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CDC Statement on Water Fluoridation and Osteosarcoma
Osteosarcoma is a type of rare bone cancer. About 400 children and
adolescents in the United States are diagnosed each year, approximately
250 of whom are males. An observed association between exposure to
fluoride in drinking water and the incidence (new cases) of osteosarcoma
in young males has been reported in a paper entitled Age-specific
Fluoride Exposure in Drinking Water and Osteosarcoma (United States) (Bassin
et al., 2006). No apparent association was observed in females. This
research, which the author describes as an exploratory analysis, adds to
the scientific knowledge base on this topic. The author acknowledges
that this study has limitations and further research is required to
confirm or refute this observation.
This paper is based on the analysis of an initial set of cases from a
15-year effort to study fluoride and osteosarcoma by the Harvard School of
Dental Medicine and collaborating organizations. The principal investigator
for the overall study cautions against over interpreting or generalizing the
results of the Bassin analysis, stressing that preliminary analysis of a
second set of cases does not appear to replicate the findings (Douglass et
al., 2006). Publications from the forthcoming analyses are expected to
provide further information as to whether and to what extent an association
may exist between osteosarcoma and exposure to fluoride.
A number of studies regarding water fluoridation and osteosarcoma have
been published in the past. At this time, the weight of the scientific
evidence, as assessed by independent committees of experts, comprehensive
systematic reviews, and review of the findings of individual studies does
not support an association between water fluoridated at levels optimal for
oral health and the risk for cancer, including osteosarcoma. In a report
issued in March 2006, Fluoride in Drinking Water: A Scientific Review of
EPA’s Standard, the National Research Council (NRC, 2006) considered all
available evidence on fluoride and osteosarcoma, including pre-publication
data from the analysis by Dr. Bassin. The NRC Committee found the overall
evidence on osteosarcoma to be tentative and mixed, and no recommendations
were made related to this health concern for revising current allowable
fluoride levels in drinking water. The report stated that the results of the
larger Harvard study, once published, may provide an important and useful
addition to the weight of scientific evidence regarding this condition.
CDC’s mission includes monitoring health, detecting and investigating
health problems, developing and advocating for sound public health policies,
implementing prevention strategies, promoting healthy behaviors, and
fostering safe and healthful environments. The overriding goal and concern
is protecting the health and well being of the public. CDC continually
monitors and evaluates scientific information on fluoridation as part of its
responsibility for public health assurance and protection. CDC, along with
experts in the scientific community, will review published studies when
they become available, will continue to monitor other scientific
developments related to water fluoridation, and will provide guidance and
recommendations about fluoride to the public.
CDC continues to strongly support community water fluoridation as a safe
and effective public health measure to prevent and control tooth decay and
to improve overall health. Water fluoridation benefits people of all ages
and socioeconomic groups, including those difficult to reach through other
public health programs and private dental care. CDC has recognized community
water fluoridation as one of 10 great public health achievements of the 20th
century. Those wishing to learn more about fluoridation can find CDC’s
Recommendations for Using Fluoride to Prevent and Control Dental Caries in
the United States and other information at
www.cdc.gov/oralhealth.
References
Bassin EB, Wypij D, Davis RB, Mittleman MA. Age-specific fluoride
exposure in drinking water and osteosarcoma (United States). Cancer Causes
and Control 2006;17:421–428.
Douglass CW, Joshipura K. Caution needed in fluoride and osteosarcoma
study. Cancer Causes and Control 2006;17:481–482.
National Research Council Committee on Fluoride in Drinking Water.
Fluoride in drinking water: A scientific review of EPA’s standards.
Washington, D.C: The National Academies Press, 2006.
Date last reviewed: October 8, 2008
Date last modified: August 9, 2007
Content source:
Division of Oral Health, National Center for Chronic Disease Prevention and
Health Promotion |
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