Fluoride is on tap for San Antiono

By Jerry Needham
San Antonio Express-News

7/26/2002

After three divisive elections and decades of bitter debate, San Antonio begins fluoridating its drinking water next week — finally shedding its distinction as one of the last large U.S. cities to shun the cavity-fighting mineral.

The first shipment of the chemical known as fluorosilicic acid arrived in San Antonio by tanker truck Thursday. By next week, it should begin coursing through pipelines serving more than a million people in Bexar County.

The delivery to three San Antonio Water System pumping stations came almost 18 months after city voters approved the addition of fluoride to the drinking water.

It took a third election — previous ones were in 1966 and 1985 — before 52.6 percent of the voters approved fluoride for the purpose of preventing and reducing tooth decay.

"This is significant for the city of San Antonio because this was voter-initiated and voter-approved," Mayor Ed Garza, who championed fluoridation as a city councilman, said from New York City, where he was attending a National League of Cities conference.

"This should provide San Antonians a health benefit — especially for those who do not have dental insurance and for the children," he said.

Over the past seven months, contractors have been installing equipment for the $4.7 million fluoridation project, a joint venture between SAWS and Bexar Metropolitan Water District, the county's second-largest water utility.

The two utilities are scheduled to start adding fluoride to the water at their 35 pumping locations beginning next Friday. Under the phase-in process, all San Antonio residents will have fluoridated water by Aug. 15. The cost will be about 12 cents per water connection per month.

James Mayor, chairman of the SAWS board, has made assurances that the project has had "a lot of oversight and technical expertise" and that safety measures to ensure the proper amount of fluoride into the water are in place throughout the process.

About a dozen SAWS employees were on hand at 8 a.m. Thursday as the first shipment of fluorosilicic acid — an industrial waste product that contains about 23 percent fluoride — arrived at SAWS' East Side Service Center. There, the seal on the black tanker was broken.

After sampling and testing, the 4,439 gallons of clear liquid was cleared for the trip to the Randolph Pump Station, where most of the load was pumped into a storage tank. Later deliveries were made to the Seale and Artesia pump stations.

A leaky connection at the Randolph station caused a bubbly, foaming mess atop the concrete, but it was cleared with water and the connection was tightened.

About 70 percent of fluoridated communities use fluorosilicic acid, a waste product from the production of phosphate fertilizers. Most of the remainder use sodium fluoride, a waste product from aluminum smelting operations.

Studies over the years have shown that fluoride helps keep teeth healthy by reducing the breakdown of minerals by sweets and acidic foods, by attacking bacteria that cause dental plaque and by strengthening enamel.

But fluoride opponents, who have at least one lawsuit pending, claim that fluoridation is a scam that will do people more harm than good. The suit alleges the election was not legal because not all affected by the decision — such as those in other cities served by SAWS and unincorporated Bexar County — were allowed to vote.

"I think it's a major fraud and that current science does not support artificial water fluoridation," said Nikki Kuhns, a San Antonio anti-fluoride activist who said her review of scientific research has convinced her fluoride can be dangerous.

"There are those in the subsets of population who are at risk and will suffer from fluoride," she said. "Plus, the chemicals being used have lots of contaminants. It really is toxic waste."

Once the project is completely under way, three small pumps will meter the substance into the flow of water from the site's three wells drawing from the Edwards Aquifer.

The process will be similar at 26 other SAWS pump stations and Bexar Met's seven pump stations, as well as Bexar Met's surface water treatment plant near Von Ormy.

Water from the Edwards, which supplies most of the drinking supply in San Antonio and Bexar County, naturally contains between 0.2 and 0.3 parts of fluoride per million parts of water (ppm).

The fluoridation systems are designed to add 0.5 ppm more of the mineral to the water, bringing the concentration up to the federally recommended level of between 0.7 ppm and 1.2 ppm. The Texas Department of Health recommends a level of 0.8 ppm.

The water of Bexar Met and SAWS customers who use the Trinity Aquifer in North Bexar County will not be fluoridated, as it naturally contains about 0.7 ppm of fluoride, officials said.

The City Council ordinance adopted after passage of the November 2000 referendum requires fluoridation of all water supplied to San Antonio residents.

The decision affects all of SAWS' almost 300,000 customers, including those in Terrell Hills, Olmos Park, Balcones Heights, unincorporated Bexar County and parts of Live Oak, Leon Valley and Shavano Park. Because the San Antonio City Council called the election, residents in those areas were not allowed to vote on the issue.

About 14 percent of residents in San Antonio get their drinking water from Bexar Met, which is not fluoridating water in other areas it serves, such as Castle Hills, Hill Country Village, Hollywood Park and in other counties. Bexar Met serves about 70,000 customers.

Dallas, Austin, Fort Worth, Houston and some communities in Central Texas — New Braunfels and Seguin — as well as San Antonio's military installations have fluoridated their water for years.

Leon Valley, Shavano Park and Alamo Heights, which have their own Edwards supply systems, also have not fluoridated.

SAWS and Bexar Met have a yearlong contract with Sealy-based Pencco to provide the fluorosilicic acid — up to 140,000 gallons a year at about $1.53 a gallon. SAWS officials estimate that it will cost $300,000 a year to maintain and operate the fluoridation facilities.

For more than a month now, newspaper, television and radio announcements have informed the public that fluoridation is coming. The area's dental, pediatric and pharmaceutical communities have been notified by letters so that they can make appropriate recommendations to their patients, said John Boggess, spokesman for SAWS.

The teeth of children exposed to large doses of fluoride can develop white spots or dark splotches and can be more vulnerable to cavities, according to federal health officials. Older people can develop brittle bones with excessive fluoride.

Besides natural or artificial fluoridation of water, people also are exposed to fluoride in some brands of bottled water and beverages, toothpaste, dental rinses and processed food.

Those who do not want to drink fluoride can install reverse osmosis water treatment systems. The systems, which range in price from $800 for under-the-sink models to $10,000 for whole-house models, remove 98 percent or more of minerals and other water contaminants, including chlorine and fluoride.

Cheryl Pursely, a San Antonio resident whose five children are on Medicaid and have a chronic hypersensitivity to fluoride, recently convinced SAWS officials to install an undersink reverse osmosis system at her house. A local vendor donated the $1,145 equipment, and SAWS paid the installation fee of $145.

"The dentists have told me the kids should not be exposed to fluoride," she said, adding that fluoride urinalyses recently showed that the children are ingesting up to 1.56 ppm of fluoride daily, simply from dietary intake.

Boggess said Pursely approached SAWS officials a number of times, expressing concern about her ability to protect her children. The utility made some calls and found someone willing to donate a system to the family, he said, adding that neither the utility nor the city has adopted any policies that would aid low-income people who may suffer ill effects from fluoride.

SAWS and Bexar Met have trained 120 people to handle the corrosive acid, with more scheduled for training.

Because of the potential for fluoride poisoning, the entire process — from the manufacturer to the utility's distribution lines — has several safeguards to ensure that too much fluoride is not used and that there has been no tampering with the product, said Val Ruiz, SAWS director of distribution and collection.

Among the safety features:

Fluoride will be stored in tanks with a capacity of up to 5,400 gallons, but only enough fluoride to last a day will be stored in pumping dispensers, which will have to be manually refilled every day.

Fluoride injection pumps can operate only when the water wells are operating, as indicated by flow meters.

Water samples will be taken daily at multiple locations to check for proper levels of fluoride.

Crews will verify the usage amount at each site by weight.