902 KAR 115:010. Water fluoridation
for the protection of dental health.
TO: KRS Chapter 211
AUTHORITY: KRS 194A.050(1), 211.090(3), 211.180(1), 211.190(11)
FUNCTION, AND CONFORMITY: KRS 211.190(11) requires the Cabinet for Health and
Family Services to provide public health services that include water
fluoridation programs for the protection of dental health. This administrative
regulation establishes the requirements for the programs.
1. Definitions. (1) "Cabinet" is defined by KRS 194A.005(1).
"Consecutive supply" means a supply that purchases its water from
another water system.
2. Community Implementation. The population served by a water system includes
its own population and the population served by its consecutive supplies. (1) A
water system serving a community population of 3,000 or more, including consecutive
supplies, shall adjust fluoride-deficient waters to protect the dental health
of the people served by the supply.
A water system serving a population between 1,500 and 3,000 shall provide
supplemental fluoridation only if adequate fluoride feed equipment is available
from the cabinet, Department for Public Health.
Although not required to provide supplemental fluoridation, a water system
serving a population of less than 1,500 that chooses to provide supplemental
fluoridation shall do so only if:
Adequate fluoride feed equipment is available from the cabinet, Department for Public
There are competently trained or certified personnel at the water system.
3. Approval. A water system shall obtain the written approval of the cabinet
before adding fluoride to a public water system, pursuant to Section 5 of this
4. Equipment, Facilities, and Services. The equipment, facilities, and services
shall meet the requirements set forth in this section.
Feeding. Feeding equipment with an accuracy within five (5) percent shall be
provided to feed the optimal dosage of fluoride.
The rate of feed shall give a fluoride content operating tolerance range between
six-tenths (0.6) ppm and one and two-tenths (1.2) ppm in the treated water,
with an optimal concentration of seven-tenths (0.7) ppm.
The point of application shall be selected so that fluoride is evenly mixed
with the water leaving the treatment plant.
Method of measurement.
Saturator tanks. If solution feed equipment is used, the water plant shall have
a corrosion-resistant solution tank and an accurate means for weighing the
stock chemical (fluoride) available. A metering device for measuring the water
for the solution shall also be used.
Dry feed hoppers. Dry feed hoppers shall be mounted on scales.
Acid systems (H2SiF6). Scales shall be available to
measure the weight loss each day or a volumetric method of measuring the amount
of acid being used each day shall be used.
Protection of operator. Precautions shall be taken to protect the operators.
Precautions shall include:
An approved respirator;
Approved rubber gloves;
An eye shield;
An apron; and
An exhaust or ventilation system for all fluoride feeding equipment.
Storage. Separate storage areas shall be used for all fluoride chemicals.
Laboratory facilities. Laboratory facilities shall be used for the
determination of the fluoride content of the water by personnel in accordance
with the current standards published by the American Public Health Association,
the American Water Works Association, and the Water Pollution Control
Samples. Raw water and plant tap water samples shall be examined at least once
per day and the results shall be included on the monthly operation report
submitted to the Energy and Environment Cabinet in accordance with 401 KAR
Additional finished water samples shall be analyzed by a laboratory certified
by the Energy and Environment Cabinet in accordance with 401 KAR 8:040 for
fluoride determination, with the results being forwarded by the water system to
the cabinet, Department for Public Health.
This sampling shall be at a rate of two (2) samples per month.
The first sample shall be collected from the plant tap during the first week of
the month and the second sample collected from the distribution system, at a
point of maximum retention, during the third week of the month.
Siphon breakers. Fluoride feeders shall be equipped with siphon breakers to
prevent back siphonage of concentrated fluoride solution into the distribution
Notification of cabinet when fluoride begins. The cabinet shall be notified of
the date on which fluoridation is to commence in order that a representative of
the cabinet may be present to calibrate and check the fluoridation equipment
and instruct the operating personnel concerning tests, records, operation, and
Notice when fluoride is interrupted. The owner or operator of the water plant
shall immediately notify the cabinet of any interruption to the addition of
fluoride to the water supply.
5. Procedure for Obtaining Approval. A system shall submit to the cabinet:
Detailed plans showing the method and point of application of fluoride and
storage facilities for stock chemicals;
Information concerning technical supervision of the treatment process;
Information on the provisions for laboratory facilities; and
Evidence that the plant facilities and operation will provide for:
Control and supervision;
Safe operation and maintenance;
The keeping of operational records; and
Compliance with this administrative regulation and 401 KAR 8:010 through 401
KAR 8:700 relating to public water systems. (21
Ky.R. 816; eff. 9-21-1994; Am. 42 Ky.R. 145; 719; eff. 9-16-2015.)