A formal proposal of fluoridation of water was presented at the September 20, 1939 meeting of the Western Pennsylvania Section of the American Water Works Association held in Johnstown, Pa.
Dismayed by the prospect of continuous litigation and fearful of recognition of widespread damage to human health, corporations initiated extensive research programs to convince communities and the courts that small amounts of fluorine are not harmful to man. They collaborated with scientists at leading universities and at industrial research laboratories.
One of these temples of learning was the Mellon Institute in Pittsburgh, Pa., founded by Andrew W. and Richard B. Mellon, the former owners of the Aluminum Company of America. LIFE magazine of May 9, 1938, described the Mellon Institute as an “Intellectual holding company and a laboratory for applied science open to the US businessman” where every possible resource and piece of equipment is available to industry. Such varied subjects as shaving, cigarette technology, or insecticides could be studied to improve products or to find new uses for them. LIFE added: “When a manufacturer is in trouble, for example, he finds the market for his goods is shrinking, he goes to the Institute. For $6,000 or more he gets a fellowship entitling him to employ a scientist for a year and use laboratory facilities. When the research is satisfactorily completed, all discoveries are turned over to the manufacturer exclusively.” (21) Thus, findings incriminating to the corporations need not be published or presented to the medical and veterinary professions.
Whereas the Mellon Institute was the most logical place to seek aid in their precarious plight, corporations also sought help from other institutions of higher learning, especially the Universities of Tennessee, Cincinnati, and Wisconsin, all of which received large research grants to create a favorable climate of opinion for fluoride. Between 1940 and 1960, a flood of scientific reports issued from these institutions, which acknowledged the receipt of financial support from nine corporations, several of whom had been dumping fluoride into the environment. (22)
One of the scientists engaged in research at the Mellon Institute, Gerald J. Cox, a biochemist, was to play a major role in promoting fluoridation. (23) Some of his research had suggested to him that fluoride “may be specifically required for tooth formation.” (24) He therefore recommended that it be added to water supplies as a means of reducing tooth decay. (25) On September 29, 1939, Cox told the Western Pennsylvania Section of the American Water Works Association meeting at Johnstown that “the present trend toward complete removal of fluorine from water and food may need some reversal.” Cox’s term “reversal” referred to the fact that water works engineers had been recommending 0. 1 PPM as the maximum level of fluoride in drinking water because they felt that at least a tenfold margin of safety should be maintained (Table 17-1 ). (26)
Recommended Maximum Levels of Ions in Water
Used for Drinking and Cooking, 1939 (26)
Ion Max. Level (ppm)
At that time even the official USPHS regulations stated: “The presence of . . . fluoride in excess of 1 p.p.m…shall constitute ground for rejection of the water supply.” (27) Because fluoride had been universally recognized as a toxic agent until then, Cox realized that water works officials might be held liable for poisoning people drinking fluoridated water. He therefore cautioned his audience: “Fluorides are among the most toxic of substances. Mottled enamel results from as little as 0.0001 percent of fluorine in drinking water [1 PPM] . The results on adults of drinking water containing sufficient fluoride to prevent dental caries in children must be determined.” (25) Cox undeniably sensed The Great Dilemma right at the start.
Cox’s theory that fluoridated water could protect teeth against decay was based on his own experiments and on evidence provided in 1938 by W. D. Armstrong, professor of biochemistry at the University of Minnesota, and a consultant for the Dental Division of the PHS. In explaining how he came to the conclusion that fluoride prevented cavities, Cox said that he heard a presentation at a meeting in Detroit on the prevention of cavities in rats by feeding them aluminum salts. He then started a study to produce mottled teeth in rats by feeding them fluoridated water during pregnancy and lactation. After weaning, the rats were put on a caries-producing diet, yet none of the rats developed cavities or mottled teeth. In his convoluted thinking, “so it appeared that fluoride was good for the teeth.” He didn’t include the aluminum salts in the prescription.
The Mellon Institute in 1935 announced the fellowship with a press article saying that Cox had discovered a new vitamin.14 At one point, he proposed a study using various milk products but this never came to fruition. He soon took another path, identifying this mysterious vitamin as fluoride or aluminum in the rat’s lab chow as the “new vitamin” that might prevent cavities. (WPF)
Cox described his experiments as the “first controlled laboratory experiments which proved that fluoride prevented cavities.” In his project proposal he suggested that the Buhl Foundation call upon men of science to back him up.16 But his critics from the Pennsylvania State College, Dr. R. Adams Ducher, chairman of the department of agriculture at Penn State, in a letter to Clare V. Starrett, associate director of the Buhl Foundation, reviewed Cox’s study and findings in 1935 along with those of his colleague, Dr. N.B. Guerrant of the same department, and found them wanting. They criticized him for his lack of control variables. Cox would feed one food, followed by a different food, then another. His critics noted that effects that Cox attributed to one substance could indeed be attributed to other substances, such as butterfat. But this criticism made no difference to any of the parties involved and Cox continued on with his flawed science, which he militantly defended. (WPF)
In collaboration with P. J. Brekhus, Armstrong had reported more fluoride in enamel of healthy than in decayed teeth. (28) Twenty-five years later, however, his own reinvestigation convinced him that he had misinterpreted his early data, and he realized that the differences in the fluoride content between the sound and the carious teeth in his study were due to differences in the age of the teeth and did not reflect their susceptibility to decay. (29) Thus the basis of Cox’s main argument for recommending the addition of fluorides to drinking water was later shown to have been wrong!
In 1943, F. A. Arnold, Jr., of the National Institute of Dental Research in Bethesda, Maryland, took up Cox’s suggestion. He advocated fluoridation in the Journal of the American Dental Association on the basis of Cox’s experiments, Dean’s PHS surveys, and the Armstrong-Brekhus fluoride analyses of tooth enamel. Arnold stated: “The cumulative toxic effects on the body from ingestion of fluoride in this concentration is admitted to be a possibility. However, all things considered, such a possibility seems rather remote.” (30) Even in 1946 he still maintained in his AAAS report that “such a procedure cannot be recommended for other than research purposes at the present time” and suggested a study which “may take 12-15 years before the final answer is clearly delineated.” (31)
In the early 1940s Cox had an excellent opportunity to introduce his idea to scientists when he became a member of the Food and Nutrition Board of the National Research Council (23) and prepared for this illustrious body several pro-fluoridation summaries of the literature on dental caries. Through this organization, with its close link between industry and government, he was able to influence many scientists…
Cox lost no time in implementing his project. On September 20, 1939, five years before Newburgh and Grand Rapids experiments were initiated, and at the very time when he first suggested the fluoridation idea to the water engineers in Johnstown, he recommended fluoridation for that city; (25) however, his proposal was rejected. Subsequently he promoted the measure more successfully before chemical and dental organizations, parent-teacher associations, and city councils.
Nevertheless, Cox’s research at the Mellon Institute and his political activities fell short of relieving the aluminum industry of its distressing plight. ALCOA also tackled its fluoride pollution problem on another front, namely through the Kettering Laboratory in Cincinnati. This institute was founded in 1930 by gifts of the Ethyl Corporation, General Motors’ Frigidaire subsidiary, and the DuPont Company to investigate chemical hazards in American industrial operations. Like the Mellon Institute, it has made many valuable scientific contributions. Its 1955 budget of $643,000 was funded by industry (about 90%) and most of the rest by government agencies. (33) Dr. Robert A. Kehoe, its first chief, one of the nation’s leading industrial toxicologists, personified the close link between PHS and industry since he was Medical Director of the Ethyl Corporation and a consultant of the Division of Occupational Medicine of the PHS, the Tennessee Valley Authority, and tile Atomic Energy Commission. He and his staff have also been consulted almost routinely by editors of medical journals as to the suitability of articles submitted for publication and have thus given industry a foothold in influencing the medical literature on fluoride. Kehoe and his colleagues at Kettering also played a key role in developing government standards to prevent lead poisoning in industry. These standards have subsequently been criticized severely because they were far too lax. (34)
Since 1931 a considerable portion of the Kettering Laboratory’s facilities has been devoted to the study of fluoride, particularly the refrigerant gas Freon 12. Like the Mellon Institute’s findings, those of the Kettering Laboratory are made available to the professions and to the public only upon approval of the industrial donor of the grant. Article 8 of one of the contract agreements between the Aluminum Company of America and the Laboratory specified that the University of Cincinnati shall “disseminate for the public good any information obtained. However, before the issuance of public reports or scientific publications, the manuscripts thereof will be submitted to the Donor for criticism and suggestions. Confidential information obtained from the Donor shall not be published without permission of said Donor.” (35) The corporations were allowed to interpret the term “confidential information.” One can only guess how much valuable research has been lost to the medical profession because of these agreements.
During the mid-20th century, the research that issued from the Kettering Laboratory dominated the medical literature on the toxicology of fluoride. Among its most useful products in the area of fluoride research were the abstracts and an annotated bibliography prepared by Irene R. Campbell covering the literature on fluoride through 1971. (36, 37)
Although written mostly by proponents, many scientific articles in Campbell’s annotated bibliography reveal serious health hazards of fluoride even in small amounts and at low concentrations. It is impossible to understand, therefore, how Kehoe could state publicly in March 1957 that “the question of the public safety of fluoridation is nonexistent from the viewpoint of medical science.” (38)
Kettering Institute scientist E. J. Largent, who subsequently became consultant for Reynolds Metals Company, has written a book entitled Fluorosis: The Health Aspects of Fluorine Compounds, which was expressly designed, as indicated on its jacket, to “aid industry in law suits arising from fluoride damage.” This book has been used as a reference source by many physicians and health organizations and strongly supports the use of fluoride in drinking water and discounts or minimizes its toxicological effects: “in recent years additional surveys of information have been reported that establish again and again the complete safety of fluoridating drinking water.” (39)
(from page 311-314)
Interestingly, the corporations that originally sponsored fluoridation rarely promoted their product publicly. In 1950-1951 ALCOA had explicitly advertised sodium fluoride “of a uniform high degree of purity” for addition to water supplies in the Journal of the American Water Works Association (61). On May 22, 1957, however, ALCOA’s Chemical Sales Manager, H.P. Bonebrake, stated in a letter to C.A. Barden of Oberlin, Ohio, that his firm was not promoting fluoride for water fluoridation or selling it “directly to any municipality.” Nevertheless, Hearings on Fluoridation before the Committee on Interstate and Foreign Commerce, House of Representatives, suggest that ALOCA was the driving force behind fluoridation:
In 1944 Oscar Ewing was put on the payroll of the Aluminum Company of America, as attorney, at an annual salary of $750,000. This fact was established at a Senate hearing and became a part of the Congressional Record. Since the Aluminum Co. had no big litigation pending at the time, the question might logically be asked, why such a large fee? A few months thereafter Mr. Ewing was made Federal Security Administrator with the announcement that he was taking a big salary cut in order to serve his country. (62)
It was Ewing, as chief of the PHS, who officially gave the green light to fluoridation only five years after the initiation of the 10 to 15-year experiments in Grand Rapids, Michigan, and Newburgh, New York. At that time the permanent teeth of children born under fluoridation had not yet erupted, and therefore no reliable scientific conclusions concerning its benefits could possibly have been reached.
Prior to Ewing’s tenure of office in the federal government, Andrew Mellon, the founder of ALCOA, had been the U.S. Treasurer. The PHS was then in the Department of the Treasury. One can only speculate concerning Mr. Mellon’s role as protector of his company. Nor can it be ascertained whether or not such scientists as Knutson, Dean, Russell, and their colleagues in the Dental Division of the PHS, were in any way influenced in their desire to please their boss, Oscar Ewing. This thought is bound to occur to anyone who is familiar with governmental agencies; it is also driven home clearly by the Watergate affair. When decisions are made at the top level -be they right or wrong -it is not easy for government employees to report “corruption, waste, or regulatory abuse.” The consequences: “Too often they are characterized as troublemakers, then are fired, frozen out of promotions or subjected to personal harassment for the rest of their careers.””
Industry’s vital role in promoting fluoridation cannot be doubted nor can the leadership of ALCOA be denied in this affair. In carefully orchestrated harmony, industry, science, and the PHS collaborated in a plan that instituted a health procedure touching virtually everyone in America. Enormous research activity produced a mountain of evidence-much positive-that fluoridation was the long-sought answer to our dental health care problems. But what of the serious problems discovered? Why were they obscured, discounted, or simply ignored? If we examine the fluoride literature closely to determine how much of it was supported or generated by industry and/or the PHS, we shall find the answers to our questions. We shall also understand some of the reasons why scientists, physicians, and dentists are generally ignorant of the true consequences of fluoridation.
1. Water Boom for Fluorides. Chemical Week, July 7, 1951, p. 14.
2. Davenport, S.J., and Morris, G.G.: US Bureau of Mines. Circular 7687, US Dept. of Interior, June 1954, p. 8.
3. Oregon Rancher Asks $200,000 of Aluminum Co. Seattle Times, Dec. 16, 1952.
4. Food Machinery and Chemical Corporation vs. W.S. Meader and May Meader, United States Court of Appeals, Ninth District, Aug. 25, 1961.
5. Ost, H.: Der Kampf gegen schadliche Industriegase. Z. Angew. Chem., 20:1689-1693, 1907.
6. The So-Called Copper Teeth of Cattle. Br. Dent. J., 28:141-142, 1907.
7. Damages Awarded for Crop Burns. Lewiston (Idaho) Morning Tribune, Feb. 6,1962.
8. Jury Decides Alcoa Liability Ended in 1955. Knoxville (Tenn.) Journal, May 7, 1958.
9. Alcoa Sued for Nearly $3 Million. Knoxville (Tenn.) Journal, July 30. 1955.
10. Sauvies Island. Portland (Oregon) Reporter, June 26, 1962.
11. Harvey Loses Fluoride Case. Hood River (Oregon) News, Oct. 29, 1970.
12. Lewis, H.R.: With Every Breath You Take. Crown Publishers, Inc.. New York, 1965, pp. 110-111.
13. Gordon, C.C., and Tourangeau, P.C.: The Impact of Fluoride on the Farmlands of Buckeystown, Maryland, Caused by the Eastalco Aluminum Smelter (cover title). Environmental Studies Laboratory, University of Montana, Missoula, Mont., February, 1977.
14. Three Win in Fume Suit. The Oregonian (Portland), Sept. 17, 1955.
15. Seven Enter Fluoride Case. The Oregonian (Portland), Oct. 15, 1957.
16. Aluminum Firm Loses Appeal in Poison Case. Cleveland (Ohio) Press. June 6, 1958.
17. Smog Battle Ends in Montana Town. New York Times, Sept. 17, 1967.
18. Park, R.: The Intalco Trial. Northwest Passage, Bellingham, Wash., March 20 – April 2, 1972, p. 9.
19. Intalco’s Fluoride Emissions Exceed State Standards, Manager Tells Jury. Bellingham (Wash.) Herald, Jan. 17, 1974. Jury Awards Damages from Intalco. Ibid., Jan. 27, 1974.
20. Utah Steel Mill Curbs Pollution. New York Times, Nov. 10, 1957.
21. Science Means Business in This Grecian Temple. LIFE, May 9, 1938, p. 48.
22. Aluminum Co. of America; American Petroleum Institute; E.I. du Pont de Nemours Co.; The Harshaw Chemical Co.; Kaiser Aluminum and Chemical Corp.; Pennsylvania Salt Manufacturing Co.; Reynolds Metals Co.; Tennessee Valley Authority; and Universal Oil Products Co.
23. Institute Hill PTA to Discuss Fluoridation. Butler (Pa.) Eagle, Jan. 28, 1959.
24. Cox, G.J.: Experimental Dental Caries. I. Nutrition in Relation to the Development of Dental Caries. Dental Rays, 13:8-10, 1937.
25. Cox, G.J.: New Knowledge of Fluorine in Relation to Dental Caries. J. Am. Water Works Assoc., 31:1926-1930, 1939.
26. Babbit, H.E., and Doland, J.J.: Quality of Water Supplies in Water Supply Engineering. 3rd Edition, McGraw Hill, New York, 1939, p. 454.
27. USPHS: Public Health Service Drinking Water Standards. Public Health Rep. 58:69-111, 1943 (at p. 80).
28. Armstrong, W.D., and Brekhus, P.J.: Possible Relationship between the Fluorine Content of Enamel and Resistance to Dental Caries. J. Dent. Res., 17:393-399, 1938.
29. Armstrong, W.D., and Singer, L.: Fluoride Contents of Enamel of Sound and Carious Human Teeth: A Reinvestigation. J. Dent. Res., 42:133-136,1963.
30. Arnold, F.A., Jr.: Role of Fluorides in Preventive Dentistry. J. Am. Dent. Assoc., 30:499-508, 1943.
31. Arnold, F.A., Jr.: The Possibility of Reducing Dental Caries by Increasing Fluoride Ingestion, in F.R. Moulton, Ed.: Dental Caries and Fluorine, 1946, pp. 99-107, and p. 105.
32. Doctor Appointed. Pittsburgh (Pa.) Post Gazette, April 4, 1962.
33. Testimony of Dr. R. Kehoe in Paul Martin Family vs. Reynolds Metals Corp., p. 960.
34. Bryce-Smith, D., and Waldron, H.A.: Lead in Food – Are Today’s Regulations Sufficient? Chem. Brit., 10:202-206, 1974.
35. Contract Agreement Between Aluminum Co. of America and U. of Cincinnati, signed by N.P. Auburn, Vice-President and Dean of Administration (April 30. 1947). Testimony McCarthy vs. The Cincinnati Enquirer, 1956.
36. Campbell, I.R., and Widner, E.M.: Annotated Bibliography: The Occurrence and Biological Effects of Fluorine Compounds. The Kettering Laboratory, Cincinnati, Ohio, 1958.
37. Fluoride Abstracts. Supplement to Annotated Bibliography The Occurrence and Biological Effects of Fluorine Compounds. The Kettering Laboratory, Cincinnati, Ohio, 1955-1971.
38. “Our Children’s Teeth,” Report to the Mayor and the Board of Estimate of the City of New York by the Committee to Protect Our Children’s Teeth, Inc., March 6, 1957. p. 27
39. Largent, E.J.: Fluorosis: The Health Aspects of Fluorine Compounds. 1961, p. 73.
61. High Purity ALCOA Sodium Fluoride for the Fluoridation of Water. J. Am. Water Works. Assoc., 42:5, 1950; Fluoridate Your Water with Confidence. Use High Purity ALCOA Sodium Fluoride. Ibid., 43: 45, 1951.
62. Hearings before the Committee on Interstate and Foreign Commerce, House of Representatives, Eighty-Third Congress, Second Session on H.R. 2341, May 25, 26, and 27, 1954, p. 51.
63. When Workers Blow Whistle on Federal Waste, Fraud. U.S. News and World Report, Dec. 19, 1977, p. 55.