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In twentieth century America, however, enormous industrial plants and new technologies increased fluoride emissions so that even tall stacks could not prevent gross damage for miles around. Following the period of explosive industrial expansion known as "industry's roaring 2Os," the magnitude of industry's fluoride dilemma became starkly apparent.

International reports of fluoride damage mushroomed in 1933 when the world's first major air pollution disaster struck Belgium's Meuse Valley: several thousand people became violently ill and 60 died. The cause was disputed, but investigations by prominent scientists, including Kaj Roholm, the world's leading authority on fluoride hazards, placed the blame on fluoride. (21)

Here and abroad, health scientists were beginning to regard fluoride as a poison, pure and simple. The trend toward its removal from the environment was potentially disastrous from industry's point of view. "Only recently, that is, within the last ten years, has the serious nature of fluoride toxicity been realized," wrote Lloyd DeEds, senior toxicologist with the U.S. Department of Agriculture (USDA) in 1933. "It is a well-established fact that chronic intoxication [poisoning] may manifest itself in man as recognized abnormalities only after constant, or at least frequent, exposure over many years....The possibility of fluoride hazard should...be recognized in industry...where this element is discharged into the air as an apparently worthless by-product." (22)

It was abundantly clear to both industry and government that spectacular U.S. industrial expansion -- and the economic and military power and vast profits it promised -- would necessitate releasing millions of tons of waste fluoride into the environment. Furthermore, two large new industries would be adding to the dose: fluorocarbon chemicals (the aerosol propellants and refrigerants now depleting the ozone layer) and aluminum, slated for a crucial economic and military role during the upcoming Second World War. By 1938 the aluminum industry, which then consisted solely of ALCOA, had been placed on a wartime schedule. And fluoride was the aluminum industry's most devastating pollutant. (23)

U.S. future industrial expansion, then, would be accompanied by complaints and lawsuits over fluoride damage on an unprecedented scale -- the most threatening aspect of which was harm to human health. Damage to animals and the environment might be tolerated and easily paid off; if, however, serious injury to people were established, lawsuits alone could prove devastating to companies, while public outcry could force industry-wide government regulations, billions in pollution-control costs, and even mandatory changes in high-fluoride raw materials and profitable technologies.

Liability Into Asset
This inter-war period saw the birth of the military-industrial complex, with its concomitant public disinformation campaigns. It also saw a federal blitz campaign to convince the public fluoride was safe and good for them. The kick-off was the 1939 announcement by ALCOA-funded scientist Gerald J. Cox: "The present trend toward complete removal of fluoride from water and food may need some reversal." (24)

New evidence of fluoride's safety began emerging from research centers plied with industry's largess. Notable among these was the University of Cincinnati's Kettering Laboratory, whose specialty was investigating the hazards of industrial chemicals. Funded largely by top fluoride-emitters such as ALCOA, the Kettering Lab quickly dominated fluoride safety research. A book by Kettering scientist and Reynolds Metals consultant E.J. Largent, for example, written in part to "aid industry in lawsuits arising from fluoride damage," became a basic international reference work. (25)

The big news in Cox's announcement was that this "apparently worthless by-product" had not only been proved safe (in low doses), but actually beneficial: it might reduce cavities in children. A proposal was in the air to add fluoride to the entire nation's drinking water. While the dose to each individual would be low, "fluoridation" on a national scale would require the annual addition of hundreds of thousands of tons of fluoride to the country's drinking water.

Government and industry -- especially ALCOA -- strongly supported intentional water fluoridation. Undoubtedly, most proponents were sincere in their belief that the procedure was safe and beneficial. At the same time, it might be noted that fluoridation made possible a master public relations stroke -- one that could keep scientists and the public off fluoride's case for years to come. If the leaders of dentistry, medicine, and public health could be persuaded to endorse fluoride in the public's drinking water, proclaiming to the nation that there was a "wide margin of safety," how were they going to turn around later and say industry's fluoride pollution was dangerous?

As for the public, if fluoride could be introduced as a health-enhancing substance that should be added to the environment for the children's sake, those opposing it would look like quacks and lunatics. The public would question attempts to point out its toxicity or its unsavory industrial connections.

ALCOA Foils Accountability
With such a powerful spin operating, fluoride might become a virtually "protected pollutant," as writer Elise Jerard later termed it. (26) One thing is certain, the name of the company with the biggest stake in fluoride's safety was ALCOA -- whose name is stamped all over the early history of water fluoridation.

Throughout industry's "roaring 20s," the U.S. Public Health Service was under the jurisdiction of Treasury Secretary Andrew W. Mellon, a founder and major stockholder of ALCOA. In 1931, the year Mellon stepped down, a Public Health Service dentist named H. Trendley Dean was dispatched to certain remote towns in the West where drinking-water wells contained high concentrations of natural fluoride from deep in the earth's crust. Dean's mission was to determine how much fluoride people could tolerate without obvious damage to their teeth -- a matter of considerable concern to ALCOA. Dean found that teeth in these high-fluoride towns were often discolored and eroded, but he also reported that they appeared to have fewer cavities than average. He cautiously recommended further studies to determine whether a lower level of fluoride in drinking water might reduce cavities without simultaneously damaging bones and teeth, where fluoride settles in humans and other animals.

Back at the Mellon Institute, ALCOA's Pittsburgh industrial research lab, this news was galvanic. ALCOA-sponsored biochemist Gerald J. Cox (27) immediately fluoridated some lab rats in a study and concluded that fluoride reduced cavities and that: "The case should be regarded as proved." (28) In a historic moment in 1939, the first public proposal that the U.S. should fluoridate its water supplies was made not by a doctor, or dentist, but by Cox, an industry scientist working for a company threatened by fluoride damage claims. (29) Cox began touring the country, stumping for fluoridation.

Initially, many doctors, dentists, and scientists were cautious and skeptical, but then came World War II, during which industry's fluoride pollution increased sharply because of stepped-up production and the extensive use of ALCOA aluminum in aircraft manufacture.

Following the war, as expected, hundreds of fluoride damage suits were filed around the country against producers of aluminum, iron and steel, phosphates, chemicals, and other major polluters. (30) The cases settled in court involved only damage to livestock or vegetation.

"Friends" of Children
Many others were settled out of court, including those claiming damage to human health, thus avoiding legal precedents. In one case, for the first time in the U.S. an Oregon federal court found in Paul M. and Verla Martin v. Reynolds Metals (1955) that the couple had sustained "serious injury to their livers, kidneys and digestive functions" from eating "farm produce contaminated by [fluoride] fumes" from a nearby Reynolds aluminum plant. (31) Soon thereafter, no less than the Aluminum Company of America (ALCOA) and six other metals and chemical companies joined with Reynolds as "friends of the court" to get the decision reversed. According to a local paper, a Reynolds attorney "contended that if allowed to stand, the verdict would become a ruling case, making every aluminum and chemical plant liable to damage claims simply by operating [emphasis added]." (32) Despite extensive medical testimony for Reynolds from Kettering Lab scientists, the Martins kept on winning. Finally, in a time-honored corporate solution, Reynolds mooted the case by buying the Martins' ranch for a hefty price.

The postwar casualties of industrial fluoride pollution were many -- from forests to livestock to farmers to smog-stricken urban residents -- but they received little more than local notice. National attention had been diverted by fluoride's heavily publicized new image. In 1945, shortly before the war's end, water fluoridation abruptly emerged with the full force of the federal government behind it. In that year, two Michigan cities were selected for an official "15-year" comparison study to determine if fluoride could safely reduce cavities in children, and fluoride was pumped into the drinking water of Grand Rapids.

Other early experiments were performed, not only without publicity, but without the knowledge of the subjects. The scientific value of these experiments -- and their ethics -- were dubious in the extreme. In Massachusetts and Connecticut, for example, the first fluoridation experiments (1945-46) were conducted on indigent, mentally retarded children at state-run schools. According to the 1954 congressional testimony of Florence Birmingham, a trustee of the Wrentham (Massachusetts) State School for Feebleminded Children, her school's administration learned only by accident that fluoride was being put in the drinking water. (33)

The trustees immediately voted to stop the fluoridation, Birmingham testified, "but to my shocked surprise, we were told by the [Massachusetts Department of Health] that it was not an experiment and the fluoridation continued on.... I found in the files a letter revealing that [a health department representative] had come to the institution school and in a conference with administration officials warned them that there should be no publicity on the fluoride program there..."

The federally sanctioned experimenters did not seem concerned that these children might accidentally receive a toxic overdose of fluoride. "The method used in putting fluoride in the water," said the president of the school employees' union, "...is enough to cause panic at the institution....A boy patient does it...He knows what it is for he said, Come up with me and I can show you how I can take care of you if I get mad at you.'" (34)

Meanwhile, in 1946, despite the fact that the official 15-year experiment in Michigan had barely begun, six more U.S. cities were allowed to fluoridate their water. The fluoridation bandwagon had begun to roll.

At this juncture, Oscar R. Ewing, a long-time ALCOA lawyer who had recently been named the company's chief counsel with fees in the then-astronomical range of $750,000 a year (35) -- arrived in Washington. Ewing was presumably well aware of ALCOA's fluoride litigation problem. He had handled the company's negotiations with the government for the building of its wartime plants. (36)

In 1947, Ewing was appointed head of the Federal Security Agency (later HEW), a position that placed him in charge of the Public Health Service (PHS). Under him, a national water fluoridation campaign rapidly materialized, .....
                              

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