Note: The following is not the full statement.
We have left out the authors' discussion of the NAEP Code of Ethics.
To read their entire statement, visit: http://www.rvi.net/~fluoride/naep.htm
Applying the NAEP Code of Ethics to the Environmental
Protection Agency and the Fluoride in Drinking Water Standard
by:
Robert J. Carton, Ph.D.
J. William Hirzy, Ph.D.
National Treasury Employees Union,
Chapter 280
Washington, D.C.
ABSTRACT
As stated in the NAEP Code of Ethics and Standards of Practice for
Environmental Professionals, the "keystone of professional
conduct is integrity..." This means that professionals must
be responsible for the validity of their work, which must be conducted
without "dishonesty, fraud, deceit or misrepresentation or
discrimination." They must not put professional judgment aside
in order to twist facts and/or conclusions to give a client, or
a superior, a desired outcome. Further, professional integrity does
not stop when a report is signed. There is a continuing responsibility
for seeing that a report is not misrepresented by others, or altered
to change its data or conclusions.
In 1997, the National Federation of Federal Employees, Local 2050
(the "Union"), representing all 1400 non-management professionals
at the headquarters of the U.S. environmental Protection Agency
(EPA), incorporated a modified version of the NAEP Code of Ethics
into its Collective Bargaining Agreement with EPA. This paper discusses
the Agreement and the need for further refinements of it, along
with the event that galvanized this effort, viz. the November 14,
1985 Federal Register notice setting a health-based standard for
fluoride in drinking water.
The NAEP (National Association of Environmental Professionals) Code
required some minor modifications to better clarify the role of
professionals who provide analyses of issues in a regulatory context.
Regulations require specific scientific endpoints to be defined.
Politicians often demand analyses that support politically acceptable
solutions. This presents a serious dilemma in that professional
ethics are forced to take a back seat to political expediency. An
enforceable code of ethics is needed to permit honest analysis to
surface from professional staff without fear of intimidation or
reprisal.
The need for a Code of Ethics at EPA has been emphasized time after
time since the Agency began in 1970. This need became critical when
it published the Fluoride in Drinking Water Standard in 1985. An
investigation by the Union revealed that scientific support documents
for the health-based standard were crafted to support a long-standing
public health policy. Objective scientific methods of data collection
and analysis were avoided in favor of presenting information that
agreed with current policy.
The National Association of Environmental Professionals
(NAEP) Code of Ethics
The NAEP Code of Ethics and Standards of Practice for Environmental
Professionals ("NAEP Code")1 states self-evident truths
in a way reminiscent of the Declaration of Independence. In the
first line it says that "the keystone of professional conduct
is integrity." It then expands on the meaning of integrity
by noting that professionals must:
1. be responsible for the validity of their own work.
2. ensure that it is done objectively, using the best scientific
and engineering principles available.
3. not condone misrepresentation of their work.
4. fully disclose any possible conflict of interest.
5. not be involved in "dishonesty, fraud, deceit, or misrepresentation
or discrimination."
6. not accept work if it is contingent upon violating their code
of ethics.
The principles outlined in the NAEP Code, if followed, should ensure
a healthy profession and result in the respect of those coming into
contact with its members. It should be easy for anyone considering
joining NAEP to agree with them.
There is a second set of statements in the Code which are offered
as "guidance" for professionals. Two of these, we believe
belong in the list of ethical principles. The first is the statement
that one should work on projects for which one is qualified, and
the other is that work should be done in concert with laws, regulations,
and ordinances. It will become clear as we discuss the application
of the code to the activities of EPA why we believe these are necessary.
Environmental Professionals at EPA Headquarters
In 1982, all of the non-management scientists, lawyers and engineers
working at EPA Headquarters, in their own declaration of independence,
decided to organize into a union that could bargain with the Agency
over conditions of employment. The organizing committee believed
there were so many outstanding grievances with management that the
only way to get resolution was by forming a Labor union. According
to the Civil Service Reform Act, the Agency must recognize and bargain
with a legally constituted union, whereas it can ignore other employee
groups, no matter how thoroughly constituted or well-intentioned
they may be.
Our grievances with the "King" (at that time it was the
"Queen", EPA Administrator Anne Gorsuch) centered around
the misuse of professional services, creating an unethical climate
that served politics, but not truth. Management was enamored with
the idea that "management rights" included, among other
things, mandating the "arranging" or "rearranging"
of scientific facts so they support predetermined conclusions. Management
acted as if the only moral duty of employees was the duty to obey
2 - even in spite of the results at Nuremberg.
When the required representational election was held in 1984, the
Union, the National Federation of Federal Employees, Local 2050
(NFFE), was chosen overwhelmingly by a 90% plurality vote. After
lengthy negotiations, we signed our first contract with EPA in 1986.
We then began to fight for the ethical and competent practice of
science and law at EPA. Our most visible effort - and the one that
will be the focus of the remainder of this presentation - was our
activity regarding EPA's regulation for fluoride in drinking water,
during which we attempted to file an amicus brief in the law suit
brought by the Natural Resources Defense Council against EPA in
April of 1986 on this issue. We also did a great deal of work on
the toxic nature of emissions from latex-backed carpeting that poisoned
over 300 EPA employees at EPA Headquarters, and the dangerously
explosive nature of aerosol foggers used extensively by ordinary
citizens in their homes. In all of these issues, professionals were
hindered in or prevented from carrying out their sworn duty to protect
the public. We took these issues to the public and the Congress
in hope of forcing a change in the ethical climate at EPA.
While these efforts were underway, we came upon a pamphlet from
NAEP. It contained a Code of Ethics which immediately struck us
as a possible solution to our problems. If we could negotiate an
enforceable code of ethics with the Agency, we might have some leverage
in eliminating the ethical abuses that were occurring. So, we took
the NAEP Code, modified it slightly, and presented it to the Agency
in 1988 as a bargaining proposal for negotiations.
...
Applying the Code to the Fluoride in Drinking Water Standard.
As stated in the proposed code of ethics, it is the duty of every
professional to understand the laws under which they operate. Laws
require professionals who are developing the scientific bases for
regulations to ask certain questions. In this particular case, the
Safe Drinking Water Act of 1975 5 (modified in 1986, "the Act")
said that EPA should identify contaminants in drinking water and
set a "recommended maximum contaminant level (RMCL)" for
each. The Act explains that:
RMCLs [changed to MCL goals in 1986] "...are non-enforceable
health goals which are to be set at levels which would result in
no known or anticipated adverse effects and which allow an adequate
margin of safety." [emphasis added]
When the Act says "no known...adverse effects" can occur
at the level chosen, that means everyone must be protected: young
and old, and those with health problems such as diabetics or those
with kidney impairment. EPA is not supposed to protect just the
average person, but everyone. The Act recognized the inherent right
of every individual to be able to drink safe water. Setting a standard
also means EPA has to consider all other sources of the contaminant,
in food, beverages, toothpaste, etc., otherwise, the contribution
EPA allowed for water may put some individuals at risk. This is
not always an easy task, but it is clear what the considerations
must be.
The Act also requires EPA to consider "anticipated adverse
effects." For instance, if data show that consumption of a
certain amount of a contaminant over 20 years causes disease, then
EPA is required to consider the level it would have to set that
would be safe over a lifetime.
And who should make this call? As noted in the code of ethics, it
should be someone qualified to make that judgment. Should a health
call be made by politicians or professionals, such as doctors, biochemists,
statisticians, chemists, etc. each addressing their particular area
of expertise?
EPA is also required to set an enforceable standard for each contaminant
called the "Maximum Contaminant Level (MCL)". The Act
explains that:
MCLs "...are enforceable standards and are to be set as close
to the RMCLs as is feasible...'feasible' means with the use of the
best technology, treatment techniques and other means, which the
administrator finds are generally available (taking cost into consideration)."
The bottom line is that an MCL is a level which may not be safe,
or at least not as safe, as the RMCL because in many cases it is
just not practical or economical to set a level equal to the RMCL.
The best example of how these distinctions are made can be seen
in the lead standard. The health goal is zero, but the MCL is 15
ug/l(ppb). The MCL is very much a political decision, although it
still must be kept as close to the RMCL as possible.
The RMCL for Fluoride in Drinking Water
EPA set an RMCL of 4 mg/l(ppm) for fluoride in drinking water on
November 14, 1985. 6 We are now going to examine how that decision
was reached in light of the original NFFE code of ethics proposed
to EPA. We are selecting only the RMCL because it represents a health
judgment unencumbered by political considerations. In the discussion
that follows, keep in mind that 1 mg/l of fluoride is the level
usually recommended for water fluoridation. This level has been
recommended for over 50 years by the Public Health Service without
wavering. In 1950, the PHS pronounced fluoridation "safe and
effective" 7 and it has made such grand claims ever since.
In 1990, Dr. Harald Loe, D.D.S., Director of the National Institute
of Dental Research said: "Water fluoridation is one of the
most effective and economical public health measures ever undertaken."
8
The Surgeon General's Report
In developing the scientific support for its regulatory action,
the Agency first turned for guidance to the Public Health Service
and asked its chief, Dr. C. Everett Koop, the Surgeon General of
the U.S., for his opinion. He in turn formed two ad hoc committees:
one to deal with dental effects of fluoride exposure and the other
with "non-dental" effects. The story of the latter committee
("the Ad Hoc Committee on the Non-Dental Health Effects of
Fluoride in Drinking Water", the "Committee") is
the more interesting.
We want to point out, right at the start, that deferring to the
Public Health Service was ethically questionable. This is because
of the PHS's long history of claiming credit for the discovery of
fluoridation and for promoting its use throughout the country. The
PHS had the most to lose from revelation of any information that
might show that the practice they had been promoting for decades
was actually harmful.
The PHS proved its bias straight away by selecting Committee members
who could be counted on to protect their policy. Many were on record
as vigorous promoters of the idea of adding fluoride to water "as
totally safe and effective." Some were from the National Institute
for Dental Research. On the other hand, not one critic of fluoridation
from the scientific community was allowed a place at the table.
(EPA sent observers to the meetings.) The final report of the Committee
9 also alluded to a group of advisors, who "were asked to review
documents and to provide counsel in regard to the Committee's recommendations."
Their recommendations may have superseded those of the Committee,
although their precise role is, even now, not known.
Despite the biases of the Committee, they provided some genuine
surprises. In secret, closed door testimony 10 (obtained under the
Freedom of Information Act by the Safe Water Foundation of Texas),
the Committee members expressed great uncertainty about the available
scientific data and what they should recommend as a safe level of
fluoride in drinking water:
"Q. Dr. Frank A. Smith: 'Why don't we see
it [skeletal fluorosis] in the areas of 4 ppm?' [RMCL = 4 mg/l(ppm)]
A. Dr. Jay R. Shapiro (Committee chairperson):
'I think you have to conclude that we haven't looked for it and
we really don't know'."
"Q. Dr. Shapiro: 'You have some data on a
town in Texas where there were some children with rather severe
fluorosis with a level of something like 1.2 ppm in the drinking
water. Is that true?'
A. Dr. Smith: I think that is correct'."
"Dr. Wallach [referring to dental fluorosis]: You would have
to have rocks in your head, in my opinion to allow your child much
more than 2 ppm'."
These statements were highlighted in an article by investigative
reporter, Joel Griffiths, in the Medical Tribune 11 in 1989. He
quoted expert after expert saying they just didn't have enough information
to make a conclusion, and they often disagreed among themselves.
The Committee eventually concluded, on a vote of 7 to 2, that fluoride
should not exceed twice the optimal level of fluoride for children
under 9 years of age, viz. 1.4 - 2.4 mg/l. The draft report of the
Committee 12 stated that "severe dental fluorosis per se constitutes
an adverse health effect that should be prevented." They also
expressed concern with the lack of data relative to:
"1. The effect of supraoptimal fluoride intake on bone turnover
in children and the relationship of moderate to severe dental fluorosis
on skeletal development.
"2. The need to confirm or refute Japanese studies implicating
chronic fluorosis and myocardial disease. (Takamori, Tokushima,
J. Experimental Med. 2:225, 1955)." [in another section of
the report they identify these concern levels as 1.9-4.9 mg/l.]
To their discredit, however, they said that calcified ligaments
[resulting in arthritic pains and a reduction in the flexibility
of joints] was not an adverse health effect, unless it was accompanied
by crippling skeletal fluorosis with x-rays showing bone lesions.
They also recommended a research program:
"The committee strongly recommends that the PHS and the EPA
join to enlarge the body of information relative to skeletal maturation
and growth in children ingesting more than twice the recommended
daily intake of fluoride." [i.e. 1.4 to 2.4 mg/l]
Once the original conclusions of the Committee became known through
the FOIA process, it was obvious that the final report did not track
with those original conclusions. The cover page carefully states
that the report was "based upon" the Committees recommendations.(emphasis
added) According to investigative reporter Dan Grossman, who talked
to a number of the Committee members, the changes were made without
the knowledge or consent of the Committee.13 This is a direct misrepresentation
of the efforts of the Committee and an obvious violation of the
NFFE Code of Ethics.
The altered conclusions of the final report
While the final report stated that the Committee recommended more
research on bone in children, it neglected to mention the Committee
had identified a level of concern of 1.4 to 2.4 mg. It also failed
to mention the conclusion of the Committee about possible heart
effects. The final report also added a conclusion that was not in
the draft report. It said: "There exists no directly applicable
scientific documentation of adverse medical effects at levels of
fluoride below 8 mg/l." It also added the following:
"...it can be concluded that 4 times optimum in U.S. drinking
water supplies is a level that would provide 'no known or anticipated
adverse effect with a margin of safety'."
Dental fluorosis was one of the areas in which some of the most
dramatic and far reaching changes were made from the draft to the
final report. The firm conclusion that it was an adverse health
effect was changed. The final report said:
"It is inadvisable for the fluoride content of drinking water
to be greater than twice the current optimal level (1.4-2.4 mg/l)
for children up to age 9 in order to avoid the uncosmetic effects
of dental fluorosis." (emphasis added).
This is a health effect that occurs in varying degrees as the teeth
of children are forming up until about the age of about 9. The mild
form of the disease may only show white spots, while the moderate
and severe forms (called objectionable dental fluorosis") are
much more disruptive. Severe dental fluorosis is classified by the
PHS as follows:
"All enamel surfaces are affected and hypoplasia is so marked
that the general form of the tooth may be affected. The major diagnostic
sign of this classification is the discrete or confluent pitting,
brown stains are widespread and teeth often present a corroded-like
appearance14."
Even after one discounts the unethical omission in the final report
of concerns about cardiac and skeletal effects, if the conclusion
of the Committee in the draft report that dental fluorosis was an
adverse health effect were allowed to stand, then fluoridation as
we know it would have been doomed. EPA noted in the proposed rule
in May 1985, that severe dental fluorosis was found to occur at
0.8 mg/l. This is at the level that fluoridation policy generally
recommends (i.e. 0.7 - 1.2 mg/l depending on the local ambient average
temperature). Since the Act requires a margin of safety, in order
to insure that no child would be subjected to this disfiguring disease,
the RMCL would have to be set much lower. This would have effectively
eliminated the practice of fluoridation, since most water supplies
already have naturally occurring fluoride at about 0.2 mg/l.
This obvious threat was recognized by one of the Committee members,
Mr. John Small, an information specialist and one of the chief fluoridation
promoters for the National Institute of Dental Research. In a memo
to Dr. Jay Shapiro, chairman of the Committee, Mr. Small said:
"I think we as a committee need to recognize that this is a
departure from the conclusions reached through fifty years of PHS-sponsored
eidemiological and clinical investigations. I too feel that moderate
and severe dental fluorosis are to be avoided, but am less certain
that we should invert history to accomplish that end."15
So the Committee's conclusions were changed to call dental fluorosis
a "cosmetic effect" and not an adverse health effect,
eliminating it as an end point of concern for possible regulation
under the Safe Drinking Water Act. We only learned about these facts
much later, when the Union began an investigation of the regulation
proposed in May of 1985.
The Cover-up at the U.S.E.P.A.
The transcripts of the Committee's deliberations mentioned above
show that management officials from EPA were present as observers.
There is some evidence that they tried to influence the Committee
towards a lower standard. However, when the final document was delivered
to EPA16, knowing full well that it did not accurately represent
the deliberations of the Committee, there is no evidence that these
EPA officials ever protested.
Sometime in the middle of April, 1985, just one month before the
proposed RMCL was published in the Federal Register17, private discussions
with key personnel involved in the drafting of the new regulation
began to surface some serious ethical problems. It started with
a chance meeting between one of the authors (Carton) and a professional
from the Office of Drinking Water in a hallway of the East Tower
of Waterside Mall, EPA's headquarters. When we saw him in the hallway,
he looked disgusted, so we asked him what was going on. He said
he was writing the fluoride regulation and didn't believe a thing
he was writing. He had to carry on, however, because it was his
job. To put it another way, it was his duty to obey. There was also
the unstated understanding which all employees know, that if you
buck the decision you may end up with a poor performance appraisal
or worse. Years later one professional, who blew the whistle on
the downgrading of results in the animal cancer study of fluoride
in drinking water, was fired, although later rehired after a protracted
court battle.18
When the fluoride regulation was published, its author did protest
with an unsigned, tongue-in-cheek "press release" that
was circulated among the staff.
"The Office of Drinking Water in conjunction with OMB proudly
presents their new and improved Fluoride Regulation or 'How we stopped
worrying and learned to love funky teeth.' Up to now EPA, under
the Safe Drinking Water Act, has regulated fluoride in order to
prevent children from having teeth which looked like they had been
chewing brown shoe polish and rocks. The old standard which was
based upon the consumer's average shoe size and the phase of the
moon generally kept fluoride levels below 2.3 mg/l. EPA in response
to new studies which only confirmed the old studies, and some flat
out political pressure, has decided to raise the standard to 4 mg/l.
This increase will allow 40% of all children to have teeth gross
enough to gag a maggot. EPA selected this level based upon a cost
effectiveness study which showed that it is cheaper for people to
keep their mouths shut then to remove the fluoride."19
As Vice-President of the Union at that time, the lead author of
this paper brought the matter of possible fraud to the attention
of the Executive Board and it decided to look into the matter. Never
having heard anything negative about fluoride in water, they were
anxious to find out what was so disturbing about the regulation
EPA was about to publish in the Federal Register. The Board's education
began when public hearings were held on the proposed standard and
some very knowledgeable citizens presented persuasive scientific
arguments against the proposal. Among other things, these citizens
presented us with the transcripts of the closed door meeting of
the Surgeon General's ad hoc committee. The union became convinced
that science did not support what EPA was doing and politics were
dictating everything.
Since then, three other professionals who were working in the Office
of Drinking Water at the time the proposal was drafted have come
forward. They told us that it was well known that the data did not
fit the conclusions being presented to the public. As a matter of
fact, the original support document for the regulation, written
by the professional staff, had concluded that the data supported
a RMCL of 2 mg/l.
The staff believed that objectionable dental fluorosis should be
considered an adverse health effect. They conveyed this finding
to Mr. Vic Kim, Director of the Office of Drinking Water, who informed
the Administrator, Mr. William Ruckelshaus 20 that:
"It is difficult to conclude a priori that teeth which spontaneously
pit are stronger teeth. Further, data suggest that the effects of
fluorosis are not merely discoloration and pitting, but fracturing,
caries and tooth loss as well...it is difficult... to conclude that
such effects are not adverse."
According to members of the professional staff in the Office of
Drinking Water, Mr. Kim's superior, Mr. Jack Ravan, Director of
the Office of Water, directed that the scientific support documents
be rewritten to support an RMCL of 4 mg/l. The final regulation,
signed by the new EPA Administrator, Mr. Lee Thomas, said: "There
is no adequate evidence of chipping, cracking or loss of enamel
associated with [dental] fluorosis."
It was entirely unnecessary for practical or economic reasons to
raise the RMCL to 4 mg/l, because it was an unenforceable goal.
Practical and/or economic reasons could have been used to raise
the MCL to 4 mg/l without playing politics with the health data.
As mentioned previously, this logic was used to set the lead standard.
The health goal was set at zero, while the enforceable standard
was established at 15 ug/l(ppb).
Skeletal Fluorosis
The Committee identified only a few adverse health effects: death,
gastrointestinal hemorrhage, gastrointestinal irritation, arthralgias,
and crippling skeletal fluorosis (CSF). The last health effect was
said to occur at exposure levels lower than the others, so the RMCL
and MCL of 4 mg/l are based on CSF. Like dental fluorosis, skeletal
fluorosis is the result of fluoride interfering with the normal
production and remineralization of collagen. When discussing this
disease, experts inevitably refer back to the classic 1937 study
by Dr. Kaj Roholm on Danish cryolite workers. 21 Summarizing Roholm's
work, the National Academy of Sciences (NAS) described three progressive
stages of the disease. 22 In Phase 1, X-rays begin to show changes
in the bones of the pelvis and vertebrae. By the time Phase 3 (CSF)
is reached, all bones are affected, particularly cancellous bones,
and the bones in the extremities are thickened. There is also considerable
calcification of the ligaments of neck and vertebral column. In
some cases, the vertebrae in the spine are actually fused.
Phase 1 is not just a subclinical stage of the disease seen on X-rays.
Roholm found that 10 of 26 workers with Phase 1 had rheumatic pains
compared to 1 of 11 workers with no sign of osteosclerosis in their
x-rays. Half of all workers with Phase 1 and 2 had a reduced ability
to rotate their upper torso. Workers exposed for as little as 2.4
years had Phase 1 of the disease, exposure for 4.8 years for Phase
2, and 11.2 years for Phase 3. EPA inexplicably set the standard
based only on the third Phase, CSF. From a professional health point
of view, it is impossible to claim that arthritic pains and reduced
body flexibility are not adverse health effects. One can only conclude
that not considering Phases 1 and 2 skeletal fluorosis was done
to avoid a conflict with current health policy, i.e. its unequivocal
pronouncement of safety for water fluoridation.
The Daily Dose and Time Required to Cause CSF
In his letter transmitting the final report of the Committee to
EPA, Surgeon General Koop said that arthritis and CSF both begin
to occur simultaneously, when fluoride consumption exceeds 20 mg/day.
He also added the caveat that it takes more than 20 years to cause
these effects. His assertion differed from the conclusion of the
National Academy of Science, which also was a source of advice to
EPA on this matter. The NAS, according to EPA in the proposed regulation,
reported that it takes only 10 years to cause CSF at a dose of 20
mg/day. EPA, however, decided in the proposed regulation to use
Dr. Koop's numbers:
". . .EPA agrees with the Surgeon General that crippling skeletal
fluorosis is an adverse health effect which results from intakes
of fluoride of 20 mg/day over periods of 20 years or more."
Two concerned citizens have identified some serious problems with
both the NAS and EPA claims of the dose/time necessary to cause
CSF. Ms. Martha Bevis of the Safe Water Foundation of Texas could
not find where the 20 mg/day was actually derived. Going back to
the original work by Roholm she found that he mentioned a figure
of 0.2 mg per kg of body weight, which for the standard 70 kg man
would translate into 14 mg. Ms. Darlene Sherrell went further and
found that, in 1979, Dr. Hodge had changed his much quoted dose/time
figures to a minimum of 10 mg/day for 10-20 years. 23 (emphasis
added) EPA referenced the 1979 paper, but used the Surgeon General's
figures which were higher for reasons that can only be considered
suspect. (Note: While EPA has not yet corrected its figures to correspond
to Hodge's reduced figures, the NAS did so in 199324.)
There is another serious deficiency with the dose/time figures used
by EPA. The Act requires the regulations to protect everyone, not
just 20-year-olds. The Committee stated in its final report that
"Fluoride in bone increase with age and linearly in relation
to fluoride intake." Therefore, it would seem logical to conclude
that if 20 mg caused CSF in 20 years, then 10 mg would cause CSF
in 40 years. Simple arithmetic tells you that only 5.7 mg a day
for a lifetime of 70 years could cause CSF. This calculation was
never done. If it were done (starting with the correct figures of
10 mg/day for 10 years) fluoridation would be stopped today.
Fluoride Dose from Current Standard of 4 mg/l.
In proposing the RMCL of 4 mg/l, EPA noted that 1% of the population
drink more than 5.5 liters/day. This means these individuals could
be ingesting 22 mg/day or more from drinking water alone. Since
EPA stated unequivocally that 20 mg/day for 20 or more years caused
CSF (forgetting for a moment that these figures are incorrect),
EPA admitted to violating the Act which requires the standard to
be set so that no one is at risk of an adverse health effect, in
this case CSF. Although the raw data about water consumption were
contained in the proposed regulation, the simple calculation presented
here was nowhere to be found.
In reality, most water supplies that are not contaminated with industrial
pollution, have low levels of naturally occurring fluoride. Surface
waters generally average about 0.2 mg/l. Where fluoride is added
to water (which is 65% of the country), the level is raised to approximately
1.0 mg/l. Based on Roholms' work and other recent studies, there
is every reason to believe that the increasing numbers of people
with carpal-tunnel syndrome and arthritic-like pains are due to
the mass fluoridation of drinking water.
Summary and Conclusions
NAEP's early efforts to define a code of ethics for professionals
directly influenced the EPA professionals' Union's own efforts to
affect the ethical climate at EPA. In 1988, the Union drafted a
Code of Ethics but encountered resistance from EPA management. Nine
years later an agreement was reached, although it still does not
provide concrete procedures for addressing ethical issues, nor sufficient
protection for individuals identifying ethical crimes. The Union
believes that an understanding of the unethical nature of the fluoride
drinking water standard will confirm the urgent necessity for significantly
improving the existing agreement between EPA professionals and management.
With regards to the fluoride standard, we found:
* The PHS, who was charged with providing advice to EPA, had a conflict
of interest.
* The Committee selected by the PHS to provide advice to EPA was
biased.
* The deliberations of the Committee were not honestly presented
in their draft report.
* The draft report was altered by unknown individuals without prior
(or subsequent) approval of the Committee.
* Individuals who knew of fraud and deceit in the report did not
report their observations to the appropriate authorities.
* EPA management ordered the support document developed by EPA professionals
to be rewritten in conflict with the known facts.
* Important calculations and observations were omitted from the
selection of the final standard for apparently political purposes,
namely, to support a long-standing public health policy.
We are unable to present all the details of scientific fraud that
occurred in this regulation because of the limits of space in this
forum (e.g. the fact that 90% of the scientific literature showing
that fluoride is mutagenic were omitted from the scientific support
document.) Hopefully, some of your elected representatives in Congress
will become aware of these accusations and begin an investigation.
The public needs to see how politics influences science in Washington,
and how public health can take a back seat when power and prestige
are more important than ethical considerations.
APPENDIX
"ARTICLE XXI. PROFESSIONALISM AT EPA"25
"The Parties agree:
A. The American people must have complete confidence that EPA professionals
and managers perform their functions and duties with honesty, integrity,
and in an unbiased manner. The public interest is best served when
the Agency performs its functions in a manner consistent with the
requirements of law, objective and dispassionate science, competent
technical analysis and decisions, and concern for effective and
consistent enforcement, voluntary compliance and effective implementation.
B. The responsibility to serve the public interest and promote the
environmental ethic is the shared responsibility of management and
bargaining-unit members. Bargaining-unit employees are encouraged
to disclose questionable activities to appropriate officials..
C. Bargaining-unit professionals who disclose or report fraud, waste
or abuse or who engage in protected activity may not be subjected
to retaliation, reprisal or coercion in employment for doing so.
D. The parties specifically recognize
1. the ethical obligations stated in the regulations promulgated
by the Office of Government Ethics, at 5 CFR 22635.101, EPA's supplemental
regulations at 5 CFR Part 6401, and the employee responsibilities
under 18 USC 203-209;
2. the prohibited personnel actions stated in 5 USC 2301, enforced
by the Office of Special Counsel pursuant to 5 USC 1212 et seq.;
3. to the extent applicable, the employee protections under the
Department of Labor Regulations at 29 CFR Part 24;
4. the criminal penalties for false statements to the Federal Government
at 18 USC 1001;
5. the provisions of the False Claims Act, 31 USC 3730(h); and
6. new or superseding laws, rules or regulations covering professionalism.
Excerpts from the above cited provisions are provided in Supplement
1 to this Agreement for reference.
E. Nothing in this provision negates or supersedes management's
rights as enumerated in Article IV of this Agreement.
F. At either Party's request, the Parties will open negotiations
one time during the term of this contract on subjects of further
protections of employees from reprisals and procedures for resolution
of disputes involving professional judgment.
References
1. National Association of Environmental
Professionals, "Code of Ethics and Standards of Practice for
Environmental Professionals,"undated, available on the WEB
at http://www.naep.org/ ethics.html.
2. See characterization of a corrupt government
bureaucrat by Charles Trueheart, "Verdict Nears in Trial of
Vichy Official," Washington Post, A21, 4/1/98.
3. 5 USC 7103.
4. "Collective bargaining agreement
between EPA management and NFFE Local 2050, Article XXI. Professionalism
at EPA," ..........
5. The Safe Drinking Water Act, 42 U.S.C.
300f, et seq.
6. "National Primary Drinking Water
Regulations; Fluoride," Federal Register, 50(220): 47142-47171,
11/14/85.
7. Mullan, F.; Plagues and Politics, the
Story of the United States Public Health Service. Basic Books, Inc.
8. Loe, H.; letter to Bernice O. Berg, 3/7/90.
9. Shapiro, J.R.: "Report to the Surgeon
General: by the Ad Hoc Committee on the Non-Dental Health Effects
of Fluoride in Drinking Water," 9/26/83.
10. Transcript of the "Surgeon General's Ad Hoc
Committee on the Non-Dental Effects of Fluoride," 4/18 -19/1983,
National Institutes of Health, Bethesda, Maryland. obtained under
the Freedom of Information Act by Ms. Martha Bevis, Safe Water Foundation
of Texas.
11. Griffiths, J.; "'83 Transcripts Show Fluoride
Disagreements." Medical Tribune, 30(11), 4/20/89.
12. Shapiro, J.R.; first draft of report on the non-dental
health effects of fluoride exposure by an ad hoc committee appointed
by the Surgeon General of the U.S., 5/26/83.
13. Grossman, D.; "Fluoride's Revenge, Has this
cure, too, become a disease?," The Progressive, 29-32, Dec.
1990.
14. McClure, F.J.; Water Fluoridation, the Search and
the Victory, HEW, 1970.
15. Small, J.; memo to Jay Shapiro, chairman of Surgeon
General's ad hoc committee on the non-dental health effects of fluoride
in drinking water, 6/1/83.
16. Koop, C.E.; letter to William D. Ruckelshaus, 1/23/84.
17. "National Primary Drinking Water Regulations;
Fluoride," Federal Register, 50(93): 20164-20175, 5/14/85.
18. "Labor Secretary Reich Orders EPA Scientist
Dr. Bill Marcus Reinstated, EPA Corruption Exposed," The Fluoride
Report, 2(1), April 1994.
19. Press release circulated within EPA Headquarters,
1985.
20. Kim, V.; Memorandum to William Ruckelshaus, 7/26/84.
21. Roholm, K.; Fluorine Intoxication, A Clinical-Hygiene
Study, With a Review of the Literature and Some Experimental Investigations.
H.K. Lewis & Co., Ltd., London, 1937.
22. National Academy of Sciences, Fluoride: Biological
Effects of Atmospheric Pollutants, 1971.
23. Hodge, H.C.; "Safety of Fluoride Tablets or
Drops," Chapter 11 in Continuous Evaluation of the Use of Fluorides,
(AA Symposium, Boulder, Colorado), Westview Press, 1979.
24. National Academy of Sciences, National Research Council,
Health Effects of Ingested Fluoride, p59, 1993.
25. From the Collective Bargaining Agreement between
the National Federation of Federal Employees, Local 2050 and the
U.S. Environmental Protection Agency, Washington, D.C., September
19, 1997.
As of April 20, 1998, EPA professionals are represented by
the National Treasury Employees (NTEU) Union, Chapter 280.
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