[Federal Register Volume 91, Number 18 (Wednesday, January 28, 2026)]
[Notices]
[Pages 3722-3724]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2026-01657]


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ENVIRONMENTAL PROTECTION AGENCY

[EPA-HQ-OW-2025-3823; FRL 13191-01-OW]


Review of Science on Fluoride in Drinking Water: Preliminary 
Assessment Plan and Literature Survey

AGENCY: Environmental Protection Agency (EPA).

ACTION: Notice of availability.

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SUMMARY: As the first step in developing the Fluoride Human Health 
Toxicity Assessment (toxicity assessment), the U.S. Environmental 
Protection Agency (EPA) is releasing the Fluoride Preliminary 
Assessment Plan and Literature Survey (Assessment Plan) for public 
comment to provide

[[Page 3723]]

transparency and gather early feedback. The objectives of the 
Assessment Plan are to describe the approach the EPA intends to follow 
to develop the fluoride toxicity assessment and present the results of 
the preliminary literature survey. The Assessment Plan is not a 
toxicity assessment; it does not contain conclusions regarding harmful 
human health effects of fluoride or determine the level of fluoride 
exposure at or above which is associated with harmful health effects. 
Such conclusions about fluoride human health effects will be released 
as part of the forthcoming draft human health toxicity assessment. The 
EPA's toxicity assessment will be used to inform future decisions about 
potential revisions to the existing fluoride drinking water standard 
under the Safe Drinking Water Act (SDWA). This notice outlines details 
on how to provide comments and describes the purpose of the Fluoride 
Preliminary Assessment Plan and Literature Survey.

DATES: Comments must be received on or before states February 27, 2026.

ADDRESSES: You may send comments, identified by Docket ID No. EPA-HQ-
OW-2025-3823, by any of the following methods:
     Federal eRulemaking Portal: https://www.regulations.gov/ 
(our preferred method). Follow the online instructions for submitting 
comments.
     Email: [email protected]. Include Docket ID No. EPA-HQ-OW-
2025-3823 in the subject line of the message.
     Mail: U.S. Environmental Protection Agency, EPA Docket 
Center, Office of Ground Water and Drinking Water Docket, Mail Code 
28221T, 1200 Pennsylvania Avenue NW, Washington, DC 20460.
     Hand Delivery or Courier: EPA Docket Center, WJC West 
Building, Room 3334, 1301 Constitution Avenue NW, Washington, DC 20004. 
The Docket Center's hours of operations are 8:30 a.m. to 4:30 p.m., 
Monday through Friday (except Federal Holidays).
    Instructions: All submissions received must include the Docket ID 
No. for this rulemaking. Comments received may be posted without change 
to https://www.regulations.gov/, including any personal information 
provided. For detailed instructions on sending comments and additional 
information on the rulemaking process, see the ``Public Participation'' 
heading of the SUPPLEMENTARY INFORMATION section of this document.

FOR FURTHER INFORMATION CONTACT: Susan Euling, Drinking Water Science 
and Engineering Division, Office of Ground Water and Drinking Water 
(Mail Code 4601M), Environmental Protection Agency, 1200 Pennsylvania 
Avenue NW, Washington, DC 20460; email address: [email protected]

SUPPLEMENTARY INFORMATION:

Table of Contents

I. Public Participation
    A. Written Comments
II. General Information
    A. Introduction to the Preliminary Assessment Plan and 
Literature Survey for the Fluoride Human Health Toxicity Assessment
    B. Next Steps for the Fluoride Human Health Toxicity Assessment

I. Public Participation

A. Written Comments

    Submit your comments, identified by Docket ID No. EPA-HQ-OW-2025-
3823, at https://www.regulations.gov (our preferred method), or the 
other methods identified in the ADDRESSES section. Once submitted, 
comments cannot be edited or removed from the docket. The EPA may 
publish any comment received to its public docket. Do not submit to 
EPA's docket at https://www.regulations.gov any information you 
consider to be Confidential Business Information (CBI), Proprietary 
Business Information (PBI), or other information whose disclosure is 
restricted by statute. Multimedia submissions (audio, video, etc.) must 
be accompanied by a written comment. The written comment is considered 
the official comment and should include discussion of all points you 
wish to make. The EPA will generally not consider comments or comment 
contents located outside of the primary submission (i.e., on the web, 
cloud, or other file sharing system). Please visit https://www.epa.gov/dockets/commenting-epa-dockets for additional submission methods; the 
full EPA public comment policy; information about CBI, PBI, or 
multimedia submissions; and general guidance on making effective 
comments.

II. General Information

A. Introduction to the Preliminary Assessment Plan and Literature 
Survey for the Fluoride Human Health Toxicity Assessment

    The EPA is committed to ensuring clean and safe drinking water for 
all Americans with the goal of protecting human health, including 
children's health. In response to concerns about fluoride in drinking 
water, the EPA is developing a new human health toxicity assessment 
that will review scientific information on the potential health risks 
of fluoride in drinking water. The toxicity assessment will be based on 
a systematic review of the scientific information on the potential 
health risks of fluoride in drinking water. The objective of the 
toxicity assessment is to determine the fluoride levels that a person 
can be exposed to and be unlikely to experience harmful health effects; 
these values are called toxicity values, specifically noncancer 
reference doses (RfDs).
    The Preliminary Assessment Plan and Literature Survey (Assessment 
Plan) is the first step in developing the toxicity assessment. The 
objectives of the Assessment Plan are to describe the approach the EPA 
intends to follow to develop the human health toxicity assessment and 
present the results of the preliminary literature survey. The 
preliminary literature survey describes the results of conducting 
initial systematic review steps to identify relevant health effects 
studies, consistent with agency human health risk assessment guidance 
and Executive Order 14303 Restoring Gold Standard Science. A summary of 
the scoping and problem formulation conclusions is also presented in 
the Assessment Plan. As part of scoping and problem formulation, the 
EPA identified key science issues specific to fluoride exposure and 
health effects measurement that will be evaluated during toxicity 
assessment development.
    The Assessment Plan is not a toxicity assessment; it does not 
contain conclusions regarding harmful human health effects of fluoride 
or determine the level of fluoride exposure at or above which is 
associated with harmful health effects. The EPA is releasing the 
Fluoride Preliminary Assessment Plan and Literature Survey for public 
comment to provide transparency and gather early feedback about the 
assessment scope and identified literature.
    The EPA's fluoride toxicity assessment will evaluate human health 
hazards. The fluoride toxicity assessment, once final, can be used by 
EPA, states, Tribes, and local communities, along with specific 
exposure and other relevant information, to determine, under the 
appropriate regulations and statutes, the potential risk associated 
with human exposures to fluoride. Specifically, the EPA's toxicity 
assessment will be used to inform future decisions about potential 
revisions to the existing fluoride drinking water standard under the 
Safe Drinking Water Act (SDWA). The results of this toxicity assessment 
will also be used to inform Centers for Disease Control and Prevention 
(CDC) recommendations regarding fluoride in drinking water (https://

[[Page 3724]]

www.whitehouse.gov/wp-content/uploads/2025/09/The-MAHA-Strategy-
WH.pdf).

B. Next Steps for the Fluoride Human Health Toxicity Assessment

    The EPA is accepting public comments on this Assessment Plan for 30 
days. The EPA will consider all public comments during the next step in 
the toxicity assessment process, which is the development of the 
Systematic Review Protocol (protocol). The protocol will present 
detailed methods for conducting subsequent steps of the systematic 
review. The EPA will then follow the protocol to develop a draft 
Fluoride Human Health Toxicity Assessment. The draft toxicity 
assessment will follow EPA human health risk assessment methods and 
guidance, summarize the health effects associated with exposure to 
fluoride during childhood, and identify the fluoride level at or below 
which a person can be exposed to and be unlikely to experience harmful 
health effects. The draft toxicity assessment will be released for 
external peer review and public comment. The EPA will consider the 
external peer review and public comments and revise the assessment as 
appropriate, before publishing a final Fluoride Human Health Toxicity 
Assessment.

Jessica L. Kramer,
Assistant Administrator.
[FR Doc. 2026-01657 Filed 1-27-26; 8:45 am]
BILLING CODE 6560-50-P