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County medical director warns EPA action could force municipalities to reconsider water fluoridation
Summary
St. Clair County's medical director told the advisory board that a court ruling under TSCA, and EPA's ensuing appeal and Safe Drinking Water Act review, make it likely EPA will set a maximum contaminant level goal for fluoride below 0.7 ppm; he advised municipalities they may consider discontinuing fluoridation and circulated a memorandum to that effect.
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St. Clair County Medical Director Dr. Nevin briefed the advisory board on March 1 about a federal legal and regulatory process that, he said, creates real prospects for a lower federal goal for fluoride in drinking water and could affect local water-fluoridation policies.
Dr. Nevin described a district court decision under the Toxic Substances Control Act (TSCA) that found merit in claims that fluoride in drinking water poses an "unreasonable risk" and ordered EPA to regulate fluoride under TSCA. He said EPA is appealing that decision and is also conducting a parallel regulatory review under the Safe Drinking Water Act.
"EPA does not dispute that fluoride in drinking water is an unreasonable risk to human health," Nevin told the board, explaining that EPA's appeal focuses on procedural issues and that the agency's forthcoming risk assessment and management decisions could lead to a maximum contaminant level goal (MCLG) substantially below current community fluoridation targets.
Nevin flagged two technical points. First, he said established toxicology practice often applies an uncertainty (safety) factor of about 10 when translating toxicology findings into safe-exposure targets, which, when applied to fluoride risk assessments, would yield target concentrations well below levels recommended for dental caries prevention. Second, he said the MCLG is not automatically binding but can influence future regulatory choices and local decisions.
He said the department circulated a memorandum to municipalities advising that, within their existing powers, they could choose to discontinue water fluoridation voluntarily if they judge doing so to be in the community's best interests while federal rulemaking proceeds. He also said he had briefed most municipalities in recent months and offered to meet with any that request further information.
Board members asked about likely timelines and the county's role in advising municipalities. Dr. Nevin said EPA's process could take months and that local water systems and councils should consider the technical and public-health trade-offs now, and that the health department would remain available for questions.
Background cited in the briefing included the Federal Register process for soliciting comment and the statutory frameworks referenced in the hearing: the Toxic Substances Control Act and the Safe Drinking Water Act. No local regulatory action was taken at the meeting; the briefing was presented for information and to encourage municipal preparedness.
Next steps: the department said it will continue outreach to municipal decision-makers and notify the advisory board of any formal federal determinations that would require re-evaluation of county guidance or local practice.

