By Gabriella Sotelo for Sentient.
Broadcast version by Mark Moran for Iowa News Service reporting for the Sentient-Public News Service Collaboration

The EPA has set its sights on fluoride. The Environmental Protection Agency announced on April 7 that it will “expeditiously” review the health risks of fluoride in our drinking water to inform the agency’s standards under the Safe Drinking Water Act. EPA Administrator Lee Zeldin praised Health and Human Services Secretary Robert F. Kennedy Jr. in the announcement, calling his advocacy on this issue “instrumental.” But while the EPA turns its attention to a compound that’s been widely considered safe and beneficial for decades, its review of a known public health threat — nitrate contamination fueled in part by factory farming — has been stalled for more than a decade and a half.

The interest in fluoride is especially popular among some Republican representatives and constituents in the Make America Healthy Again, or MAHA, contingent. Many in the MAHA movement believe a number of myths about fluoride in the water, seeing it as a symbol of government overreach and a threat to personal autonomy. By contrast, addressing contaminants like nitrates would mean the agency would have to hold polluters in the agriculture industry accountable. That’s a far more politically tricky move, since many Republican lawmakers have close ties to the beef and agribusiness industries, often counting on them for campaign support.

One source of nitrate contamination is manure from livestock operations. Factory farms are responsible for producing 941 billion gallons of animal manure each year, according to Food and Water Watch. This pollution, often overlooked by state and federal environmental agencies, is responsible for toxic runoff that seeps into public waterways, including sources for drinking water.

The apparent disconnect between actual risk and the EPA’s new focus doesn’t sit well with David Cwiertny, the director of the University of Iowa’s Center for Health Effects of Environmental Contamination. “They should at least apply a uniform standard to how they want to reevaluate new science,” Cwiertny tells Sentient. “It would seem that there’s a pretty compelling case that we need to reevaluate science on nitrate, just as much, if not more, than what we need to be doing on fluoride.”

Fluoridation of drinking water was named one of the “ten great public health achievements” of the 20th century by the Center for Disease Control and Prevention (CDC) in 1999. According to a web page from the CDC last updated May 2024, fluoride in the water helps reduce cavities by around 25 percent.

Meanwhile, a 2018 review on nitrate and human health found that nitrate in drinking water was linked to a rare blood disorder, increased risks of colorectal cancer, thyroid disease and certain birth defects.

Despite this, the EPA remains intent on shifting its regulatory attention to fluoride, though it has yet to move forward an investigation of agricultural runoff in drinking water. The agency first initiated a health assessment of risks from nitrates back in 2017, and it remains uncompleted today. The assessment was still in progress in 2018, when it was paused during President Trump’s first term. It was restarted under President Biden, but not completed by the time Trump returned to the White House.

What We Know About Nitrates in Water

Nitrate contamination comes from a number of sources, including human wastewater and synthetic fertilizer, as well as the massive amounts of manure produced by factory farms.

Industrial animal agriculture operations — colloquially referred to as “factory farms” and regulated either as animal or concentrated animal feeding operations (CAFOs) — are significant contributors to nitrate pollution in drinking water sources.

These operations produce vast amounts of manure, and with that comes a lot of nitrogen. As manure decomposes and comes into contact with oxygen in soil, microbial processes in the soil convert both ammonium and organic nitrogen from manure into nitrate. When the manure is spread on fields as fertilizer, the nitrogen that isn’t absorbed by the soil or crop leaches into the groundwater or runs off into nearby rivers and streams, and in doing so can contaminate local water supplies.

“If there’s no regulatory mechanism trying to limit those discharges, it’s really hard to see how we’ll oversee meaningful improvement,” says Cwiertny. “All we can do is think about how we want to limit what’s being applied to land. But that seems to be a conversation folks aren’t going to have.”

Iowa has become a major hub for industrial hog farming, among other types of factory farming operations in the state. Though Iowa has been a major hog producer since the 1880s, the hog population increased in the early 1990s. Iowa’s hog inventory increased from around 15 million in 2004 to around 25 million in 2023.

The state’s many large-scale farms produce 109 billion pounds of manure each year. At the same time, along with slaughterhouses, these operations regularly pollute Iowa’s waterways, contributing to a growing water quality crisis in the state.

In many cases, this contamination has become so pervasive that residents of these areas must rely on filtration systems to remove the nitrates. In Des Moines, the city government’s Water Works operates one of the world’s largest nitrate removal facilities to treat the drinking water to address the nitrate problem.

The EPA’s Slow Response on Nitrates

Nitrate contamination in water has been linked to conditions like “blue baby syndrome,” which reduces oxygen in the blood and can be fatal, and higher rates of certain cancers and thyroid disorders in adults.

The legal limit for nitrate in drinking water is set at 10 milligrams per liter (mg/L), a standard established in 1992. Under the Safe Drinking Water Act, the EPA is required to review and potentially revise these standards, which should include the nitrate limit, every six years. Four reviews have been conducted so far. In the second review, released in 2010, the EPA announced it would assess the health effects of consuming elevated levels of nitrates. The agency also acknowledged concerns regarding developmental effects to babies in the womb from nitrates, as well as potential cancer risks.

Around this time, the EPA also conducted a study on nitrate contamination in Washington State, focusing on the Lower Yakima Valley, where multiple investigations over the past 30 years showed nitrate levels consistently exceeding the EPA’s maximum contaminant level of 10 mg/L. Livestock, primarily dairy farms, were one of three sources of contamination, according to EPA researchers, as the study identified dairy waste lagoons and manure piles, as well as synthetic fertilizers used on irrigated cropland.

In 2017, the EPA announced a 30-day public comment period for their draft IRIS Assessment Plans for nitrate and other contaminants. But this ongoing assessment was paused in 2018, under the first Trump administration.

In 2023, the Biden administration restarted the health risk assessment, but it remains uncompleted. The last status for the 2024 review reads “New information, but no revision recommended because [of] emerging information and/or data gaps.”

“I think it’s safe to say that it’s likely the current administration, if they paused it once before, it’s hard for me to think that they won’t pause it again” Cwiertny says. “And so here we are. 15 years after we realized we need a health assessment and we still don’t have it.”

The Bottom Line

At safe levels, fluoride continues to be endorsed by leading health organizations like World Health Organization and, at least for now, the CDC. In contrast, nitrate contamination from factory farming is a documented threat to public health that has essentially been stalled at the investigation stage for nearly two decades.

“There’s clearly already evidence from the EPA for 15 years that we need to be reevaluating the health assessment for nitrate,” Cwiernty says.

Targeting fluoride seems like a “win” for lawmakers, while addressing nitrate contamination would require regulating the impacts of the meat industry. Sentient reached out to the EPA with questions regarding the recent fluoride announcement and nitrate regulations but received no response.


Gabriella Sotelo wrote this article for Sentient.


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"Don't go into the water" is a warning Illinoisans may want to heed. A 2024 study released this week found all state-border beaches on Lake Michigan last year had evidence of contamination.

Findings from the Safe in Swimming report indicate these conditions could cause serious gastrointestinal and respiratory ailments. The data show bacteria levels were well above the EPA's "Beach Action Value" water quality standards. These guidelines help determine advisories and closures.

Emily Kowalski, outreach and engagement manager for the Environment Illinois Research and Education Center, explained the odds of exposure.

"One hundred percent of those beaches had potentially unsafe levels of fecal indicator bacteria at least one day in 2024, meaning that swimmers were potentially at risk," she said.

A water sample exceeding acceptable BAV standards increases the chances of a higher illness rate among swimmers. The study shows 71% of Great Lakes beaches had at least one potentially unsafe test day. Three beaches in Cook County had the highest degrees of dirty water - Winnetka Lloyd Park had the highest at 21. Glencoe Park and Montrose beaches had 14 days each.

The study identified runoff from paved streets and parking lots, and overflow from outdated, bacteria-encrusted sewage systems as harmful contributors. Livestock waste from concentrated animal feeding operations, or CAFOs, is another source.

Human contact with water tainted by manure could cause an E. coli infection. Kowalski suggested the environment could be one solution to interrupt the pathogen flow.

"Investing in nature-based solutions, green infrastructure, but also the repair needed in aging sewage systems nationally," she continued.

An estimated 57 million Americans experience nausea, diarrhea, ear and eye infections, and skin rashes after swimming in polluted waters. Kowalski adds the EPA estimates a price tag of $630 billion over 20 years will be needed to address sewage runoff and other wastewater problems nationwide.

Illinoisans can check the status of their favorite beach at Chicago Park District Beaches website.

Following last year's historic drought in Montana and hot temperatures early this spring, the Blackfoot River is running at roughly 25% of normal water levels.

Water rights have shifted some this year but experts said management will continue to be community-driven.

Clancy Jandreau, Blackfoot water steward for the nonprofit group Blackfoot Challenge, said the river's fish population declined in the late 1980s and early 90s, but there has also been a long history of restoration efforts. The new Blackfoot Drought Response Plan, updated in April, helps build on those efforts, Jandreau noted.

"We really wanted to more explicitly recognize that habitat restoration efforts that improve fisheries can in and of itself be a response to drought, as it builds resilient fisheries," Jandreau explained.

The new plan also incorporates deferred changes from the 2015 Montana Water Rights Compact, in which the Confederated Salish and Kootenai Tribes and Montana Fish, Wildlife and Parks became co-owners of a water right historically associated with hydropower production.

During a dry summer like this one, Jandreau pointed out the drought plan encourages a "shared sacrifice for shared benefit" model, in which irrigators, anglers and other water users voluntarily reduce their effects on the resource.

"Everybody's going to be seeking the refuge of the river over this summer," Jandreau added. "That includes humans and wildlife. So just doing their best to be aware of that and being responsible and ethical recreators this summer out there on the river."


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Because of drought and failing infrastructure, the state of Texas will run out of water by 2030, according to the Texas Water Development Board.

But two new pieces of legislation are on the books that are designed to address the state's water shortage.

Senate Bill 7 and House Joint Resolution 7 would allocate $20 billion for infrastructure improvements and new projects.

Agriculture Commissioner Sid Miller said he's been trying to get lawmakers to address the state's water crisis for 10 years.

"We completely lost our sugar cane industry because - no water," said Miller. "We've brought it to light that Mexico is not paying their water bill with our treaty on the Rio Grande, so that was brought to light. We've got a drought over half the state of Texas."

An increase in population has also contributed to the state's water woes.

JR 7 would authorize the state to use $1 billion a year from sales tax revenue for the water projects. The resolution must be approved by voters in November.

If the amendment is approved, the projects and funds will be overseen by the Texas Water Development Board. Miller said in the meantime, the state needs to do a better job at managing the water it has.

"We spend millions and millions of dollars on stormwater drainage, getting rid of excess water when it rains," said Miller. "We need to capture that water and use it. We need to capture the water out of these water treatment plants. I'm not advocating that we drink it but, my farmers sure would like to irrigate with it."

Miller said the state can also benefit from rainwater harvesting. He added that up to 70% of the state's water is lost, as it's transported to various municipalities because of old, worn-out infrastructure.




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