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The U.S. Environmental Protection Agency (EPA) on Thursday announced that it has taken the next step in its plan to do a “gold standard” review of the health effects of fluoride in drinking water.
Also on Thursday, the agency separately filed a brief in its appeal of a landmark September 2024 federal court ruling that ordered EPA to take regulatory action on fluoride, based on evidence that water fluoridation at current U.S. levels poses an “unreasonable risk” to children’s health.
In its press release, the EPA said it plans to release a preliminary scientific assessment plan and literature survey to inform future protective recommendations. It said the review could eventually influence allowable federal limits on fluoride in water.
A similar comprehensive review, focused on fluoride’s neurotoxic effects on children, was published in 2024 by the National Toxicology Program (NTP), an interagency research body housed within the U.S. Department of Health and Human Services (HHS).
The September 2024 court ruling cited the NTP’s findings linking prenatal and childhood exposure to fluoridated water to reduced IQ as key evidence.
“The most pressing need right now is actual action to protect people, not another government review,” said Michael Connett, the attorney who represented the plaintiffs in the EPA lawsuit. “That’s what the court directed EPA to do, and which EPA is refusing.”
The EPA’s plans for its own review will be published in the Federal Register. The plan will explain how the EPA’s Office of Water plans to evaluate scientific research on fluoride’s health effects. It will also identify key scientific questions for investigation, the EPA said.
Once the plan is published, there will be a 30-day public comment period and outreach efforts, including a Jan. 28 webinar on the preliminary plan.
A spokesperson from the Office of Water said in a media call about the plan that the review will be subject to peer review. However, details on what follows after the public comment period were vague.
EPA recommends fluoride limits, but HHS decides if fluoride should be added to public water
The announcement of a proposed plan comes nine months after EPA Administrator Lee Zeldin announced the agency would “expeditiously review” new science on the possible health risks of water fluoridation.
Thursday’s EPA press release did not specify whether the EPA will review other health concerns related to fluoride. However, overwhelming scientific research shows that fluoride’s benefits to teeth are topical, not the result of ingesting fluoride.
Research also shows that ingesting fluoride is linked to reduced IQ, behavioral issues, disruption of thyroid functioning and the gut microbiome.
The EPA is responsible for setting the maximum allowable limits for toxins in drinking water. However, HHS, through the Centers for Disease Control and Prevention (CDC), recommends whether and how much — not to exceed the EPA recommended limit — fluoride should be added to public drinking water.
The maximum limit for fluoride under existing EPA rules is 4 milligrams per liter (mg/L), which is orders of magnitude higher than the 0.7 mg/L level public health agencies recommend for water fluoridation.
The water fluoridation limit has recently been at the center of a heated national debate.
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EPA continues to fight court order to regulate water fluoridation
The growing body of research showing fluoride’s toxic effects gained national attention when U.S. District Judge Edward Chen ruled against the EPA in the landmark lawsuit. Fluoride Action Network, Mothers Against Fluoridation and Food & Water Watch were among the groups that sued the agency.
Chen ruled that water fluoridation at the 0.7 mg/L level currently recommended by public health agencies in the U.S. poses an “unreasonable risk” to children’s health. Chen said the EPA must regulate fluoride under the Toxic Substances Control Act (TSCA).
However, in Thursday’s press release, the agency said “the most appropriate regulatory pathway” for regulating fluoride is under the Safe Drinking Water Act (SDWA), not the TSCA, and that the EPA’s Office of Water should lead that effort.
The EPA did not explain why it disagreed with Chen’s reasoning. The agency also said that it concluded its last review of allowable maximum fluoride levels under the SDWA in 2024. The agency did not change the allowable levels at that time.
In July, the EPA, represented by the U.S. Department of Justice, appealed Chen’s ruling directing the agency to regulate fluoride under the TSCA.
In its appeal, the agency did not contest the court’s finding that water fluoridation at 0.7 mg/L poses a risk to children’s neurodevelopment. Instead, it challenged the judge’s decision to consider new evidence during the case and the plaintiffs’ legal right to sue.
In its latest rebuttal to plaintiffs’ arguments filed Thursday, EPA reiterated its position that the court overstepped its role.
Oral arguments in the appeal are set for March.
Related articles in The Defender
- EPA to Review Health Risks of Water Fluoridation as RFK Jr. Says He’ll Tell CDC to Stop Recommending It
- ‘Perversion of Public Health’: EPA Appeals Landmark Ruling That Fluoride Poses ‘Unreasonable Risk’ to Kids’ Health
- EPA’s Final Witnesses Concede Fluoride’s Harm, Admit to Flaws in Key Study as Trial Closes
- Breaking: New Study Linking Fluoride to Lower IQ in Children Sparks Renewed Calls to End Water Fluoridation
