Water, water, water… in a town named for water, surrounded by water and often awash with water falling from the sky, water has become the most pressing problem facing Bonney Lake, the fastest growing community in Pierce County. In a three-part series The Courier-Herald will look at some of the most vexing water service problems facing the city - fluoridation, water sources and delivery, and the survival of Lake Tapps - the problems, the solutions and the future. This week's topic, "Fluoridation - Mandate or Medicine?"
By Dennis Box, The Courier-Herald
Looming above all other issues concerning the public water system for Bonney Lake is the pending Washington State Supreme Court opinion that will decide whether the Tacoma-Pierce County Health Board has the constitutional authority to mandate a fluoridation program for county water systems.
The legal and political tug-of-war began in April of 2002 when the Health Board voted unanimously to require that fluoride be added to any water system serving a population greater than 5,000. Within five months of the board's decision, the Bonney Lake City Council voted to sue in an attempt to block the fluoridation mandate. The suit was filed in November 2002 by the city of Bonney Lake, which was joined by six other water utilities.
The lawsuit's core argument, stated in the appellant brief, is "The Resolution infringes the rights of the City's water customers to refuse medical treatment and to preserve their bodily integrity, in violation of the Due Process Clause of the Fourteenth Amendment of the United States Constitution."
The City Council's decision to file suit against the board has become a year-long struggle that ended up in front the Supreme Court on Sept. 8 after two consecutive lower court defeats, at a cost to the city of more than $100,000 thus far.
"The Supreme Court decision will affect us in a very sizable way," Mayor Bob Young said. "We'll have to spend $600,000 to $700,000 or more to build a fluoridation system or we'll have to look at the cost of hooking up to Tacoma Water, which is fluoridated at its headwaters."
The Bonney Lake City Council voted unanimously against the board's fluoridation program. "We wanted the people to have a vote and then we would live by that vote," councilman Neil Johnson said. "The council was really against an unfunded mandate coming from the county without a citizen vote."
Beyond the issue of an unfunded mandate, Johnson said the medical questions the program raised were troubling to the council. "Fluoridation means ingesting a chemical. There are a lot of medical pros and cons. Some folks are allergic to it and it can cause problems with seniors," he said.
The City Council conducted an unscientific survey concerning the fluoridation plan on May 28, 2002, sending 9,000 survey forms through the mail. People could also print the form out from the city's Web site and mail it. The question was, simply, "Would you like fluoride added to the water?" Of those who voted, 74 percent were against adding fluoride to the water system. The City Council received 1,804 no votes and 640 yes votes.
"It was really off the books," Young said. "The survey came back overwhelmingly against fluoride."
Battle goes back 50 years
The battle over fluoride has been fought in one municipality after another across the United States for more than 50 years. Fluoride is a naturally occurring mineral that is present in variable amounts in nearly every water supply system. The principle of fluoridation is to adjust the fluoride level in the water to a level that will prevent tooth decay, but low enough to avoid the brown stains caused by high levels of fluoride, known as mottling.
The fluoridation movement owes its origin to an inquisitive young dentist practicing in Colorado Springs in 1901. Dr. McKay noticed that many of his patients' teeth were stained with brown spots. His initial investigation of this cosmetic problem led to a 30-year study resulting in the discovery of high levels of fluoride occurring naturally in the water and its effect on preventing teeth from decay.
The first city in the United States to add fluoride to its water supply, according to the National Center for Fluoridation Policy and Research, was Grand Rapids, Mich., on Jan. 25, 1945. The center reports that of the 50 largest cities in the U.S. today, only four do not add fluoride - San Jose, Calif., Honolulu, Hawaii, Wichita, Kan. and Portland, Ore.
Director of Health for the Tacoma-Pierce County Health Board, Dr. Federico Cruz-Uribe, said he is confident the Supreme Court decision will uphold the board's decision. "I want people to understand that the board acted because it's the best way to fight a dental epidemic across our county," Cruz-Uribe said. "We sent a team of dental hygienists out to screen kids all over the county. What we found was advanced disease, not just a cavity, but in many cases the decay that had broken through the surface with the risk of losing the tooth."
The Health Board's unanimous decision to mandate fluoridation of public water systems will affect 238,000 people throughout the county and is set to go into effect on Jan. 1, 2004. "Somehow fluoride has gotten associated with something bad. It's just not true," Dr. Cruz-Uribe said. "It's in leafy vegetables, fruits, fish and in the Puget Sound. We have scientists who looked at it independently and called it safe. There are hundreds and hundreds of studies that support fluoride, not just a few."
City leaders were not convinced
Despite the assurances of the board regarding the safety of fluoridation and a pledge to help defray the cost, the Bonney Lake City Council was still not persuaded it was the best way to improve the dental health of the children in the area.
"The council came up with several different options," Deputy Mayor Dan Swatman said. "But the Health Board was a one-way street. All they were interested in was their mandate. Bonney Lake water is very clean. We don't even have to put chlorine in it. Once you start putting chemicals in it, it all runs down hill from there."
Councilman Johnson added, "The council felt there were things we could do that would be more cost effective. We thought a fluoride tablet program would be a better way. There so many things added to the water systems, why add more? We have to let the people make these choices, not someone in Tacoma."
The Supreme Court decision is expected at any time. The court's public information officer, Wendy Ferrell, said, "three to six months is not unusual, but the opinion could come at any time. It could be longer."
If the city of Bonney Lake loses its appeal, Swatman said, the City Council could decide to file an appeal in federal courts that could ultimately end up being argued before the U.S. Supreme Court. "We may take it above this court. We'll have to look carefully at what will work after the court's decision," he said.
Dennis Box can be reached at dbox@courierherald.com
