Statements taken from Expert Declarations for the U.S. Court Case Against the EPA
Professor Philippe Grandjean, MD, DMSc
World-leading Page 4 Points 6 and 7
6. I have published about 500 scientific papers, of which most are research articles in international scientific journals with peer review. My h-index in the Web of Science data base is 70, and my work is cited in scientific journals well over a thousand times every year. Seven of my articles published in the last 10 years have earned the attribute “Highly Cited Paper,” i.e., they received enough citations to place them in the top 1% of published papers in the field. 7. My study on the neurodevelopmental effects of prenatal mercury exposure in a birth cohort from Faroe Islands was relied upon by the EPA as the critical study for the Agency’s derivation of a Reference Dose for methylmercury (EPA 2001).
Comparable to Lead Page 50, Point 159
159. This approximate estimate can be compared with calculations made by Professor David Bellinger on IQ losses due to major pediatric diagnoses affecting 0-to-5-year-old children (Bellinger 2012). According to CDC data and Bellinger’s calculations, the top pediatric etiologies for IQ loss are preterm birth at 34 million IQ points lost and lead exposure representing 23 million IQ points lost. For fluoridation, the estimate for children aged 0 to 5 years is approximately 25 million IQ points. Even if this estimate is somewhat imprecise, and unevenly distributed, the order of magnitude is likely to be correct and is very considerable.
Professor Bruce Lanphear, MD, MPH
World-leading Page 3 Point 5 and Page 4 Point 8
- My research has been published in leading medical and scientific journals, including Journal of the American Medical Association, New England Journal of Medicine, and Pediatrics, and has been extensively relied upon by environmental and public health agencies, including the EPA. My pooled analysis of blood lead and IQ (Lanphear 2005) was cited by the EPA as the critical study upon which the Agency based the current national air standard for lead.
- My research has earned various awards and honors, including the Research Integrity Award from the International Society for Environmental Epidemiology in 2012, the Public Policy and Advocacy Award from the Academic Pediatric Association in 2013, and the Research Award from the Academic Pediatric Association in 2015.
Comparable to Lead Page 14, Point 47
- The effect sizes that we found are large and rival the impact of a population blood lead concentration of 5 µg/dL.7 Fourteen percent of the women had urinary fluoride concentrations exceeding 1.0 mg/L, and thus the impact for some children may exceed the ranges identified above.
Howard Hu, MD, MPH, ScD
World-leading Page 31
HONORS AND AWARDS: 1978-1982 National Health Service Corps Scholarship 1985-1988 National Research Service Award 1990-1992 Agency for Toxic Substances and Disease Registry Clinical Environmental Medicine Award 1994 1997 1998 1999
Will Solimene Award of Excellence, American Medical Writers Association, for: Chivian E, McCally M, Hu H, Haines H, eds. Critical Condition: Human Health and the Environment. Cambridge: The MIT Press, 1993.
Alice Hamilton Lecturer, University of California at San Francisco First Prize for Best Infant Nutrition Research, Instituto Danone, Mexico (for González Cossío T, Peterson KE, Sanín L, Fishbein SE, Palazuelos E, Aro A, Hernández-Avila M, Hu H. “Decrease in birth weight in relation to maternal bone lead burden.” Published in Pediatrics)
National Institute for Environmental Health Sciences “Progress and Achievement of the Year Award”, 1998-1999
1999 True Memorial Lecturer, Maine Medical Center, Portland ME. 2000-2001
Faculty Sabbatical Award, Harvard School of Public Health 2000-2001
Senior Fulbright Scholar in India 2001 Hoopes Prize, Faculty Mentorship (for Senior Thesis of Charles Lin, “More than Black and White: Lead Poisoning as an Environmental Justice Issue in Boston”) 2003 2004 2005 2006 2006 2009 2011 2015 2016
Best Paper in Preventive Medicine by a Medical Student (for Senior Thesis of Vanitha Janakiraman; Janakiraman V, Hu H, Mercado-Garcia A, Hernandez-Avila M. A randomized crossover trial of nocturnal calcium supplements to suppress bone resorption during pregnancy. Am J Prev Med 2003;24:260-4.).
American College of Preventive Medicine, Ulrich and Ruth Frank Foundation for International Health. Das Travel Grant Award, The South Asia Initiative, Harvard University (for Travel in India)
Adolph G. Kammer Merit in Authorship Award, the American College of Occupational and Environmental Medicine (for Rhodes D, Spiro A, Aro A, Hu H “Relationship of Bone and Blood Lead Levels to Psychiatric Symptoms: The Normative Aging Study”, Published in the Journal of Occupational and Environmental Medicine)
Teacher of the Year Award, Occupational/Environmental Medicine Residents, Harvard School of Public Health
Harriett Hardy Award, the New England College of Occupational and Environmental Medicine
Linus Pauling Award for Lifetime Achievements,
American College for the Advancement of Medicine Award for Excellence,
American Public Health Association John R. Goldsmith
Award for Outstanding Contributions to Environmental Epidemiology, International Society for Environmental Epidemiology
Election to Fellowship, Canadian Academy of Health Sciences
Comparable to Lead Page 9, Point 23
- Prenatal Fluoride Exposure Is Associated with Substantial and Significant Adverse Effects on IQ and ADHD-Behaviors in the ELEMENT Cohort In the ELEMENT cohort, we found that prenatal fluoride exposure has a linear, dose response relationship with reduced IQ among both 4-year old and 6-12 year old children (Bashash 2017).5 In our main model that adjusted for potential confounders, we found that each 0.5 mg/L increase in maternal urinary fluoride (which approximates the interquartile range, i.e., the difference between the 25th v. 75th percentile) was significantly associated with a loss of 3.15 GCI points among the 4-year olds, and a loss of 2.5 IQ points among the 6-to-12 year olds. These are substantial reductions in intelligence that rival the effect sizes associated with lead exposure. As one measure of practical impact developed and published in 2009 by an expert from the Economics Policy Institute, each IQ point lost due to lead exposure was estimated to represent a loss of $17,815 in present discounted value of lifetime earnings (in 2006 USD) (Gould 2009).
- The effect sizes between prenatal fluoride and ADHD behaviors in our cohort were substantial. For those effects which reached statistical significance, increases of 0.5 mg/L in maternal urinary fluoride were associated with 2.4 to 2.8-point higher scores (higher scores reflect indicate poorer performance). Whereas IQ is standardized to a mean of 100, the ADHD behavior scales are standardized to a scale of 50. The effect sizes that we found for prenatal fluoride are similar to what we have found for childhood blood lead levels (Huang 2016).
Kathleen M. Thiessen, Ph.D
World-leading Page 4 Point 6
- More recently, I served on two subcommittees of the National Research Council, one which was asked by EPA to review the toxicologic literature on fluoride (which resulted in the 2006 publication Fluoride in Drinking Water: A Scientific Review of EPA’s Standards), and one dealing with guidance levels for air contaminants in submarines. For the latter review, published in 2009, the NRC asked me to write much of the chapter on hydrogen fluoride.
Comparable to Lead Page 85, Point 219
- This factor weighs in favor of an unreasonable risk finding for fluoridation chemicals. The extent of human exposure to fluoridation chemicals is nothing short of massive, much like lead exposure was during the era of leaded gasoline. Today, approximately 200 million Americans, or nearly 2/3 of the population, have municipal water to which fluoridation chemicals are added. Moreover, most of the remaining population living in “non-fluoridated” areas will routinely consume fluoridation chemicals in processed beverages and foods, as many beverages and foods are produced in fluoridated areas.306 To put these numbers in perspective, EPA has found unreasonable risks for conditions of use involving as few as 1,046307 and 1,900 occupationally- exposed workers.308 With such widespread exposure to fluoridation chemicals among the general population, even small risks can amount to widespread harm.
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