The judge advocates for the EPA to take additional steps due to potential hazards related to fluoride in tap water.
Judge Edward Chen expresses uncertainly about the direct correlation between the standard fluoride levels added to water and a decline in children's IQ, but he acknowledges that an accumulation of evidence indicates a potential unreasonable risk. As a result, he obligates the Environmental Protection Agency (EPA) to lessen this potential risk, without specified actions.
This ruling adds to the controversy surrounding an intervention widely celebrated as one of the 20th century's notable public health successes. Fluoride reinforces tooth enamel and minimizes cavities by substituting lost minerals during regular wear and tear, as per the US Centers for Disease Control and Prevention.
In recent times, a federal agency declared "with moderate confidence" that elevated fluoride exposure can be linked to reduced IQ in children. The National Toxicology Program reached this conclusion based on examinations involving fluoride levels more than double the suggested limit for safe drinking water.
The EPA, a party to the trial, argued that the influence of fluoride at lower exposure levels remained unclear. However, the EPA is bound to maintain a distinction between the safety threshold and the exposure threshold. If this margin is insufficient, the agent poses a risk, according to Chen's 80-page judgment released Tuesday.
"To summarize, the hazard to health at exposure levels in US drinking water is significant enough to warrant regulatory intervention by the EPA" under the law, he concluded.
Jeff Landis, an EPA spokesperson, stated that the agency was scrutinizing the decision without offering further comment.
In 1950, federal authorities endorsed water fluoridation as a preventative measure against tooth decay, persisting in its promotion even after the introduction of fluoride toothpaste on the market.
Although fluoride comes from various sources, drinking water is the primary source for most Americans. Approximately 65% of the US population currently receives fluoridated water, according to CDC statistics.
Since 2015, federal health authorities have recommended a fluoridation level of 0.7 milligrams per liter of water. Prior to this, the recommended upper range was 1.2 milligrams per liter. The World Health Organization has set a safe maximum fluoride level for drinking water at 1.5 milligrams per liter.
Separately, the EPA has maintained a long-standing rule that water systems should not exceed 4 milligrams of fluoride per liter of water. This regulation targets preventing skeletal fluorosis, a potentially debilitating condition characterized by weaker bones, stiffness, and discomfort.
However, studies over the last two decades have raised concerns about a different issue: a connection between fluoride and brain development. Researchers pondered the impact on developing fetuses and infants who might ingest water used for preparing baby formula. Animal studies suggested that fluoride could affect neurochemistry, cell functioning, and brain regions responsible for learning, memory, rational thought, and behavior.
The trial, initiated in US District Court in San Francisco in 2017, saw the Food & Water Watch serve as the lead plaintiff. Judge Chen put the hearings on hold in 2020 to wait for the National Toxicology Program report, but he heard arguments from both sides earlier this year.
This ruling has raised questions about the safety of long-term exposure to fluoride, which is often considered a health benefit due to its role in minimizing cavities. Despite the US Centers for Disease Control and Prevention's endorsement of fluoride reinforcing tooth enamel, there is growing concern about its potential impact on brain development, especially in children.
