BOH Agenda 032520 - Laserfiche WebLink

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with fluoride in drinking water. The authors obtained fluoride information from the public water supplier associated with the cancer registry patient and found no increased risk in these two bone cancers over a 25-year period. The EPA Six-Year Review 34 included a study by Bassin (2006)5 that found an increased risk of osteosarcoma in males exposed to higher levels of fluoride. The review authors note serious study design limitations. The EPA review also includes a study by Kim (2011)6 that found no association between osteosarcoma and bone fluoride levels. The CADTH' review includes a case-control study done in Texas by Archer et a17 that found no association. Conclusion The reports and studies reviewed do not clearly support an increased risk of the bone cancer, osteosarcoma, due to fluoride exposure from water in community water supplies with fluoride levels < 0.7 ppm. o Hypothyroidism - Previous reviews by the CADTH, NRC and EPA have not identified strong evidence of increased thyroid disorders and community water fluoridation at recommended levels. Since 2010, an ecological study of two metropolitan areas in England (Peckham et al, 20158) reported higher rates of clinic patients diagnosed with hypothyroidism in two areas of England with fluoridated vs non-fluoridated water. Critiques of the study include using the General Practitioner's clinic office location for drinking water status rather than residence and not controlling for the potential confounder of iodine deficiency. A 2017 cross-sectional study by Barberio et a19 found no association and used urinary fluoride or tap water measurements for the measure of exposure. A study in India in areas with levels of fluoride significantly higher than those found in fluoridated community water supplies in the U.S. found higher TSH levels in the areas with higher fluoride, but levels were still within normal. 19