Fluoride proposal draws criticism.

The Environmental Protection Agency (EPA) proposes changing the recommended ceiling on fluoride concentrations in drinking water to 4 milligrams per litter -- up from 1.4 to 2.4 milligrams/liter (a temperature-dependent range adopted in 1977). Studies have shown that at levels of 1 to 2 mg/i, fluoride helps fight tooth decay. At higher levels, it can cause dental fluorosis, a discoloring (usually browning) and pitting of teeth (SN: 7/19/80, p. 42). At 4 mg/i it can even alter bone density, though EPA's announcement on the proposed standard says this would "cause no detectable health effects."

The new primary limit, as a recommendation, would not be enforceable. However, it is a necessary first step in setting enforceable standards under the Safe Drinking Water Act. A final enforceable rule is to be set as close as possible to the recommended level.

Battle lines being drawn over the proposal are based primarily on the issue of whether fluorosis constitutes an adverse health effect. EPA cites a 1982 report by the U.S. Surgeon General in which he said he did not consider it to be one. The Natural Resources Defense Council (NRDC), an environmental group based in New York City and Washington, D.C., maintains otherwise. And inc omments it has filed with EPA, NRDC points to a number of groups that share its view, among them the World Health Organization, the National Academy of Sciences, members of the Surgeon General's Ad Hoc Committee on non-dental health effects of fluoride and the National drinking Water Advisory Council.

"EPA concedes that moderate to severe fluorosis has been shown in as many as 40 percent of children exposed to fluoride at the level of the proposed [recommended limit]," NRDC says. The group contends that the disfiguring condition could also result in long-term psychological harm for those affected.

Moreover, the group says,

EPA is apparently ignoring the susceptibility of certain groups -- mainly diabetics and kidneystone formers -- whose recommended high intake of water might result in their receiving toxic doses of the chemical.

Like EPA, the Chicago-based American Dental Association sees dental fluorosis as "a cosmetic problem, not a health problem," according to Lisa Watson, ADA's director for fluoridation and preventive dentistry. As such, she says, ADA sees no need for a federal primary standard for fluoride in drinking water, since these standards are only to limit health hazards. However, she adds, ADA recommends maintaining fluoride at levels providing optimal dental benefits--roughly 1 mg/l.

EPA will hold hearings on its proposal Dec. 18 in Washington, and will accept written comments on it through Dec. 30. NRDC plans to challenge it, both in that forum and in the courts.