The Health Issues of Chlorine, Iodine and Fluorine in Drinking Water

Water is one of the necessary substances for the life of every living creature on earth and especially in Israel where there is a scarcity of rain, safe wells, and adequate amounts of surface water to fill our reservoirs.

Today, we look west to the sea as a new source of our drinking water. But don’t be fooled into thinking that desalinated sea water is the magic replacement of a proper natural water management system. Every Israeli that operates a reverse osmosis(RO) water treatment system in their homes is faced with the same concerns that exist with the government’s desalination of sea water, and even more. Whatever the government may do in the future to replenish lost minerals from the desalinated water that reaches your home, your home RO system will reverse it. The minerals, Sodium, Potassium, Calcium, Magnesium, Iodine and trace minerals are excluded from the final product unless you replace them after the RO process.

Regardless of the water processing steps used, a chemical to disinfect the final product, usually chlorine, will reach your kitchen’s drinking water. There is no argument that chlorine has been successful in virtually wiping out water-borne diseases. But it also reacts with other organic and inorganic chemicals to produce new compounds known as disinfection byproducts, such as trihalomethanes, thought to cause cancer and other long term health risks.(1) Chlorine also reacts with dissolved Iodine in the water and reduces its solubility and causes it to be removed during the water filtration process and contributes to iodine deficiency.(5) It is important for the water treatment facilities to carefully monitor the residual free chlorine that you drink to minimize the disinfectant byproducts. Activated charcoal filters are useful to help you eliminate almost all of the residual chlorine from your drinking water. In regard to chlorinated drinking water, you can reduce the exposure by using a charcoal drinking water filter, or a Reverse Osmosis water treatment system . The RO system wastes the most water during its operation and requires replacement of salts lost during the process. The State water authority could require that charcoal be used during the final steps of water treatment to minimize the public’s exposure to the chlorinated hydrocarbons.

Chlorine is a member of the Halogen family on the Periodic Chart of elements. They are listed by their molecular weight. The heaviest is Iodine then bromine, chlorine and fluorine. Chlorine, having a lower molecular weight than iodine chemically displaces it and significantly reduces the chemical iodine in the water. “Iodine is an essential mineral for the proper functioning of the thyroid gland. This is especially true before and during pregnancy and breastfeeding and the proper brain development of fetuses and the newborn.(2)”. Iodine reaches the blood stream via the ingestion of iodine in food such as vegetables grown in soil that contains iodine, seaweed, fish, dairy products ,especially liquid dairy products, and eggs. The thyroid gland absorbs iodine from the blood and makes thyroid hormone, which is then secreted into the blood stream and is used by every cell of the body. There are geographical variables that affect the content of iodine in food and water.

The important immediate health concern in Israel is that the natural sources of clean, safe drinking water from the surface water and underground aquifers have been severely reduced, as a result of drought, the chemical pollution of surface water by industry and the military, and the agricultural land being contaminated with toxic herbicides and pesticides. The human mismanagement of many of the wells in Israel has resulted in their contamination with sea water, or excessive toxic organic and inorganic chemicals. Add to these issues the bottled beverage industries tapping into the available water supply and the public’s use of water for non-drinking purposes and you have the conditions that forced Israel to become dependent on the desalination of sea water for its shrinking supply of drinking water and to supplement irrigation for agriculture. The citizens of Israel unknowingly became the experimental population to support the desalination technology, of IDE technology, a former 50% holding of Israel Chemicals Ltd,(ICL). Their technology has been exported to 400 plants in 40 countries across over 40 years. The estimated value of the company has been estimated in publications to be in the range of 800 million dollars. ICL denies that figure when it sold their 50% holdings to Alfa Water Partners and the Delek Group for 167 million dollars in 2017(Reuters -Dec 10, 2017).

In August 2013 the “ Iodine Deficiency Disorders” (IDD ) newsletter published “Seawater desalination and iodine deficiency: is there a link?”( 4) The investigators in conjunction with Barzilal Medical Center, Ashkelon and the School of Nutrition Science, The Hebrew University, Jerusalem, stated “ Israel is one of the few countries that have no iodization policy and where a national iodine survey has never been done.” They continued,” of concern, between 2003 -2010 the use of thyroid disease medication among Israeli adults increased from 2.9% 4.7%.” “Iodine deficiency can be a significant risk factor for thyroid disease”. Three of the largest seawater reverse osmosis (SWRO) desalination plants in the world were built along Israel’s coast. The plants remove soluble minerals including iodine from seawater. Israel has a majority of its drinking water from SWRO, and it varies according to the seasons. The reduction of iodine from the drinking water of SWRO plants may increase the risk for iodine deficiency not only in Israel but throughout the countries that have been using this technology to produce drinking water. Since Israel is located on the the coast of the Mediterranean sea, it was assumed that iodine deficiency disorders (IDD) would not be a health concern. The findings of this study challenge the belief that Israel was iodine sufficient due to its proximity to the Mediterranean sea. Furthermore, the findings showed that the Israeli adults (n.34) without reported or known thyroid disease, living in the Ashkelon district, and using water from the Ashkelon desalination plant, had a finding of possible iodine deficiency ie. serum thyroglobulin > 10 uIU/ml among 76% of the participants which is higher than that reported 10 years ago. (4)

In the IDD newsletter of 2014, the “number of iodine deficient countries more than halved in the past decade (3). Israel was listed among the 41 countries that did not report testing of their population for IDD(3). Did the health ministry of Israel turn a blind eye to the adverse health effects of desalinated water on the health of its own citizens while IDE was promoting Israel’s desalination technology all over the world? A Health Ministry spokesperson denies the claim and attributes the lack of testing for iodine deficiency is the same as for all of the other bio markers that impact our health, “a lack of funding!”Depending on the origin of the source, drinking water is not a major source of iodine in the diet, however when desalinated water is used to irrigate the land, it lacks iodine and other minerals which can have a negative impact on the nutritional value of the food we eat. The brine water (hyper-saline) and other discharge materials from the desalination plants along Israel’s coastline may have a dangerous environmental impact on the marine life and the ambient salinity along the discharge coastal areas of the Mediterranean. (7) Will the same “lack of funding “ response be used in the future to explain why the effluent of desalination plants in Israel were not monitored for their environmental impact on our coastal border?

In response to the agricultural demands for desalinated drinking for their crops, and the need for drinking water for its people, Israel has been increasing the use of treated sewage effluents to irrigate its crops. Re-used sewage effluents in Israelis is 90%, the highest in the world. The process is carried out in 135 treatment plants around the country. What can the citizens of Israel expect to learn about the effects of applying treated sewage on their vegetables in the next 5 years? Will the “lack of funding” be raised by the Ministry of Health as the reason they couldn’t monitor the various organic chemicals such as pharmaceuticals, and various metals that went from the toilet bowl into your cereal bowl and your salad plate? We need full transparency about the safety of the treated sewage that is being used on our food supply. The monetary savings to sell and re-use the treated sewage in place of desalinated irrigation water must be large.

When government or private companies adversely impact our health, safety and welfare, they must be held financially responsible and accountable to the people for any negative environmental impact they have had on our lives and the lives of our children. Israeli citizens must be protected from the enemies outside the country but also inside the country who create the conditions that harm the environment, adversely affect our food supply and reduce the quality of life in the Land of Israel now and for future generations.

On March 27, 2017, in a report from the Robert H. Smith Agriculture, Food and Environment , School of Nutrition Science, at Hebrew University, entitled “High burden of Iodine deficiency found in Israel’s first national survey”,(6) Prof. Aron Troen, principal investigator with colleagues at Maccabi Healthcare and Barzilal University Medical center in Ashkelon and ETH Zurich,Switzerland published the first nationally representative data about the iodine status in the Israeli population. The collected pre-discarded spot urine samples from 1023 school-age children and 1074 pregnant women , representing all regions and major sectors in Israel, during 2016 at the Maccabi Healthcare services central laboratory. The study points out that 62% of school aged children and 85% of pregnant women fall below the World Health Organization”s (WHO) adequacy range. They reported that the data collected indicates that” The iodine status in Israel is among the lowest in the world.”Ethnicity or regional areas had virtually no differences suggesting that the low iodine status is widespread and universal throughout the country. Two of the factors for this low iodine result must be placed upon the Israel’s reliance upon desalinated water for drinking and irrigation and an absence of a universal salt and food iodization program (6).

Adequate iodine intake is essential for thyroid function and the need for iodine exists the entire life span of a human being. The population most immediately and seriously affected, are pregnant women and young children. There is a high risk of maternal and fetal hypothyroidism (low thyroid hormone) which may prevent children of the next generation from obtaining their full intellectual potential. If you take the results of the sampling for pregnant women,(85%) you can say that a majority of Israeli children may be lacking iodine in the womb, and years after birth.

IODINE CONCLUSIONS:

There are two immediate actions that are needed to combat the Iodine deficiency problem in Israel. The health services must provide regular routine urine testing of pregnant women and children for iodine deficiencies. The cost to the health system in the future from the consequences of children and pregnant mothers with hypothyroidism and the resultant brain dysfunctions and intellectual degradation to their children is a public health emergency

The second action is to require all grocery stores to provide 500 grams of iodized salt as the primary dietary source of salt in Israel. The grocery stores must have shelf advertising explaining the importance of iodized salt in Israel with the goal of having every household in Israel using iodized salt for cooking and in their salt shaker. In Europe, many countries have been using iodine in their commercial bread recipes. The Health Ministry can provide strict dietary guidelines for the quantities of iodized bread that will be safe for adults and children. Periodic urine screening of various geographic sectors of the country is essential until adults and children begin to test within the normal range of iodine and the iodine deficiency is no longer a medical concern.

Another halogen that impacts our health is Fluorine, having the lowest molecular weight, it is at the bottom of the halogen elements and is the most chemically reactive halogen. It is attracted to a long list of organic and inorganic chemicals which makes it a top priority for safety and health concerns. Fluoridation of the drinking water supply just adds another health hazard with an unreasonable risk to the long list of toxic chemicals that already exists in our drinking water. The city of Netanya has fluoride as a natural contaminate in its drinking water from underground sources. Adding more fluoride to what already exists in the ambient water supply is an option, and not a necessity. The Environmental Protection Agency of the USA classifies fluoride as a contaminate in drinking water, like pesticides,and heavy metals. Some of the natural contaminates and those caused by man, in drinking water are not able to be removed without great expense. Only fluoride, not a nutrient, but a toxic industrial waste-by- product of the phosphate industry and various Chinese fertilizer and chemical companies is deliberately and against the evolving science of today forced upon every man women and child that drinks water.There are no doses for fluoride based upon the weight, age or the level of health that exists of the users. Parts per million is a concentration and not a dose. Infants and young children will be forced to ingest the same amount of fluoride as a 75 Kg. Male. Today we know that the tooth decay issue can be treated very well with topical application of fluoride in toothpaste, and mouthwash and not by its chronic lifetime ingestion with its harmful systemic effects throughout the body. See “Fluoride the poison that is good for you” The Times of Israel, Jan 2017. Recently, a suit brought by Yael German of the Knesset against the Health Ministry for deciding to add fluoride to the drinking water was decided in favor of the State. Within months you will be forced to ingest 0.7mg of fluoride/liter of drinking water. In 2016,The Fluoride Network and others filed a legal petition with the EPA of the United States “to protect the public and susceptible subpopulations from the neurotoxic risks of fluoride by banning the addition of fluoridation chemicals to water”.(9) Fluoride’s neurotoxicity is supported by over 180 studies published since the National Research Council’s (NRC) 2006 review. The “safe levels” of fluoride that evaluate only the drinking water, and not the use of fluroridated toothpaste, mouthwash, and many foods like tea and grape juice undermine”confound” the value of the studies .

In an Intervention review the first since 2006, published in Issue 6, 2015, by The Cochrane Collaboration, the Cochrane Oral Health Group “Water fluoridation for the prevention of dental caries”, Cochrane Database of Systematic Reviews. This review began with history of community water fluoridation which was initiated in the United States of America in 1945. Since that time health authorities in America and a handful of other countries including Israel have made fluoridation the keystone for the prevention of tooth decay especially for children. It was for that reason that the Cochrane Oral Health Group decided to investigate the statistical published facts that provide the best answer to the value of fluoridation of the public’s drinking water in 2015. They made the following startling statements that resulted regarding the final electronic data of 155 studies from 4677 records examined on the prevention of tooth decay and markings on teeth(dental fluorosis). Randomized clinical trials are non-existent so Cochrane reviews had concerns about the methods used or the reporting of the results in 97% of the studies.The risk of reporting bias includes,sampling,confounding, blinding, incomplete outcome data.There is very little contemporary evidence meeting the inclusion criteria that has evaluated the effectiveness of water fluoridation for the prevention of caries.

Approximately 71% of the included caries studies that evaluated the initiation of water fluoridation were conducted prior to 1975. These old studies compared tooth decay in two communities around the time fluoridation began and may not be applicable today. With the introduction of fluoride toothpaste the size of the effects of water fluoridation or the number of people likely to have dental fluorosis is difficult to be confident to declare.

There is insufficient information to determine whether initiation of a water fluoridation program results in a change in disparities in caries across socioeconomic levels

No studies, that met the reviews inclusion criteria investigated the effectiveness of water fluoridation for preventing caries in adults.
There is insufficient information to determine the effect of stopping water fluoridation on caries levels.

In developed countries the widespread use of fluoride toothpaste from the mid-to late 1970’s along with other caries preventive strategies such as topical applications of sealants and varnishes may mean that the benefit of water fluoridation is reduced in such populations.

Adverse effects other than dental fluorosis(white streaks on the enamel) were rarely reported in the included studies.

The only obstacles the citizens of Israel have to stop this fluoridation hysteria is to demand that the State of Israel focus on the scientific studies of last 30 years that evaluated fluoride toothpaste, and mouthwash with the reduction of dental caries. The first 40 years,(starting in 1945)as we have seen, has been filled with bad science, politics, and a reckless disregard by some health professionals to require the entire population of a country to ingest fluoride from birth to death. The answer to this government ignorance is the truth about the safety and risks from all sources of fluoride for a variety of populations. To the extent possible exposures should be characterized for individuals, such as infants and the elderly rather than communities. The individuals should be grouped by the exposure level rather the source of exposure, location of residence or fluoride concentration in drinking water. Intakes should be characterized with and without normalization for body weight. It is absolutely essential that Israel have a nationwide bio monitoring and nutritional studies with analysis of fluoride in blood and urine. Parents are mixing infant baby formula with fluoridated water and the elderly with various levels of kidney diseases are also drinking fluoridated water. In a hot climate like Israel both the military and the civilian excising population may be consuming large volumes of fluoridated water and unknown amounts of fluoride.

There is a need to not only look at tooth bone but also skeletal bone and to clarify the relationship between fluoride ingestion, fluoride concentration in bone and clinical symptoms. Quantitative measures of fractures, such as radiological assessment of vertebral body collapse should be used instead of self-reported fractures or hospital records. Other health parameters of important interest have moved from bone to the endocrine effects and brain and neurotoxicity of fluoride. If the State of Israel demands that its citizens ingest fluoride from the womb to the grave than it is their responsibility to not make us sick! In the meantime, see what options are available to reduce your overall exposure and consumption of fluorides.

REFERENCES:
1. Erin Brockovich, Protection or Poison ? Chloramination of Drinking Water, October 2010
2. State of Israel Ministry of Health, “iodine”
3. Global scorecard 2014: Number of Iodine deficient countries more than halved in past decade, IDD newsletter Feb 2013
4. Ovadia YS, Troen AM, Gefel D, “Seawater desalination and Iodine deficiency”: “Is there a link”? IDD newsletter,Aug 2013
5. L.Sampson,I Czegeny etal, “Addition of chlorine during the water purification reduces Iodine content of drinking water and contributes to iodine deficiency” Journal of Endocrinology Invest. 35: 21-24, 2012
6. Troen,A, Arbelle J. Ovadia Y. ,Research Findings 46th Annual Meeting of the Israel Endocrine Society, March 20-21,2017
7. Mohamed A. Dawoud, “Environmental Impacts of Seawater Desalination: Arabian Gulf Case Study” International Journal of Environment and Sustainability, Vol.1 NO.3 pp.22-37 (2012)
8. Limeback, H.,etal, National Academy of Science”Fluoride in Drinking Water “ 2006,ww.nap.edu/11571/fluoride-in-drinking-water-a-scientific-review-epas-standards
9. EPA, Citizen Petition Under Section 21 of the toxic Substances Control Act, November 22, 2016

About the Author
Nachum Jacobs operates a small business in Israel which imports drinking water treatment products from England. He has many experiences with the Standardization Institute of Israel, and the process of importing into Israel. He is 74 years old, and an Aleyah from the US in 2008. Nachum owned and operated a Pharmacy in the US for 30 years, and holds a Pharmacy degree from the University of Maryland. He manufactured nutritional products and has extensive knowledge in alternative medicines.
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