to eventually overcome this irrationality and properly educate the Board members on the safety, effectiveness, and importance of water fluoridation for the good of all its constituents.”
    Sauerheber: Fluoridation and chlorination are not related in the slightest. Yes, chlorine does not treat people. But fluoride is added for the purpose of treating teeth in humans. It may be compared to the use of Luride sodium fluoride tablets also swallowed to treat teeth. The latter requires a prescription and yet is not approved by the FDA and is not considered clinically necessary by Medicare.
    First you say fluoridation doesn’t treat people (it treats the water). Now you say it’s effective in prevention of decay. Soaking teeth in 0.7 ppm fluoride water cannot prevent decay. (If it replaced soaking with soda pop, then I would have agreed with your claim). Swallowing fluoride water where fluoride enters the blood and organs of people does not prevent decay, but can cause abnormal enamel formation during teeth growth (not in adults) and bone fluorosis with weakening after lifelong accumulation. Fluoridation affects people, it is ineffective in preventing decay, and it is harmful. That’s what everyone needs to know.
    The EPA relinquished all oversight of water additives decades ago. Additives are chemicals added to treat water for sanitation, not supplements that treat people through ingestion. Read the Federal Register. The EPA regulates contaminants, including fluoride when naturally present or when accidentally spilled into water. EPA does not have jurisdiction to regulate chemicals intentionally infused into water to treat humans. EPA cannot request any such infusion because of the Safe Drinking Water Act (you can contact the Office of Water, U.S. EPA yourself), but does have employees that are unaware of this and advise water chemists on how to fluoride (everyone knows this).
    If only plain water is available, Medicare does nothing to pay for the desire of dentists that insist one must ingest fluoride. This is because fluoride is not a supplement as you have argued. Supplements are taken for metabolic health. If a person was dying of scurvy, Medicare covers treatment with vitamin C to spare him. Medicare will not cover treatment with fluoride if a person has caries, because fluoride lack does not cause caries. Absence of vitamin C however is specifically the cause of scurvy.
    Claim that fluoride ion from natural calcium fluoride or from fluorosilicic acid or sodium fluoride are identical, not just in physical structure, but in biologic action.
    Johnson, D.D.S.: “I challenge you to provide a reference that shows the fluoride ion from natural calcium fluoride is different than the fluoride ion used in water fluoridation. Water Fluoridation is the Gold Standard for delivering fluoride to everyone in a community. All that you have to do to reap its benefits is to drink the water. Fluoridation is Safe, Effective, and Cost Saving. Fluoride. It does our bodies good.”
    Slott: “The fluoride ions which are ingested, whether released from CaF, or from HFA are indistinguishable from one another. If you want to continue to make the argument that they are different from each other, fine with me. I don’t think you will convince many of that idea, though, as a fluoride ion is a fluoride ion is a fluoride ion. There is no differentiation in the behavior of any of the fluoride ions either before or after ingestion, regardless of from which source they were derived. Fluorosilicic acid immediately and completely dissociated into fluoride ions identical to those fluoride ions already existing in groundwater, and trace contaminants in barely detectable concentrations so miniscule as to pose no risk whatsoever of adverse biological effect. A miniscule few parts per million of fluoride ions indistinguishable from those already existing in water. That’s it. Fluoride added to drinking water at 0.7 ppm is not a drug. It is simply a mineral identical to that which already exists in water, which the FDA must classify as a drug due solely to its stated purpose as a therapeutic rather than as a disinfectant. As the EPA, not the FDA, controls and regulates mineral additives to water, it is the EPA, not the FDA that controls and regulates fluoride additives at the optimal level. As such, there is neither a requirement nor a need for FDA approval of use of fluoride water additives at 0.7 ppm. The FDA has no jurisdiction over any such mineral additives to water. There is no “fluoride treatment of people” occurring as a result of water fluoridated at 0.7 ppm. just as there is no “chlorine treatment of people” occurring as a result of water chlorination. Thus it would be as ridiculous to expect Medicare to cover water fluoridation as it would be to expect it to cover water chlorination.”
    Sauerheber: There is no publication that could ever prove that a fluoride ion in one compound is not identical to that in another compound. Everyone knows they are structurally identical. So you again misunderstand like Steve does. It’s not the identical structure to which I refer but the difference in function, the activity of the ion always being determined by the electrostatic forces from the ions that coexist in the solution. For that there are references, such as any Physical Chemistry text. Calcium does not eliminate absorption, it reduces it commonly around 4 fold over the varying degrees of hardness in U.S. water supplies. Those who develop significant fluorosis on calcium fluoride water do so only when the level of fluoride is correspondingly higher, above 2 ppm, than that for industrial fluoride in soft water. which occurs even below 1 ppm, because calcium minimizes uptake. Ingesting 25 grams of industrial fluoride causes the same stage of bone fluorosis as 120 grams of natural fluoride.
    Eating fluoride all day won’t decrease dental caries. It has no human function and can’t possibly “do a body good.” There is no scientific agency in the world that claims systemic fluoride helps the body. This country wastes billions yearly on infusions that do nothing of the sort. I didn’t say there is a conspiracy. It’s simply people believing something that is actually false. Fluoridated bone breaks easier than normal bone. When you try to rehab and die of pneumonia is it not the fault of the fluoride? Thinking otherwise is a gross lack of understanding,
    Cite the Kumar study? If we look at the children say the 13 year olds after most all teeth have probably finally erupted, even for the children exposed to fluoride that delays teeth eruption, notice the typical result. The decay rate values chosen for low fluoride vs. high fluoride were:
    1.58 ± 2.13 (0.3 ppm fluoride) vs. 1.18 ± 1.89 (0.7 ppm fluoride). There is not a rat’s chance I would refer to an article containing data interpreted like this, as a “19 % decay reduction”. I’m a trained scientist, not a propagandist with pipedreams. I would never make a claim that two means were significantly different, unless the standard deviations do NOT overlap—period.

    Claims of absence of harm.
    Slott: “Dental fluorosis is simply not an issue of concern with fluoridated water, in spite of the best efforts of you and other such unqualified antifluoridationists to make it so. I’m telling you that mild dental fluorosis is not an adverse condition.”
    Sauerheber: Detectable fluorosis is abnormal at any level and it is a condition because it is abnormal no matter how mild. This is old news, known since 1943 as published in the Journal of the American Medical Association (Sept 18,1943) stating abnormal enamel hypoplasia labeled mottling occurs at 1 ppm fluoride in water.
    Webster’s Dictionary knows what it is and I quote: “fluorosis is a condition caused by excessive exposure to fluorine and marked by mottling of the teeth and damage to the bone” (College Dictionary, 2nd edition, 2005).
    Enamel hypolasia induced by fluoride ingestion is not a desirable goal for any dentist
    the claim that bone incorporation of fluoride that always accompanies enamel fluorosis is acceptable is an opinion, it is not a fact. Dentists are not quailfied or authorized to provide health information that only an internist can legally offer. Sutton demonstrated clearly that the calcium level in Newburgh is 300% higher than the city used as a control, Kingston, NY. This is the very reason the bone cortical defects observed in fluoridated Newburgh children were not more extensive than they were. And the reason that fluorosis was not more extensive than it was.

    Slott and Jimmy Johnson, D.D.S:. “I do not believe there is any valid scientific reason for fearing adverse health conditions from the consumption of water fluoridated at the optimal level.” . . John Doull PhD
    Sauerheber: Doull provides no explanation for his viewpoint that fluoride accumulation into bone in an irreversible pathologic manner is somehow fully acceptable to him. The FDA ruled that fluoride does not strengthen bone after experimental data became available from NIH investigators. Claims from fluoridationists that fluoride in bone somehow “strengthens” bone were false. He did not explain why he views that it is acceptable or even “normal” to have unsightly enamel fluorosis hypoplasia due to systemic blood fluoride from allowed levels in water. He makes no statement about fluoride from other ingested sources–only fluoride from water. So the claim of absence of any adverse condition is an ideal theoretic only because multiple sources exist for fluoride. Moreover, in today’s very newspaper nutritionists are now strongly recommending at least 4 liters of water be consumed daily, not 2. The Doull statement was based on 2 and does not apply to any consumer who follows the new recommendation.
    Tooth fluorosis is an abnormal condition so the statement is blatantly false regardless. Neither Doull nor anyone else can change the definition of enamel fluorosis to be somehow not abnormal.
    So bone alterations due to fluoride-induced micro-canals of osteoclastic action are of little concern to you or Doull. But I am on a very different wavelength because it is a definite problem for victims of fibromyalgia, osteoporosis, and osteomalacia.
    The Doull statement is incredibly weak and a simplistic summary of the issue. Fluoride ingestion is always accompanied with uptake into bone by ion exchange, the extent determined by water hardness since calcium inhibits fluoride assimilation. That is a pathologic effect and osteoblasts are stimulated unaturally as a result of the insult. Doull has no right to claim that no adverse health condition results as though this is the case for all persons, even those with bone disease such as osteoporosis, osteomalacia, or other metabolic bone disease with abnormal PTH and calcitonin with abnormal osteoclast and osteoblast activity already. He cannot claim that patients lacking kidneys have no adverse effects from optimal fluoride. In fact the statement is of very little clinical use.
    Blood electrolytes can remain normal at “optimal fluoride” levels in water except for the fact that fluoride is not a blood electrolyte– it is a contaminant ion. Calcium levels can remain normal but only at the expense of activated mechanisms to maintain it, including alterations in microstructure of bone and activity of PTH. Doull proclaims by inference that since electrolytes are within normal ranges, that there are no adverse health consequences of optimal fluoride ingestion. Nonsense. He fails to appreciate the work required by organ systems to achieve this normality in the face of dilute fluoride poisoning of the bloodstream.
    Your sweeping proclamation that claims that all stomach cancers in the U.S. and all ulcers in the U.S. have no relationship whatsoever to the HF bathing the mucosa in fluoridated cities is pure fantasy with zero data to back it up. Words have consequences. Millions are now continuing to accumulate bone fluoride even though heart disease is our nation’s number one lethal disease entity. So you as promoting advertisers for your cause are responsible for determining answers to questions that have not been answered, while bone fluoride accumulates, and our elderly are perishing from hip fractures that won’t heal. Who are you to proclaim that these deaths are NOT related whatsoever to the fluoride accumulated into their bone? You are claiming that fluoride somehow magically hides and exerts absolutely zero pathology in anyone during its accumulation. Wow. Where precisely then does the fluoride incorporate– is it in only the spongy bone anatomic regions where the bony trabeculae are interspersed with marrow? Or does it accumulate instead into compact bone that is not as readily exchangeable with plasma calcium for heart function maintenance? No one has answers to these questions, but suddenly you guys are taking full responsibility by providing medical advice online by claiming fluoride ingestion has zero side effects. You are responsible for providing those answers, otherwise that’s what snake oil salesmen do–all talk, no answers or consideration of detail. No one has any right to proclaim that morbidity from bone disease and bone weakness is unaffected by the fluoride that has accumulated inside them, typically now to 5,000 mg/kg in U.S. citizens after lifetime fluoridation.
    Drinking fluoride water for decades in most people produces nothing visibly obvious other than enamel hypoplasia, so when you eventually die it is assumed it had to be from something else–never related at all to the fluoride that you accumulated during lifelong consumption of treated water supplies. It’s as illogical and magical a claim as that made in Bryson–it is baseless. Clinical trials lacking
    Stoll: “It is impossible to provide the “double blind random testing” for which antifluoridationists are so fond of requesting. There are far too many variables which cannot be controlled to obtain any valid results from this type testing. Thus, we are left to the next best form of testing of such an initiative, which is observational. Just tell me how many pages you would like me to fill with peer-reviewed observational studies demonstrating the effectiveness of water fluoridation and I will be glad to accommodate. Water fluoridation is a public health initiative. As with all public initiatives its effectiveness is measured on the population as a whole. Whether the effect is topical, systemic, or any combination of the two, is irrelevant. Studies have shown that the constant exposure of the teeth to low concentrations of fluoride all during the day is a very effective means of enhancing the teeth to be more resistant to decay. Fluoridating the water supplies is the most effective and inexpensive means of providing this constant exposure. No matter how much effect comes from the saliva or how much from strictly topical, there is no more more effective means of getting this protection to the entire population.”
    Sauerheber: I’m talking about controlled clinical trials as with any drug–with volunteers– so confounding variables are controlled such as how much sugar one eats, how much toothpaste one uses. And yes since it hasn’t been done, non one can claim that effectiveness from ingested fluoride has been somehow “proven”.
    No one yet knows its distribution between spongy bone with trabeculae and some marrow vs. compact bone but it is pathologic, not physiologic in spite of an extrapolation one would make from the Doull claim of “zero adversity”. 1) Flier sent to the Olivenhain Municipal Water District
    PUBLIC NOTICE TO ALL WATER CUSTOMERS [http://www.illustrationsof.com/royalty-free-patriotic-clipart-illustration-97975.jpg] [http://www.hellasmultimedia.com/webimages/patriotic/images/eagle222.jpg]
    Olivenhain Municipal Water District has scheduled to add sodium fluoride into all of its public water supply beginning July 1 in an attempt to treat dental caries through ingestion. Dental chemicals are not to be swallowed (this is useless and harmful). Do not give up rights to access plain water without this added diluted insecticide that causes bone fluorosis long-term. Sodium fluoride is the active ingredient in the drug Luride®, at one time thought to affect dental caries in children systemically (Physician’s Desk Reference, 48th ed., 1994 p. 839). Luride® is NOT FDA approved for ingestion in the U.S. and is only allowed by the FDA to be used by prescription only. The prescription states it is not to be used by children if water fluoride exceeds 0.3 ppm, which is now the approximate fluoride level in OMWD water. The Safe Drinking Water Act does not allow any drug, supplement, food, mineral nutrient, or pollutant to be added into public water other than to sanitize the water. Sodium fluoride is added by OMWD to treat humans. The CA Dept. of Public Health requested ‘fluoride’ be added into water based on a 1976 law that was unaware of its side effects particularly in soft water and that ingested fluoride yields useless 0.02 ppm in saliva and greater than 0.2 ppm in blood where it does not belong (1-5). The law does not mention the starting chemical to be used to supply the fluoride ion. OMWD has chosen to use the most soluble fluoride of all, as in Luride®. Its addition violates Federal water law, does not reduce caries through ingestion, causes bone fluorosis long-term, abnormal enamel fluorosis in many children, and requires funds to cover costs. In Escondido, fluoridated since 2005, ratepayers are now charged in water bills for the drug infusions. OMWD funds are insufficient for it— you’re to be charged in your bill.
    To help delay or prevent this corruption of our drinking water contact OMWD Board and staff. Let them know that rubber-stamping a political policy is not good enough and that they should perform due diligence with public participation. http://www.OMWD.com/ or telephone 760-753-6466. Many drink fluoridated water by intimidation. Encinitas knows better.
    1. National Research Council, Fluoride in Drinking Water, Washington, D.C., 2006. 2. Connett, P. et al. The Case Against Fluoride, 2010
    3. R. Sauerheber, Physiologic conditions affect the toxicity of ingested industrial fluoride, Journal of Environmental and Public Health, 2013 At: http://www.hindaawi.com/journal/jeph/2013/439490/ 4. www.fluoridealert.org http://omwdbreach.wordpress.com/

    39.
    July 19, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346. On the other hand, natural calcium fluoride in some water supplies is of course a recognized contaminant regulated by the U.S. Environmental Protection Agency.
    Enclosed please find, as a privileged communication now being considered for publication, the article On Racehorse Breakdowns and Artificially Fluoridated Water in Los Angeles, an Editorial which is an invited editorial for the journal Fluoride. This represents many years of work. It appears that fluorosilicic acid infusions into public water supplies can be associated under certain conditions with increased incidence of fatal breakdowns in racehorses, up from 0.5% of racing starts to 1.0% after artificially fluoridated water began over the entire Los Angeles basin in 2007. The details of the observations, being currently under review for publication, are submitted here for FDA reviewers only and indicate that increased fatalities amounted to 108 horses in one season at Los Alamitos and 58 horses in the shorter season at Hollywood Park (see http://www.chrb.ca.gov/annual_reports.html, 2005-2012). Hollywood Park sadly is now closing its doors after 50 years of honorable racing.
    It is apparent that chronic consumption of industrial fluoridated water supplies (30 gallons daily) by racehorses when housed without regular access to pasture for grazing may be responsible for the increased breakdown rate (personal communications). Assimilation of fluoride and silicic acid under those conditions is substantial enough that elimination by kidney filtration is unable to prevent pathology. (Pasture grazing while drinking water lowers fluoride assimilation by calcium sequestration). Likely the most serious outcome is that HF in the acidic horse stomach could aggravate ulcers that are common in racehorses (see attached article). Any heartburn pain during a race is a lethal outcome if the horse mis-steps and breaks a bone and is then euthanized (see article).
    It is possible that Los Alamitos with its similar breakdown incidence rate, the highest in the Nation, will also close. Although the city of Del Mar, CA is soon to be “fluoridated,” the problem at the Del Mar track, although a concern, should be less severe because horses are not stabled there for long periods. Most horses racing there reside on pasture lands usually with well water (as in Kentucky and other popular racing venues). But recent newspaper announcements indicate that the Del Mar track is considering seeking an exemption from CA State Fairground rules to begin stabling horses long-term to accommodate horses from the closed-down Hollywood Park.
    This is a serious problem. And it can be remedied easily by the FDA. It will not be “solved” by: stopping horse racing unless pasture land is nearby, or requiring owners to haul all drinking water to racetracks, or prohibiting long-term stabling at racetracks, or halting construction of stables for long-term housing with municipal water. It can only be solved properly by halting the infusion of all industrial toxic calcium chelator fluorides into public water supplies in the U.S. that were never intended for ingestion by horses. Horse teeth enamel is covered with a layer of organic cementum and fluoride treatment of horse teeth is never done.
    Some argue that the above analysis is ambiguous from “circumstantial evidence,” but diet and housing conditions are strictly controlled for all these carefully-cared-for, age-matched horses. These data are more reliable than observations in 1945 on Newburgh, NY fluoridated water consumers of all ages with diets that could not be controlled. U.S. Health and Human Services on their website still cites this prematurely-terminated study with sodium fluoride as evidence to continue “water fluoridation” with fluorosilicic acid today. It is disturbing that those promoting water fluoride infusions still claim the 1945 observations, without knowing the intrinsic caries incidence before fluoridation started, are somehow “definitive” — while also claiming that observations for a 7-year period of over 100,000 racing starts with diet-controlled animals is somehow “ambiguous.” All horses examined were within strict racing age (2-6 years old) in prime condition and in the prime of their lives.
    Please understand the science. It is not possible to denounce these controlled racehorse observations pointing to halt fluoride water infusions unless one first denounces the study of uncontrolled consumers in Newburgh used to support fluoridation. It is certainly logical though to avoid the weaker Newburgh observations used to set fluoridation policy for the U.S. Public Health Service in 1950, while considering the long-term data reported here that points to ending mass water fluoridation policy. The Newburgh study attempted to use Kingston, NY as a “control” but caries incidence there declined in 6 year olds substantially during the observations and that city had 5 times less calcium in the water than Newburgh. The horse data here avoid invented controls from another region and rely on intrinsic breakdown incidence before and after water from the same source was artificially fluoridated. The 1945 data were used in an attempt to promote artificial fluoridated water in the interest of fighting dental caries. The trials were thoroughly discredited (see the three volume set of textbooks by the dental statistician Sutton, P., Fluoridation: Scientific Criticisms and Fluoride Dangers, 1980, Fluoridation : Errors and Omissions in Experimental Trials, 1959, and The Greatest Fraud: Fluoridation, 1996, Kurunda Pty. Ltd., Lorne, Australia). Data presented in the attached article confirm the need to halt industrial fluoride treatment of water supplies in the interest of animal welfare. A key mission of the FDA is indeed to regulate the use of veterinary drugs and supplements.
    The EPA regulates the water contaminant calcium fluoride of low toxicity found naturally in some waters, but will not and cannot be expected to regulate safety and effectiveness of intentionally added fluoride compounds used to treat humans (see previous letter from the Office of Drinking Water, U.S. EPA). Meanwhile, the FDA does not regulate the presence of natural calcium fluoride in water, but is in charge of regulating all supplements and drugs intended for ingestion in the U.S. to treat human and animal conditions. This includes fluorosilicic acid and sodium fluoride artificially added into water to be taken internally by consumers to elevate fluoride in blood as a presumed treatment of dental caries.
    We humbly ask the FDA to clarify that: 1) public water supplies containing natural calcium fluoride contamination are exclusively regulated by the U.S. Environmental Protection Agency; 2) the ingestion of fluoride from any synthetic compound has never been FDA approved (including from artificially treated water); and 3) the FDA recommends that fluorosilicic acid and sodium fluoride infusions into general public water supplies be halted (or preferably banned if possible).
    Again, the FDA has never approved the ingestion of fluoride supplements including artificial fluorides added into public water supplies intentionally to treat humans. But fluoride present naturally in water is of course not under the purview of the FDA. An FDA recommendation would clarify this once and for all. Thank you again
    .

    p.s. We were recently informed by Freedom of Information Act request that the sodium fluoride based material to be infused into Encinitas, CA beginning next week (in spite of citizen requests to retain plain water Encinitas has always had) is being purchased by the Olivenhain Municipal Water District from China. It has not undergone proper certification required by Standard 60 and of course more importantly as for the rest of the country no fluoride compound is FDA approved for ingestion in the U.S.

    40.
    September 4, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346.
    NSF argument and response. The National Sanitation Foundation International (NSF) certifies the industrial byproduct known as fluorosilicic acid as being consistent with its Standard 60 regulations for use in public drinking water. NSF publicly formally lists itself as a Public Health and Safety Organization. Their official Product and Service Listings, September 4, 2013 specifically label fluorosilicic acid H2SiF6 as an “NSF/ANSI 60 Drinking Water Treatment Chemical” with a maximum use of 6 mg/L (6 ppm).
    As previously noted, 6 ppm H2SiF6 at 19% by mass fluoride produces 1.5 ppm fluoride in water at this level of treatment. 1.5 ppm is 75% of the U.S. Environmental Protection Agency SMCL of 2 ppm and 38% of the EPA MCL of 4 ppm for the fluoride contaminant in public drinking water. This violates NSF’s own Standard 60 regulations that require the final product concentration to not exceed 10% of the allowed contaminant levels published by the EPA. The NSF website URL for this listing is available at:
    http://info.nsf.org/Certified/PwsChemicals/Listings.asp?CompanyName=&TradeName=&ChemicalName=Fluorosilicic+Acid&ProductFunction=Fluoridation&PlantState=&PlantCountry=UNITED+STATES&PlantRegion=
    Furthermore, no clinical trials data for safety or effectiveness of ingested fluorosilicic acid are held or known to NSF International. NSF claims zero responsibility to obtain or provide such data for the use of this substance to be consumed through public drinking water (see NSF publication submitted previously to FDA). The reason the material is labeled a “water treatment chemical” is to avoid the fact that the chemical is added to treat humans for caries reduction purposes as an oral ingestible. Detailed discussions with more than three pro-fluoridation dentists on public news sites reveal their claim that fluoridation of water supplies “cannot harm anyone and has never harmed anyone” because it merely “treats the water, not the people who consume it.” Thus any harm that may have been reported cannnot possibly by definition be due to fluoridation itself because fluoridation only “treats water, not people.” This of course avoids liability on the part of the NSF in describing its use this way rather than as a supplement or drug, or drug-like substance which would invite scrutiny by the U.S. FDA.
    Understand that the only reason to fluoridate water is to elevate the blood level of fluoride to target levels of 0.2 ppm from 0.7 ppm treated water to treat dental caries (see original petition court testimony under oath from David Nelson, CA Dept. of Public Health). The fluoride added into water intended to elevate the blood level in consumers necessitates that it be considered either a drug, a supplement, or a drug-like substance. The U.S. Pharmacopia lists fluoride added into water as a drug. The FDA ruled fluoride added into water is an uncontrolled use of an unapproved drug (see petition). In 1966 the FDA banned the sale of fluoride intended to be ingested by pregnant women in the U.S. because of lack of effectiveness in the newborn.
    FDA Pregnancy Category Rating. The FDA classification scheme clearly described by M. Adams and L. Holland in Pharmacology for Nurses, A Pathophysiologic Approach (Pearson Publishing, Boston, MA, 2011, p. 66) indicates that fluoride added into water intended to be consumed by pregnant women is an FDA Pregnancy Category Rating X. This means that fluoride added into water to treat pregnant women who consume the water has controlled or observational studies in animals providing evidence of fetal abnormality or risk. And there is no indication for its use in pregnancy. Detailed studies demonstrate harm to offspring in mammals exposed to blood fluoride levels typical in humans in 1 ppm fluoridated regions, particularly to various regions of the brain (Mullenix; Redi; Varner and others, see petition letters, JEPH 43940, and Connett, The Case Against Fluoride).
    Generic/Trade Names. Sodium fluoride (where the fluoride free ion is structurally identical from sodium fluoride or fluorosilicic acid as the active anti-caries ingredient through oral ingestion) is marketed with several generic and trade name titles world-wide under two therapeutic categories, Caries Prophylaxis (ingestible) or Mineral Supplement (ingestible) as listed at www.Drugs.com (see the Walgreen’s description at http://www.drugs.com/international/sodium-fluoride.html). Indeed it is proper to label industrial fluoride, when intentionally ingested to achieve a therapeutic concentration, as either a drug or a drug-like substance. Therefore the ingestion of added fluoride is subject to FDA approval. It is improper labeling by NSF to claim fluoride added into water is merely a “water treatment chemical” that is not a drug or drug-like substance. Also the casual label used by the U.S. CDC and others that it is a “supplement” is improper because fluoride is not a normal constituent of the human bloodstream (JEPH 439490). No fluoride compound has been approved for ingestion by the U.S. FDA.
    Miniscule Therapeutic Range. Finally, the blood level of fluoride exhibits an unusually small therapeutic range since the targeted level perceived to be therapeutic, 0.21 ppm, is a significant percentage of the lethal concentration LD50 of 3 ppm in blood (Journal of Environmental and Public Health, 2013 available online at : JEPH 439490, see previous letter submitted to FDA). The clinically-recognized Therapeutic Index, traditionally acceptable when larger than 100, is unacceptably small. Using known blood fluoride measurements in humans, the Index is a mere 15 ! This is computed by dividing the median lethal dose LD50 of 3 ppm in blood by the presumed median effective dose ED50 of 0.2 ppm. The index is even smaller for patients who lack kidneys and require hemodialysis (JEPH 439490).
    Conclusion. The above facts taken together indicate that it is imperative that the FDA either:
    1) ban the infusion of industrial fluoride compounds into public drinking waters in the U.S. since it is being used as a drug-like substance without clinical trials data proving effectiveness and safety;
    2) or formally declare lack of support for the use of fluoride compounds as oral ingestible dental prophylactics since ingested industrial fluoride used as an intended therapeutic substance requires adequate well-controlled human clinical trials data submitted to the FDA for attempted approval for ingestion in the United States.

    Clarifications. As you know this petitioner holds the view that the best description of ingested industrial fluoride is a toxic calcium chelator that is not an ingredient in living organisms but is a contaminant poisonous substance at any concentration no matter how dilute. Ingested fluoride exerts zero therapeutic action including a complete lack of effect on dental caries (Sutton; Ziegelbecker; Yiamouyiannis; Teotia and Teotia; Hilemann among other detailed data analyses as previously provided to the FDA).
    The reason that the FDA is contacted with this petition is because unnatural industrial fluoride lacking protective calcium is being used as an “oral ingestible agent” with perceived therapeutic effect. This interpretation of course is based on anecdotal inaccurate correlations, not adequate clinical trials, that convinced the Oral Health Division of the CDC and former U.S. Surgeons General to promote the ingestion of industrial fluoride and water districts/fluoride promoters to believe it is a therapeutic substance. The previous decision by the FDA in 2010 on this petition, that the EPA needs to regulate the infusions, was based on the fact that indeed fluoride has no proven therapeutic benefit and is a contaminant in water and not a mineral nutrient. The fact however is that the EPA will not regulate the infusions because 1) they are intentional and at low enough levels that serious acute harm does not occur (in the absence of overfeeds) and chronic effects do not occur quickly and 2) fluoride is being added for perceived therapeutic benefit. This forces the FDA to become directly involved because the toxic chelator is being used as though it has therapeutic benefit based on studies that have supplanted and have prevented true clinical trials. Widely held perceptions are that added industrial fluoride is not actually a drug requiring FDA oversight and is merely a substance that when ingested has therapeutic benefit. The fact that it is being used as a therapy requires FDA action regardless of its labels as either a drug-like substance, therapeutic agent/supplement, ingestible water treatment chemical, contaminant/pollutant, toxic calcium chelator, or any other descriptor that suggests is it an ingestible substance. EPA will not become involved since the added level is below the serious 4 ppm MCL for natural calcium fluoride designed to protect against severe bone fluorosis and the 2 ppm SMCL designed to minimize but not eliminate severe dental abnormal fluorosis. Infusing industrial fluoride without antidote calcium for perceived therapeutic benefit is a completely different matter and requires FDA regulation.
    Citizens across the country are becoming increasingly informed about ingested industrial fluoride used for perceived therapeutic benefit. Portland, Oregon citizens last month voted for the fourth time against the infusions and the city remains non-fluoridated. Wichita, Kansas, Albuquerque, New Mexico and Parkland, Washington all halted fluoridation because of ineffectiveness as a therapeutic and because of undue expense.

    Attachment– Walgreen’s Drugs.com listing for sodium fluoride: Scheme

    USP

    ATC (Anatomical Therapeutic Chemical Classification)

    A01AA01,A12CD01

    CAS registry number (Chemical Abstracts Service)

    0007681-49-4

    Chemical Formula

    Na-F

    Therapeutic Categories

    Caries prophylaxis

    Mineral supplement[http://images.intellitxt.com/ast/adTypes/icon1.png]

    Chemical Name

    Sodium fluoride (NaF)

    Generic Names
    Sodium Fluoride (OS: USAN, JAN)
    · Natrii fluoridum (PH: Ph. Eur. 7, Ph. Int. 4)
    · Natriumfluorid (PH: Ph. Eur. 7)
    · Sodium (fluorure de) (PH: Ph. Eur. 7)
    · Sodium Fluoride (PH: BP 2010, Ph. Int. 4, USP 34)
    · Sodium fluoride (PH: Ph. Eur. 7)
    Brand Names
    · Arthrofluor Teva, Hungary
    · Bifluorid 12 (Sodium Fluoride and Calcium[http://images.intellitxt.com/ast/adTypes/icon1.png] Fluoride) Voco, Poland
    · Bifluorid (Sodium Fluoride and Calcium Fluoride) Meda, Sweden; Voco, Denmark; Voco, France
    · Buclorhex (Sodium Fluoride and Chlorhexidine) Sertex, Argentina
    · Butler Fluodent Foam N Sunstar, Japan
    · Caristop Diario Maver, Chile
    · Caristop Semanal Maver, Chile
    · Caristop Maver, Chile
    · CISNaf Cis Bio International, France
    · Dentan Meda, Sweden
    · Dentasep-F (Sodium Fluoride and Chlorhexidine) Stedman, India
    · Dentifluor Dentoral, Turkey
    · Dentirol Fluor
    Dentirol Medical[http://images.intellitxt.com/ast/adTypes/icon1.png], Sweden
    · D-Flor (Sodium Fluoride and Colecalciferol) Berko, Turkey
    · D-Fluoretten (Sodium Fluoride and Colecalciferol) Sanofi-Aventis, Germany
    · Diadent Showa Yakuhin Kako, Japan
    · Duraphat
    Colgate, Greece; Colgate Palmolive A/S, Norway; Colgate-Palmolive, Austria; Colgate-Palmolive, Switzerland; Colgate-Palmolive, Germany; Colgate-Palmolive, Denmark; Colgate-Palmolive, Finland[http://images.intellitxt.com/ast/adTypes/icon1.png]; Colgate-Palmolive, Georgia; Colgate-Palmolive, Iceland; CSP, France; CTS, Israel; Gaba Vebas, Italy
    · Duraphat Fluorid Colgate-Palmolive, Switzerland
    · Fludent Actavis, Finland; Actavis, Iceland; Actavis, Sweden
    · Fluocaril Bifluore (Sodium Fluoride and Sodium Monofluorophosphate) Sanofi-Synthelabo, Taiwan
    · Fluocaril Sanofi-Synthelabo, Greece
    · Fluocaril (Sodium Fluoride and Sodium Monofluorophosphate) Sanofi-Aventis, Belgium
    · Fluocaril bi-fluoré (Sodium Fluoride and Sodium Monofluorophosphate)
    Procter & Gamble[http://images.intellitxt.com/ast/adTypes/icon1.png], France; Teriak, Tunisia · Fluoden A Sunstar, Japan
    · Fluodontyl Procter & Gamble, France; Vicks, Spain
    · Fluonatril Belupo, Croatia (Hrvatska)
    · Fluor Kin Kin, Spain
    · Fluor Lacer Lacer, Spain
    · Fluor Vigantoletten (Sodium Fluoride and Colecalciferol) Merck KGaA, Romania
    · Fluor SMB, Belgium
    · Fluor-a-Day
    Dental[http://images.intellitxt.com/ast/adTypes/icon1.png], United Kingdom; PendoPharm, Canada · Fluordent Bernabo, Argentina
    · Fluorette Fertin, Norway; Meda, Sweden
    · Fluorette Novum Meda, Sweden
    · Fluoretten Sanofi-Aventis, Germany
    · Fluorex Crinex, France
    · Fluoricare Otto, Indonesia
    · Fluoride PSM, New Zealand
    · Fluorigard Colgate-Palmolive, United Kingdom
    · Fluorilette Leiras, Finland
    · Fluorin Panacea, Bulgaria
    · Fluorogal Galenika, Serbia
    · Fluorogel Naf, Argentina
    · Fluorolex Fertin Pharma, Denmark
    · Fluor-Vigantoletten (Sodium Fluoride and Colecalciferol) Merck Serono, Germany
    · Fluossen
    ICN, Czech Republic[http://images.intellitxt.com/ast/adTypes/icon1.png]
    · Fluostérol (Sodium Fluoride and Colecalciferol) Crinex, France
    · Fluotrat Biolab, Brazil
    · Flurodeks Grindeks, Latvia
    · Flux Actavis, Norway
    · NAF
    Bosnalijek, Bosnia & Herzegowina; Bosnalijek, Georgia; Naf, Argentina
    · Natrium Fluoratum Slovakofarma Zentiva, Czech Republic; Zentiva, Slovakia
    · Natriumfluorid Baer Baer, Luxembourg; Südmedica, Germany
    · Natriumfluoride PCH Pharmachemie, Netherlands
    · Nitra-OR (Sodium Fluoride and Potassium Nitrate) Micro Eros, India
    · Oligosol Fluor Labcatal, France
    · Oligostim Fluor Boiron, France
    · Ora Bliss Showa Yakuhin Kako, Japan
    · Ossin Grünenthal, Lithuania
    · Otoflur (Sodium Fluoride and Calcium Gluconate[http://images.intellitxt.com/ast/adTypes/icon1.png]) SIT, Italy
    · Paradontax Flúor (Sodium Fluoride and Sodium Bicarbonate) GlaxoSmithKline, Peru
    · Paro Fluor Esro, Switzerland
    · Sanoformin Domesco (Sodium Fluoride and Copper Sulphate) Domesco, Vietnam
    · Sanoformine (Sodium Fluoride and Copper Sulphate) Mayoly Spindler, Vietnam
    · Sanogyl Rogé-Cavaillès, France
    · Scodyl Hua Shin, Taiwan
    · Senquel-AD (Sodium Fluoride and Potassium Nitrate) Dr. Reddy’s, India
    · Sensodyne GlaxoSmithKline, Austria
    · Sensodyne (Sodium Fluoride and Potassium Nitrate) GlaxoSmithKline, Canada
    · Sensodyne Fluorid
    GSK Consumer Healthcare[http://images.intellitxt.com/ast/adTypes/icon1.png], Switzerland
    · Sensodyne ProNamel (Sodium Fluoride and Potassium Nitrate) GlaxoSmithKline, Canada
    · Sensodyne ProNamel for Children (pediatric[http://images.intellitxt.com/ast/adTypes/icon1.png]) GlaxoSmithKline, Canada
    · Sensodyne Proschmelz GlaxoSmithKline Consumer Healthcare, Germany
    · Sensodyne-F (Sodium Fluoride and Potassium Nitrate) GlaxoSmithKline Consumer Healthcare, Canada
    · Sodium Fluoride Agusa Nippon Agusa Nippon, Japan
    · Sodium Fluoride Chewable GPO GPO, Thailand
    · Sodium Fluoride Neo Dental Seiyaku Neo Dental Chemical, Japan
    · Sodium Fluoride Sunstar Sunstar, Japan
    · T.A.C. Grimberg, Argentina
    · Teeth-Tough Vitamed, Israel
    · Top Dent fluor Meda, Sweden
    · Vinafluor Nicholas, Indonesia
    · Xerodent Actavis, Finland; Actavis, Iceland; Actavis, Norway; Actavis, Sweden · Z Fluor
    Novartis Consumer Health[http://images.intellitxt.com/ast/adTypes/icon1.png], Belgium
    · Zymaduo (Sodium Fluoride and Colecalciferol) Novartis Santé Familiale, France
    · Zymafluor Bb Farma BB Farma, Italy
    · Zymafluor Farma 1000 Farma 1000, Italy
    · Zymafluor Porgrammi Sanitari Programmi Sanitari int., Italy
    · Zymafluor
    Novartis, Bulgaria; Novartis, Czech Republic; Novartis, Oman; Novartis, Poland; Novartis, Portugal; Novartis, Romania; Novartis, Thailand; Novartis, Turkey; Novartis Consumer Health, Austria; Novartis Consumer Health, Switzerland; Novartis Consumer Health, Hungary; Novartis Consumer Health, Italy; Novartis Consumer Health, Netherlands; Novartis Consumer Health, South Africa; Novartis Santé Familiale, France; Zymal Laboratory Inc., Taiwan

    41.
    July 19, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This note supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346. On the other hand, natural calcium fluoride in some water supplies is of course a recognized contaminant regulated by the U.S. Environmental Protection Agency.

    We now have published studies of skeletal fluorosis diagnosed on X-ray examination by expert diagnosticians as a function of prevailing blood free fluoride ion concentrations over a wide range. It is possible to provide a reasonably accurate estimate of the number of American citizens expected to exhibit significant bone fluorosis, chiefly as a result of the consumption of fluoridated water. A detailed analysis is enclosed.

    To summarize the findings quickly, a study supported by the NIH claims no particular concern exists for serum levels of free fluoride ion below 0.03 ppm. Other published detailed data indicate that serum free fluoride ion levels above 0.04 ppm correlate strongly with progressively increasing incidence of significant bone fluorosis.

    The known blood total fluoride range in the U.S. from 0.2 – 0.5 ppm (Teitz,1976) produces a serum free fluoride ion level range of 0.02 – 0.08 ppm (where 85% of total fluoride is bound to blood proteins). An estimated 40% incidence of fluorosis occurs in that 34% of the U.S. population having blood free fluoride ion between 0.04 and 0.08 ppm. This is also consistent with the known fact that 41% of all U.S. teens aged 12-15 have significant tooth enamel hypoplasia fluorosis which is permanent and abnormal.

    Thus it may be said that as a conservative estimate, 14% of the U.S. population is expected to have progressively worsening bone fluorosis, particularly while continuing to consume fluoridated water supplies.

    It is hoped that this will assist the FDA in its determination of the status of this petition. A public statement by the FDA should be made regarding claims by fluoride promoters that fluoridated water consumption causes decreased dental decay without ANY adverse health impacts. This is not consistent with the data discussed here or with all previous FDA rulings (see petition and supplemental letters).

    Sincerely,

    Richard Sauerheber, Ph.D.

    Attached: Editorial On Blood Fluoride Concentrations and Human Health

    42.
    November 12, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This letter supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346. On the other hand, natural calcium fluoride in some water supplies is of course a recognized contaminant regulated by the U.S. Environmental Protection Agency.
    The seven year long prospective study conducted in Southern California on the effects of fluoridation chemicals on thousands of racehorses over the period 2002-2012 has now been published. The article entitled Racehorse Fatalities and Fluoridated Water in Los Angeles (Fluoride, November, 2013 pp.170-178) is enclosed.
    The view is very widely held in the U.S. that ingesting fluoride compounds somehow will impair or correct dental caries and that fluoride from most any source when ingested is not harmful and may even be considered a diet supplement. Improper labeling of sodium fluoride as an ingestible “effective decay preventive” and fluorosilicic acid as a “water additive” and an important “public health achievement”, by dentists from the Oral Health Division with offices inside the U.S. Centers for Disease Control, has led to this widespread misunderstanding of the nature of chronically poisonous industrial fluorides.
    Because of this widespread misunderstanding, scientific journals in the U.S. do not review submitted publications on fluoride toxicology. This is why the human toxicology data we published earlier this year was submitted to the international journal, the Journal of Environmental and Public Health (published online at: JEPH 439490). This is also the reason we submitted our 7 year prospective racehorse fluoride exposure data to the journal Fluoride which specializes specifically on the interaction of fluoride with physiologic processes. This journal was founded by Dr. Waldbott, fluoride allergist, and has continued with articles from international scientists under the editorial work of Dr. Albert Burgstahler. Dr. Burgstahler asked me one year ago to write a summary of the racehorse work, and the article is now finally being published. The work was dedicated to Burgstahler who passed away last month, and was unable to attend a meeting he scheduled with me at the University of Kansas. Burgstahler is missed.
    The true nature of all industrial fluorides that lack calcium as biologic poisonous substances is adequately documented in Fluoride and many chemical toxicology texts. Fluoride is not a normal component in the bloodstream of horses or man and is not a mineral nutrient, as the FDA correctly ruled in 1963. There is no ingested amount of fluoride that will prevent its accumulation into bone in a biochemically irreversible manner. It is important for the FDA to understand that fluoride is NOT electronegative (fluorine is) and as an extremely tiny concentrated negative charge fluoride ion binds bone calcium as an abnormal component without any physiologic mechanism of resorption, as exists for calcium that is mobilized by parathyroid hormone.
    Please examine carefully the racehorse article in its entirety. There are multiple mechanisms by which ingested artificial fluoride compounds can lead to increased racehorse fatalities. Drinking fluoridated water without feed forms HF which aggravates ulcers during a race, the combination of artificial fluoride ingestion with fluorine containing drugs, and the continuous accumulation of fluoride in thin racehorse leg bone are all significant.
    The extreme irony not mentioned in the article is that the percentage of racing starts that lead to fatal breakdowns exactly mirror the concentration of fluoride in drinking water when expressed in the typical ppm unit. In other words, when water contained 0.2-0.3 ppm from unknown sources the fatality incidence was 0.2%. When the water was raised to 1 ppm industrial fluoride from fluorosilicic acid, the fatality rate increased to approximately 1%. When the fluoride level was lowered to 0.7 ppm by request of the U.S. HHS, the breakdown incidence lowered to approximately 0.7%. These data are stunning and compel us to continue to oppose the intentional ingestion of synthetic fluoride compounds. Again, the FDA has never approved any fluoride compound for ingestion in the U.S. and our request for the FDA to halt the practice of intentionally exposing horses and man to ingested fluoride materials is reasonable.
    Accordingly I have joined California Clean Water. Their campaign to rid drinking water of artificial fluoridation chemicals I suspect will one day succeed universally. For example Whichita, KS who is intimately familiar with the work of Dr. Burgstahler, succeeded in halting fluoridation recently. Soon to follow was Portland, OR where citizens blocked industrial fluoridation of their water supply, then Parkland, WA who discontinued the infusions and then Davis, CA who decided to protect their normal drinking water. These all took a tremendous amount of effort on the part of citizens in each case and were heavily opposed by false advertising paid for by promoters who believe claims by the OHD.
    We need help from the FDA. The FDA can easily rule that any claim (or implication) that industrial synthetic fluoride compounds are “ingestible dental prophylactics” is false labeling and is not FDA approved. California Clean Water and other similar groups around the country, including San Diegans for Safe Drinking Water, humbly request that the FDA rule favorably in some way on this petition.
    Racehorse owners and racing personnel are now expected by the Los Angeles MWD to either change their stabling conditions or to haul massive amounts of de-fluoridated water to tracks to protect their animals. Since 99% of all racing starts are successful, most in the industry just absorb the cost and confusion associated with fatal breakdowns that increased from 0.2 to 0.7% under current conditions. This is unacceptable and completely unnecessary since ingested fluoride does not decrease dental caries, as demonstrated in the petition and previous letters to the FDA. It is time to block exposure of man and animals to internal industrial fluoride.

    43.
    November 29, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    The information in this letter is important and supports the petition to ban the addition of industrial synthetic fluoride compounds, sodium fluoride and fluorosilicic acid (each LD50 = 60 mg/kg single oral dose), into U.S. public drinking water supplies, petition #FDA2007-P-0346. These compounds are listed poisons on poisons registries for known acute toxicity. On the other hand, fluoride present in some water supplies naturally from calcium fluoride (LD50 = 3-5,00 mg/kg) is a recognized contaminant regulated by the U.S. Environmental Protection Agency. The EPA continues NOT to regulate ingested industrial synthetic fluoride compounds added into public water, because these compounds are added intentionally to treat consumers. The EPA does not evaluate the safety or effectiveness of the ingested synthetic materials and allows their addition into public drinking water as long as the fluoride ion concentration is below the SMCL for fluoride (2 ppm). Unfortunately the SMCL was estimated from data for natural calcium fluoride contamination which is not an acute poisonous substance, while industrial fluorides are.
    The EPA, after repeated requests to do so, will NOT exert any oversight for any production or disbursement facility that produces and infuses fluoride compounds into public water supplies. EPA labels fluorosilicic acid as a hazardous waste in concentrated form but labels the diluted waste as a fluoridating agent for treatment of dental caries through ingestion. EPA has no authority to label fluorosilicic acid used as either a food, supplement, mineral nutrient, or drug, so instead EPA labels it a fluoridating agent. But fluoridation has the sole purpose of ingestion of fluoride to mitigate dental caries and is thus not an additive under EPA jurisdiction. Only the FDA has authority to regulate materials taken internally to treat human tissue. EPA has written that fluoridation with diluted fluorosilicic acid does not violate either the Clean Water Act or the Safe Drinking Water Act since it is added intentionally to treat humans.
    Further proof that the EPA has not, does not, and will not regulate ingested fluoride compounds (or test for safety and effectiveness for long-term consumption) is presented below. Basically, water districts do not bother to apply for a permit to discharge industrial fluorides into water supplies (even though technically this is required by statutes in the Clean Water Act) because the EPA does not accept such applications or request them. This is because the waste material is diluted and used as a drug-like intentionally ingested substance. As a result, water officials tend to believe commonly that no permit is required from ANY Federal agency to infuse the material. Fluorosilicic acid is both a hazardous waste (when concentrated) and a drug (when the hazardous waste is diluted and used for putative effects on teeth after ingestion). Even though it is known that the EPA does not require a permit to infuse fluorosilicic acid waste into water supplies, nevertheless questions were submitted to water district officials asking for either a permit to discharge waste discharge OR proof of effectiveness and safety for long-term ingestion as putative dental prophylactic as required by the Food Drug and Cosmetic Act. It was hoped that water officials would listen to reason on their own accord and honor the CWA, SDWA, and FDCA. Although this has been futile, a variety of beliefs have been discovered that are widely-held by water officials. One, fluoride is “food grade”, second fluoride is a drug but does not require FDA oversight, or third it is a waste materials but it is below the EPA MCL and thus is not regulated.
    A most widely-held belief is that fluoride ion, being structurally identical in any compound, is presumed to have identical chronic toxicity as natural calcium fluoride. As shown above, of course this is false. The switch from natural calcium fluoride minerals in water, to industrial synthetic sodium fluoride, and then to hazardous waste fluorosilicic acid have never been subjected to controlled clinical trials. Another belief held by many water officials is that fluoride infusions are indeed drugs, but without understanding that fluoride compounds are not FDA approved for ingestion in the U.S. The most egregious argument however is the false belief that vendors supply fluoride that is “food grade.” Water officials apparently do not understand that only the FDA has the exclusive authority to determine what substances can be labeled food grade or not, and what substances are drugs, approved or not. The FDA in 1975 ruled that fluoride is not considered safe to be added to foods [1]. The FDA also ruled that fluoride added into water is an uncontrolled use of an unapproved drug and banned the sale of fluorides for ingestion by pregnant women (1966).
    Below, please find correspondence recently obtained from three water districts. The Escondido District argues that their supplier for fluorosilicic acid materials sells food grade products! But only the FDA regulates and defines what are foods or drugs, not water officials. MWD Los Angeles argues that Federal permission is not necessary to treat consumers with fluorosilicic acid by ingestion from treated water supplies because the discharges are not into United States waters! If one were to rule that fluoride is not a drug or food or is not under FDA oversight, and that fluoridation only treats water as an additive rather than consumers, then it would be necessary to obtain a permit for this waste discharge. Finally, Olivenhain Water District believes that sodium fluoride is indeed a human medicament but does not realize it is not FDA approved to be taken internally. OWD alerted health professionals to adjust medical prescriptions as might be necessary after fluoride infusions were to begin. Water districts have no means to evaluate medicinal needs, drug allergies in consumers, or progress of drug treatment, and can only control the concentration added, not the total dosage consumed. Fluoride is not FDA approved for ingestion and yet water district officials, without a license to practice medicine, are supplying a substance for its drug-like properties without FDA oversight.
    A recent bill signed into law by the President explicitly gives the FDA authority to regulate and inspect facilities that manufacture and/or formulate drug substances sold for ingestion in the U.S. [2]. It is thus the exclusive role of the FDA to inspect fluorosilicic acid and sodium fluoride manufacturing facilities to determine whether any are capable of producing either food grade materials that could be used for ingestion, or are producing counterfeit drugs. The FDA has never approved any fluoride compound for human consumption, including sodium fluoride known commercially as Luride. But Luride is allowed to be used by prescription (in areas that are not fluoridated artificially) as an unapproved drug. Unfortunately, fluorosilicic H2SiF6 acid is a counterfeit drug for Luride. It bears little resemblance to the drug Luride, NaF. The new law fortunately includes a track–and-trace system to be developed by the FDA designed to help authorities catch counterfeit drugs that have been making their way into the U.S. Much fluorosilicic acid is now imported from China and Mexico. Manufacturers will be required to add serial numbers to all drug packages within four years. After 10 years, the industry must upgrade to electronic codes that can be used to track medical substances from the factory to the end user. This would apply not only to Luride but also to its counterfeit substitute fluorosilicic acid. The EPA does not interpret the Clean Water Act permitting process to apply to intentionally added materials designed to treat people. Therefore, the newly acquired authority given to the FDA is necessary and timely.
    Please do not consider that since fluoridation violates the SDWA and CWA, that it is the job of the EPA to regulate the intentional treatment of humans with fluoride compounds. This petitioner has extensively pursued that possibility in writing with the Office of Drinking Water, U.S. EPA (and with the Oral Health Division, CDC). The Office has made it strictly clear that there is no possibility whatsoever that the EPA will regulate materials used to intentionally treat humans in the U.S., regardless of provisions in the CWA or SDWA. And the OHD, CDC still cannot answer glaring discrepancies in their claims of effectiveness of water fluoridation and yet continues to refuse to accept liability for their recommendations to fluoridate U.S. drinking water. Thank you,

    Richard Sauerheber, Ph.D.
    [1] Sutton, P. The Greatest Fraud: Fluoridation, Kurunda Pty. Ltd., Lorne, Australia, 1996.
    [2] Drug Mixes to Receive More Scrutiny, Associated Press, Washington, D.C.. Union Tribune San Diego, November 28, 2013.

    Dr. Richard Sauerheber
    Palomar College, San Marcos, CA
    November 25, 2013 Metropolitan Water District, Los Angeles
    Dear President Kightlinger,
    On this 50th anniversary of the murder of President John F. Kennedy, we remember his words “we will oppose any foe in the defense of liberty.” Indeed, we citizens of the United States will oppose the enemy of clean regular fresh drinking water, that is waste fluorosilicic acid forced infusions.

    We citizens forced to consume water that is treated with diluted hazardous waste fluorosilicic acid by the Metropolitan Water District hereby request a copy of the permit that must be issued to municipal water districts to be allowed to discharge hazardous materials into public water. The Clean Water Act requires anyone who wants to discharge pollutants into water to first obtain an NPDES (National Pollutant Discharge Elimination System) permit, or else that discharge will be considered illegal (U.S. EPA see: http://cfpub.epa.gov/npdes/cwa.cfm?program_id=45_ Title IV Section 402). The EPA does not request or require a permit for fluorosilicic acid because the material before infusion is diluted, and the EPA allows its diluted use for ingestion for presumed drug-like properties. However, it is hoped that you will honor statues in the Clean Water Act anyway in good faith and seek permission from the EPA if you do not perceive that diluted fluoride is a drug or food and that it is an adjusted contaminant.
    The EPA classifies concentrated fluorosilicic acid from phosphate rock fertilizer production facilities as waste material:
    “Fluorosilicic acid waste material is recovered from the water scrubber”
    (see:http://www.epa.gov/osw/nonhaz/industrial/special/mining/minedock/id/id4-hfa.pdf).
    The EPA does not regulate materials that are intentionally ingested to treat consumers. Without authority to recommend use of any substance to be ingested for drug-like purposes, the EPA report goes on to write:
    “Fuorosilicic acid can be used in water fluoridation after it is recovered.” And “this waste may exhibit the characteristics of corrosivity.”
    The well-known opinion letter issued in 1986 by Rebecca Hanmer, former EPA Administrator, that suggested using hazardous waste fluorosilicic acid as a public water additive for the fluoride it contains [1,2], is not an officially approved NPDES permit. The EPA has no jurisdiction in defining what constitutes a food, supplement, nutrient, medicament, or drug safe for ingestion by all consumers. If you argue fluoride does not require a new drug application from the FDA, then it must be labeled as hazardous waste material and a permit is required to discharge said waste into public water supplies. Alternatively, if you define the material as either a drug-like substance or food or mineral to be ingested for caries benefit, then information must be secured from the U.S. FDA that the material is effective and safe for ingestion long-term by all consumers. The FDA has already ruled that fluoride added into water is an uncontrolled us of an unapproved drug, but you have rejected this in previous letters. The public needs to see a copy of any such officially approved permit. Of course if the permit or information is not available, then it would be necessary to halt fluorosilicic acid infusions into MWD water supplies.

    Thank you for your reply, Richard Sauerheber, Ph.D.

    [1] Connett, P., et.al. The Case Against Fluoride, 2010.
    [2] Sauerheber, R. Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, Journal of Environmental and Public Health, 2013, available online at: JEPH 439490.

    Dr. Richard Sauerheber
    Palomar College, San Marcos, CA 92069
    November 27, 2013 Dear President Kightlinger,
    Thank you very much for your prompt reply.
    The response however is confusing since the water into which MWD adds fluorosilicic acid (since 2007) is obtained from the Colorado River. The headwaters of this River are as far North as West Central Wyoming, within the contiguous United States. The location where the fluorosilicic acid is added is here in Southern CA, within the United States. The definition of U.S. waters is any water originating in the United States, rather than a foreign country.
    Most of the tonnage of fluorosilicic acid that MWD infuses into water is used in agriculture in the Los Angeles basin and in North San Diego County. It is added for the purpose of being ingested by customers for putative effects on teeth caries and is not added to sanitize the water for which chlorination is already used. It is thus not a water additive. It was also ruled unsafe to be added into food by the FDA in 1975 and is thus not a food.
    Synthetic fluorides intended for ingestion may be labeled either drugs or drug-like substances which are regulated by the U.S. FDA. The EPA has no authority to determine effectiveness or safety of long-term ingestion of drugs. The EPA labels fluorosilicic acid a hazardous waste when concentrated, that can be used after dilution for fluoridation to be ingested by consumers. But the EPA has no authority to recommend medicinal substances or drug-like substances to be taken internally in the U.S. Such authority belongs to the FDA. Since you apparently have no permit to discharge the material into the water supply (as required by the Federal Clean Water Act for hazardous wastes) then apparently you hold the view that it is not hazardous waste but is instead a substance intended to be ingested for putative effects on teeth. We thus urge you to contact the FDA for information on fluoride ingestion, to remain above board on this. We customers certainly don’t want to be charged to pay for any litigation that could arise from these discrepancies. Thanks for your consideration on this, Richard Sauerheber, Ph.D.

    ENCINITAS CHOOSES SODIUM FLUORIDE
    Encinitas began fluoridation in 2013. However, city fathers have heard all the negative science on fluorosilicic acid – including the facts that it contains lead and leaches lead from pipes, as well as that it contains numerous other contaminants fluorosilicic acid contains, including arsenic, cadmium, mercury, and thallium. For an analysis of fluorosilicic acid see www.fluorideclassaction.com.
    Sodium fluoride is not as contaminated as fluorosilicic acid is, but it is also a listed poisonous substance. Once in the acidic stomach, fluoride ions combine with hydrogen ion to form HF hydrofluoric acid, a tiny neutral molecule which is freely permeable through the fatty lipid layer of the stomach into the blood stream.
    At this time it is not known whether the sodium fluoride used is commercial grade or pharmaceutical grade. We are asking Encinitas for a certificate of analysis, which would yield more information. If the sodium fluoride is commercial grade, it could contain numerous contaminants – in addition to the fluoride ion itself.
    We are asking residents in the area to send a Freedom of Information request to Encinitas to obtain a certificate of analysis, invoice, and bill of lading –and to ask for other documents pertaining to sodium fluoride, including those which would show whether it is commercial or pharmaceutical grade.
    Four italicized statements in the newspaper article below are most important. 1) Although the material is being used to treat humans in place of sodium fluoride Luride drugs, the supplier is Univar Chemicals, not a recognized drug manufacturer or distributor. 2) What is computer operated is not a dosing process but is merely an infusion at a fixed concentration. Dosage refers to the total amount ingested daily by a consumer. 3) In spite of claims by an EPA official, fluoride is not an element. Th element is noxious fluorine. Fluoride is the reduced ion that cannot be either oxidized or further reduced. It is incorrect to state that “all elements are nutrients.” All industrial fluorides are poisonous substances that have no nutritive value of any kind. 4) Water district officials admit that the infusions require adjustments be made to prescription medicines, thus admitting also that the water district is medicating the public without a license.
    Fluoridation process delayed for OMWD
    By Tony Cagala Thanks to the Coast News.
    Jul 02, 2013 • 560 views • 6 comments
    Alex Fidel, Dr. David Banks, Simone Siebert and her 7-year-old daughter Summer held signs out front of the OMWD offices on Monday. “I’m just generally worried about my daughter’s health,” Siebert said, adding that she prefers to be able to choose what is in their drinking water.
    ENCINITAS — The introduction of sodium fluoride into the OMWD (Olivenhain Municipal Water District) water supply was delayed by a week or two, following a permit amendment issue, according to Tom Kennedy, operations manager of OMWD. Initially scheduled to begin the fluoridation process on July 1, Kennedy, in an email Tuesday, said the delay stems from a permit amendment issue with the California Department of Public Health.
    The new fluoride facility finished construction more than a month ago at the David C. McCollom Water Treatment Plant in Elfin Forest and took about six months to complete, though the design plans for the project began in 2007-08. At a cost of more than a million dollars, it was paid for mostly with grants received from the First 5 Commission and the CDAF (California Dental Association Foundation). The First 5 Commission contributed $892,384, with the CDAF contributing $110,000.
    Once the fluoridation process begins, OMWD will begin adding doses to the 30 million gallons of water that go in and out of the plant. Tom Kennedy, operations manager at the Olivenhain Municipal Water District, said that there’s already a naturally-occurring amount of fluoride in the water that varies from about 0.2 to 0.3 parts per million. The district will be adding another 0.4 parts per million of sodium fluoride to reach a target number of about 0.7 parts per million — a number suggested by the U.S. Department of Health and Human Services in July 2011 to water systems practicing fluoridation.
    The granular form of sodium fluoride the district opted to use comes from Univar, a global distributor of commodity and specialty chemicals. They have more than 260 distribution centers around the world, including one in Redmond, Wash.
    The sodium fluoride is delivered by truckload, which makes for safer transportation given the narrow, winding roads leading to the facility. They’ll take about three to four shipments per year. A 2,000-pound sack of the sodium fluoride will be loaded into the newly-built tank every four days during the peak of summer, and in the winter time once every two weeks. The dosing process is completely computer operated. When their lab analyzes the raw water for the naturally-occurring fluoride levels, that number will determine how to set the dose levels to reach the targeted level, explained Dave Smith, water treatment facilities supervisor.
    “We have a very complex monitoring system,” Kennedy said. That includes daily lab samples, and monitors on all pumps and tanks and systems. There are thousands of different sensors that monitor every aspect of the water treatment process on a continuous basis.
    While the fluoride addition is not a primary standard, if it went over a certain preset value it would shut down the fluoride pump from overdosing the water supply. “Unless we’re running really low flow rates, the fluoride pumps aren’t big enough to pump way too much fluoride in..”
    The DPH visits the plant annually. But despite safety precautions, Kennedy and the water district have heard from the public both in support of and against the addition of fluoride into the water supply. Dr. David Banks, an Encinitas resident and a dentist for 40 years, is against the use of fluoride in the water.
    On Monday, a group of concerned residents gathered in front of the OMWD offices with signs against the use of industrial synthetic fluoride. Dr. Banks was one of those holding a sign against it. He practices in San Marcos where fluoride has already been introduced into the water supply. From that, he said he’s seen an increase in fluorosis in children’s teeth. “We’ve always seen fluorosis, but we’re seeing more and more fluorosis.” Fluorosis is mostly a surface condition where white spots show on the teeth. “When it gets bad,” he said, “they turn yellow, brown and the enamel doesn’t form correctly. And instead of it becoming more resistant to decay, it becomes less resistant to decay.”
    The CDC (Center for Disease Control) said fluorosis does occur from fluoridated water, but added that it also was a result of other fluoridated products as toothpaste and mouth rinses. Evidence did show that infants, whose formula was mixed with fluoridated water, could also develop fluorosis, according to the CDC.
    Alex Fidel, 21, organized Monday’s protest and said his concerns were over the matter of choice. “I think as people, regardless of whether fluoride is good or bad, I think it comes down to choice, and what they’re doing is they’re force medicating people who may not want to,” he said.
    Banks said there is a popular misconception that fluoride is a nutrient. It’s not, he said. “Fluoride is a toxin.” He said the industrial form of fluoride used in the water isn’t buffered as much as the naturally-occurring calcium fluoride and it accumulates in peoples’ bones, which could have impacts such as weaker bone, more tendencies to arthritis, and other problems. Banks feels that less than 0.1 part per million would be a safe fluoride level at the natural calcium water level here.
    The EPA (Environmental Protection Agency) said on Wednesday that, “fluoride is an element, just like nitrogen, phosphorus, metals, etc. They can all be considered ‘nutrients’ because biological life depends on them. They can also be considered ‘toxins’ if the exposure concentration exceeds the effects threshold.”
    We want the people to know where the water is fluoridated and if there’s any objection to it they can take whatever measures they need to do. It lets all of the dentists know so that they don’t add fluoride supplements to patients they shouldn’t, Kennedy added. Kennedy said that, ultimately, the decision to fluoridate was that of the water board and that their job is to execute their decision.
    Residents can remove some of the fluoridation in their water by using a distillation or reverse osmosis water filtration system. A charcoal-based water filtration system or boiling the water won’t remove the fluoride, according to the CDC.

    Dr. Richard Sauerheber

    November 23, 2013

    Dear C. McKinney, EscondidoWater,

    We residents are forced to consume water that is treated with diluted hazardous waste fluorosilicic acid by the city of Escondido hereby request a copy of the permit that technically is supposed to be required for any point source to be allowed to discharge hazardous materials into public water. The Clean Water Act requires anyone who wants to discharge pollutants into water to first obtain an NPDES (National Pollutant Discharge Elimination System) permit, or else that discharge will be considered illegal. The EPA does not request permits for added fluoride compounds, and officials within the agency have recently, without authority to do so, allowed waste fluorosilicic acid to be substituted for sodium fluoride (Luride drug) for water fluoridation to treat dental caries. So it would behoove you to request a permit or to contact the FDA, since the material is added for drug-like effects on teeth by ingestion.

    The EPA classifies fluorosilicic acid from phosphate rock fertilizer production facilities as waste material:

    “Fluorosilicic acid waste material is recovered from the water scrubber.” And without authority to regulate ingestible substances for drug-like purposes, the EPA goes on to write: “Fuorosilicic acid can be used in water fluoridation after it is recovered.” And “this waste may exhibit the characteristics of corrosivity.”

    The well-known opinion letter issued in 1986 by Rebecca Hanmer, former EPA Administrator, that suggested using hazardous waste fluorosilicic acid as a public water additive for the fluoride it contains [1,2], is neither an officially approved document that would substitute for a specific NPDES permit nor is it a declaration that fluoride is a food or supplement safe for ingestion by all consumers. Thus, either an official permit to discharge waste into public water supplies, or information from the FDA that fluorosilicic acid is approved for human consumption, must be obtained and made available to consumers. Of course if no such permit or information is available, then it would be necessary to halt fluorosilicic acid infusions into public water supplies.

    Thank you for your reply, Richard Sauerheber, Ph.D.
    [1] Connett, P., et.al. The Case Against Fluoride, 2010.
    [2] Sauerheber, R. Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, Journal of Environmental and Public Health, 2013, available online at: JEPH 439490.

    From:cmckinney@ci.escondido.ca.us To:richsauerheb@hotmail.com Subject: RE: fluorosilicic acid

    Date: Mon, 25 November, 2013

    Dear Dr. Sauerheber,

    The fluoride added to the Escondido water supply is purchased from a chemical vendor who specializes in food-grade additives. Therefore, the addition of fluoride to our water supply is not a discharge of pollutants and does not require an NPDES permit.

    Please feel free to contact me if you have any other questions or concerns.

    Christopher W. McKinney, P.E.

    Director of Utilities, City of Escondido

    201 North Broadway

    Escondido, CA 92025

    cmckinney@escondido.org Office Phone: (760) 839-4090

    Dr. Richard Sauerheber
    Palomar College, San Marcos, CA
    November 26, 2013 Dear C. McKinney, Public Utilities Director, Escondido, CA,
    Your comment that the vendor for fluorosilicic acid sells food grade additives is quite telling. Please understand that the FDA ruled in the Federal Register in 1975 that fluoride is “not recognized as safe for addition to food.” This was described in detail in the textbook by Sutton, as referenced in the JEPH 439490 article.

    What you may also not realize is that none of the 47 vendors of fluorosilicic acid in the U.S. have submitted any information indicating that swallowing the material positively affects teeth. They do not have such data because ingested fluoride from water produces only 0.02 ppm in saliva, which is unable to affect teeth at 75,000 times lower in concentration than in toothpaste. Swishing 1 ppm water and spitting it out is also purposeless.

    Clean Water California sent the information below. Notice that tooth decay is highest in regions of Canada that do add industrial fluorosilicic acid, as is expected for bone-perturbing poisonous fluoride.

    It would be good if you could please read JEPH 439490. This is over 19 years of research work that was finally published this past summer. Again, please send inquiries to the Food and Drug Administration to determine safety and effectiveness of ingested fluoride compounds because the EPA has no authority to regulate substances used as drugs and has chosen not to require permits for such use for fluorosilicic acid or sodium fluoride drugs. The FDA never approved any fluoride compound for ingestion, including Luride sodium fluoride, but allows use of Luride only by prescription in areas that are not fluoridated. Thank you, Richard Sauerheber, Ph.D.
    Clean Water California: About 30 different Canadian municipalities have voted to ban fluoride in recent years, including Calgary, Windsor and Waterloo. Each time, city councils were pressured to ban the substance by small and vocal anti-fluoridation groups. Each time, a raft of scientists would descend on the public hearings to insist there is nothing wrong with fluoridated drinking water and that it is one of the most cost-effective public health policies ever devised.

    The decision whether to fluoridate lies with local governments, with guidelines set by provincial, territorial, and federal governments. Brantford, Ontario became the first city in Canada to fluoridate its water supplies in 1945.

    In 1955, Toronto approved water fluoridation, but delayed implementation of the program until 1963 due to a campaign against fluoridation by broadcaster Gordon Sinclair.The city continues to fluoridate its water today.

    In 2008 the recommended fluoride levels in Canada were reduced from 0.8-1.0 mg/L to 0.7 mg/L to minimize the risk of dental fluorosis. Ontario, Alberta, and Manitoba have the highest rates of fluoridation, about 70-75%. The lowest rates are in Quebec (about 6%), British Columbia (about 4%), and Newfoundland and Labrador (1.5%), with Nunavut and the Yukon having no fluoridation at all. Overall, about 45% of the Canadian population have fluoridated water supplies in 2007.

    #44.
    December 5, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This letter supports the petition to ban the addition of industrial, unnatural fluoride compounds into U.S. public drinking water supplies, petition FDA2007-P-0346. On the other hand, natural calcium fluoride that exists in some water supplies is of course a recognized contaminant regulated by the U.S. Environmental Protection Agency. Fluoridation refers to the artificial infusion of industrial fluorides that lack calcium into public water with the intent to treat consumers. The previous letter described the widely varying beliefs of water district officials who justify whole body fluoridation in an attempt to ablate dental caries. Some claim synthetic fluoride is a food, others claim fluoride is a drug substitute for natural fluoride that does not require FDA approval, and others provide no explanation except “State law makes us do this,” regardless of published harm. This is the 45th letter to the FDA since the petition for reconsideration was filed in 2010 and is the most important. Hopefully, no further letters will be required. All the information submitted has been crucial for proper understanding of the significance of whole body fluoridation by ingestion of soluble calcium-chelating fluorides.
    The singular pathologic effect of ingested synthetic soluble fluoride compounds at any concentration is its incorporation into the bone of all consumers. Bone accumulation after ingestion is unavoidable. 50% of that ingested is retained, 95% permanently in bone (J. Env. Pub. Health, 43940, 2013). It is unknown whether ingested fluoride incorporates into compact dense bone or into spongy bone or both. Recent data indicate the overall concentration in bone accumulates to 2,500 mg/kg in two years when drinking water contains 1 ppm fluoride (National Research Council, Report on Fluoride in Drinking Water, A Scientific Review of EPA’s Standards, 2006, Washington, D.C.). High level lifetime accumulation of approximately 5-6,00 mg/kg is now typical due to use of synthetic industrial fluoride in pastes and in water, and even higher levels are reached for people with kidney impairment, those with calcium deficient diets, or those who enjoy or need to drink lots of water. Historical data indicate fluoride contamination of bone in 1958 England from natural calcium fluoride in water can be less extensive, due to calcium inhibition of fluoride assimilation and absence of synthetic fluoridated water or toothpastes. But the accumulation is nevertheless also very significant (see attached Figure).
    Understand that fluoride ion is identical in size to hydroxide ion which it physically replaces by ion exchange in hydroxyapatite to form abnormal fluoroapatite. Fluoroapatite is not biochemically or hormonally responsive, while normal hydroxyapatite is sensitive to resorption caused by parathyroid hormone, based upon calcium need. Parathyroid hormone is abnormally elevated during fluoride consumption to ensure normal calcium levels are maintained in plasma to support the beating heart. Parathyroid hormone is elevated in man at typical fluoride levels of 0.2 ppm in blood (NRC pp. 241-251 and p 263). This is the target blood fluoride level intended to treat caries by artificially fluoridating water at approximately 1 ppm (see original petition).
    Calcium regulation requires large volumes of normal mobilizable bone. The longer one consumes fluoride, the larger the fraction of bone becomes fluoroapatite. Bone cells initially respond to the fluoride perturbation by increasing osteoblast activity to form new but less dense bone that is abnormally thickened. This is an aberration of normal but is not sensed as a functional impairrment by the consumer since normal blood calcium levels are assured by the action of PTH.
    A mere decrease in blood calcium of 1 % causes a massive 100% increase in parathyroid hormone from 0.3 to 1.0 ng/ml (Textbook of Medical Physiology, Guyton, A., W.B. Saunders Co., Philadelphia, 5th edition, 1976) to protect the beating heart. Abnormally elevated PTH decalcifies bone in order to maintain normal calcium homeostasis. When this effect is prolonged, the condition is referred to as secondary hyperparathyroidism. The condition protracted long-term is associated with bone weakening due to resorption required to maintain normal blood calcium. Continuous long-term fluoride incorporation into bone eventually causes normal hydroxyapatite to become a diminishing percentage of total bone volume. Bone becomes weakened and more subject to fracture at 3-4,000 mg/kg fluoride (NRC, 2006).
    The function of parathyorid hormone is to increase osteoclast activity that resorbs bone, removing calcium from bone into the plasma. Prolonged elevation of PTH is known in some patients to cause large bone cavities filled with large osteoclasts. Hyperparathyroid patients usually come to the doctor for a broken bone where X-rays show extensive decalcification and cystic areas. Fractures of the weakened bones result from only slight trauma. The cystic bone disease of hyperparathyroidism is often called osteitis fibrosa cystica. Secondary hyperparathyroidism can result from a low calcium diet, lactation of pregnancy, or osteomalacia. The hyperplasia of the parathyroid glands is a corrective measure for maintaining the level of calcium in the extracellular fluid at an essentially normal value.
    Human studies on fluoride and parathyroid hormone were reviewed by the NRC 2006 panel who concluded:
    “Fluoride induces a net increase in bone formation and also decreases calcium absorption from the GI tract beyond the degree expected by formation of calcium fluoride complexes. Both of these effects lead to an increase in the body’s calcium requirement. If dietary calcium is inadequate to support the increased requirement then there is an increase in parathyroid hormone. PTH acts to increase resorption of bone, but the effect is uneven—low fluoride bone is resorbed most readily. As bone fluoride increases, the solubility of the bone or the ease with which it is resorbed is decreased because of the greater amount of fluoroapatite, giving an apparent resistance to the effect of PTH. Any cause of hypocalcemia can lead to secondary hyperparathyroidism with increased PTH in an attempt by the body to maintain calcium homeostasis. Fluoride clearly decreases serum calcium and increases calcium mineral requirements in many exposed persons. PTH is elevated in response to fluoride exposure, contributing to a number of diseases including osteoporosis, hypertension, arteriosclerosis, some forms of muscular dystrophy, and colorecetal carcinoma.”
    The real surprise is that fluoride ingestion in man also paradoxically causes elevated levels of calcitonin (NRC, p. 237). This parafollicular cell hormone is responsible for inhibiting bone loss from calcium resorption, and is normally secreted during times of dietary substantial calcium intake. The NRC report was unable to explain the paradox, why hormones that exert opposing effects on bone are both elevated by the presence of blood fluoride. Normally calcium intake causes PTH to drop and calcitonin to rise, to replenish bone calcium and promote growth. And when calcium intake is low, PTH rises and calcitonin drops to promote resorption of calcium from bone. Both increase in response to fluoride calcium chelation because calcitonin helps promote new bone growth (to substitute for bone that is converted to fluoroapatite) and PTH rises because less calcium is available from fluorotic bone. In prolonged calcium deficient states, the goal of PTH is to degrade bone substantially in order to protect calcium levels required for normal heart function.
    Thus blood fluoride causes an abnormal condition where hormones with opposing functions are elevated at the same time. This forms new bone (in an attempt to correct for loss of normal bone) but also simultaneously prohibits significant lowering of blood calcium. Both are required during chronic continuous fluoride ingestion, acting together that eventually causes anatomic abnormality of bone, the extent depending of course on diet and total fluoride exposure from all sources. The enclosed photograph of a fluorotic human leg bone is thickened from new abnormal bone growth, the product of calcitonin action, but is also deteriorated in texture due to PTH resorption coupled with extensive fluoroapatite formation. It is not known if the spicules emanating from the surfaces are calcium fluoride-rich outgrowths or if it is bone of normal composition in an abnormal anatomic arrangement that attempts to correct for the presence of substantial fluoroapatite. A fluoride poisoning expert informed me that this is very severe fluorosis and probably is in the area of 12,000 mg/kg. These spicules cause severe pain when walking. When fluoridation of bone is far less extensive, bone weakening occurs as previously mentioned.
    In horses, PTH and calcitonin also function to maintain calcium homeostasis when calcium intake fluctuates. Fluoridated blood causes hormonal abnormality to maintain calcium homeostasis at the expense of altered bone structural integrity. Horses given insufficient calcium are most susceptible. The article Racehorse Breakdown Incidence in Fluoridated Los Angeles now published in Fluoride, December, 2013 (submitted previously) described the increased bone breakdowns that occur in racehorses stabled long-term at fluoridated racetracks without pasture grazing. 200,000 racing starts were investigated and breakdowns clearly increased 3 fold after beginning artificial fluoridation of public water supplies delivered to the tracks. A slight decrease in breakdowns occurred when fluoride levels were adjusted from 1 to 0.7 ppm. Fluoride in bone is not reversible, so it is not expected that halting fluoridation will completely reverse breakdown incidence until a new population of untreated horses appear. The observed slight lowering of breakdown incidence after fluoride levels were lowered may be associated with fluoride removal from soft tissues.
    We urge the FDA to ban the use of public water supplies as a vehicle to deliver the fluoride drugs sodium fluoride (e.g. Luride) and its counterfeit drug substitute fluorosilicic acid. The act of whole body low level fluoridation, a futile attempt to ablate dental caries without FDA approval, needs to be halted. It is a person’s right to not consume dairy products and to live on a calcium-depleted diet. And it is a person’s right to consume large amounts of water depending on his/her requirements in health or disease. These citizens in particular need protection from artificially fluoridated water, as explained in this letter. This country is experiencing unprecedented numbers of bone replacement surgeries and serious hip fractures in the elderly, and whole body fluoridation is especially contraindicated.
    I have been contacted by Clean Water California, dedicated and committed to end industrial fluoride infusions for all cities in California. Crescent City and Davis, CA recently blocked fluoridation, and the entire State will someday return to regular water use. But it would be appreciated if the FDA could help facilitate this. Informed citizens fully support you in this effort. You may contact the head of CWC Clint Griess at: clintgriess@yahoo.com. He is very friendly and quite informative.
    The U.S. EPA does not regulate fluoride infusions (below 2 ppm) because the material is added intentionaly to treat consumers and as such is expected to be regulated by the FDA. The FDA has not banned fluoride infusions as yet in part because fluoride naturally in water is regarded as a pollutant/contaminant that is expected to be regulated by the EPA. Federal dental officials in offices within the CDC request state Departments of Public Health to enforce “mandatory fluoridation” because it is a violation of the Safe Drinking Water Act for any National requirement to add substances into water other than to sanitize water. The SDWA statute indicating that States can be no less restrictive is ignored in an exuberant attempt to treat dental caries through whole body fluoride ingestion. State laws “mandating fluoridation” are falsely based on the belief that ingested fluoride is an “effective decay preventive” and a “public health measure,” though this has been disproven in vast published literature. As you know, the FDA has never approved any fluoride compound for ingestion in the U.S. and only allows sodium fluoride tablets any prescription in cities that do not fluoridate at 0.7 ppm or higher (online at: JEPH 439490). Thank you,
    Richard Sauerheber, Ph.D. Chemistry
    (This is dedicated to all those professional and lay persons who continuously fought against whole body fluoridation from infused public water supplies since its first unauthorized trial in 1945)

    Normal and Severely Fluorotic Human Leg Bones, Museum of Man, Balboa Park, San Diego, CA [cid:image172.jpg@01D47B9C.4AC11730]
    Normal leg bone is smooth and moderate in thickness. Note the broad structure of the fluorotic bone and its extremely rough surface structure. The detailed history or mechanism by which fluorosis occurred in the individual from which these leg bones were obtained is not described, but is obviously sublethal low level fluoride exposure for a very long time period. Bone is in part responsible for delivering calcium into the blood, both from rapidly exchangeable calcium phosphate, and that mobilized under the influence of parathyroid hormone. This abnormal bone was caught in the hopelessly ungodly competing actions of parathyroid hormone calcium resorption, calcitonin mediated bone replication and thickening, and conversion of normal hydroxyapatite to fluoroapatite by the calcium chelator fluoride from the blood. The extent of incorporation is determined by water hardness that minimizes fluoride assimilation, as well as the fluoride concentration in water, calcium content of the diet, and fluoride exposure from various possible sources. Bone pathology in consumers of 1 ppm fluoride water over a typical lifespan (4-5,000 mg/kg) are far less disfigured than pictured here. Significant additional sources of fluoride must be present to cause this level of pathology. An example of this would be the infamous case published in the Fluoride Deception (Bryson, Seven Stories Press, 2004) by the individual who ingested sodium fluoride tablets daily for decades to “prove” its safety. He eventually became immobilized and proclaimed before passing that ”it could not be the fluoride that did this because I’ve been taking that for years.” This ironically is a widely held belief of proponents of whole body fluoridation. Recall that the FDA ruled officially against fluoridationist claims that fluoride “strengthens” bone by stating that fluoride is not a mineral nutrient, addition into water is an uncontrolled use of an unapproved drug, and fluoride does not strengthen bone as proven in well controlled human studies. It is for bone pathology reasons that administration of fluoride clinically in an attempt to mitigate hyperthyroidism was discontinued. Whole body fluoridation in an attempt to reduce dental caries must also be discontinued.

    Contamination of Human Bone as a function of Time from a Natural Water Supply [cid:image173.png@01D47B9C.4AC11730]
    Fluoride accumulation in human rib bone as a function of years consuming water that was naturally contaminated with calcium fluoride at 0.8 ppm (squares) in South Shields and 1.9 ppm (diamonds) in West Hartlepool, England (from Jackson
    and Weidmann, Journal of Pathology and Bacteriology, 1958). Note that the incorporation is a pathologic accumulation, not a normal physiologic mineral process, because it is not actually saturable (bone has been reported as high as 14,000 mg/kg in some cases of exposure), it is permanent and irreversible, not subject to resorption by parathyroid hormone, and represents a permanent conversion of normal bone hydroxyapatite (Ca10[PO4]6[0H]2) into abnormal fluorotic bone containing “fluoroapetite” (Ca10[PO4]6F2). This accumulaton rate occurs without fluoridated toothpaste and without industrial fluoridated water. With industrial fluoride infusions in soft water areas, a 0.8 ppm level of accumulation would compare to natural fluoride levels of 3 ppm in water because calcium inhibits natural fluoride assimilation (by 4-fold merely drinking milk during consumption of fluoridated water). 4 ppm water lifetime consumption has been reported to lead to bone fluoride of 12-14,000 mg/kg (National Research Council, Report on Fluoride in Drinking Water, Washington, D.C., 2006, p. 93).
    Note the rapid accumulation initially here is followed by a slower rate of incorporation. This is due to filling of high affinity sites (perhaps the first hydroxide replaced on the formula unit for hydroxapatite) followed by slower filling of sites of lower affinity (perhaps the secdond hydroxide in the formula unit). Fluoride ingestion did not change, but rather a greater proportion accumulates into softer tissues including ligaments, tendons, and other calcium-rich regions in addtion to bone when bone sites become occupied with fluoride (Goodman and Gillman, The Pharmacologic Basis of Therapeutics, Fluoride, 2005). Recall that bone cortical defects were discovered on X-ray examination of children in Grand Rapids, MI after industrial fluoridation of the water supply in 1945 (Connett, P., et.al., The Case Against Fluoride, A Scientific Review of EPA’s Standards, 2010), even though the water contained substantial natural calcium (see previous letters and Sutton, P., The Greatest Fraud: Fluoridation, 1994).
    These and other like data led the U.S. EPA to originally set the secondary maximum contaminant level SMCL for fluoride at 2 ppm at which time consumers must be warned. This was an attempt to protect against severe dental fluorosis, but notice that under the best of conditions (e.g. the absence of synthetic fluoride in water, toothpaste, or other fluoride sources) bone weakening occurs after lifelong ingestion of only 1.9 ppm natural fluoride in water. The EPA 4 ppm MCL attempted to protect from severe skeletal fluorosis but was also mistakenly based on data from natural calcium fluoride, not industrial. Industrial fluoride is fully assimilated and a much more potent bone chelator than calcium fluoride found naturally. Also many sources of synthetic fluoride are now prevalent in the U.S. in addition to fluoridated water. Thus, 40% of U.S. teens as of 2004 have unsightly dental fluorosis because the U.S. is widely fluoridated. Irreversible pathologic bone in fluoridated population groups is also rampant, varying in degree of severity of course. Consumers can deceptively remain without symptoms for very long periods of time because of the high capacity of bone to accumulate fluoride ion. But it is necessary to halt industrial fluorosilicic acid and sodium fluoride infusions into public water supplies to mitigate current rates of progressive bone contamination from whole body fluoridation from simply consuming water and eating fluoridated water-based meals.

    #45.
    December 31, 2013
    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    Recent developments forced this petitioner to submit the following information. This supports the petition to ban the addition of industrial synthetic fluoride compounds, sodium fluoride and fluorosilicic acid, into U.S. public drinking water supplies for the purpose of whole body fluoridation to treat caries in teeth surface enamel (petition #FDA2007-P-0346).
    The use of ingested dental fluoride compounds taken internally through public water supplies remains an ongoing, spreading battle in Southern California. I am proud to have been able to help by completing the seven year study of over 150,000 racing starts at Los Alamitos and Hollywood Park in the Los Angeles basin before and after fluorosilicic acid infusions took place. Here horses were housed year-round at fluoridated tracks without pasture grazing. This article is now published in Fluoride, Volume 46, Issue No. 4, December, 2013, pp. 170-177. The article is in the permanent file at the Santa Fe Irrigation District and the Del Mar Public Works Department. This work should help these districts defend their policy of opposing whole body fluoridation that is being forced on the region. The Del Mar racetrack is supplied by horses from the nearby Fairbanks Ranch, Rancho Santa Fe, Olivenhain (now treated with the Luride sodium fluoride drug), and Del Mar. Although Del Mar Water officials are opposed to fluoridated water, Del Mar water is piped from San Diego Water that is infused with fluorosilicic acid.
    Fluoridation promoters forced Escondido, CA to infuse fluorosilicic acid for its fluoride into all public water in 2005. The Los Angeles basin followed in 2007, under pressure by visiting officials from the U.S. Centers for Disease Control who have no authority to require fluoridation, and by EPA representatives who advise on fluoridation methodology, but also without authority to require fluoridation. San Diego Water was forced to fluoridate by the CA Dept. of Public Health in 2011. Olivenhain Water in 2013 began infusing Luride (sodium fluoride) into all public water supplies, after notifying newspapers that health practitioners can adjust dosages of medications as necessary. The only significant portions of Southern CA from Los Angeles to Mexico that do not fluoridate consumers yet are the cities of Poway, Rancho Santa Fe, and Solana Beach, as well as the U.S. Marine Corps base at Camp Pendleton.
    Luride is an unapproved drug and is allowed by the FDA for use by prescription only, and only in cities that do not fluoridate to 0.7 ppm or higher. Public water is being treated with the unapproved drug Luride, or with fluorosilicic acid, for the purpose of elevating fluoride in the bloodstream to 0.2 ppm (personal communication, Dr. Donald Nelson, former CA DPH Fluoridation Officer). Administering Luride without a prescription is a violation of the Food Drug and Cosmetic Act. Furthermore, since whole body fluoridation does not decrease caries on enamel surfaces (see petition references), administering fluoride compounds to treat consumers constitutes a form of medical malpractice.
    Fluoride promoters are attempting to force San Dieguito Water District to fluoridate now. In discussions with officials at nearby Santa Fe Irrigation, I was informed that fluoride will not be infused into public water supplies to treat consumers there. Their horse population is the largest in San Diego County (covering the massive Fairbanks Ranch area), and they were aware of the closure of Hollywood Park. (As demonstrated in the aritcle, whole body fluoridation of horses contributed to increased breakdowns in Los Angeles, requiring horses to be euthanized). San Dieguito Water District shares the same filtration plant and thus will also not be adding fluoride as an ingestible dental prophylactic into water supplies, even though the SDWD writes in water quality reports that fluoride is “an additive that strengthens teeth.” The practice of whole body fluoridation to treat dental caries in So CA has thus extended to its final reaches, ending here in horse country, where I hope these Districts can make a bold stand to protect their water supplies.
    Horse owners are moving stock to San Diego County from the now-closed Hollywood Park. The Del Mar racetrack is applying for permission to construct stables for permanent housing of these animals, as was done at fluoridated Hollywood Park. Owners need to be informed to stable horses at Fairbanks Ranch or Rancho Santa Fe to avoid industrial fluoride consumption, rather than Del Mar or Olivenhain which now subject their animals to useless whole body fluoridation via treated water supplies.
    To help horse-rich water districts, we would very much appreciate a ruling from the FDA, that the FDA advises against treatment of man or horse with industrial fluorides, due to lack of proof of effectiveness, and that the FDA has not approved any fluoride compound to be taken internally in the U.S. for man (ruled in 1963) or horse. This authority is granted by the Food Drug and Cosmetic Act. The EPA also has authority to halt water fluoridation since it can also be defined as the willful addition of an EPA contaminant into public water. However, the EPA Office of Water informed us in writing that EPA allows cities to decide this for themselves. EPA decades ago relinquished oversight for all water additives, which includes any substance such as fluoride that is argued to have drug-like benefit in humans.
    The San Diego Union Tribune today published the attached article from the very knowledgeable local dentist Dr. David Banks. Also enclosed is a color copy of the final version of the article published in Fluoride. Thank you, Richard Sauerheber

    San Diego Union Tribune, December 31, 2013
    Fluoridated Water Does No Good
    I appreciate the letter on sarin chemicals in the ocean (Dec. 20). It’s funny how people get upset about a poison that’s easily neutralized to safety, but ignore the diluted hazardous waste fluorosilicic acid intentionally discharged directly into San Diego public drinking water.
    If the fluoride added were useful, then we should brush our teeth with the water and spit it out. But it’s useless. Fluoride in toothpaste is 1,500 times the level added in the water. The CDC already published that cavities are not reduced by fluoride in the blood, after eating or drinking it.
    I cannot believe we are expected to pay tax money for whole body fluoridation in an attempt to teat surface enamel cavities.

    David Banks, DDS, San Marcos

    46.
    January 25, 2014

    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This information supports the petition to ban the addition of industrial synthetic fluoride compounds, sodium fluoride and fluorosilicic acid, into U.S. public drinking water supplies for the purpose of whole body fluoridation to treat caries in teeth enamel (petition #FDA2007-P-0346).
    The European Commission (EC) has now done what we are hoping the FDA will do here in the U.S. The deadline for European member governments to provide proof of effectiveness and long-term safety of fluoride ingestion in controlled clinical trials with human volunteers expired Jan. 19, 2014 (see attached description). This makes it illegal now to infuse fluorosilicic acid into public water supplies in the entire European Union, not just in those countries that already prohibit it. Although an official ban was not decreed, until clinical trials data are obtained, fluoridation in the EU will remain illegal.
    The Oral Health Division of the U.S. Centers for Disease Control has been contacted with this information as well. This agency promotes, but cannot legally require, fluoride infusions into public water supplies in an attempt to treat dental caries through oral ingestion. The CDC promotion campaign does not include reference to controlled clinical trials data with human volunteers. Instead, their request to treat water and consumers with ingestible fluoride is based merely on anecdotal observations, where diet, especially sugar consumption and calcium and vitamin D content, and dental hygiene were never controlled. The EC carefully recognized this distinction and set the deadline to receive clinical data from those agencies that planned to fluoridate consumers. Fluoride is a contaminant of water and food, not a normal component of the human bloodstream, and is thus not a nutrient or supplement. So the EC recognized fluoride as a mineral that is being used as a medicine. It is illegal to administer medicines without approved controlled human clinical trials data in both the EU and in the U.S.
    As a reminder, also attached is the public news service announcement describing the FDA ban on the sale of fluoride compounds intended to be ingested by pregnant women in the U.S. because of lack of effectiveness. This ruling remains in effect. As well, until clinical trials data are submitted to the FDA, we need an injunction on the use or sale of fluoride compounds intended to be ingested by consumers in general without a prescription.
    When a segment of a government recommends, and in some cases mandates and requires, the infusion of a diluted toxic hazardous waste material into public water supplies and then is led to believe the act is a public health achievement, it is a case where government got it wrong. Well-controlled clinical trials data are a necessary (but not necessarily sufficient) step in promoting the use of a medical treatment.
    The question now is when and how the FDA, the only Federal agency with authority to collect and evaluate clinical trials data, will halt the sale and use of fluoride compounds intended to be administered for ingestion without FDA approval. Sales and use of this material used as a drug for claimed benefit through whole body internal fluoridation in consumers needs to be stopped. In some cases water districts argue industrial fluoride is ‘food grade’ or is a broad-based “one- concentration-fits-all” drug/supplement. But the FDA in 1975 ruled that industrial fluoride is not considered safe to add to food at any concentration. And when added into water it is an uncontrolled use of an unapproved drug where dosage cannot be controlled (see original petition). Thank you,

    Richard Sauerheber, Ph.D.

    FDA Attacks Prenatal Fluorides SOURCE: Drug News Weekly | October 24, 1966
    WASHINGTON (FNS) – The Food and Drug Administration last week moved to strike from the market fluoride-containing vitamin and mineral prescription preparations for prenatal use.
    “A number of vitamin-mineral preparations containing fluoride have been promised to as preventing tooth decay in children when the drugs are taken by expectant mothers. There is insufficient evidence to support that claim,” explained FDA Commissioner James L. Goddard.
    Dr. Goddard said FDA has consulted leading dental authorities “and their opinions are in accord with ours. It is not recognized that taking fluorides before a child is born will impart stronger teeth or prevent decay.”
    FDA said that when taken in “usual dosages,” the prescription products present “no problem of safety.” Limited scientific studies reportedly have shown untoward effects from the drug in at least one species of animals, the agency said. There has been some scientific debate as to whether fluoride might aggravate mental retardation and mongolism in offspring.
    But the effects of fluoride on the fetus are not precisely known, FDA officials said. There are 20 to 30 of the fluoridated vitamin-mineral products on the market and all are sold on prescription, FDA officials said.
    In a statement of policy in the Oct. 20 Federal Register, FDA said that these products are misbranded and are subject to regulatory proceeding if offered for prenatal tooth strengthening and decay prevention. Drugs may be legally sold with such claims only if the evidence of effectiveness is shown in an approved New Drug Application.
    FDA left the door open for further study on the effects of fluoride for prenatal use.

    Here’s the latest from Europe.
    From: Doug Cross UKCAF
    Date: 21 January 2014 02:59

    IT’S INDEPENDENCE DAY!

    As from today, water fluoridation must be prohibited

    in all Member States of the EC

    20th January 2014

    For years the British and Irish governments have wriggled around the food and medicine laws in order to continue fluoridation, They claim it’s a food, and that it complies with the quality standards set by the Drinking Water Directive. (It’s not – the Directive doesn’t apply to any ‘medicinal water’, but let’s run with this for a moment.)

    At midnight last night (19th January 2014) the last loophole in the food laws of the EC was slammed shut, when the deadline for using an unconventional chemical source materials for any mineral added to food finally expired. It is now not possible to argue that fluoridated water is still regulated under food and water law, like real potable water.

    In both EC and English law fluoride is listed as a mineral. EC Regulation 1925/2006 lists all of those chemicals that are authorized to be used to add a ‘mineral’ to any food. Fluoridation chemicals are not authorized, but back in 2006 the European Parliament left a loophole that would have allowed the British of the Irish governments to get permission to continue fluoridation after the deadline expired, had they followed the proper procedures. Application to continue to use these unorthodox chemicals in foods were permissible until 10th January 2010, but remarkably, neither government submitted one. Had they done so, they could have argued for fluoridated water is a legitimate food until 19th January 2014 – that’s last night.

    So as from today, the addition of fluorosilicic acid to any food is completely prohibited banned throughout the entire European Community, and our rogue governments can no longer claim that fluoridated is a food. As Lord Jauncey, David Shaw and I have argued, it’s a medicine, and since it’s unlicensed for medicinal use, its supply to us, the public, is illegal.

    The legal and commercial implications of this are enormous. Any EC Member State can now refuse to allow the importation of any food that has been prepared – or even just washed – with fluoridated water,during its processing. This includes a potential ban on any foods from States outside the EC, such as Australia, New Zealand, the USA and many other countries that allow the contamination of public water supplies with this illegal ingredient.

    For the full story, go to https://www.ukcaf.org/independence_day.html Then pass the PDF to your Local Authority, your MP, your MEP, and any others who are concerned for the enforcement of those laws that have been passed to protect us from fake medicines and contaminated foods. Doug Cross. BSc. CSci, CBiol. FSB UK Councils Against Fluoridation

    47.
    March 15, 2014

    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This information supports the petition to ban the addition of industrial synthetic fluoride compounds, sodium fluoride and fluorosilicic acid, into U.S. public drinking water supplies for the purpose of whole body fluoridation to treat caries in teeth enamel (petition #FDA2007-P-0346). Natural calcium fluoride is not added into water and this compound requires no FDA oversight. The EPA only labels water unsafe at high fluoride levels above the EPA MCL of 2-4 ppm, which was developed for natural calcium fluoride, not for soluble industrial fluoride.
    It is important for the FDA to understand the information attached that was published in the Fallbrook, CA newspaper. Southern CA has a salt abatement program that is not successful thus far. Although sodium is a mineral nutrient that belongs in blood at 115 mM, pristine fresh drinking water naturally contains no sodium. In this way, fresh water is able to be consumed to maintain normal hydration status in man and animals. The U.S. National average in fresh water supplies is about 15 ppm sodium. Sadly, fluorosilicic acid infusions into public water requires the addition of sodium hydroxide to neutralize acidity. This adds to the sodium burden in fresh water. In So CA the sodium level from industrial emissions along the Colorado River have averaged 85 ppm. The fluoridation of public water in 2007 by the Metropolitan Water District, Los Angeles caused sodium to exceed 100 ppm in order to maintain the normal pH of 8.4. After HHS requested fluoride levels be lowered to 0.7 ppm, the sodium level also lowered somewhat.
    In man and animals, sodium in drinking water causes water retention and when too high causes high blood pressure and other longterm sequelae as you know. Also, avocados are saline intolerant. The large avocado industry in So CA has been adversely affected with lower crop yields after fluoridation began. We contacted the CDC to ask permission to be exempted from their recommendations for water fluoridation in So CA because of the avocado problem. One rancher traveled to Israel to obtain saline resistant avocado strains and is replanting his entire orchard. We cannot expect all other CA ranchers to have to do this, simply to maintain a fluoridation program that is harmful and useless in affecting dental enamel anyway.
    Please examine the attachments while keeping in mind that many people in the U.S., particularly those with damaged kidneys or high blood pressure, are required to have sodium restricted diets. Two liters of drinking water daily, plus water for cooking, amounts to a minimum of 200 mg sodium daily (with 30 mg from fluoridation itself) from water use. All nutritional sodium (180-500mg daily need, see CDC.gov page on sodium attached) is supposed to come from food consumption only, not from fresh drinking water. The CDC reports that foods in the U.S. contain ever-increasing levels of sodium and that 51% of Americans are consuming too much sodium. If the FDA is not planning to address halting the infusions of fluorosilicic acid and sodium hydroxide into all U.S. public water supplies, then please consider halting the infusions in So CA and other regions where significant sodium contaminates the water supply.

    Thank you,

    Richard Sauerheber, Ph.D. Chemistry

    See: http://www.cdc.gov/features/dssodium/
    CDC Centers for Disease Control and Protection. Saving Lives. Protecting People. Americans Consume Too Much Sodium (Salt)
    Sodium intake from processed and restaurant foods contributes to increased rates of high blood pressure, heart attack, and stroke. Decreasing sodium intake to within recommended limits could prevent thousands of deaths annually.
    [Chart: Average daily sodium intake age 2 and up: 3,436 mg. Tolerable upper intake level: 2,300 mg. Recommended adequate intake level: 1,500 mg. How much daily sodium our bodies need: 180-500. Decreasing sodium intake could prevent thousands of deaths annually, because nearly 400,000 deaths each year are attributed to high blood pressure.]Americans eat too much sodium, commonly consumed as salt. High sodium consumption raises blood pressure. High blood pressure is a major risk factor for heart disease and stroke, the nation’s first and third leading causes of death, respectively.
    Research shows a dose-dependent relationship between consuming too much salt and elevated blood pressure. When salt intake is reduced, blood pressure begins decreasing for most people within a few days to weeks. Populations who consume diets low in salt do not experience the increase in blood pressure with age that is seen in most Western countries. Sodium Consumption and the American Food Supply
    We all need a small amount (e.g., between about 180 mg and 500 mg per day) of sodium to keep our bodies working properly. The Institute of Medicine recommends 1500 mg of sodium per day as the Adequate Intake level for most Americans and advises everyone to limit sodium intake to less than 2300 mg per day, the Tolerable Upper Limit. Current dietary guidelines for Americans recommend that adults in general should consume no more than 2,300 mg of sodium per day. At the same time, consume potassium-rich foods, such as fruits and vegetables. However, if you are in the following population groups, you should consume no more than 1,500 mg of sodium per day and meet the potassium recommendation (4,700 mg/day) with food.
    You are 51 years of age or older; African American; you have high blood pressure; you have diabetes; you have chronic kidney disease.
    The 1,500 recommendation applies to about half of the U.S. population overall and the majority of adults. Nearly everyone benefits from reduced sodium consumption.
    · The Adequate Intake (AI) of 1500 mg per day is the recommended average daily sodium intake level. The IOM set the AI for sodium for adults at 1500 mg per day to ensure that the overall diet provides sufficient amounts of other nutrients and to cover sodium sweat losses in physically active individuals.
    · The Upper Limit (UL) of 2300 mg per day refers to the highest daily level of sodium that is likely to pose no risk of adverse health effects to almost all individuals in the general population. The UL is not a recommended intake and there is no apparent benefit to consuming levels of sodium above the Adequate Intake (AI).
    · The average daily sodium intake for Americans age 2 years and older is 3,436 mg.
    · Since the 1970s, the amount of sodium in our food has increased, and we are eating more food each day than in the past.
    The vast majority of the sodium consumed is from processed and restaurant foods; only a small portion is used in cooking or added at the table.
    Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Sodium Fact Sheet. [Adobe PDF file] [PDF – 308KB] November 2009.
    U.S. Department of Health and Human Services, U.S. Department of Agriculture. Dietary guidelines for Americans 2010. Washington, DC: Government Publishing Office, 2010.
    Institute of Medicine. (2005) Dietary reference intakes for water, potassium, sodium chloride, and sulfate. 1st ed. Washington, DC: The National Academies Press.
    Institute of Medicine. (2010) Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press.

    Fallbrook Village News, 12/19/2013
    Flouride is not a cavity fighter
    Thursday, February 6th, 2014
    Issue 06, Volume 18.

    Incorrect complaints were written on the Village News website against letter writers who were trying to protect consumers’ bone from fluoride incorporation. These same fluoridationists do this in newspapers in any city that halts the infusion of industrial sodium fluoride into drinking water. Both sodium and fluoride ions are contaminants of fresh drinking water and their addition violates the U.S. Safe Drinking Water Act and Water Pollution Control Act (article 439490, J. Envir. and Pub. Health, 2013). Toothpaste chemicals do not belong in public drinking water.
    Drinking fluoride does not affect dental caries systemically or topically. The FDA ruled fluoride is not a mineral nutrient and in water is an unapproved use of an unapproved drug. The European Commission deadline for human clinical trials passed this week, so fluoridation is not legal now in all of Europe. The sales of fluorides intended to be ingested by pregnant women were banned by the FDA in 1966. Fluoride is not a listed component of normal blood but is a blood contaminant.

    Further, avocados are salt-intolerant. Infusing sodium to neutralize the industrial fluorosilicic acid hazardous waste is unconscionable in Southern Calif. MWD water rose from 85 to 100 ppm sodium because of “fluoridation,” with corresponding reductions in crop yield.

    Richard Sauerheber, Ph.D

    48.
    March 28, 2014

    U.S. Food and Drug Administration
    Center for Drug Evaluation and Research
    Rockville, MD 20857
    Dear Reviewers,
    This information supports the petition to ban the addition of industrial synthetic fluoride compounds, sodium fluoride, fluorosilicic acid, and sodium fluorosilicate, into U.S. public drinking water supplies that are added for the purpose of whole body fluoridation to treat dental caries (petition #FDA2007-P-0346). Of course no request is made to remove natural calcium fluoride from public water supplies at levels below the EPA MCL/SMCL of 2-4 ppm. Unfortunately, the EPA and the CDC are unable to understand the vastly higher toxicity of industrial fluorides in calcium deficient water, for which there is no MCL.
    The key point presented here is that no data exist proving that artificially fluoridated water use is safe for all subsets of society. Of particular concern are those with health conditions that would be most affected by industrial fluoride exposure, including those with osteopososis, arthritis, osteomalacia (bone), with acute migraine, epilepsy, Alzheimer’s disease (brain), and with Crohn’s disease, ulcers, diverticulitis (GI tract), and other conditions expected to be influenced by the HF corrosive even at minute levels, and the fluoride ion recognized now by the EPA as a neurotoxic substance. The conditions referred to as autism spectrum disorder (ASD) are discussed in more detail in the enclosed material. Already well-described are acute reactions to low-level fluoride in drinking water by Dr. Waldbott (The American Fluoridation Experiment, Devin-Adair Co., N.Y., 1957; A Struggle Against Titans, Carlton Press, N.Y., 1965; Fluoridation the Great Dilemma, Coronado Press, Lawrence, KS, 1978; Health Effects of Environmental Pollutants, C.V. Mosby Co., St. Louis, 1973), Dr. Spittle (Fluoride Fatigue, Paua Press, New Zealand, 2008) and the extensive publications of the late Dr. Albert Burgstahler for whom the current issue of Fluoride is dedicated in memoriam that contains his own personal thyrotoxic reaction to fluoridated water consumption (Fluoride 44(6) Dec. 2013).
    Because low level exposure to industrial fluoride causes harm in subsets of the population, it is necessary for the FDA to halt all industrial fluoride infusions into public water supplies. Industrial fluorides are not FDA approved for ingestion of course, but additional effort must be expended on the part of the FDA so that other Federal agencies, such as the CDC and EPA, will be able to understand that the Food Drug and Cosmetic Act cannot be violated by placing substances into water to treat consumers without formal proof of safety and effectiveness. Dental officials at the CDC and elsewhere have no rights to request or recommend the treatment of the general population with industrial fluorides, no matter what the assumed benefit, especially without a prescription. It is necessary to interview potential consumers to determine the existence of any of the above conditions, as well as the existence of allergies, diabetes, kidney disease, heart disease, atherosclerosis, and high blood pressure (see previous letters). Administering this material for ingestion without such information is a violation of reputable medical practice. The mass treatments of populations of people with artificial fluorides makes or implies false claims of lifetime safety for all consumers without formal proof. This is a violation of the Food Drug and Cosmetic Act.
    In this letter it is hoped that you will understand that this is an acceptable plea for people in need and that it is necessary to halt the practice of chemically treating populations through public water supplies. The unavoidable presence of some natural calcium fluoride contamination of some water supplies has nothing to do with the intentional infusion of artificial industrial toxic fluorides lacking calcium to treat people. Fluoride infusions that have not been banned have opened the door for those who believe it is acceptable to add agents into public water to treat people, such as statin drugs, lithium, or other substances as has been proposed by drug companies in recent times. Caregivers of children with ASD are in a very difficult and lonely position. This is surpassed only by the physical pain and the tendency to withdrawal from society experienced by victims of ASD. What must be stopped immediately is the added burden of exposure of these innocent people to industrial fluoride by mass treatment of public water supplies. The organized program of dosing all Americans without FDA approval involves CDC dental officials and State Health Departments under them, fluoridation engineers and equipment manufacturers, suppliers of industrial fluorides, and EPA personnel cooperating with the program, which has been completely discredited in being ineffective in its stated purpose.

    Thank you,

    Joint letter: Dr. Richard Sauerheber and Audrey Adams, Washington Action for Safe Water, parent of autistic child.
    Acute effects of fluoride ingestion. Many of the adverse effects of consuming fluoridated water are chronic on bone, brain and other systems and have been described in previous letters. There are subsets of the population that experience acute, immediate adverse effects upon exposure to water treated with industrial fluorides (whether by oral ingestion or in some cases transdermal smaller exposures), in particular in regions where the water supply is devoid of protective calcium such as the Pacific Northwest. Approximately 1% of people are either allergic or hypersensitive to industrial fluoride exposure whether systemic or topical (see previous letters). We now know that children with autism spectrum disorder (ASD) can be unusually susceptible to harm from fluoride exposure. The U.S. CDC reported that the incidence of autism spectrum disorder (ASD) in U.S. children is now approximately 1 in 68 children, 1.5% of children in the entire country. The exact causes of ASD remain unclear in spite of this astounding substantial number of cases, totaling 1.2 million Americans (1). Recent studies from the University of California, San Diego Department of Neurosciences reported that disrupted patches of neurons (but not glial cells) occur in the prefrontal cortex in ASD brain, detected with detailed RNA mapping in autopsies (9,10).
    Scores of published studies have confirmed that consumption of water containing fluoride causes decreased mental IQ in man (3,4,5). Published animal research proved that fluoridated water consumption causes brain degeneration and functional abnormality in newborn mammals (see previous letters describing studies by Reddy, by Mullenix, and by Varner). Detailed epidemiologic published studies indicate that fluoridated water consumption correlates with increased incidence of Down’s syndrome with its substantial mental abnormality aspects. Many instances of adverse reactions in autism cases have been reported specifically to water fluoridated to desired levels (approx. 1 ppm) (2; personal testimonies of mothers of autistic children). A recent study from Harvard University listed neurotoxic agents that accentuate autism (see attached news report). Fluoride is the only one intentionally ingested to treat humans. All fluoride compounds intended to be taken internally through ingestion are not FDA approved.
    Whether industrial fluoride consumption can directly cause autism or not is unclear. What is most certain however is that symptoms extant in autism are worsened by systemic fluoride. Fluoride incorporates into intracellular regions of brain tissue, as in other organs after assimilation, where it is a contaminant. The ion disrupts normal hydrogen bonds between H and oxygen and between H and nitrogen, whether in water, proteins, DNA or other macromolecules, and forms abnormal hydrogen bonds between H and fluoride ion instead (5). Recent research from several laboratories including Johns Hopkins, the Krieger Institute, and the Great Plains Laboratory all concur that a substantial portion of children with ASD have extremely low serum cholesterol levels, substantially below normal levels in children aged 0-19 (see attached graph). Brain myelin is concentrated cholesterol and acts as insulation around neural cells in white matter. Myelin is essential in allowing neurons to function normally in the complex network circuits in the brain.
    Fluoride ion is charged and lipid in-soluble. Abnormally thin myelin sheaths around brain cell membranes not only are part of the cortex disorganized patches but would also allow fluoride to hydrogen bond with proteins on these unguarded cell surfaces. HF is always present with fluoride at a small but non-zero percent depending on prevailing pH. The intracellular pH is 6.9 with a larger component of HF than at pH 7.4 in extracellular fluid. The exposed neurons that normally require a thick myelin covering could explain the fluoride sensitivity seen in many people with ASD. In some cases of ASD, cholesterol levels are low simply because of a deficiency of vitamin B5 (pantothenic acid required in the metabolic pathway to synthesize cholesterol (8)). In other cases, it has been found that low cholesterol is caused by the genetic absence of one enzyme in this pathway (see attachments).
    There is now a very high incidence of mental disorders in the U.S. without a proven, certain cause. Mental derangements are caused by fluoridated water consumption (3,4). The use of fluoridated water in the U.S. is widespread and is increasing because of requests made by dental officials within the CDC who desire to treat teeth through ingestion of industrial fluoride (4,5). The EPA recently ruled that fluoride is a neurotoxin in man. Taken together, these facts now compel the FDA to halt the infusion of industrial fluoride compounds into public water supplies. It is imperative that the CDC halt any further recommendations to “fluoridate” water supplies. The FDA must aid the CDC in this effort.
    ASD pathophysiology and care. Victims of ASD are in immediate need of assistance. In most cases the bodily movements that seem erratic are actually rythmic maneuvers that are made simply to attempt to lessen the chronic never-ending pain that is felt. The rocking back and forth of the upper torso is likely a response to the GI tract abnormalities that so commonly accompany ASD with pain, diarrhea, and other symptoms. The consumption of HF as an extreme corrosive from the acidic fluoridated stomach would further aggravate any ulcerated GI tissue. This is the likely mechanism by which fluoridated water in Los Angeles caused increased incidence of breakdowns in racehorses stabled permanently with fluoridated water (11). The FDA is obligated to point out and to correct this grotesque mistake.
    What is commendable is the activity of the UC Davis Mind Institute. This school accepts college students with autism in their degree program. Many of the students become employed in support-assisted jobs and this program helps with student self direction and communication skills. Severe ASD of course requires completely different levels of care. The city of Davis recently boldly halted all fluoridation of public water supplies. This was achieved in spite of attempts by dental and public health fluoridationists who insist that fluoridation be undertaken because of a 40 year old State law that they alone interpret as a “mandate” and that “no one has ever been harmed from fluoridated water.”
    For too long the health industry has obsessed with lowering everyone’s cholesterol. Too many physicians purposely administer drugs to lower cholesterol with the attitude that “the lower the better” and there is “no level that is too low”. Yes there are many hypercholesterolemics who need such treatment, but they are not as numerous as the public assumes. And the tragedy is that many people can become hypocholesterolemic if these drugs are misused. The symptomatology of those with ASD has proven how essential cholesterol is at proper minimum levels.
    Required Actions. Citizens demand action, not mere paper-pushing, statements of concern, calls for further research or for “proof” of harm, or other decisions that do not produce a halt to industrial fluoride consumption from water supplies. Only a halt of the insidious, ineffective, expensive, illegal practice is acceptable. The Food Drug and Cosmetic Act requires that any chemical substance, intended to be administered for ingestion to treat humans, be tested and verified for safety. And this is only a minimum, because such testing needs to consider autistic children, now that 1.5% of U.S. children are afflicted with ASD. There are no excuses to ignore this situation. U.S. children deserve to be protected from willful injury.
    The idea is baseless that long-term fluoride ingestion is harmless. The EPA is NOT in a position to expend efforts to intervene on behalf of subgroups of people who are affected by a regulated pollutant that is below the EPA MCL. Innocent victims of autism experience immediate, acute reactions to the fluoride pollutant at intended concentrations allowed by the EPA added into water. It must be emphasized that people afflicted with ASD require our immediate attention and help. The unusual muscle movements we now know are a reaction to the pain that is experienced, where rhythmic movements are the only mechanism available to attempt to minimize that chronic pain. Any exposure to industrial fluoride must be blocked and any attempt by a government to inflict fluoride exposure intentionally on those afflicted with ASD is unconscionable. Only the FDA, not the EPA of course, is capable of addressing and halting such nonsense. Richard Sauerheber, Ph.D.Chemistry
    Audrey Adams, WASW

    1. Autism Estimate Rises to 1 in 68 Children, Associated Press, Union Tribune San Diego, page A4, 2014.
    2. Rookard, C., Fluoride and Autism, is There a Connection? Fluoride 33, 2000, p.99; available at: http://www.fluorideresearch.org/332/files/FJ2000_v33_n2_p99-100.pdf
    3. National Research Council 2006 Report on Fluoride in Drinking Water, A Scientific review of EPA’s Standards, Washington, D.C.
    4. Connett, P., et.al., The Case Against Fluoride, Chelsea Green Publishing,White River Junction, Vermont, 2010.
    5. Sauerheber, R., Physiologic Conditions Affect the Toxicity of Ingested Industrial Fluoride, Jour. Envir. Pub. Health, article 439490, 2013.
    6. Kelly, R. Deficient Cholesterol: A Common new Factor in Autism, Adv. Pediatr.2000 47:1, Great Plains Laboratory, Health, Metabolism and Nutrition (see attached), available at: http://www.greatplainslaboratory.com/home/eng/cholesterol.asp
    7. Tierney, E., Director, Autism Metabolic Research Program, Kennedy Krieger Institute, Autism: New Study Discovers Statistically Significant Link Between Abnormally Low Cholesterol Levels And Autism Spectrum Disorders, 2006,Baltimore, MD. Available at: http://www.kennedykrieger.org/node/1676.
    8. Martin, et.al., Harper’s Review of Physiological Chemistry, Lange Publishing, 1989.
    9. U-T San Diego March 27, 2014 http://www.utsandiego.com/news/2014/mar/27/tp-autism-begins-in-pregnancy-ucsd-led-study-finds/
    10. Stoner, R., Chow, M., Boyle, M., Sunkin, S., Mouton,P., Roy, S., Winshaw-Boris, A., Colamarino, S., Lein, S., Courchesne, E. Patches of Disorganization in the Neocortex of Children with Autism New Eng. J. Med. 370, 2014 p.1209, available at: http://www.nejm.org/doi/full/10.1056/NEJMoa1307491 11. Sauerheber, R. Fluoride 44, Dec. 2013 (see previous submission to FDA).

    Cholesterol levels in serum(mg%)
    Normal children 0 – 19 years age (squares)
    Children with ASD symptoms (triangles)
    [cid:image174.png@01D47B9C.4AC11730]
    Cholesterol levels are graphed for comparison from average published values for children and values reported for children with ASD described in the accompanying attached report. The Great Plains Laboratory, Health Metabolism and Nutrition

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