Safety l Fluoridation Facts 37 Safety 17. Harmful to humans?. .............................................37 18. More studies needed?..........................................38 19. Recommended level?. ...........................................39 20. EPA maximum?......................................................40 21. EPA secondary level?............................................41 22. Total intake?...........................................................43 23. Daily intake?...........................................................44 24. Prenatal dietary fluoride supplements?............46 25. Body uptake?.........................................................47 26. Bone health?..........................................................47 27. Dental fluorosis?...................................................49 28. Fluoridated water for infant formula?...............52 29. Prevent fluorosis?.................................................52 30. Warning Label?......................................................54 31. Acute and chronic toxicity?.................................55 32. Cancer?...................................................................56 33. Osteosarcoma?......................................................57 34. Enzyme effects?...................................................58 35. Thyroid?..................................................................59 36. Pineal gland?..........................................................60 37. Allergies?................................................................60 38. Genetic risk?..........................................................61 39. Fertility?.................................................................61 40. Down Syndrome?..................................................62 41. Neurological impairment/IQ?..............................62 42. Lead poisoning?.....................................................64 43. Alzheimer’s disease?.............................................65 44. Heart disease?.......................................................66 45. Kidney disease?.....................................................67 46. Erroneous health claims?.....................................68 17. Does fluoride in the water supply, at the levels recommended for the prevention of tooth decay, adversely affect human health? Answer. The overwhelming weight of scientific evidence supports the safety of community water fluoridation. Fact. For generations, millions of people have lived in areas where fluoride is found naturally in drinking water in concentrations as high or higher than the optimal level recommended to prevent tooth decay. Research conducted among these persons confirms the safety of fluoride in the water supply.1-5 As with other nutrients, fluoride is safe and effective when used and consumed as recommended. No charge against the benefits and safety of fluoridation has ever been substantiated by generally accepted scientific knowledge. A number of reviews on fluoride in drinking water have been issued over the years. For example, in 19516 the National Research Council (NRC), of the National Academies, issued its first report stating fluoridation was safe and effective. Additional reviews by the NRC followed in 19777 and 19938 with the most recent NRC review completed in 2006.9 Additional reviews completed over the ten year period from 2007- 2017 include: 2017 Australian Government. National Health and Medical Research Council (NHMRC). Information Paper — Water Fluoridation: Dental and Other Human Health Outcomes.10 2016 O’Mullane DM, Baez RJ, Jones S, Lennon MA, Petersen PE, Rugg-Gunn AJ, Whelton H, Whitford GM. Fluoride and Oral Health.11 2016 American Water Works Association. Water Fluoridation Principles and Practices. AWWA Manual M4. Sixth edition.12 2015 Water Research Foundation. State of the Science: Community Water Fluoridation.13 2015 The Network for Public Health Law. Issue Brief: Community Water Fluoridation.14