HomeMy WebLinkAboutPresentation on Fluoridation of Bozeman's Drinking Water and Possible Decision to repeal Resolution 7411
Commission Memorandum
REPORT TO: Honorable Mayor and City Commission
FROM: Debbie Arkell, Director of Public Services
Chris Kukulski, City Manager
SUBJECT: Presentation on Fluoridation of Bozeman’s Drinking Water (Gallatin City-
County Health Officer Matt Kelly (10 minutes) and Possible Decision to
Repeal Resolution 741 (July 1, 1953) to Stop Fluoridation of Bozeman’s
Water* (Arkell)
*NOTE: The Commission is not required to take any action regarding this item
MEETING DATE: April 23, 2012
AGENDA ITEM TYPE: Action
RECOMMENDATION: Hear presentations and public comment. Consider the following two
options:
• If the Commission desires to continue fluoridation, we recommend the Commission take
no formal action. Resolution No. 741, Providing for the Introduction of Fluoride into the
Drinking Water Supply System of the City of Bozeman will remain in effect.
• If the Commission desires to end the practice of fluoridation, we recommend the
Commission do so by motion and vote at this meeting the result of which will be for the
staff to immediately cease the practice of fluoridation. To formalize that motion and vote,
because the practice of fluoridation was begun by resolution we will then bring back to
you on a future consent agenda a resolution formally repealing Resolution 741.
BACKGROUND: Commission Resolution 741, passed July 1, 1953, establishes community
water fluoridation for the City of Bozeman water supply and distribution system. That resolution
requires the addition of fluoride to the community water system to attain a value of 1.0 parts
fluoride to one-million parts water (1.0 ppm or mg/l) and recognizes that this value may, from
time to time, be subject to change if ordered by the Board of Health of the State of Montana.
The resolution further directs the City Manager to make periodic reports to the City Commission
concerning the status, cost, and progress of such service.
The most recent periodic report on fluoridation was presented by city staff to the Commission on
August 1, 2011. It was reported at that time the U.S. Department of Health and Human Services
(HHS) Center for Disease Control (CDC) is revisiting its recommended fluoride limits for
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community water fluoridation, as fluoride products are now readily available on the oral health
market. At present, the CDC recommends adding fluoride at a dosing limit of 0.7 – 1.2 parts
fluoride per one-million parts water (ppm), and they are proposing that the recommended
fluoride limit be set at 0.7 ppm. While the HHS website states the federal HHS expects to
release its final recommended level towards the beginning of 2012, that release has not yet
occurred.
The Commission recognized this pending reduction in the amount of fluoride concentrations and
directed staff to continue its community water fluoridation practices by adding fluoride to the
water supply and distribution system at the recommended limits as they are periodically
established by the HHS, or any other agency having regulatory authority.
When preparing the periodic report delivered to the Commission last August, City staff contacted
the Gallatin City-County Health Department (GCCHD) regarding the proposed 0.7 ppm fluoride
limit contemplated by CDC to obtain their opinion on the matter. GCCHD subsequently
contacted local health providers requesting their input, and several replied in support of
fluoridation. At that time, various city staff were beginning to receive sporadic public comments
from individual community members opposed to the city’s fluoridation practices.
In the last several months, members of the public have spoken during the Commission meeting
public comment periods both for and against the addition of fluoride in the water. Proponents
generally discuss the oral health benefits of adding fluoride and the attendant cost savings
derived from decreased demand for costly dental care. Opponents generally claim harmful
effects of fluoride, that there is no choice to have it added to the water, and that it is difficult to
remove with filtration. The Commission has also previously received much written information
from the public on the topic. That information can be viewed at or obtained from the City
Clerk’s office.
Water Fluoridation
Community water fluoridation is a voluntary public health initiative promoted by the U.S.
Department of Health and Human Services (HHS) Centers for Disease Control and Prevention
(CDC.) Neither the CDC nor the State of Montana requires community water systems to be
fluoridated. In Montana, fluoridation is a community-based decision made at the local level.
Water systems that elect to fluoridate are subject to system design rules and reporting
requirements of the Montana Department of Environmental Quality. Fluoride often occurs
naturally in water and is present in almost all groundwater monitored by the Gallatin County
Local Water Quality District. In Montana, five communities adjust natural fluoride levels in the
water to amounts recommended by the CDC. Those communities are: Bozeman, Colstrip,
Hardin, Miles City, and Scobey.
Community water fluoridation is not without controversy. The nation’s leading public health
organizations – including the CDC, the National Institutes of Health, the U.S. Surgeon General,
the American Dental Association, the American Medical Association, and World Health
Organization – have voiced strong support for community water fluoridation, citing a 50-year
history of peer reviewed scientific research that shows the practice safely reduces dental decay
by 20% to 60%. Community water fluoridation has been shown to prevent tooth decay and
reduce the prevalence of dental caries (cavities) by providing frequent contact of teeth to fluoride
ion at low concentrations. In a 2004 statement, U.S Surgeon General Richard H. Carmona called
community water fluoridation “the single most effective public health measure to prevent tooth
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decay and improve oral health over a lifetime.” Community water fluoridation is an inexpensive
option to deliver oral health benefits to all residents of a community regardless of their
socioeconomic condition. According to the CDC, for every $1 invested in fluoridation, a savings
of $38 is realized in preventive dental treatment costs. Furthermore, the CDC has recognized
water fluoridation as one of 10 great public health achievements of the 20th century. According
to national statistics compiled in 2008, 72.4% of the U.S. population served by community water
systems received fluoridated water, or roughly 195.5 million individuals.
Regarding safety, the American Dental Association has stated the following: “No charge against
the benefits and safety of fluoridation has ever been substantiated by generally accepted
scientific knowledge. After 60 years of research and practical experience, the preponderance of
the scientific evidence indicates that fluoridation of community water supplies is both effective
and safe.”
Fluoride is available in many dental hygiene products (fluoride toothpaste, mouth rinse, etc), is
added to some bottled water, and dentist-applied topical fluoride treatments are available.
Excessive quantities of fluoride can cause dental fluorosis, which is a staining and pitting of the
tooth surface – principally a cosmetic defect. Prolonged exposure to excessive fluoride
concentrations may rarely result in chronic fluoride toxicity causing skeletal fluorosis exhibited
by symptoms of weakened bones and adverse effects on the kidneys, amongst other negative
effects. With other forms of fluoride readily available to consumers, controversy surrounds the
question of whether the oral health benefits of fluoride are better administered by the individual
as a personal health choice, or through local governance in the management of its public water
system. According to the ADA, research indicates that 94% of fluorosis is mild or very mild and
has no effect on tooth function and is rarely detected by anyone other than a medical
professional. Evidence suggests that nearly all fluorosis does not cause functional health defects
and is caused by risk factors other than community water fluoridation, such as inappropriate
ingestion of fluoride products.
Gallatin City-County Board of Health Recommendation
On March 22, 2012, the Gallatin City-County Board of Health discussed the subject of
fluoridation, heard public comment, and voted unanimously to send a letter to the City
Commission supporting fluoridated drinking water in the city of Bozeman and urging that the
practice continue. On March 26, 2012, City-County Health Officer Kelley spoke to the
Commission regarding the benefits of fluoride and presented the letter from the Board of Health
(attached). As the City-County Board of Health is the formal advisory board for the City
Commission on public health issues, we enclose the reference materials enclosed with the Board
of Health’s March 22nd letter.
Current State of Technical Operations of City of Bozeman Water Fluoridation
Fluoride is present naturally in the raw water supplies of the City of Bozeman (Lyman Creek,
Sourdough Creek and Hyalite Creek). Background concentrations vary seasonally, typically
ranging from 0.1 – 0.35 parts fluoride per one-million parts water (ppm). Raw water samples are
tested every 15 days at Lyman Creek and combined Sourdough/Hyalite raw water to determine
the concentration of natural fluoride in these sources. This value is then subtracted from the 1.0
ppm fluoride dosing target to determine the quantity of additional fluoride needed to supplement
the system to raise the fluoride concentration of water placed into the distribution system to the
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targeted 1.0 ppm level. Separate fluoride feed systems are employed at the Lyman Creek
treatment plant and the Sourdough treatment plant. The dosing calculation takes system demand,
purity and percent fluoride ion in the respective fluoride products into account.
At the Lyman Creek water plant, the fluoride product used is liquid hydrofluorosilicic acid. The
chemical is supplied through Thatcher Chemical Company’s Missoula terminal, although other
vendors have been used in the past. The product is certified for use in potable water through the
National Science Foundation (NSF). This acid is dangerous at high concentrations as fluoride
ion is an extremely powerful oxidizer so protective clothing must be worn while handling it. The
product is metered into the finished effluent as it leaves Lyman Reservoir through a peristaltic
pump that is controlled through a flow meter and Programmable Logic Controller (PLC)
arrangement, according to distribution system demand. The PLC communicates through a
Supervisory Control and Data Acquisition (SCADA) system with the Human Machine Interface
(HMI) employed at the Sourdough water treatment plant. The desired fluoride dosage limit (1.0
ppm minus measured background fluoride concentration) is set to result in the targeted 1.0 ppm
dosage input at the HMI. The dosage limit is changed every fifteen days, or more often, if
quality control tests dictate.
The fluoride product used at the Sourdough plant is sodium silicofluoride, which is a solid
ground to powdered form. This product presents inhalation hazards to treatment plant operators
requiring the use of supplied air when working with the product. The product is presently
purchased from Hawkins Chemical Company’s Billings terminal and is certified for potable
water use through the NSF. The process employed to add the product to the Sourdough effluent
is similar to that used at Lyman, however it is less automated. Because the product is added in
solid form, a volumetric feeder is used. Manual adjustment to the feeder is required with each
change to the effluent flow rate leaving the Sourdough plant. The feeder is calibrated for
accuracy at least every thirty days.
Quality control procedures are in place in the day-to-day fluoride operations of the Lyman and
Sourdough treatment plants. Each day at midnight, a fluoride dosage is calculated according to
the respective products used at each plant. Daily water samples are taken from at least eight
sampling locations within the water distribution system in town. Each sample is then tested daily
to ensure the desired 1.0 ppm targeted fluoride concentration is met. These sampling results are
forwarded to the Public Water Supply Section of the Montana Department of Environmental
Quality to ensure reporting requirements are satisfied.
Petition on Referendum 2012-01
On April 11th, the Gallatin County Election Administrator approved a petition to place City of
Bozeman Referendum 2012-01 on the November 6, 2012 election ballot as a special election of
the City of Bozeman. The referendum seeks repeal of Resolution 741. The petitioners must
obtain 4,041 qualified signatures to place the referendum on the ballot. The petitioners have until
5:00 pm July 10, 2012 to obtain the required signatures. After submittal of all petitions, the
Election Administrator will have four weeks from July 10th to review the petitions and signatures
for compliance with all legal requirements and determine whether sufficient qualified signatures
have been gathered. If so, the Election Administrator will place the referendum on the November
6th election ballot.
Pursuant to Sect. 7-5-133, MCA, the Commission may, within 60 days of receiving the petition,
take the action called for in the petition (i.e., the Commission may repeal Resolution 741). As the
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petition was received by the Election Administrator on March 21, 2012, the 60-day period
expires on May 20, 2012. Thus, the last day for the Commission to take such action at a regular
meeting will be May 14, 2012. If the Commission took such action, the question need not be
submitted to the electors. The second recommended option for action cited above is your
opportunity to take the action called for under Sect. 7-5-133, MCA.
Due to the existence of the petition for a referendum on Resolution 741, the City Attorney
recommends that if the Commission is interested in continuing to fluoridate the City’s water
supply, the Commission refrain from taking formal action to continue fluoridation. If the
Commission takes no action Resolution 741 will remain in effect and the City will continue to
fluoridate the City water supply. The rationale is simply to avoid confusion over which
Commission action (the July 1, 1953 action adopting Resolution 741 or an action at this April
23rd public meeting) would be subject to the petition and possible referendum.
FISCAL EFFECTS: During a typical year, approximately $35,000 in chemical cost is
expended to supply products to the respective the fluoride feed systems used at the Lyman and
Sourdough plants (hydrofluorosilicic acid for Lyman at $24,000; sodium silicofluoride for
Sourdough at $11,000). Maintenance cost on these systems is nominal. The new Sourdough
water treatment plant will use hydrofluorosilicic acid, eliminating the use of sodium
silicofluoride.
If the CDC recommended fluoride limit of 0.7 ppm is put into use, a 30% reduction in annual
chemical costs is reasonably expected, saving the city approximately $10,500 annually. Should
the Commission decide to cease fluoridation practices, $35,000 of annual savings will be
realized. The new Sourdough plant is designed to add fluoride. If fluoride is not longer added to
the water, the equipment can be sold and/or recycled.
Attachments: March 22, 2012 Board of Health Letter and attachments.
Report compiled on April 12, 2012 with input from City-County Health Officer
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