Brown Prof Testifies That Fluoride IQ Studies Have Gaps - Mr. Mark Smith, LL.M., Certified Paralegal and Legal Document Preparer

A Brown University epidemiologist testified Friday on behalf of the U.S. Environmental Protection Agency in a bench trial over fluoride's risks Friday that there are data "gaps" in studies linking fluoride exposure to lower IQ, while acknowledging under cross-examination that he hadn't reviewed studies assessing the effects of high-dose fluoride exposure. Brown University professor of epidemiology David Savitz's testimony came during the EPA's defense case on the sixth day of a two-week bench trial before U.S. District Judge Edward Chen in San Francisco in high-stakes litigation launched by Food & Water Watch Inc., the Fluoride Action Network and others against the U.S. Environmental Protection Agency in 2017. The groups seek to force the EPA to make a new federal rule under the Toxic Substances Control Act that would ban fluoride from being added to drinking water. Local municipalities have added the chemical to public water for decades to boost public dental hygiene and prevent dental decay, but the groups' experts have testified during the trial that the latest scientific studies suggest that fluoride is neurotoxic and that even low levels of exposure lowers IQ. The EPA called Savitz as its first witness on Wednesday, and he testified that he recently participated in a Canadian health panel reviewing the latest scientific studies on the potential effects of fluoride exposure. Savitz testified that there's too much uncertainty in the scientific data on the neurocognitive impacts of fluoride exposure from drinking water, which typically has 0.7 mg/L of fluoride, and it would be premature to regulate fluoridated water based on its potential neurotoxicity. Before trial recessed Wednesday, Savitz said his panel recommended that Canadian water regulators instead focus on moderate dental fluorosis — a condition resulting from taking in too much fluoride as a kid — that can occur with fluoride exposure above 1.56 mg/L. Trial resumed Friday morning with the EPA continuing Savitz's direct examination, and over the course of about three hours, the professor took issue with various aspects of the dozens of fluoride IQ studies that were analyzed by the plaintiffs' epidemiological expert. Savitz explained that his panel was also tasked with closely reviewing the recent National Toxicology Program's fluoride monograph, which included multiple studies showing a steep drop in IQ points over a fluoride range from 0.2 mg/L to 1.5 mg/L. "We were really scrutinizing the document, looking at it in detail, as we were charged to do, and we remained concerned," Savitz said. Savitz took issue with various aspects of the studies, claiming that some had "double counting" issues with overlapping populations and "in broad terms, there was a bit of a disconnect" between the studies' analysis and results. He also took issue with certain studies he said didn't adjust for keratin. "It's not to say that their conclusions were wrong, but that trail from raw evidence to assessments, [there were] gaps and concerns," he said. Savitz also acknowledged that there wasn't a single problem definitively showing the studies' conclusions were wrong. Instead, he said, there were a series of issues, including various methods of fluoride testing and population demographics, that "might seem to be modest initially, but cumulatively ... it's not making its case well." "They were not being as direct as we would want them to be," he said of the NTP's monograph. "It sounds like nitpicking, and I suppose in a way it is, but when you look at the details there were some troubling issues," he said, adding, "The question is did they implement their strategy effectively, not if it's the best strategy." Although the professor acknowledged the fluoride IQ studies do appear to "follow the pattern" that NTP researchers suggest, showing a link between IQ drops and levels of fluoride exposure above 1.5 mg/L, Savitz cautioned against drawing strong inferences from them. "I'm not saying they were completely off base — not at all," he said. "They probably got it right, but there are some real concerns about the description of the process and the details." The EPA's counsel asked how fluoride compares to lead. During trial, the judge has heard testimony from the plaintiffs' experts that the resistance to regulating fluoride is similar to resistance to lead regulations in the 1970s. In 1976, the U.S. Supreme Court eventually required the EPA to prohibit companies from adding lead to gasoline, even in small amounts, due to its risks, despite significant pushback from industry, according to trial testimony. Savitz testified that he believes lead is different from fluoride, because "in the early days" of lead research, scientific studies clearly showed that lead was dangerous at high exposures, and the question was the "ratcheting down" of lead exposures. "It wasn't moderate confidence. It was airtight. You weren't taking a leap when you pushed [lead exposure] further and further in that direction," he said. "It's very different where we stand with fluoride." But the plaintiffs' counsel objected repeatedly, arguing that some of Savitz's testimony constitutes undisclosed opinions. The plaintiffs also noted that Savitz acknowledged that he has not analyzed studies analyzing the effect of high levels of fluoride exposure, or even exposures above 1.5 mg/L, so he can't claim fluoride doesn't follow the same risk pattern as lead exposure. But the judge mostly overruled the objections. Savitz's cross-examination began with the plaintiffs' counsel reading the professor quotes from his own textbook stating that the precise "causal nature of any given effect is almost never known" in epidemiological studies. The counsel also tried to get Savitz to concede that at least one other member on his panel had a conflict of interest in assessing the risks of fluoride, but Savitz denied knowing about the other panelist's purported conflicts, and the judge sustained objections to further questioning on the issue. During cross-examination, Savitz acknowledged that he had never conducted a fluoride study himself, and that when he joined the panel he wasn't an expert on fluoride. Savitz also acknowledged that confounding of data "probably could not" explain the relationship between fluoride and IQ, and he agreed that he never reviewed fluoride studies involving doses of fluoride of 1.5 mg/L or higher. Before trial recessed for the day, Savitz also repeatedly acknowledged that he's not a risk assessor, and that he doesn't know how the EPA evaluates "risk" under TSCA. Trial will resume Monday morning, and it's expected to conclude Wednesday. The legal fight went to a first bench trial in 2020, with the plaintiff groups asking the court to declare that fluoride in tap water posed a risk to human health. But Judge Chen suspended litigation so the EPA could conduct another study and reevaluate fluoride's risks. Litigation resumed in October 2022. The groups are represented by C. Andrew Waters and Michael Connett of Waters Kraus & Paul LLP and Christopher T. Nidel of Nidel & Nace PLLC. The EPA is represented by Brandon N. Adkins and Paul A. Caintic of the U.S. Department of Justice's Environment and Natural Resources Division and Emmet P. Ong of the U.S. Attorney's Office for the Northern District of California. The case is Food & Water Watch Inc. et al. v. Environmental Protection Agency et al., case number 3:17-cv-02162, in the U.S. District Court for the Northern District of California.