Five reasons behind the city’s rationale, and how experts evaluate them.
With Montreal city councillors holding 87 per cent of the vote compared to 13 from the demerged municipalities in the agglomeration, decisions backed by Projet Montréal often dominate.
The following breaks down the debate at the agglomeration meeting.
Cost
The Service de l’eau claims the cost of keeping the fluoridation program would be $19 million to make the necessary upgrades to the plants, plus $330,000 per year in maintenance. In a presentation they gave on fluoride, they pointed to “operational, technical and economic” factors as the main influence in their decision, with health, environment and social acceptability taking lower priority.
Children’s health
“We want to use the precautionary principle,” Vodanovic said during Thursday’s agglomeration council meeting. John Bucher, one of the leading toxicologists on the NTP study, told The Gazette they found “insufficient numbers of studies and insufficient data to assess the relationship below 1.5,” in line with the adage that the dose makes the poison.
But Bucher said the NTP’s assessment of fluoride levels in urine showed that “there are quite a range of levels of fluoride seen in the urine, suggesting that there are sources, significant sources other than drinking water,” such as dental products and bottled beverages.
Vodanovic resonated with this idea, telling The Gazette that “if you combine the brushing of the teeth and the water, we don’t know how much each child actually gets,” adding the city should “not use our water to administer medication.”
Levy said he thinks the decision is premature.
“If you apply the precautionary principle, there’s always a cost to it … where do you draw the line?” he asked.
“I don’t think that right now we have the evidence to justify that we should just terminate water fluoridation. … That doesn’t mean we don’t have to be careful. We have to be always very careful. We have to continue the studies at 0.7 (mg per litre), and also the studies at 1.5 and more.”
Bucher agrees that “there’s very little information available” and more research must be done. “Before you make any decisions on changing the water fluoridation levels, there needs to be another meeting” of public health experts.
Many major health organizations still recommend water fluoridation under 1.5 mg per litre for dental health, including Montreal public health, Quebec’s Ministry of Health and Social Services, Health Canada, and the U.S. Centers for Disease Control and Prevention.
Environmental harm
“We don’t think that something like fluoride should be put in 100 per cent of water when we only use one per cent, and that 99 per cent ends up in the rivers. And in the rivers, we don’t know what effect the fluoride has,” Vodanovic said at the meeting Thursday. “If we do not add fluoride, (the water) will remain clear and pure like before.”
Both Bucher and Levy say there is little research on the ecological impacts of fluoride. Bucher says there are potentially different fluoride-containing compounds that can be damaging to aquatic animals, but could not speak to the environmental effect of the fluoride ion itself.
Standardization
The Service de l’eau underlined that only one per cent of Quebec fluoridates its water, and 38.8 per cent of Canadians drink fluoridated water.
Vodanovic referenced Thursday that one per cent of British Columbia adds fluoride to water, and “most European countries do not fluoridate their water. And the main reason for that being: they do not believe, like we do not believe, that our water filtration system should be used for other things than to provide the best quality water we can.”
During the citizen question period Thursday, former Baie-d’Urfé city councillor Janet Ryan asked: “Why do we have to have coherence across the island? The status quo has worked very well for all concerned for 70 years.”
“The systems have operated effectively for over 50 years, including during Montreal’s administrative oversight — the need for a ‘standardization’ lacks any rational basis,” Levy wrote in a letter to the mayor of Beaconsfield.
Corrosiveness
Corrosion to infrastructure is another cited concern. The Service de l’eau wrote that added fluoride “could accelerate the degradation of aqueducts and increase the occurrence of red water.”
Levy disagrees. “The City of Montreal’s assertion that fluoride is highly corrosive and can damage water infrastructure in the long term is inaccurate,” he wrote in his letter. “A fluoridation system designed to accepted engineering standards does not pose corrosion issues. Chlorine, dissolved oxygen, and improper pH control are the major corrosion factors, not fluoride. The key is proper water chemistry management — maintaining appropriate pH, alkalinity, and hardness levels.”