Sometimes there’s a little to say about a lot of things. Welcome back to Variable Flow.

Fluoride follies

Grand Rapids, Michigan began adding fluoride to its water in 1945 to help fight tooth decay; opposition to fluoridation has been a hardy perennial ever since. Fluoridation hate gained new momentum with Robert F. Kennedy Jr.’s appointment as Secretary of Health and Human Services.

Earlier this year Florida and Utah enacted new laws prohibiting utilities from adding fluoride to public drinking water; similar bans are under consideration in several more states. Meanwhile, municipalities across the country are abandoning the practice, including several in Wisconsin.

Voluminous peer-reviewed public health research from around the world demonstrates that fluoridation significantly reduces tooth decay and improves economic outcomes for low-income people. The loudest opponents of the practice cite fluoride’s negative effect on children’s cognitive development. I’m no toxicologist, so I won’t weigh in on the merits of that argument. But conversations with experts I trust and my own reading of the literature indicate that excessively high levels of fluoride reduce children's IQ; there’s no evidence of a negative cognitive effect at the concentrations recommended for water fluoridation.

Some natural public policy experiments underway in the real world seem to affirm that take. In Alaska, Juneau stopped fluoridating its water in 2007, leading to increased dental care costs compared with Anchorage (which maintained fluoridation). In Alberta, the City of Calgary ended fluoridation in 2011 and saw increased tooth decay and wider socioeconomic disparities in dental health compared with Edmonton (which maintained fluoridation). In 2021 Calgarians voted to reintroduce fluoridation; this summer the city’s water will include fluoride again.*

Reality sometimes loses a political battle, but it always wins the war. Expect similar policy reversals in 10-15 years from now as teeth decay and dental bills surge in places that abandon fluoridation. Unfortunately, a generation of kids in the Beehive and Sunshine States will pay with their teeth.

Live it up while you can, cavity creeps.

Some of these fountains are centuries old, others are brand new. In many European cities drinking fountains are both beautiful and functional; in Switzerland they are also exceptionally plentiful.

American public drinking fountains can be beautiful, too. The Benson Bubblers scattered across Portland are city icons and perhaps the best surviving example of a large-scale, continuously operating public drinking water fountains in the U.S. New York City’s Croton Aqueduct system deliberately incorporated pretty public drinking fountains for both safe water and cultural symbolism. Earlier this year New York’s city council approved the construction and/or upgrade of 500 drinking fountains across the city. Notably, NYC approved the drinking fountain proposal over the objections of the city’s DEP Commissioner, who cited the cost of maintaining the fountains.

Now that drinking fountains are fashionable again, we ought to seize on the opportunity to put them in every neighborhood we can. Well designed and properly maintained, these fountains deliver great water while making water infrastructure familiar and beloved.

That’s important for the PFAS rule, since fellow WHACo Chad Seidel’s analysis finds that EPA significantly overestimated the rule’s impact on large systems and underestimated its impact on small systems.

Meanwhile, EPA will revisit the rules for the four other PFAS chemicals (PFHxS, PFNA, GenX, and PFBS) regulated together under a composite Hazard Index. Nominally, the fight here is less about toxins and more about legality: opponents argue that the Hazard Index falls outside under the SDWA’s statutory framework; EPA points to the interactive and cumulative effects of contaminants and the longstanding use of composite hazard indices in Superfund administration.

Arcane legalities aside, the announcement carries some interesting policy and management implications. My view from the cheap seats is that this looks like the regulatory goalpost shifting that we often see in SDWA and CWA implementation. Rather than adjusting rules (which invites lawsuits and makes the agency look bad), the regulator strings out compliance deadlines for small systems (which blunts legal challenges and makes the agency look reasonable). When some systems inevitably fail to comply, regulators will issue strongly worded letters and extend compliance deadlines again.

My best guess about PFAS rule implementation: large utilities will comply more or less on schedule, with ratepayers picking up the tab—modest in most places, massive in others. Small systems with the most severe PFAS problems will find a way to address them, maybe with some grant assistance, but mainly with big rate increases. Small systems with PFAS contamination above EPA’s new regulatory thresholds but below most international standards will violate the rule more or less indefinitely. Researchers and environmental advocates will move on to the next contaminant du jour.**

Etc.

New York Times publishes a valentine for tap water.  \\ In another reminder that we Gen-Xers are old, Night Ranger plays the GFOA conference.  \\  President Trump order aims to make showers great again. \\ Small towns from California to Oklahoma to Tennessee are staring down the barrel at triple-digit wastewater rate increases or systemic failure. Sweeping consolidation is badly needed on the sewer side, too. \\ Sacre bleu!

* Mayor Adams has yet to sign the legislation into law.

** Microplastics? I’m thinking it’s probably microplastics. Yeah, it’s microplastics.