Fukushima Radiation Alarms Doctors

***Please note*** Source from Al Jazeera

Scientists and doctors are calling for a new national policy in Japan that mandates the testing of food, soil, water, and the air for radioactivity still being emitted from Fukushima's heavily damaged Daiichi nuclear power plant.

"How much radioactive materials have been released from the plant?" asked Dr Tatsuhiko Kodama, a professor at the Research Centre for Advanced Science and Technology and Director of the University of Tokyo's Radioisotope Centre, in a July 27 speech to the Committee of Health, Labour and Welfare at Japan's House of Representatives.

"The government and TEPCO have not reported the total amount of the released radioactivity yet," said Kodama, who believes things are far worse than even the recent detection of extremely high radiation levels at the plant.

There is widespread concern in Japan about a general lack of government monitoring for radiation, which has caused people to begin their own independent monitoring, which are also finding disturbingly high levels of radiation.

Kodama's centre, using 27 facilities to measure radiation across the country, has been closely monitoring the situation at Fukushima - and their findings are alarming.

According to Dr Kodama, the total amount of radiation released over a period of more than five months from the ongoing Fukushima nuclear disaster is the equivalent to more than 29 "Hiroshima-type atomic bombs" and the amount of uranium released "is equivalent to 20" Hiroshima bombs.

Kodama, along with other scientists, is concerned about the ongoing crisis resulting from the Fukushima situation, as well as what he believes to be inadequate government reaction, and believes the government needs to begin a large-scale response in order to begin decontaminating affected areas.

Distrust of the Japanese government's response to the nuclear disaster is now common among people living in the effected prefectures, and people are concerned about their health.

Recent readings taken at the plant are alarming.

When on August 2nd readings of 10,000 millisieverts (10 sieverts) of radioactivity per hour were detected at the plant, Japan's science ministry said that level of dose is fatal to humans, and is enough radiation to kill a person within one to two weeks after the exposure.

10,000 millisieverts (mSv) is the equivalent of approximately 100,000 chest x-rays.

It is an amount 250 per cent higher than levels recorded at the plant in March after it was heavily damaged by the earthquake and ensuing tsunami.

The operator of Japan's crippled Fukushima Daiichi nuclear power plant, Tokyo Electric Power Company (TEPCO), that took the reading, used equipment to measure radiation from a distance, and was unable to ascertain the exact level because the device's maximum reading is only 10,000 mSv.

TEPCO also detected 1,000 millisieverts (mSv) per hour in debris outside the plant, as well as finding 4,000 mSv per hour inside one of the reactor buildings.

The Fukushima disaster has been rated as a "level seven" on the International Nuclear and Radiological Event Scale (INES). This level, the highest, is the same as the Chernobyl nuclear disaster in 1986, and is defined by the scale as: "[A] major release of radioactive material with widespread health and environmental effects requiring implementation of planned and extended countermeasures."

The Fukushima and Chernobyl disasters are the only nuclear accidents to have been rated level seven on the scale, which is intended to be logarithmic, similar to the scale used to describe the comparative magnitude of earthquakes. Each increasing level represents an accident approximately ten times more severe than the previous level.

Doctors in Japan are already treating patients suffering health effects they attribute to radiation from the ongoing nuclear disaster.

"We have begun to see increased nosebleeds, stubborn cases of diarrhoea, and flu-like symptoms in children," Dr Yuko Yanagisawa, a physician at Funabashi Futawa Hospital in Chiba Prefecture, told Al Jazeera.

She attributes the symptoms to radiation exposure, and added: "We are encountering new situations we cannot explain with the body of knowledge we have relied upon up until now."

"The situation at the Daiichi Nuclear facility in Fukushima has not yet been fully stabilised, and we can't yet see an end in sight," Yanagisawa said. "Because the nuclear material has not yet been encapsulated, radiation continues to stream into the environment."

Health concerns

Al Jazeera's Aela Callan, reporting from Japan's Ibaraki prefecture, said of the recently detected high radiation readings: "It is now looking more likely that this area has been this radioactive since the earthquake and tsunami, but no one realised until now."

Workers at Fukushima are only allowed to be exposed to 250 mSv of ionising radiation per year.

Junichi Matsumoto, a TEPCO spokesman, said the high dose was discovered in an area that does not hamper recovery efforts at the stricken plant.

Yet radioactive cesium exceeding the government limit was detected in processed tea made in Tochigi City, about 160km from the troubled Fukushima Daiichi nuclear plant, according to the Tochigi Prefectural Government, who said radioactive cesium was detected in tea processed from leaves harvested in the city in early July.

The level is more than 3 times the provisional government limit.

Yanagisawa's hospital is located approximately 200km from Fukushima, so the health problems she is seeing that she attributes to radiation exposure causes her to be concerned by what she believes to be a grossly inadequate response from the government.

From her perspective, the only thing the government has done is to, on April 25, raise the acceptable radiation exposure limit for children from 1 mSv/year to 20 mSv/year.

"This has caused controversy, from the medical point of view," Yanagisawa told Al Jazeera. "This is certainly an issue that involves both personal internal exposures as well as low-dose exposures."

Junichi Sato, Greenpeace Japan Executive Director, said: "It is utterly outrageous to raise the exposure levels for children to twenty times the maximum limit for adults."

"The Japanese government cannot simply increase safety limits for the sake of political convenience or to give the impression of normality."

Authoritative current estimates of the health effects of low-dose ionizing radiation are published in the Biological Effects of Ionising Radiation VII (BEIR VII) report from the US National Academy of Sciences.

The report reflects the substantial weight of scientific evidence proving there is no exposure to ionizing radiation that is risk-free.

The BEIR VII estimates that each 1 mSv of radiation is associated with an increased risk of all forms of cancer other than leukemia of about 1-in-10,000; an increased risk of leukemia of about 1-in-100,000; and a 1-in-17,500 increased risk of cancer death.

Dr Helen Caldicott, the founding president of Physicians for Social Responsibility, a group that was awarded the Nobel Peace Prize in 1985, is equally concerned about the health effects from Japan's nuclear disaster.

"Radioactive elements get into the testicles and ovaries, and these cause genetic disease like diabetes, cystic fibrosis, and mental retardation," she told Al Jazeera. "There are 2,600 of these diseases that get into our genes and are passed from generation to generation, forever."

So far, the only cases of acute radiation exposure have involved TEPCO workers at the stricken plant. Lower doses of radiation, particularly for children, are what many in the medical community are most concerned about, according to Dr Yanagisawa.

"Humans are not yet capable of accurately measuring the low dose exposure or internal exposure," she explained, "Arguing 'it is safe because it is not yet scientifically proven [to be unsafe]' would be wrong. That fact is that we are not yet collecting enough information to prove the situations scientifically. If that is the case, we can never say it is safe just by increasing the annual 1mSv level twenty fold."

Her concern is that the new exposure standards by the Japanese government do not take into account differences between adults and children, since children's sensitivity to radiation exposure is several times higher than that of adults.

Al Jazeera contacted Prime Minister Naoto Kan's office for comment on the situation.

Speaking on behalf of the Deputy Cabinet Secretary for Public Relations for the Prime Minister's office, Noriyuki Shikata said that the Japanese government "refers to the ICRP [International Commission on Radiological Protection] recommendation in 2007, which says the reference levels of radiological protection in emergency exposure situations is 20-100 mSv per year. The Government of Japan has set planned evacuation zones and specific spots recommended for evacuation where the radiation levels reach 20 mSv/year, in order to avoid excessive radiation exposure."

The prime minister's office explained that approximately 23bn yen ($300mn) is planned for decontamination efforts, and the government plans to have a decontamination policy "by around the end of August", with a secondary budget of about 97bn yen ($1.26bn) for health management and monitoring operations in the affected areas.

When questioned about the issue of "acute radiation exposure", Shikata pointed to the Japanese government having received a report from TEPCO about six of their workers having been exposed to more than 250 mSv, but did not mention any reports of civilian exposures.

Prime Minister Kan's office told Al Jazeera that, for their ongoing response to the Fukushima crisis, "the government of Japan has conducted all the possible countermeasures such as introduction of automatic dose management by ID codes for all workers and 24 hour allocation of doctors. The government of Japan will continue to tackle the issue of further improving the health management including medium and long term measures".

Shikata did not comment about Kodama's findings.

Kodama, who is also a doctor of internal medicine, has been working on decontamination of radioactive materials at radiation facilities in hospitals of the University of Tokyo for the past several decades.

"We had rain in Tokyo on March 21 and radiation increased to .2 micosieverts/hour and, since then, the level has been continuously high," said Kodama, who added that his reporting of radiation findings to the government has not been met an adequate reaction. "At that time, the chief cabinet secretary, Mr Edano, told the Japanese people that there would be no immediate harm to their health."

Kodama is an expert in internal exposure to radiation, and is concerned that the government has not implemented a strong response geared towards measuring radioactivity in food.

"Although three months have passed since the accident already, why have even such simple things have not been done yet?" he said. "I get very angry and fly into a rage."

According to Kodama, the major problem caused by internal radiation exposure is the generation of cancer cells as  the radiation causes unnatural cellular mutation.

"Radiation has a high risk to embryos in pregnant women, juveniles, and highly proliferative cells of people of growing ages. Even for adults, highly proliferative cells, such as hairs, blood, and intestinal epithelium cells, are sensitive to radiation."

'Children are at greater risk'

Early on in the disaster, Dr Makoto Kondo of the department of radiology of Keio University's School of Medicine warned of "a large difference in radiation effects on adults compared to children".

Kondo explained the chances of children developing cancer from radiation exposure was many times higher than adults.

"Children's bodies are underdeveloped and easily affected by radiation, which could cause cancer or slow body development. It can also affect their brain development," he said.

Yanagisawa assumes that the Japanese government's evacuation standards, as well as their raising the permissible exposure limit to 20mSv "can cause hazards to children's health," and therefore "children are at a greater risk".

Nishio Masamichi, director of Japan's Hakkaido Cancer Centre and a radiation treatment specialist, published an article on July 27 titled: "The Problem of Radiation Exposure Countermeasures for the Fukushima Nuclear Accident: Concerns for the Present Situation".

In the report, Masamichi said that such a dramatic increase in permitted radiation exposure was akin to "taking the lives of the people lightly". He believes that 20mSv is too high, especially for children who are far more susceptible to radiation.

"No level of radiation is acceptable, for children or anyone else," Caldicott told Al Jazeera. "Children are ten to 20 times more sensitive than adults. They must not be exposed to radiation of any level. At all."

In early July, officials with the Japanese Nuclear Safety Commission announced that approximately 45 per cent of children in the Fukushima region had experienced thyroid exposure to radiation, according to a survey carried out in late March. The commission has not carried out any surveys since then.

"Now the Japanese government is underestimating the effects of low dosage and/or internal exposures and not raising the evacuation level even to the same level adopted in Chernobyl," Yanagisawa said. "People's lives are at stake, especially the lives of children, and it is obvious that the government is not placing top priority on the people's lives in their measures."

Caldicott feels the lack of a stronger response to safeguard the health of people in areas where radiation is found is "reprehensible".

"Millions of people need to be evacuated from those high radiation zones, especially the children."

Dr Yanagisawa is concerned about what she calls "late onset disorders" from radiation exposure resulting from the Fukushima disaster, as well as increasing cases of infertility and miscarriages.

"Incidence of cancer will undoubtedly increase," she said. "In the case of children, thyroid cancer and leukemia can start to appear after several years. In the case of adults, the incidence of various types of cancer will increase over the course of several decades."

Yanagisawa said it is "without doubt" that cancer rates among the Fukushima nuclear workers will increase, as will cases of lethargy, atherosclerosis, and other chronic diseases among the general population in the effected areas.

Yanagisawa believes it is time to listen to survivors of the atomic bombings. "To be exposed to radiation, to be told there is no immediate effect, and afterwards to be stricken with cancer - what it is like to suffer this way over a long period of time, only the survivors of the atomic bombings can truly understand," she told Al Jazeera.

Radioactive food and water

An August 1 press release from Japan's MHLW said no radioactive materials have been detected in the tap water of Fukushima prefecture, according to a survey conducted by the Japanese government's Nuclear Emergency Response Headquarters.

The government defines no detection as "no results exceeding the 'Index values for infants (radioactive iodine)'," and says "in case the level of radioactive iodine in tap water exceeds 100 Bq/kg, to refrain from giving infants formula milk dissolved by tap water, having them intake tap water … "

Yet, on June 27, results were published from a study that found 15 residents of Fukushima prefecture had tested positive for radiation in their urine.

Dr Nanao Kamada, professor emeritus of radiation biology at Hiroshima University, has been to Fukushima prefecture twice in order to take internal radiation exposure readings and facilitated the study.

"The risk of internal radiation is more dangerous than external radiation," Dr Kamada told Al Jazeera. "And internal radiation exposure does exist for Fukushima residents."

According to the MHLW, distribution of several food products in Fukushima Prefecture remain restricted. This includes raw milk, vegetables including spinach, kakina, and all other leafy vegetables, including cabbage, shiitake mushrooms, bamboo shoots, and beef.

The distribution of tealeaves remains restricted in several prefectures, including all of Ibaraki, and parts of Tochigi, Gunma, Chiba, Kanagawa Prefectures.

Iwate prefecture suspended all beef exports because of caesium contamination on August 1, making it the fourth prefecture to do so.

Due to caesium contaminated straw, beef exports have been banned in four Japanese prefectures [EPA]

Jyunichi Tokuyama, an expert with the Iwate Prefecture Agricultural and Fisheries Department, told Al Jazeera he did not know how to deal with the crisis. He was surprised because he did not expect radioactive hot spots in his prefecture, 300km from the Fukushima nuclear plant.

"The biggest cause of this contamination is the rice straw being fed to the cows, which was highly radioactive," Tokuyama told Al Jazeera.

Kamada feels the Japanese government is acting too slowly in response to the Fukushima disaster, and that the government needs to check radiation exposure levels "in each town and village" in Fukushima prefecture.

"They have to make a general map of radiation doses," he said. "Then they have to be concerned about human health levels, and radiation exposures to humans. They have to make the exposure dose map of Fukushima prefecture. Fukushima is not enough. Probably there are hot spots outside of Fukushima. So they also need to check ground exposure levels."

Caldicott said people around the world should be concerned about the ongoing nuclear crisis at the Fukushima Daiichi plant. Radiation that continues to be released has global consequences.

More than 11,000 tonnes of radioactive water has been released into the ocean from the stricken plant.

Scientists warn that tuna caught off the Pacific coastal prefecture in northern Japan are now at risk of being radioactive [EPA]

"Those radioactive elements bio-concentrate in the algae, then the crustaceans eat that, which are eaten by small then big fish," Caldicott said. "That's why big fish have high concentrations of radioactivity and humans are at the top of the food chain, so we get the most radiation, ultimately."

On August 6, the 66th anniversary of the US nuclear bombing of Hiroshima, Japanese Prime Minister Naoto Kan said: "Regarding nuclear energy, we will deeply reflect over the myth that nuclear energy is safe. We will thoroughly look into the cause of the [Fukushima] accident, and to secure safety, we'll implement fundamental measures while also decreasing the degree of dependence on nuclear power generation, to aim for a society that does not rely on nuclear power."

But doctors, scientists, agricultural experts, and much of the general public in Japan feel that a much more aggressive response to the nuclear disaster is needed.

Kodama believes the government needs to begin a large-scale response in order to begin decontaminating affected areas. He cited Japan's itai itai disease, when cadmium poisoning from mining resulted in the government eventually having to spend 800 billion yen to decontaminate an area of 1,500 hectares.

"How much cost will be needed if the area is 1,000 times larger?"
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Industry and Fluoridation

***PLEASE NOTE THAT THIS INFORMATION IS FROM: FLUORIDE ACTION NETWORK  Excerpt from: Waldbott GL, Burgstahler AW, and McKinney HL. (1978). Fluoridation: The Great Dilemma. Coronado Press, Inc., Lawrence, Kansas. p. 295-305. INDUSTRY AND FLUORIDATIONINDUSTRY WELCOMED fluoridation with open arms. Chemical Week, a publication for the chemical industry, vividly portrayed this fact in 1951 with an enthusiastic news account: All over the country, slide rules are getting warm as waterworks engineers figure the cost of adding fluoride to their municipal supplies. They are riding a trend urged upon them by the US Public Health Service, the American Dental Association, the State Dental Health Directors, various state and local health bodies, and vocal women's clubs from coast to coast. ... it adds up to a nice piece of business on all sides and many firms are cheering the USPHS and similar groups as they plump for increasing adoption of fluoridation. (1) The beneficiaries named in this article were chemical companies and equipment firms: General Chemical, Harshaw Chemical Co., Blockson Chemical Co., American Agricultural Chemical Co., Aluminum Co. of America (ALCOA), Davison Chemical Corp., and Baugh Chemical Co. Chemical Week obviously failed to discuss how many other industries in addition to chemical corporations would eventually gain financially from the unexpected bonanza. Even so, the desire of corporations to sell their products was not the only significant motive for industry to "plump" for the new health measure. THE PROBLEM In the early 1930s, ALCOA and other manufacturers of aluminum had a problem so serious that it threatened their very existence. During the smelting and reduction process, when bauxite (aluminum oxide) is dissolved and electrolyzed in molten cryolite, hydrogen fluoride and other volatile fluorides are released into the air, and sodium fluoride remains in the bath. (2) The latter cannot simply be dumped on the ground because it seriously pollutes grass and other forage. Indeed, in 1950 ALCOA's plant in Vancouver, Washington, was fined for dumping fluorides into the Columbia River, and the airborne fluorides heavily contaminated the grass and forage, "which resulted in injury and death to cattle." (3) If it could be established further that human health also suffered from fluoride pollution, the consequences to the company in terms of damage suits would have been immeasurable. Damage to Animal Life. Many other industries, especially the manufacturers of steel and phosphate fertilizer, shared this problem with ALCOA. On August 25, 1961, W. S. Meader and his wife May, near Pocatello, Idaho, obtained a judgement in the US Court of Appeals, Ninth Circuit, against Food Machinery and Chemical Corp. for the sum of $57,295.80 and against J. R. Simplot Co. for $4,246.41. The factories of these corporations emitted solid and gaseous fluoride compounds which seriously damaged the Meader trout farm and fish hatchery. According to the court record, "eggs were worthless" and did not hatch properly; the fish also exhibited malformations. "During the week after rains, the Meaders were hauling away about a ton of dead fish per day." (4) Fluoride levels in water samples from the Meader hatchery ranged between 0.5 and 4.7 ppm - no different than the fluoride concentrations in food and drinks consumed today by humans in many places. Inevitably, the business of the farm began to deteriorate as "customers were lost." Damage to fish is not the only source of litigation resulting from environmental fluoride. Ever since the beginning of the industrial revolution, wholesale pollution of air and of the countryside with fluoride fumes and fallout has taken place, and fluoride poisoning has become an important industrial hazard. Early reports of damage came from Great Britain and also from Freiburg, Germany, where by 1893, 880,000 marks (about $200,000) had been paid for current injuries and 644,000 marks for permanent relief. Around the industrial city of Freiburg in Saxony a disease of cattle, endemic for 20 years, was identified in 1907 as fluoride poisoning from the smelters. (5) At about the same time, cattle near copper mines of Anaconda, Montana, were reported to have developed "copper teeth," which were remarkably similar to what was later recognized in humans as "Colorado brown stain" or "mottled teeth" (Fig. 17-1). (6) In the early 1950s American industry was plagued with a virtual epidemic of litigation. In 1950, Mr. and Mrs. Julius Lampert had won their suit against the Reynolds Metals Company's Troutdale aluminum plant for fluoride burns to their gladiolus crops. (7) In Blount County, Tennessee, prior to January 1, 1953, ALCOA had hardly made up the loss of income incurred by 141 farmers and cattle raisers, (8) when another suit charged that fluoride fumes "damaged farmlands, injured registered cattle," making them unmarketable, and caused premature deterioration of teeth, stiffness of joints, knots on ribs, loss of appetite, and general retardation of growth. (9) Other suits involved the ALCOA plant at Vancouver, Washington, which had to pay cattleman William Fraser $60,000 in 1962 and in the same year, $20,000 to Earl Reeder because of fluoride injury to their cattle on Sauvies Island. (10) In 1961 Fairview Farms. Inc., received $300,000 from the Harvey Aluminum Company's reduction plant in The Dalles, Oregon, because of damage to dairy herds, loss of forage and of milk supply, as well as depreciation of the lands. Orchardist W. J. Meyer and his wife Mary Ann also received $485,000 for "willful damage" to cherry, apricot, and peach crops. (11) The threat to farming by fluoride pollution can be visualized if we realize that Polk County, which was Florida's leading cattle producer in 1954 with 120,000 head, had some 30,000 fewer cattle by 1965. Fluoride emissions from phosphate plants on pastures were building up toxic levels as high as 1800 ppm in the grass and other forage. The official maximum allowable concentration for cattle is 40 PPM, (12) but even this level permits significant damage. (13) Human Health. When human health was at stake, the spectre of these damage suits became even more ominous for the corporations. In the 1955 suit Paul M. Martin and his wife Verla vs. Reynolds Metals, it was proved for the first time in the United States that fumes from an aluminum reduction plant had caused illness to humans. (14) The significance of this litigation is underscored by the fact that seven other aluminum, metal, and chemical companies joined Reynolds Metals as "friends of the court" to obtain a reversal of the judgement against their fellow corporation. Fred Yerke, a Reynolds attorney, "contended that, if allowed to stand, the verdict would become a ruling case, making every aluminum and chemical plant liable to damage claims merely by operating." (15) The verdict did stand: in June 1958, the U.S. Court of Appeals upheld the decision against Reynolds by a five to one vote. (16) Finally, in 1968, the company settled the case by buying the Martin ranch - a solution to the problem that has been followed by other corporations. Another suit involving human health threatened the Rocky Mountain phosphate plant in Garrison, Montana, when residents complained constantly of "strep" throats, burning eyes, and asthmatic symptoms which they associated with fumes emanating from the plant. Classes of the Garrison school were interrupted 35 times during the first year of the plant's operation (1963-1964) because of fluoride fumes. That fluoride was the chief culprit became evident when ranchers observed: their cows suffered from mottled teeth (Fig. 17-1) and legs so stiff and painful that they had to graze on their knees (Fig. 17-2). Samples of vegetation near the stack fallout showed fluoride concentrations several thousand times the usual levels. (17) In spite of the installation of pollution control equipment, the plant had to be shut down repeatedly. Finally, the factory discontinued operation altogether for reasons unrelated to the pollution problem. In another part of the country, a jury decided on March 13, 1972, in favor of P. G. and P. N. Barci, father and son, in the suit of Barci vs. Intalco Aluminum Company of Ferndale, Washington, because of damage to cattle, trees, and to human health. A lung specialist from Spokane testified that P. G. Barci suffered from pulmonary fibrosis, a permanent lung disease which had completely disabled him. (18) About two years later, the same aluminum company lost a $130,500 fluoride emission suit to Ray and Helen Freeman, who resided a mile away from the plant on Lake Terrell. (19) THE SOLUTION These are but a few of the numerous law suits highlighting the magnitude of environmental damage by fluoride. Ironically, the expenditures I have discussed are small compared to the cost of installing effective air-cleaning equipment. For instance, by 1957 the United States Steel Corporation's Columbia-Geneva Division's plant in Provo, Utah, had spent $9 million to install electrostatic precipitators and other anti-pollution devices. The same company had previously been faced with nearly 900 damage claims totaling approximately $4.5 million. (20) Unfortunately, even high-priced air-cleaning equipment does not solve the problem, since fluoride scrubbed from chimneys does not disappear; it has to be washed onto the land or into rivers and lakes and eventually creates further difficulties. 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 is 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) Table 17-1 Recommended Maximum Levels of Ions in Water Used for Drinking and Cooking, 1939 (26) Ion Max. Level (ppm) Calcium 30 Magnesium 10 Lithium 5 Iron 0.5 Bicarbonate 150 Carbonate 20 Sulfate 100 Chloride 200 Iodide 0.01 Fluoride 0.1 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 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 Associationon 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. REFERENCES 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.