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Is Fluoride in Water Safe to Drink During Pregnancy?

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Wednesday, May 22, 2024

The LatestA small study published Monday suggested that higher levels of fluoride consumed during the third trimester of pregnancy were associated with a greater risk of behavioral problems in the mothers’ children at 3 years old. The authors of the study, which was funded in part by the National Institutes of Health and the Environmental Protection Agency and published in the journal JAMA Network Open, believe it is the first to examine links between prenatal fluoride exposure and child development among families living in the United States, where fluoride is often added to community water supplies to prevent dental cavities.The study’s authors and some outside researchers said that the findings should prompt policymakers to evaluate the safety of fluoride consumption during pregnancy.“I think it’s a warning sign,” said Dr. Beate Ritz, an environmental epidemiologist at the U.C.L.A. Fielding School of Public Health.But other experts cautioned that the study had several important limitations that made it difficult to assess the potential effects of fluoride consumption during pregnancy.“There is nothing about this study that alarms me or would make me recommend that pregnant women stop drinking tap water,” said Dr. Patricia Braun, a professor of pediatrics at the University of Colorado School of Medicine and a spokesperson for the American Academy of Pediatrics.The BackgroundFluoride strengthens tooth enamel, and research suggests that drinking water with added fluoride can reduce cavities by up to 25 percent. Many communities in the United States have added fluoride to their water for this reason since the 1940s, a practice widely celebrated as a major public health achievement. In 2020, 63 percent of people in the United States lived in areas with at least 0.7 milligrams per liter of fluoride in the water — considered optimal for cavity prevention — though some areas have levels that are higher, in part because of naturally high fluoride in the groundwater.In the last few years, several studies from Mexico and Canada have suggested that fluoride exposure during pregnancy is linked to slightly lower scores on intelligence tests and other measures of cognitive function in children.But recent studies from Spain and Denmark have found no such link.There is a “contentious debate” about water fluoridation, acknowledged Ashley Malin, an assistant professor of epidemiology in the College of Public Health and Health Professions at the University of Florida and the lead author of the new study. The issue is currently the subject of a lawsuit filed by the nonprofit Food and Water Watch and other groups against the Environmental Protection Agency. The nonprofit claims that water fluoridation poses a risk to children’s health.The ResearchThe study looked at a group of 229 predominantly low-income Hispanic pregnant women in Los Angeles who were already being followed in other research. Most of the women lived in areas with fluoridated water. The researchers measured the fluoride levels in their urine in a single test during the third trimester. Then, when their children were 3 years old, the mothers filled out the Preschool Child Behavior Checklist, a measure used to detect emotional, behavioral and social problems.Overall, 14 percent of the children had a total score in the “borderline clinical” or “clinical” range, meaning that a doctor may want to watch or evaluate them, or provide additional support, Dr. Malin said. And on average, higher fluoride levels in the mothers’ urine were correlated with a greater risk of behavioral problems in the children. The researchers found that women with urine fluoride levels at the 75th percentile were 83 percent more likely to have children with borderline or clinically significant behavioral problems than women with levels at the 25th percentile.The main problems reported by the mothers were emotional reactivity, which is the tendency to overreact; somatic complaints, such as headaches and stomachaches; anxiety; and symptoms linked to autism (though those symptoms alone would not be enough for an autism diagnosis).The researchers did not find an association with other behavioral symptoms like aggression or issues with concentration.The findings are important and add to evidence suggesting prenatal fluoride consumption may affect the developing brain, said Joseph Braun, a professor of epidemiology and the director of the Center for Children’s Environmental Health at Brown University, who was not involved in the research. That said, the increases in behavioral scores were relatively small — about two points on a scale from 28 to 100 for overall behavioral problems. It’s hard to say whether such a difference might be noticeable in an individual child, he said.But given how widespread water fluoridation is, he added, even minor behavioral changes in individual children could have a meaningful impact on the overall population.Subscribe to The Times to read as many articles as you like.

New research suggests a link between prenatal fluoride levels and behavioral issues in children. Experts are divided on the study’s significance.

The Latest

A small study published Monday suggested that higher levels of fluoride consumed during the third trimester of pregnancy were associated with a greater risk of behavioral problems in the mothers’ children at 3 years old. The authors of the study, which was funded in part by the National Institutes of Health and the Environmental Protection Agency and published in the journal JAMA Network Open, believe it is the first to examine links between prenatal fluoride exposure and child development among families living in the United States, where fluoride is often added to community water supplies to prevent dental cavities.

The study’s authors and some outside researchers said that the findings should prompt policymakers to evaluate the safety of fluoride consumption during pregnancy.

“I think it’s a warning sign,” said Dr. Beate Ritz, an environmental epidemiologist at the U.C.L.A. Fielding School of Public Health.

But other experts cautioned that the study had several important limitations that made it difficult to assess the potential effects of fluoride consumption during pregnancy.

“There is nothing about this study that alarms me or would make me recommend that pregnant women stop drinking tap water,” said Dr. Patricia Braun, a professor of pediatrics at the University of Colorado School of Medicine and a spokesperson for the American Academy of Pediatrics.

The Background

Fluoride strengthens tooth enamel, and research suggests that drinking water with added fluoride can reduce cavities by up to 25 percent. Many communities in the United States have added fluoride to their water for this reason since the 1940s, a practice widely celebrated as a major public health achievement. In 2020, 63 percent of people in the United States lived in areas with at least 0.7 milligrams per liter of fluoride in the water — considered optimal for cavity prevention — though some areas have levels that are higher, in part because of naturally high fluoride in the groundwater.

In the last few years, several studies from Mexico and Canada have suggested that fluoride exposure during pregnancy is linked to slightly lower scores on intelligence tests and other measures of cognitive function in children.

But recent studies from Spain and Denmark have found no such link.

There is a “contentious debate” about water fluoridation, acknowledged Ashley Malin, an assistant professor of epidemiology in the College of Public Health and Health Professions at the University of Florida and the lead author of the new study. The issue is currently the subject of a lawsuit filed by the nonprofit Food and Water Watch and other groups against the Environmental Protection Agency. The nonprofit claims that water fluoridation poses a risk to children’s health.

The Research

The study looked at a group of 229 predominantly low-income Hispanic pregnant women in Los Angeles who were already being followed in other research. Most of the women lived in areas with fluoridated water. The researchers measured the fluoride levels in their urine in a single test during the third trimester. Then, when their children were 3 years old, the mothers filled out the Preschool Child Behavior Checklist, a measure used to detect emotional, behavioral and social problems.

Overall, 14 percent of the children had a total score in the “borderline clinical” or “clinical” range, meaning that a doctor may want to watch or evaluate them, or provide additional support, Dr. Malin said. And on average, higher fluoride levels in the mothers’ urine were correlated with a greater risk of behavioral problems in the children. The researchers found that women with urine fluoride levels at the 75th percentile were 83 percent more likely to have children with borderline or clinically significant behavioral problems than women with levels at the 25th percentile.

The main problems reported by the mothers were emotional reactivity, which is the tendency to overreact; somatic complaints, such as headaches and stomachaches; anxiety; and symptoms linked to autism (though those symptoms alone would not be enough for an autism diagnosis).

The researchers did not find an association with other behavioral symptoms like aggression or issues with concentration.

The findings are important and add to evidence suggesting prenatal fluoride consumption may affect the developing brain, said Joseph Braun, a professor of epidemiology and the director of the Center for Children’s Environmental Health at Brown University, who was not involved in the research. That said, the increases in behavioral scores were relatively small — about two points on a scale from 28 to 100 for overall behavioral problems. It’s hard to say whether such a difference might be noticeable in an individual child, he said.

But given how widespread water fluoridation is, he added, even minor behavioral changes in individual children could have a meaningful impact on the overall population.

Subscribe to The Times to read as many articles as you like.

Read the full story here.

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Asheville restores drinking water 53 days after Hurricane Helene - but not all are ready to sip

Residents concerned as North Carolina city lifts boil advisory and scientists detect lead in water at area schoolsWhen the western North Carolina town Swannanoa was battered by Hurricane Helene in September, two large trees crushed Stephen Knight’s home. His family of six was launched into a complicated web of survival: finding a temporary home, applying for disaster relief, filing insurance claims.The new logistics of living included the daily search for food and water. Until earlier this week, most residents of this town east of Asheville had no drinkable tap water for 52 days. After the storm damaged infrastructure around the region, water had been partly restored in mid-October. It was good for flushing toilets but not safe for consumption. In some places, sediment left the water inky like black tea. Continue reading...

When the western North Carolina town Swannanoa was battered by Hurricane Helene in September, two large trees crushed Stephen Knight’s home. His family of six was launched into a complicated web of survival: finding a temporary home, applying for disaster relief, filing insurance claims.The new logistics of living included the daily search for food and water. Until earlier this week, most residents of this town east of Asheville had no drinkable tap water for 52 days. After the storm damaged infrastructure around the region, water had been partly restored in mid-October. It was good for flushing toilets but not safe for consumption. In some places, sediment left the water inky like black tea.Local government advised residents not to consume the water without boiling. People with illnesses or open wounds were also advised to skip showers. Parents were cautioned that children should keep their mouths closed while bathing to avoid accidental ingestion.Drinking the water, even after boiling, was the last-resort option, and bottled water became a precious commodity. In the first days after the hurricane, many hauled creek water in buckets to flush their toilets. People bathed and did laundry at public “comfort stations”. Tankers with clean water occupied vacant lots around western North Carolina. Churches, schools and fire stations became water distribution centers. Households changed their routines: Meals that required boiling in water – pasta or rice – fell off home menus. Families stockpiled clean water to mix baby formula, and washing dishes was often a matter of dipping dishes in a solution of bleach and water.As of 18 November, the city of Asheville lifted its boil advisory. That provided some relief to Knight, who works as a nonprofit communications director. Like many residents impacted by the hurricane, he “had to learn what terms like potable and turbidity meant” as they waited for repairs to the badly damaged water North Fork plant that serves much of the region. (Turbidity measures cloudiness caused by tiny particles in water and is a key indicator of water quality.) Residents constantly listened for reports about how long it would take to be able to drink, bathe and use water in their homes or workplaces again. Initial estimates suggested water restoration could have taken as long as December, and many feared their lack of water access could stretch into next year.The remnants of a waterline pile up downstream from North Fork reservoir, a main source of water for the city on 2 October 2024, after the line was destroyed during Hurricane Helene. Photograph: Jeff Roberson/APStill, some residents and institutions are not yet tapping into the newly restored city water supply, concerned that the water may still not be entirely safe. Lead was detected in water at seven area schools, a relatively common problem in American schools due to older pipes. For 19 days, the city of Asheville treated water with high amounts of chlorine in case harmful materials had seeped into the badly damaged system. But while chlorine is a decontaminant, it can also corrode pipes. Right now, no lead has been discovered in the water system’s source, but many North Carolinans are wondering: am I in harm’s way from toxic lead, which can cause serious and fatal illness, or other materials?Knight is skeptical of using city water for preparing food or washing dishes. He remarked that while the cloudiness in the North Fork reservoir’s water has dropped, it still isn’t back to pre-storm numbers. “I’m thinking, I need to order [wipes used for camping or outdoor use] because I still can’t use the water here.”According to the ABC affiliate WLOS, Mission Hospital, one of the region’s largest health systems, is currently using water from recently drilled wells and storage tanks at almost all its facilities, with the exception of a freestanding emergency room.Clear and effective communication and widespread testing will ensure there is not a second crisis in AshevilleSally A Wasileski SchmeltzerIn the immediate aftermath of the storm, Stephanie Allen, a mother of three, hung curtains outside and constructed a makeshift toilet with a five-gallon bucket. Recently, when her son had a high fever, she filled the bathtub with water to cool him down. But she recoiled at the water’s appearance and opted to give him a sponge bath instead.When asked if she would resume drinking Asheville city water in the near future, Allen was hesitant. “I’m not quite ready to drink from the faucet,” she shared. “I need more scientific studies and anecdotal evidence of its safety. More time”.In a open letter to public officials, the University of North Carolina Asheville professor Sally A Wasileski Schmeltzer urged further investigation and communication educating the general public about the risk of lead poisoning. Schmeltzer chairs the school’s chemistry department and specializes in environmental research.Among her recommendations: widespread testing for lead and copper for buildings built before 1988, when lead was commonly used. She also advocated for blood tests for people who consumed the water – even after boiling – and especially for infants, other children, and pregnant or nursing people. Free testing is available, but she noted that homeowners need to understand when and how to test their water and themselves.“ [P]otential damage to private plumbing could be much more widespread than just to those schools that were tested,” Schmeltzer wrote. “I understand that it is very important not to cause a panic. Yet clear and effective communication and widespread testing will ensure there is not a second crisis in Asheville and Buncombe county.”skip past newsletter promotionThe planet's most important stories. Get all the week's environment news - the good, the bad and the essentialPrivacy Notice: Newsletters may contain info about charities, online ads, and content funded by outside parties. For more information see our Privacy Policy. 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Texas agreed to take 120,000 acre-feet of water from Mexico this month, only after the U.S. and Mexico agreed to an updated treaty.

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news. McALLEN –– South Texas farmers remain concerned about their access to water despite back-to-back announcements this month that signaled better days ahead. First, the U.S. and Mexico signed an amendment to an international water treaty that dictates how water is shared between the two countries. Then earlier this week, Texas agreed to accept a relatively small offer of water that would go toward paying off Mexico's current water debt while also bringing relief to farmers and ranchers whose land has gone dry in the face of the current water shortage. However, relief is still a ways off as the Texas Commission on Environmental Quality, the state agency that decides how to allocate the water, has yet to give the green light for that water to be used. The water in question is 120,000 acre-feet from Mexico's San Juan River. 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A new documentary about the Flint water crisis draws out the complexities of the problem.

“There’s a definite sense of people being expendable in this country,” says University of Florida professor Riché Barnes in director William Hart’s new film, Lead and Copper. “And it usually runs across racial lines. When it gets outside of racial lines, it runs on economic lines.” Barnes’s observation underscores the moral clarity that Hart brings to his investigation of the Flint water crisis, which exposed an entire community to high levels of lead through contaminated drinking water. That clarity helps cut through the morass of finger-pointing and misinformation that various politicians and bureaucrats use to abdicate responsibility. Lead and Copper reminds viewers that these decisions threaten people’s lives. Although just forty miles from Lake Huron, Flint, a post-industrial city whose population has dwindled to a nearly 100-year low, has been getting its water via a pipeline through Detroit since 1967. 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Together, Walters and Del Toral demanded that city officials stop using the polluted water and provide emergency provisions for Flint Residents. Hart employs several on-screen graphics to help clarify the crisis, including a sleek line-art map of the United States and animation illustrating the passage of time. As the camera pans across the map, the narrative turns its attention away from Flint to similarly affected neighborhoods in Newark, New Jersey, and Washington, D.C., in which the full scope of the problem is revealed. These visual elements don’t just provide clarification; they also underscore the complicated nature of the problem. One of the film’s most effective moments shows then governor of Michigan Rick Snyder at a Congressional hearing about the crisis in Flint, in which the late Representative Elijah Cummings, Democrat of Maryland, questions Snyder about the extent of his knowledge about the crisis in Flint. As the film features Snyder’s testimony, a simultaneous graphic element reveals that someone close to the governor raised concerns much earlier. With every spin of the dial, and with every expansion on the map, viewers see in clear, unmistakable terms what various government officials and politicians have tried to obscure: that the water poisoning started after the city manager, the mayor, or someone in government made a cost-saving decision, and the adverse effects flowed down to the most vulnerable. While Lead and Copper’s complex representation of the crisis often works to underscore the movie’s point that the least powerful suffer the most, the narrative sometimes gets unnecessarily muddy. The film’s talking heads include Newark Mayor Ras Baraka and former Flint Mayor Dayne Walling, two figures with far more influence than the mothers of afflicted children. The film allows both of these leaders to speak for themselves, rarely provides overt fact checks to their explanations, and therefore seems to endorse their claims that they, too, were duped by bureaucrats above them and helpless to change things. Lead and Copper also gets muddled when Edwards begins diagnosing the problems. Like a good professor, he shows the viewers physical evidence of the water poisoning, such as the thick lead pipes used in the houses of most Flint residents. He explains in simple terms that lead from the pipes seeps into the water unless certain chemicals are used, and that Flint neglected to use these chemicals. Edwards’s explanation makes sense, but he’s introducing a problem independent of the decision to get water from the Flint River. The use of lead pipes helps connect the problems of Flint to those of Newark, Washington, D.C., and several other locations listed in the movie’s final title cards. But without distinguishing between water poisoned because of pollution in the Flint River and water poisoned because of lead pipes that have been in place for decades, these revelations introduce issues beyond the city’s water source, unnecessarily complicating Lead and Copper’s central line of argument. In fact, all of the connections between Flint, Newark, and Washington, D.C. feel more like appendices than they do expansions of the film’s central theme. With so many people actively trying to obfuscate the facts, these instances can sometimes create more confusion than clarity. Despite these occasional problems, Lead and Copper is ultimately about the affected community members. The film reminds viewers that we are not helpless against structures that allow the powerful to carelessly poison Black and low-income families. The film might end in a terrifying set of statistics about counties across the country with high levels of lead in their water systems, but we first see footage of Janae Young educating an elementary class about recycling and LeeAnne Walters vowing to continue the fight. There’s much work to be done, but Lead and Copper can bring others along. Given the many held unaccountable and the work yet to be done in Flint, it’s not accurate to say that Lead and Copper has a happy ending. But when we see people working to save lives and deliver justice, viewers cannot help but believe that they can turn the flow of even a poisoned river. Lead and Copper is available to rent on streaming services everywhere starting Tuesday, November 19. Joe George is a pop culture writer whose work has appeared in Polygon, Slate, Den of Geek, and elsewhere. You can follow him on Twitter at @jageorgeii and read more at joewriteswords.com. Read more by Joe George November 21, 2024 2:13 PM

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Family

Vanishing Springs

The Florida you know is a lie. In contrast to what Americans have been told, Florida’s magic is not found in the giant mouse, the rolling green golf courses, or in the beachside palaces. The beauty and uniqueness of Florida is under our feet - the aquifer. This pure, crystal clear water is the life blood of our state and without it, life as we know it in the sunshine state would not exist. This life sustaining force is only seen where it bubbles up to the surface through Florida’s collection of 1,000 springs. These springs were originally what drew society to this land. Wealthy tourists in the 1900’s flooded the Florida springs seeking medicinal cures from its pristine waters. As springs became a popular tourist destination, spring houses were built around these pools of water. When this development began, the springs began flowing less and some eventually stopped altogether. People assumed this was the natural order of this wonder and moved on. Theme parks, golf courses and resorts were erected to entice tourists to visit Florida, the natural beauty of the state soon faded out of our memory. The springs of Florida now silently suffer from the effects of continued development in Florida. The current strain we are placing on the fragile ecosystem is choking the life out of our state. Overdevelopment is one of the leading forces that is damaging the springs. The once pure sources of water no longer boil up like a fountain the way they have for centuries. The water that the springs do produce is polluted by nitrates. This pollution fuels the growth of toxic algae blooms, which are taking over springs and the rivers they feed, thus putting our health at risk. Over 90% of our drinking water gushes out of these sapphire pools. These glorious reservoirs have begun to shrink. If something is not done soon, the springs will simply become part of Florida history. In southern Florida they already have. Springs once bubbled up all across the state. They were wiped out in South Florida decades ago by the ditching and draining of the landscape as well as over-pumping of the aquifer. This water was then sprayed on suburban lawns and farmers' fields, run through showers and flushed down toilets, turned into steam to crank turbines for electricity, or siphoned into plastic bottles for sale around the country. Because of poor use and neglect of our greatest resource, we will soon be without this supply of fresh water. Floridians regard their water supply as abundant and cheap, when the fact is it's neither. Until this attitude changes, the springs will not be rescued.

Water

Conservation

Health

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