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In 1975 Dean Burk, former head of research at National Cancer Institute, and John Yiamouyiannis, a biochemist and fluoride expert, reported their analysis of fluoridation effects. After reviewing official public health statistics on 180 million Americans they found a significant increase in death from cancer in fluoridated cities. They limited their study to the ten largest fluoridated cities compared to the ten largest unfluoridated cities in America over a twenty-year period, from 1950 to 1970.

The selection of cities was based upon similar cancer death rates for the preceding ten years, 1940-1950, i.e. before fluoridation was begun. After fluoridation, there were a million cancer deaths between 1950 and 1970. If there was ever an opportunity to evaluate the health effects of fluoride, this was it because since that time the amount of fluoride in water, toothpaste, soft drinks and food has gone up all over the country, blurring the differences between fluoridated and non-fluoridated areas. For practical purposes, all of America is already fluoridated nowadays, even if the local water supply is not.

But at the time of the Burk-Yiamouyiannis study, the fluoridated cities had an average cancer death rate of 220 cancer deaths per 100,000 people per year, while the nonfluoridated cities had only 195. This represented an excess of over 10 percent in the cancer death rate within a surprisingly short period of only 13 to 17 years after fluoridation. Their analysis further showed that the increase was not due to differences in age, race or sex composition of the fluoridated and non-fluoridated populations although the increase in cancer death occurred primarily in people over age 45 and especially after 65 years old, in whom there was a statistically significant increase of 37 deaths per 100,000 in the fluoridated cities from 1952 to 1969. The ten non-fluoridated cities averaged an insignificant increase of only 3 deaths per 100,000 in the over-65 age group, i.e. 13 times less increase in cancer.

These findings posed a direct challenge to the pro-fluoridation policy of the United States government Public Health Service. In response, the United States Center for Disease Control assigned Dr. J. D. Erickson of The Center to re-analyze the health effects of fluoride. He confirmed the above findings-but then expanded the database by choosing more cities on the basis of five additional factors: age, sex, race, population density and median educational level. By this means he was able to expand the original 20 cities to 46 cities and the analysis was broadened to include 29 fatal conditions, including cancer and coronary heart disease (also called ischemic heart disease). He performed over 2000 independent calculations and so arrived at parity: no difference in cancer deaths after all! Naturally, this was published in the New England Journal of Medicine and accepted by the medical and dental establishment as a vindication of fluoridation.

I am more comfortable with the original data because it is validated by selection of cities with similar cancer death rates in the baseline time period: 182 per 100,000 in the control cities and 183 in those that were fluoridated in between 1950-1960. In addition Burk and Yiamouyiannis analyzed total cancer deaths from 1953-1969. Dr. Erickson took his mortality data only from 1970 census figures and was thus unable to describe year to year trends.

Even if we accept all of Erickson’s statistical manipulations, there remains a 15 percent excess death from hypertension, 13 percent excess from arteriosclerosis, 12 percent excess from other arterial diseases, and 25 percent excess from pregnancy complications. However even this is questionable because Dr. Erickson excluded the death certificates of all Asians and Hispanics from his analysis; yet he included them in the population density and educational level data[i].

How could experts be so opposite in their view of the same data? In this case it comes down to a matter of method.

  • Burk and Yiamouyiannis compared the cancer rates in fluoridated and nonfluoridated cities chosen for their similar cancer rates before fluoridation was begun in the fluoridated cities. Theirs is a true before-after study.
  • Erickson compared cancer rates in fluoridated cities to non-fluoridated cities in 1970. It is a side-by-side comparison but the differences are obscured by his adjustment of the data using statistical means beyond an ordinary person’s understanding, i.e. combining five factors in the selection of his cities and excluding sub-groups, e.g. Asians and Latinos.

It is hard to avoid a suspicion that Dr. Erickson was pre-ordained with the goal of neutralizing the Burk-Yiamouyiannis findings. Bias is present if only because Dr. Erickson represents the public health establishment, whose avowed goal is to fluoridate all of the United States, whether the locals want it or not. Thus he changed the cities in his survey and left out Atlanta and Seattle, two of the non-fluoridated cities of the original study. And finally, he filtered his data with age, sex, race, median education and population density.

The Burk-Yiamouyiannis report on fluoride and cancer was presented to the United States Congress in 1976. It came out that there wasno data to support the conclusion that fluoride was safe[ii]. What an incredible oversight! On that basis alone, fluoridation should have been stopped. Instead Congress ordered an investigation, the results of which did not appear until 12 years later! When the studies in rats and mice by Battelle Institute were released in 1989 the conclusions again fanned the flames of controversy, for an excess number of rats developed bone cancer, osteosarcoma. The total amount of fluoride in the bones of these rats was about the same as is found in humans after 20-30 years living with 1 part per million of fluoride in their water.

Over-all there were four fluoridated animals with cancer: one male rat out of fifty on 45 ppm fluoride water and three males out of eighty receiving 79 ppm fluoride water. Females and control animals on low fluoride diets had no cancers[iii]. However historical control rats used in other studies typically exhibit such cancers in 3 out of 500 animals--probably because the commonly-used rat feeds contain fluoride between 12 and 45 parts per million[iv] and this study was no exception in using fish meal, which is high in fluoride, in their feed. This diminishes the difference between fluoride intake in control and treated rats and obscures the increased cancer rate in these fluoride experiments.

And there is another side to this story: political forces succeeded in influencing scientists to down-grade already diagnosed pre-cancerous tumors, such as dysplasia, thyroid nodules and liver cancers that were found in these animals. In an action that some might view as fraud, a pre-publication review committee, representing the National Institute of Health, reclassified one osteosarcoma cancer as non-malignant because the microscope picture looked as if the cancer could be outside the bone. By cutting the number of cancers by just this one, the cancer rate was not statistically significant but only equivocal--and “equivocal” was the final opinion of the report to Congress by the National Toxicology Panel.

One conscientious and courageous researcher, Dr. William Marcus, a senior scientist in the Department of Drinking Water at the Environmental Protection Agency, wrote an internal memo recommending that these questions be resolved by consultants outside the government. For this he was fired! But he sued and won his job back plus compensation of $50,000. There is no question that he was in the right; and the trial transcripts verify that public officials illegally destroyed documents and used subterfuge to get Dr. Marcus fired in the first place.

The American Dental Association responded to the National Toxicology Study: “Water fluoridation remains the safest, most effective, and most economical public health measure to prevent tooth decay and to improve oral health for a lifetime.” Their director of scientific affairs responded: “one would have to consume about 380 eight-ounce glasses of water a day to obtain 45 parts per million of fluoride and 700 glasses daily for 79 parts per million.” By ridiculing the research findings this way, she obscured the fact that the rats only drank the water for two years. Humans accumulate the fluoride over a lifetime and an equivalent dose would take only 18 years (45 ppm) and 32 years (79 ppm) respectively. Human levels can actually exceed those of the laboratory rats that got cancer.

The United States Public Health Service also issued a rebuttal[v]. The only concession was that “the prevalence of dental fluorosis may have increased.” On the other hand, they made note of the fact that in the years 1973-1987 the annual incidence of osteosarcoma among males under 20 years of age increased from 3.6 cases per million population to 5.5 cases per million. “Although the increase in rates of osteosarcoma for males during this period was greater in fluoridated than non-fluoridated areas, extensive analyses revealed that these patterns were unrelated to either the introduction or duration of fluoridation.”

Nevertheless, do you feel safe with fluoride in your drinking water, knowing that since 1973 there has been a fifty-plus percent increase in bone cancer in our young men, an epidemic that is five times worse in fluoridated areas? The Public Health Report was published in 1991. Has research been done? Has a public debate ensued? Why have we sat by while our misguided political leaders have mandated fluoridation of the entire state of California? Will we passively permit the Public Health Service to do the same all over America?

Dr. Dean Burk, former Chief of Research at the National Cancer Institute, was so convinced of the danger from fluoride that he addressed the District Court in Houston, Texas as follows: “I know of absolutely no, and I mean absolutely no means of prevention, that would save so many lives as simply as to stop fluoridation, or don’t start it where it is otherwise going to be started. There you might save 30,000 or 40,000 or 50,000 lives a year, cancer lives. That is an awful lot of lives a year[vi].”

AB 733 was approved by the California legislature and signed into law by Governor Wilson in September, 1995. We are all potential victims--of our well-meaning but over-confident officials. The only hope is You, the citizen. It is important that you be informed. For more information:


© Richard A. Kunin, M.D. 2010


[i] Erickson JD, Mortality in Selected Cities with fluoridated and non-fluoridated water supplies. 1976, NEJM, 298:1112-1116.

[ii] Yiamouyiannis J and Burk D. Fluoridation and cancer; Age-dependence of cancer mortality related to artificial fluoridation. 1977, Fluoride, 10:102-125.

[iii] Bucher JR, Hejtmancix MR, Toft JD et al: Results and conclusions of the national toxicology program’s rodent carcinogenicity studies with sodium fluoride. 1991, In J Cancer, 48:733-737.

[iv] Rao GN and Knapka JJ. Contaminant and nutrient concentrations of antural-ingredient rat and mouse diet used in chemical carcinogenicity studies. 1987, Fundam appl Toxicol, 9:329-338.

[v] Public Health Service Report on Fluoride Benefits and Risks. Morbidity and Mortality Weekly Report, vol 40, RR-7, 1-8, June 14, 1991.

[vi] Burk D, Judicial hearing, Safe Water Foundation vs. City of Houston, District Court of Texas, Harris County, 1561st Judicial District. 80-52271. January 1982.


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