A new report from a U.S. government agency has sparked significant debate by suggesting that fluoride levels in drinking water exceeding twice the recommended amount may be associated with reduced IQ levels in children.
This report, marking the first instance where a federal body has identified a potential connection between high fluoride exposure and decreased cognitive function in children with “moderate confidence,” was released on Wednesday by the National Toxicology Program (NTP), part of the Department of Health and Human Services. Although the report does not directly assess the health impacts of fluoride in drinking water alone, it highlights a notable concern regarding possible neurological risks.
Fluoride, known for its role in strengthening teeth and preventing cavities by replenishing lost minerals, has been a cornerstone of public health initiatives. The U.S. Centers for Disease Control and Prevention (CDC) has long hailed the fluoridation of drinking water as one of the most significant public health achievements of the past century.
Ashley Malin, a researcher from the University of Florida who has investigated the impact of elevated fluoride levels on pregnant women and their offspring, described the report as a crucial advancement in understanding these risks. She commended it as the most thorough review conducted on the subject.
The NTP’s extensive report is the culmination of a review of global studies from countries including Canada, China, India, Iran, Pakistan, and Mexico. It found a consistent link between fluoride concentrations exceeding 1.5 milligrams per liter in drinking water and lower IQ levels in children. Although the report does not specify the exact IQ reduction at varying fluoride levels, some studies indicated a decrease of 2 to 5 points in children with higher fluoride exposure.
Federal guidelines have recommended a fluoride concentration of 0.7 milligrams per liter in drinking water since 2015, reduced from the previous upper limit of 1.2 milligrams per liter. The World Health Organization (WHO) considers a safe limit for fluoride in drinking water to be 1.5 milligrams per liter. Currently, about 0.6% of the U.S. population, or approximately 1.9 million people, consume water with fluoride levels at or above this threshold.
Malin emphasized the need for protective measures and policy discussions to address these findings. The 324-page report did not address the potential risks of lower fluoride levels or the effects on adults, indicating a need for further research.
The American Dental Association (ADA), a strong proponent of water fluoridation, had previously criticized earlier analyses related to this topic. As of Wednesday afternoon, the ADA had not yet issued a formal response, stating that its experts were still reviewing the new report.
Fluoride, a naturally occurring mineral, was first added to municipal water supplies in Grand Rapids, Michigan, in 1945. Since then, its inclusion in water has been endorsed by federal health officials as a preventive measure against tooth decay. Despite the introduction of fluoride toothpaste, drinking water remains a primary source of fluoride for Americans.
In 2015, the recommendation for fluoride levels in drinking water was adjusted to mitigate fluorosis, a condition causing discoloration of teeth. The Environmental Protection Agency (EPA) maintains a maximum allowable fluoride concentration of 4 milligrams per liter to prevent skeletal fluorosis, a disorder affecting bone health.
Emerging research has increasingly raised concerns about the impact of high fluoride levels on brain development. Studies in animals have suggested that fluoride might affect brain regions related to learning, memory, and behavior. This concern prompted the National Research Council in 2006 to call for more research on the neurological effects of fluoride exposure.
Following ongoing investigations and the need for further evidence, the NTP began a comprehensive review in 2016 to assess whether new fluoride regulation measures might be necessary. The final report, which faced several delays, reflects the importance of accuracy in addressing public health concerns.
Rick Woychik, director of the NTP, underscored the importance of ensuring the scientific accuracy of the findings. Malin suggested that pregnant women consider reducing fluoride intake from both drinking water and certain teas and recommended policy discussions on fluoride labeling for beverages.
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