More independent voices speak up on fluoridation.
In a later bulletin we will be summarizing our current situation with respect to the number of professionals who have signed the statement calling for an end to fluoridation worldwide. The last time I looked there were over 4,400 signers and we are hoping that 2013 will see us top the important milestone of 5,000. Meanwhile, 2012 witnessed four important review articles from independent scientists and other experts looking at the practice and finding it wanting on several fronts: on safety and effectiveness, and on legality, and on ethics. These four reviews came from Ireland, Scotland, Australia and Romania. (The abstracts of each paper are posted at the bottom of this bulletin)
We have heard a lot about tornados this year but the press has not yet taken note of the tornado that has hit Ireland – on the fluoridation front that is. Almost out of the blue this one-man tornado called Declan Waugh – a professional environmental consultant -produced a damning review of Ireland’s fluoridation program, which has been mandatory since 1963. Declan pointed out that:
Ireland is the only country in the European Union with a mandatory legislative policy on water fluoridation. The worst that could happen if the policy ended tomorrow would be that Irish citizens would have the same rights as every other European citizen to clean, safe non-fluoridated drinking water.
In his 328-page review Declan gives an abundance of reasons – with scientific documentation - why Ireland should end this practice. Since issuing this report Declan has been working tirelessly to that end. Having spent 16 years studying this issue myself I am amazed at just how much of the scientific literature Declan was able to master in a relatively short time.
A pdf copy of Declan’s full report can be viewed online.
Declan will be writing one of the December bulletins for us summing up the current situation in Ireland on this issue. Meanwhile, on his blog in Augusthe summarizes the four independent reviews published this year.
Independent Scientific and Medical Reviews of Fluoride and Implications for Water Fluoridation
We have now had four independent reviews of water fluoridation undertaken this year.
The first review was by Declan Waugh titled Human Toxicity, Environmental Impacts and Legal Implications of Water Fluoridation published in March 2012. Mr. Waugh is an independent environmental scientist, member of the Chartered Institution of water and Environmental Management and Institute of Environmental Management and Assessment.
The third review was undertaken by Dr. Awofeso, Professor of Public Health, University of Western Australia, and University of New South Wales, Australia published in the peer reviewed Oxford journal Public Health Ethics. Professor Awofeso concluded that “artificial water fluoridation cannot be justified on major ethical parameters such as effectiveness, proportionality, necessity, least infringement and public justification”. The review also found that “to date, there is no evidence to support the assertion that water fluoridation reduced social disparities in caries incidence internationally” and “ironically found that the most well-known adverse effect of artificial water fluoridation, that is, dental fluorosis is inequitably distributed, with poorer children more likely to develop dental fluorosis than children from [wealthier] communities.” The review also found that “Public justification of water fluoridation is anchored in the ‘common good’ utilitarian principle—that is, the best outcome for the greatest number. While this principle is valid in some public health contexts such as mandatory wheat flour fortification with folic acid…it cannot be justified in the case of water fluoridation given the wide availability of alternative sources whose intake are easier to regulate.” Dr. Awofeso goes on to state that “the fluosilicic acid brands used in artificially fluoridating water supplies are known to be contaminated with lead, arsenic and mercury—major public health hazards for which no safe level exists” and “rather than addressing the legitimate concerns of the public with regards to the ethics of fluoridation, pro-fluoridation activists dismiss anti-water fluoridation advocates as misinformed trouble makers intent on undermining public health.” For these and other reasons, the author concluded that, “Water fluoridation fails the precautionary principle test as defined by the (Commission of the European Communities, 2000). Read the full review here.
The fourth review was undertake by Dr. Balan, Associate Professor of Public Health published in the Romanian Journal of Internal Medicine, which finds that the fluoride compounds which are put into water for fluoridation have never been tested for human safety while highlighting the potential neurological and general health risks that may be associated with exposure to fluoride including disturbances to central nervous system, osteosclerosis, arthritic symptoms, chronic joint pain and calcification of ligaments. Dr. Balan concluded that, "All the recent large-scale studies of water fluoridation have shown that there are no positive effects. A supplementary confirmation is given by the fact that countries without fluoridation have shown an equal improvement in dental health than those with fluoridation. And there are also proofs regarding the fact that excessive fluoride exposure leads to increased levels of caries".
Paul Connett adds: Below are abstracts to three of these papers. To the best of my knowledge none of these four scientists and academics were in contact with one another before writing these pieces. The fact that they have come from four different parts of the globe suggests to me that we are seeing a shift in attitude towards the acceptability of speaking on this hitherto taboo subject – at least in the fluoridated countries. This bodes well for ending fluoridation worldwide. When more and more scientists and academics review this issue with an open mind it is hard to believe that such a foolish practice will prevail, despite the powerful forces in the handful of fluoridating countries that want it to continue regardless of the scientific evidence.
Paul Connett, PhD
Director of FAN and co-author of The Case Against Fluoride
David Shaw’s review from Scotland
Weeping and wailing and gnashing of teeth: the legal fiction of water fluoridation
University of Strathclyde, Glasgow, UK
Medical Law International
While current UK legislation clearly permits water fluoridation, there is a degree of obfuscation concerning whether the practice amounts to medication. Were it to be acknowledged that fluoridated water does constitute a medicine, the legality of the practice (as it currently occurs) might be put in serious doubt. This paper explores in detail the legal position of, and legal justifications for, water fluoridation in the UK. First, it examines the UK jurisprudence, which very much sets the stage for the subsequent legislative analysis. It then goes on to consider the wider European Union (EU) context and how that might (or should) impact on the UK’s position. It concludes that an accurate and honest interpretation of the law would result in the conclusion that water fluoridation does indeed constitute medication, as it seeks to improve health by the addition of a chemical, with the result that the current manner of doing so (where it is done) is not compliant with the law. (emphasis added)
Professor Niyi Awofeso’s review from Australia
Public Health Ethics, 2012, 1-12 (advanced access published August 21, 2012)
Ethics of Artificial Water Fluoridation in Australia
Niyi Awofeso, School of Population Health, University of Western Australia, and School of Public Health, University of New South Wales, Australia
Corresponding author: Niyi Awofeso, Email: firstname.lastname@example.org
A recent decision by several Australian federal politicians to support a parliamentary review of artificial water fluoridation has an intensified debate on the public health intervention. While there is a majority agreement among Australian dentists and other health professionals that adequate enamel fluoride is essential for dental health, the ethics of artificial fluoridation of public water supplies as a contemporary vehicle for facilitating adequate supply of fluoride to teeth is highly contested. Opponents of artificial water fluoridation insist that there are many alternative sources of fluoride, that mandatory water fluoridation violates the ethical principle of autonomy and that water fluoridation is not only expensive and unnecessary but also may endanger health by causing fluorosis and, potentially, hypothyroidism and pathological bone fractures. In contrast, proponents of water fluoridation posit that mandatory water fluoridation facilitates health equity and that the benefits accruing to society from prevention of dental caries (beneficence principle) outweighs impairment of individual autonomy. This article utilizes Childress’ ‘justificatory conditions’ to evaluate the ethical appropriateness of artificial water fluoridation in Australia. The author concludes that there is insufficient ethical justification for artificial water fluoridation in Australia. (emphasis added)
Dr. Balan’s review from Romania
Fluoride – the Danger that we must Avoid
“Carol Davila”University of Medicine and Pharmacy, Bucharest
Medical Clinic Clinical Emergency Ilfov County Hospital, Bucharest, Romania
One of the sad stories about what was considered to be a successful prevention of tooth decay is represented by fluoride supplementation of water and toothpastes. But even today, without knowing all the scientific reliable proofs, all the pieces of a very large puzzle, this action has many (especially in developing countries) promoters. That’s why we considered that a well-documented review in this domain would be of large interest, especially because the deleterious effects are many, accompanied by a large number of threats for the health, and the benefits are lacking. (emphasis added)