On Thursday, the Water Advisory Commission listened to the opposition to fluoridation present their case. The meeting, which reportedly lasted three hours, had dozens of public commenters. The WAC will make their recommendation on whether Davis should add fluoride to its water supply at their next meeting.
But ultimately the Davis City Council will have to figure out how to handle this matter. A few weeks ago, we reported that councilmembers and staff may be inclined to put the matter to a vote. While some people have suggested such a notion is preposterous, ironically, this would not be the first public vote on fluoridation.
Professor Emeritus John Lofland, a sociologist by training but an historian of Davis, has posted an account of the 1960 vote on fluoridation in Davis that resulted in a narrow defeat. In fact, he notes on his blog, Davis History Today, this was the first of four episodes on the public debate on fluoridating water.
The January 14, 1960, Davis Enterprise reported that the council unanimously voted to adopt a proposal that would have called for authorization to fluoridate the municipal water supply in order “to prevent dental decay.”
The resolution received four votes, with one member being absent, and there was said to be “no debate.” The vote appears to have coincided with the 1960 council elections that saw five candidates for three council positions while the fluoridation issue was said to be “even more hotly contested.”
Wrote the Enterprise, “Measure B (fluoridation) has been hotly contested and is expected to be a nip-and-tucker at the polls.”
At the close of polls, the ballot measure was close enough that it was thought to be decided by the absentee ballots. At the close of polls, the measure received 966 votes in support with 1059 opposing it.
Wrote the Enterprise, ” ‘Almost anything can happen’ to close the narrow gaps in one of the most warmly contested elections of the city’s history.”
The final vote was razor thin – a margin of 32 votes, 1108 against to 1076 in favor. Professor Lofland notes one other thing of interest from the 1960, by way of context, that Davis favored Nixon for President while the nation narrowly went to President Kennedy. So the politics of Davis in 1960 were a little different from today.
The issue returned in 1964 – apparently twice. The paper reported, “The attorney allows that in April of 1964 voters here passed an ordinance that called for a supplementing Davis’ water supple (sic) with fluoride (sic) and that in November of the same year they defeated a proposition that would have repealed any ordinances that provided for fluoride.”
It does not appear that fluoridation was ever added, despite the close votes in its favor in 1964.
In contrast to 1960 and 1964, in 1971 the Davis Enterprise on January 11 reports, “Fluoridation of Davis water probably should be a decision for the city council and that body alone and not one to be handled by the initiative petition process,’ said the city attorney James Callaway, Jr., in a memo to council.
“There has always been considerable question in my mind – whether the initiative process is an appropriate one to direct an administrate task,” the city attorney told the council. “Other cities have done and of course we have done it in the past. However, my personal legal opinion is that it is inappropriate.”
On November 23, 1970, petitions on both sides of the issue were presented to council but those did not take the form of any legal petititon.
Meanwhile, the council the next day “left no doubt… that it will decide whether Davis water should be fluoridated but remaining in the wake of over an hour of sometimes stormy debate were strong indications that such a system – because of its high cost – is years away from installation here.”
The Enterprise reports:
“The initial cost is prohibitive,” observed mayor Vigfus Asmundson, who voted against plugging the system into the budget. “I’m not ready to support it at this cost to the community.”
Even councilman Norman Woodbury, who moved approval, had his doubts. “Cost appears to be one of the major items we face,” he said.
Councilman Maynard Skinner, who also favored trying to wedge the system into the budget, remarked the “city’s dwindling reserves could not stand the cost.”
The vote appears to have been 3-2 in favor of fluoridation, with Councilmember Ralph Aronson joining Mr. Skinner and Mr. Woodbury, and Mayor Asmundson and Councilmember Harry Miller dissenting.
The Enterprise reported, “Professor Harold S. Olcott, of UCD’s department of food sciences, was the sole out-and-out proponent of water fluoridation here. He was partially joined by Henry A. Rolewicz, a local dentist, who favored use of fluoride as a tooth decay preventative but opposed placing the chemical in the city water.”
“Olcott, citing several studies which he said found fluoridation a strong tooth decay preventative, stated that fluoridation is ‘the only reasonable thing for the children of Davis.’ He said he had come across no research that proved the chemical toxic to the body.”
On the other hand, Hubert Arnold, a professor of math at UC Davis, “cited numerous cases of studies that he said said either indicated flourides were potentially harmful or that drew erroneous conclusions.”
A statistics instructor, Professor Arnold pointed to what he called the use of faulty math “in its conclusion that most fluoride passes through the body and thus is harmless.”
He said, “Elementary statistics are enough to tell you that this is not the way to conduct an experiment.”
Councilmember Miller used an argument that some opponents of fluoridation have used today when he stated, “What troubles me the most is the ethics of forcing everyone to accept fluoridation of city water. The voters have indicated there is a large number of residents here against it.”
Given this contentious history in Davis, it is remarkable that forty years plus later, we are still revisiting this issue and using many of the same arguments, despite the fact that most of the rest of the nation has fluoridated water and has had it for some time.
—David M. Greenwald reporting
“Olcott, citing several studies which he said found fluoridation a strong tooth decay preventative, stated that fluoridation is ‘the only reasonable thing for the children of Davis.’ He said he had come across no research that proved the chemical toxic to the body.”
These observations have changed a bit over time. Today, I think a more reasonable statement would be :
1) fluoridation is the only reasonable option for those children of Davis who do not have ready access to healthy food, good dental hygiene, and
Preventive dentistry. To his credit, Alan Pryor has proposed using the money that would be spent on fluoridation on dental care for these
children. This however ignores the facts that this allocation of funds would likely not pass to begin with, would be unlikely to be sustained, and
does not address the stated lack of enough Communicare dentists to meet the need.
2) The second statement would more accurately read : there is no research that proves fluoride to be toxic with the exception of fluorosis.
Despite 60 + years of population exposure, there are no studies demonstrating human neurotoxicity, carcinogenic potential, or skeletal
fluorosis at the proposed quantity. There is no proof that fluoride serves as an endocrine disruptor of clinical significance.
Yet these myths are still being circulated by the opponents as though they had scientific merit.
I can and do respect the opinions of those who state that they oppose this for ethical or moral reasons while heartily disagreeing with the values that lead them to this conclusion. What I do not respect are the statements of those who choose to use pseudoscience, or selectively quote studies to “prove” their preconceived belief without any consideration of the validity, limitations, or applicability of those studies to our situation.
I thought this side comment interesting in Lofland’s blog referencing the 1960 fluoridation vote: ‘Also about Davis in 1960, in the words of the Enterprise: “Davis vote favors Nixon for president as county goes for Kennedy.”’
Apparently a comment made to take the political temperature of Davis relative to national politics at the time
.
off topic post, should be removed
Actually it’s not, both Professor Lofland and I referenced it in the article in part to show how while the community has shifted politically, this remains a contentious issue.
[quote]…. there is no research that proves fluoride to be toxic with the exception of fluorosis.
Despite 60 + years of population exposure, there are no studies demonstrating human neurotoxicity, carcinogenic potential, or skeletal
fluorosis at the proposed quantity. There is no proof that fluoride serves as an endocrine disruptor of clinical significance. [/quote]
[b]Incredibly, fluoride promoters are saying that the absence of study is the same as the absence of harm.[/b] An aspect of the inadequate scientific approach to fluoridation is how poorly potential health effects have been investigated and how poorly fluoride exposure has been monitored. Fluoride promoters like to state, “If there was any problem, we would have seen it by now. It’s been going on for 60 years.” [i][b][u]This is anecdotal, not scientific evidence.[/u][/b][/i] Ingested fluoride causes dental fluorosis by altering the biochemistry of growing teeth. It is logical that fluoride affects other cells by a similar mechanism. Damage to other tissues may be less visible and less obvious, but possibly far more dangerous. It requires careful study to see other effects. The only way fluoridating countries have been able to deny adverse health effects is by not conducting relevant studies. Fluoridation is a giant experiment, but those conducting the experiment are not even collecting the data. The government does not track potential harm from fluoridation, basic health studies in fluoridated communities are not performed, and there is no effort to monitor exposure. There has been no systematic collection of measurements of fluoride levels in the urine, blood, or bones of people living in communities with fluoridated water. Since 1950, when aggressive fluoride promotion began, no rigorous scientific studies have established safety or effectiveness. What we have instead from state and federal government and local health agencies is out and out promotion of fluoride, which has involved downplaying and ignoring health effects.
There’s a blind trust on the part of fluoride promoters that while drinking fluoridated water can damage growing tooth cells resulting in fluorosis, fluoride couldn’t possibly damage any other tissue in a child’s developing body or cause any damage whatsoever to adults after a lifetime of exposure to uncontrolled doses. Ingested fluoride causes dental fluorosis by altering the biochemistry of growing teeth. But fluoride promoters claim that this is merely [i]cosmetic[/i] and of no consequence. Suggesting that this is merely cosmetic is as irrational as saying that the blue-black line which appears on the gums due to chronic lead poisoning is also of no significance and is merely cosmetic.
There is ample scientific evidence that fluoride is harmful, and it is mind-boggling that fluoride proponents say with a straight face that there is not. Fluoridealert.org has compiled a comprehensive catalog of fluoride research, including detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity. [url]http://www.fluoridealert.org/researchers/health_database/[/url] This is a gold mine of information for anyone interested in the science
[quote]What I do not respect are the statements of those who choose to use pseudoscience, or selectively quote studies to “prove” their preconceived belief without any consideration of the validity, limitations, or applicability of those studies to our situation[/quote]
Medwoman claims that all science that calls into question the toxicity or efficacy of fluoride is “pseudoscience” but that all of the questionable and sometimes outright dishonest and fraudulent studies proving the efficacy of fluoride in reducing cavities is “good science”
Questioning the scientific integrity of those who oppose their view is an old tactic refined to perfection by the proponents of fluoridation over decades. As medwoman so has adequately demonstrated in her opines in the Vanguard on fluoridation, it is much easier to label studies questioning the merits and risks of fluoridation as “pseudoscience” rather than offering up your own proof that fluoridation works and is safe.
Actually, medwoman is being kind compared to Dr. Wilkes characterizations of opponents of fluoridation as “alarmists and suggestion of conspiracy theorists” in his recent editorial to the Vanguard entitled “Health Council’s Support for Fluoridated Water” on May 10.
I think the reason proponents have to resort to such name-calling is because their factual case supporting fluoridation is so flimsy and getting weaker every year. This is apparent when one looks at how the different opposing sides presented their arguments to the WAC. In the case of the fluoridation proponents at the April 25 meeting, they had a slew of public health workers who essentially stand up and say “Trust us, we’re (insert profession here – doctors, dentists, nurses, etc). Don’t’ you think we would know if there is a problem or if it didn’t work by now” without offering up a shred of evidence supporting their case.
In fact, as amply shown by Dr Terri Leonard in her letter to WAC members which was published in the Vanguard on May 20, Dr. Lyman completely misstated that all Europeans “ingest” fluoride orally in water, salt, or milk when he attempted to justify the fact that many European countries have lower rates of decay that in the US. In fact, Dr. Lyman was flat out wrong and the only question was whether he knew it or not. Dr. Leonard clearly and factually demonstrated that many European countries have much lower rates of decay and do not ingest any fluoride in salt, milk, or water, or any other public means of ingestion. Well, I can not accuse Dr. Lyman of using pseudoscience here, though, because he is simple making stuff up with out even any shred of pseudoscientific objectivity.
In contrast, at the May WAC meeting when I presented the case against fluoridation, I referenced many peer-reviewed studies published by the government or dental/public health journals that soundly rebuked the so-called science supporting water fluoridation. Vanguard readers can view my presentation to the WAC in its entirety by going to the City website (www.cityofdavis.org/media) where they can view my PowerPoint to the Mat 23, 2013 WAC meeting. Or they can access all of the materials and all of the sources I used to support my arguments on the Water Advisory Committee’s agenda webpage at http://city-council.cityofdavis.org/Media/CityCouncil/Documents/PDF/CityCouncil/Water-Advisory-Committee/Agendas/20130523/Item-5-Staff-Report-Meeting-Presentation-Outline-and-Items-Submitted-by-Presenters.pdf.
Fortunately, this pattern of name-calling by pro-fluoridationalists to question the integrity and expertise and motivations of the anti-fluoridationalists is now being widely recognized by the American public as evidenced by the recent “No” votes on fluoridation by progressive cities such as Napa, and Albuquerque. Indeed, only last week, the residents of Portland OR crushed a pro-fluoridation measure on their ballot by a 61% No to 39% Yes margin.
What should be done instead – Provide access to dental health care services by low income and disadvantaged people – mostly those of color. This could be easily done by eliminating the stranglehold by dentists on allowing dental hygienists to practice in the community without the dentists taking their cut of the pie. And perhaps more than 4 general practicing dentists in the whole county should accept new Denti-Cal patients instead of foisting them off on CommuniCare because the State of California will not pay them more money. This isn’t pseudoscience…it is just common sense.
It is easy to accept the studies you have come to believe and label the others “pseudoscience” even when those other studies cause most European countries and Japan to not fluoridate water and has the 1500 member US EPA scientists/professionals’ union voting unanimously to oppose water fluoridation despite their management’s decision to allow it. It is easy to make ad hominin arguments (support fluoridation because John Birchers first opposed it; support smoking because Nazi Germany led the first anti-smoking campaign). It’s easy to assume everything “naturally occurring” is safe (arsenic, for example).
It also seems easy to confuse lack of statistical significance with certain lack of effect. When a study finds there is “no significant effect” it means the authors are not at least 95% confident that any results they are seeing is not the luck of the draw in choosing experiment participants or is not the effect of unmeasured causes (like other toxicants). Maybe there is no effect or maybe the sample size is too small to tease out the effect. Maybe odds are in favor of an effect but not 20 to 1 in favor of it. It is notoriously hard to prove the effect of one toxicant in the environment dispersed among many – this is why you have plenty of mesothelioma lawsuits (based on visible asbestos exposure) and few other lung cancer lawsuits.
When individual samples are too small to show effects with 95% confidence, researchers may do meta-analyses, where they essentially combine the study samples into one supersample, after eliminating studies of dubious procedure. A 2012 Harvard meta-analysis did that and found that fluoride-contaminated water was statistically significantly associated with lower IQ. The average effect was size was small but the researchers wrote that with neurotoxins, small average effects tended to indicate a large effect on some populations (those of lowest and highest IQ) averaged with little or no effect on the rest. Their study addressed populations with fluoride at higher levels than the current EPA requirement, which leaves us hope – but not evidence – smaller dosages would be ok for drinkers of average amounts of tap water per pound of body weight.
Countering that hope, a 2011 study excluded from the Harvard meta-analysis because of low doses, found 331 children exposed to varying low levels of fluoride experienced a an average 0.6 point drop in IQ for each increase in 1 mg/L of urine fluoride (with 98.8 percent confidence the effect was real). http://www.ncbi.nlm.nih.gov/pubmed/21237562) To put this magnitude in context, Medical Therapeutics by G. S. Sainini, says “a range of 1.2-10 mg/24h is indicative of endemic fluorosi” so in the range of fluorosis listed, the expected average IQ differential is 15 IQ points.
Meanwhile, a 2012 study shows that children with more fluorosis are needing to produce more Thyroid Stimulating Hormone (TSH) to obtain the same levels of thyroid hormones, which could foreshadow thyroid problems. Thyroid illness is growing in the general population, and fluorisis is endemic and growing in the U.S., so common usage of fluoride does not prove it is safe for the thyroid. (Fluoride can take the place of the thyroid nutrient iodide.)
While true believers keep arguing the science is complete and fluoride is known to be safe, the National Research Council argued differently in 2006. As the working arm of the National Academy of Science, National Academy of Engineering, and Institute of Medicine, it called for further study because “it is apparent that fluorides have the ability to interfere with the functions of the brain” and suggested studying “ neurochemical changes that may be associated with dementia” with attention to chronic and “late-in-life” effects and “individual susceptibility.”
While we await proof or very high statistical likelihood that low dose systemic fluoride is safe and useful, let us spend the fluoridation money on dental care and supplies for populations at need, as Alan Pryor proposed.
Obviously in some places putting fluoride in the water is and has been very controversial. Good evidence of this is the recent vote of Portland citizens, who once again last week overwhelmingly voted down a proposal to fluoridate their water. Thus, regardless of the competing scientific, social, economic, and moral/ethical positions different persons take on the issue, the question should go to a vote of the people and not be decided by five members of the council or an advisory board. This is exactly what happened in Portland and it raised the ire of the voters, who then voted again the proposal. It never hurts to vote in a democracy on issues near and dear to the hearts and minds of the people.
Alan
[quote]Medwoman claims that all science that calls into question the toxicity or efficacy of fluoride is “pseudoscience” but that all of the questionable and sometimes outright dishonest and fraudulent studies proving the efficacy of fluoride in reducing cavities is “good science”
[/quote]
No Alan, I have never claimed that “all science that calls into question the toxicity or efficacy of fluoride is ‘pseudoscience'”. Nor have I ever made the claim that “all of the …..studies proving the efficacy of fluoride in reducing cavities is “good science”, I have claimed that much of what has been cited by the opposition is or is so selectively quoted as to completely alter the claims and reservations of their work as cited by the authors themselves especially with regard to the total disregard of the dosing issue in the Harvard meta analysis.
I do not believe that I have been “kind”, I believe that what I have been is fair.
What is demonstrated is that the only proven human adverse affect is fluorosis. As you have stated yourself here in the Vanguard is that all other adverse effects are at most “associations”. Which when worded differently is speculation about whether ( or not) fluoride might ( or might not) play a role in a given deleterious effect.
All of the other proposals for what fluoride might do are just that, proposals. Some are based on evidence of physical accumulation in the body, such as bone cancer or presence in neurons. The problem is that the presence of fluoride does not equate to the deleterious effect of fluoride as demonstrated in the very elegant study by Kim et al “An Assessment of Bone Fluoride in Osteosarcoma” in which actual tissue taken from bone affected by osteosarcoma and disease free bone from the same individual did not show a difference in the amount of fluoride in the samples.
Further illustrations of the lack of actual scientific evidence for the human toxicity are found in quotes from the opponents themselves and in articles from the Fluoride Action Network. Some examples:
1)” It is notoriously hard to prove the effect of one toxicant in the environment dispersed among many – this is why you have plenty of mesothelioma lawsuits (based on visible asbestos exposure) and few other lung cancer lawsuits.” I agree. So why would one make the assertion that a specific is a known toxicant when this has not been demonstrated ? Some of the opponents are claiming association, others are claiming they “know” what has never been demonstrated.
2) “Meanwhile, a 2012 study shows that children with more fluorosis are needing to produce more Thyroid Stimulating Hormone (TSH) to obtain the same levels of thyroid hormones, which could foreshadow thyroid problems. ” This is a typical comment. Note which [u]could[/u] ( or might not) foreshadow thyroid problems.
This is the hallmark of the opponents scientific evidence. Fluoride might affect this system, or may have a deleterious effect on that system often ignoring evidence to the contrary and other potentially beneficial effects.
For example, no where in the opponents comments about Europeans wisely avoiding fluoridation of the water supply have I seen any recognition that many in many European countries the fluoride patch is available for
prevention of osteoporosis but has not been accepted by the FDA because of efficacy and safety concerns totally going against their claim that the FDA is heedless about the effects of fluoride.
tleonard
[quote]There is ample scientific evidence that fluoride is harmful, and it is mind-boggling that fluoride proponents say with a straight face that there is not. Fluoridealert.org has compiled a comprehensive catalog of fluoride research, including detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity. http://www.fluoridealert.org/r…_database/ This is a gold mine of information for anyone interested in the science[/quote]
I did exactly what you suggested that I do. I read the articles found on this site. What I found is that there is ample suggestion that fluoride might be harmful and precious little evidence that it is. As a matter of fact some of the evidence found on the data base is highly suggestive that water fluoridation at the proposed level is in fact safe or even beneficial.
1) From the much quoted Harvad meta analysis at least 1/2 the studies used 0.7 ppm of fluoride in the water
as their reference range, namely that associated with higher IQs. Is this an argument for fluoridation of our
water ? Of course not, but it is a strong suggestion that doing so would be safe from the point of view of IQ.
2) Another article listed on the FAN site which I found quite interesting was by Bhatnager et al publishing in
Molecular Cell Biochemistry. These authors were seeking a treatment protocol for fluoride toxicosis which
apparently occurs ( or is believed to occur) in areas where there is very high concentrations of fluoride
naturally occurring in the water. Their treatment protocol included the use of antioxidants as is common.
However, more pertinent to the current discussion is that they also recommended the “provision of safe
drinking water” defined by the authors as containing less than 1ppm of fluoride. Dose matters as
demonstrated by these authors who are suggesting that the level of fluoride we are recommending could
be used as part of a treatment regimen for fluoride toxicosis.
It is very important when analyzing the literature to consider all of the points made by authors including validity, confounding factors, applicability to diverse situations and strength of the evidence. Unfortunately, although neither side has a monopoly on ignoring that which does not support their point, it would seem to me that the bulk of the speculation and reliance on association lies on the side of the opposition.
I am well aware that there are differences of opinion on this. I speak only for myself.
medwoman…
You say [quote]I did exactly what you suggested that I do. I read the articles found on this site[/quote]
I seriously doubt your statement. There are hundreds of articles referenced in the fluoridealert.org bibliography [url]http://www.fluoridealert.org/researchers/fan-bibliography/authors01/[/url] I am certain that you have not read all of them. There were 500 new studies added in 2012 alone.
You also stated [quote]As a matter of fact some of the evidence found on the data base is highly suggestive that water fluoridation at the proposed level is in fact safe or even beneficial.
1) From the much quoted Harvad meta analysis at least 1/2 the studies used 0.7 ppm of fluoride in the water
as their reference range, namely that associated with higher IQs. Is this an argument for fluoridation of our
water ? Of course not, but it is a strong suggestion that doing so would be safe from the point of view of IQ. [/quote]
In response, I will quote from the debate you and I already engaged in on the comments section of another Vanguard article [url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7277:would-a-vote-on-fluoridation-accomplish-anything&catid=60:water&Itemid=92&cpage=60[/url]
[quote]You go so far as to say that the Harvard meta-analysis
“supports the lack of demonstrable harm in the groups of children supposedly consuming 0.7 ppm or less daily.”
You ignore the fact that one of the studies showed decreased IQ at a water fluoride level of .88 ppm, 6 of the studies showed decreased IQ at levels of 1-2 ppm, and 10 of the studies showed decreased IQ at fluoride levels of 2-4 ppm. In conventional risk assessment, the U.S. EPA uses a default margin of safety of ten. This means the EPA seeks to limit exposure to chemicals to levels that are ten times less than the levels that cause adverse effects. Margin of safety is a deeply rooted cornerstone in all modern risk assessments, yet you act as if you don’t even know the concept exists. [/quote]
The 2006 National Research Council report was the first U.S. report to look at low-level fluoride toxicity in a balanced way. The report concluded that the maximum contaminant level goal (MCLG) of 4 ppm in drinking water was too high and should be reduced. Since 4 ppm is too high (by an unspecified amount) to be acceptable as a contaminant, it is not sensible to deliberately add fluoride to our drinking water to bring the level of fluoride in our water up to .7 ppm. That implies a margin of safety of less than 5.7 times, and possibly much less, which is absurdly low by toxicological standards. Acceptance of such a small margin of safety indicates a disregard for public health.
Fifty percent of the daily intake of fluoride is absorbed by and accumulates in bone. An important study from China (Li et al.,2001) indicates practically no margin of safety sufficient to protect a whole population with a lifelong consumption of water at 1 ppm from hip fracture.
More information concerning the Portland vote against fluoridation can be found at:
http://d3n8a8pro7vhmx.cloudfront.net/cleanwaterportland/pages/14/attachments/original/1369241854/FOR_IMMEDIATE_RELEASE-Portland_OR_votes_to_reject_water_fluoridation_v9am.pdf?1369241854
To medwoman re:
[quote]All of the other proposals for what fluoride might do are just that, proposals.[/quote]
You are incorrect in saying that fluorosis is the only proven side-effect of fluoridation. Hypersensitivities are well established including the side-effects and reactions occurring in gravid women and in children of all ages including the dermatologic, gastrointestinal and neurological systems. Eczema, atopic dermatitis, urticaria, epigastric distress, emesis, and headache were all observed and disappeared when fluoride exposure was removed.
See Feltmnn, R. and Kosel, G., Prenatal and Postnatal Ingestion of Fluorides — Fourteen Years of Investigation — Final Report, Journal of Dental Medicine, 16:190, October 1961.
Further, the main proposal on which the entire case of fluoridation is based – that being it reduces caries rates – is far from proven and amounts to nothing more than speculation based on the largest meta-studies.
tleonard
[quote]I seriously doubt your statement. There are hundreds of articles referenced in the fluoridealert.org bibliography http://www.fluoridealert.org/r…authors01/ I am certain that you have not read all of them. There were 500 new studies added in 2012 alone.
[/quote]
You are correct. I have not read them all. I have only read those relevant to the positions I was taking. There is much about this topic that I have not read, just as I am sure that you have not read 60 years worth of research in peer reviewed journals either supporting or debunking your claims. I apologize if anyone was misled by my lack of clarity.
Alan
[quote]You are incorrect in saying that fluorosis is the only proven side-effect of fluoridation. Hypersensitivities are well established including the side-effects and reactions occurring in gravid women and in children of all ages including the dermatologic, gastrointestinal and neurological systems. Eczema, atopic dermatitis, urticaria, epigastric distress, emesis, and headache were all observed and disappeared when fluoride exposure was removed.
[/quote]
This is suggestive evidence, but hardly proof. In order to demonstrate conclusively that hypersensitivity is due to a given substance, one needs additional evidence besides the alleviation of the symptom when a substance is removed. One does not know the symptom would not have resolved on its own even in the continued presence of the proposed toxicant. The way to truly make this determination is to re challenge with the same substance to see if the identical symptoms recur. To the best of my knowledge, this has not been done. Are you aware of articles to the contrary ? As always, just because I have not found them does not mean they do not exist and I am open to reading anything you suggest.
Many people falsely attribute rashes and many other symptoms that they encounter in close temporal proximity to antibiotic ingestion to the antibiotic. In the case of a true allergy or hypersensitivity, this same reaction would occur
with repeat ingestion which is frequently not the case.
Also, if fluoride is responsible for hypersensitivity reactions, we should see higher incidences of these reactions stratified by quantity of fluoride in water supplies. I have found no evidence that this is the case. If you have,
please send me the references.
I doubt that the Davis City Council will be looking forward to voting up or down on the fluoride issue in the near future. The pending campaigns between Councilmen Krovoza and Wolk could be revealing on this issue though.
you really think people are going to decide who to vote for in the assembly race based on such a parochial and peripheral issue?
Medwoman, you state
[quote]Also, if fluoride is responsible for hypersensitivity reactions, we should see higher incidences of these reactions stratified by quantity of fluoride in water supplies. I have found no evidence that this is the case. If you have,
please send me the references. [/quote]
Please see my comment above at 11:41 AM. I will repeat it here [quote][u][b]Incredibly, fluoride promoters are saying that the absence of study is the same as the absence of harm. An aspect of the inadequate scientific approach to fluoridation is how poorly potential health effects have been investigated and how poorly fluoride exposure has been monitored.[/b][/u] [u][b]Fluoride promoters like to state, “If there was any problem, we would have seen it by now. It’s been going on for 60 years.”[/b][/u] [u][b]This is anecdotal, not scientific evidence.[/b][/u] Ingested fluoride causes dental fluorosis by altering the biochemistry of growing teeth. It is logical that fluoride affects other cells by a similar mechanism. Damage to other tissues may be less visible and less obvious, but possibly far more dangerous. [u][b]It requires careful study to see other effects. The only way fluoridating countries have been able to deny adverse health effects is by not conducting relevant studies. Fluoridation is a giant experiment, but those conducting the experiment are not even collecting the data. The government does not track potential harm from fluoridation, basic health studies in fluoridated communities are not performed, and there is no effort to monitor exposure. There has been no systematic collection of measurements of fluoride levels in the urine, blood, or bones of people living in communities with fluoridated water. Since 1950, when aggressive fluoride promotion began, no rigorous scientific studies have established safety or effectiveness. What we have instead from state and federal government and local health agencies is out and out promotion of fluoride, which has involved downplaying and ignoring health effects.[/b][/u]
To medwoman re:
[quote]This is suggestive evidence, but hardly proof. In order to demonstrate conclusively that hypersensitivity is due to a given substance, one needs additional evidence besides the alleviation of the symptom when a substance is removed. One does not know the symptom would not have resolved on its own even in the continued presence of the proposed toxicant. The way to truly make this determination is to re challenge with the same substance to see if the identical symptoms recur.[/quote]
This is exactly what the study showed. All of the symptoms occurred with the use of fluoride and disappeared upon the use of placebo tablets, only to recur when the fluoride tablet was, unknowingly to the patient, given again.
This sounds like exactly what you are looking for to demonstrate proof.
Sorry Alan, I will go back and look at the study. I obviously misunderstood.
tleonard
[quote]Incredibly, fluoride promoters are saying that the absence of study is the same as the absence of harm. [/quote]
I certainly am not making this claim. Again, I speak only for myself.
Absence of study does not equate to absence of harm. And suggestion of potential harm likewise is not the same as proof of harm. Many of the opponents have stood up and stated unequivocally that fluoride is a neurotoxin.
This is simply not substantiated at the levels proposed within the measurement error of the item being studied as
Dr. Canning pointed out in his statistical analysis as presented before the WAC.
Lack of evidence of harm however is at least as suggestive of safety as is the suggestion of potential harm without
substantiating evidence. We can disagree on this, but many of the articles cited on your link either pose only the suggestion of potential harm, or have limitations many of which make them irrelevant to our situation.
Alan
I read the abstract of the Feltmann article and was unfortunately only able to access the abstract. When evaluating any article in which I have more than passing interest, I do not rely on a summary or abstract but want to see the methodology used and the authors statements of limitations of their own study, none of which was available to me.
As is pointed out the misuse of the Harvard meta analysis, it is very important to read the entire article, evaluate the methodology and carefully consider the authors own assessment of its limitations prior to making sweeping statements based only on their conclusion, a synopsis, or abstract.
While it may be that review of the entire article would resolve these issues for me, I have several concerns based on the abstract only.
1) The dosage amounts were higher than those one would encounter at our proposed level of fluoridation.
2) The abstract does not specify what if any covariates were controlled for.
3) The abstract does not make clear which specific symptoms each subject encountered and whether or not those
were the exact same symptoms that each subject experienced on repeat exposure. When so many adverse
consequences are being attributed to a substance, it is critical to ensure that it is exactly the same symptom
complex. I have had women in my clinic erroneously believe that they were allergic to a drug because they
believe it was related to a rash at one point, and nausea and vomiting at another point in time. This does not
support any kind of allergic or hypersensitivity reaction.
4) The abstract does not make any statement about timing of onset of symptoms after initial exposure nor about
duration of symptoms from discontinuance to resolution.
This is a common confounding factor in determining whether or not a substance is related to any given adverse
effect. Many people will erroneously attribute symptoms to a substance when the time line does not support that
conclusion. Unfortunately, once documented, either in a chart or study protocol, it tends to become accepted
as truth even if the substantiation is not there.
I have no interest in purchasing the article myself, but if you have the full article, I would appreciate you providing me with a copy. I would then be happy to tell you if it does meet the standard I would set for “proof”.
Medwoman,you oppose a precautionary principle, many of us support it. My view: before you add a chemical to the water supply you must demonstrate with a very high degree of probability that it is safe for the various population groups and the environment. Your view, I infer: before you forbid adding a chemical to the water supply you must “prove” it is unsafe.
Responding to your earlier comment: the fact that I carefully use words like “could” harm the thyroid does not mean thyroid harm can be dismissed without further study. Low-dose fluoride was used as medication for overactive thyroid in Europe and South America before better drugs came along. And unbalanced TSH levels at a young age are worrisome.
Offer each family dental care plus topical fluoride (toothpaste, mouthwash, dental applications) with instruction to rinse well. You may offer them oral fluoride (pills or salt) to choose or not based on their own preferences of risks vs. benefits given their own situations. People without good dental hygiene habits might favor the swallowed fluoride – if they are convinced oral fluoride helps, a decision I won’t make for them.
But a diabetic might choose no fluoride, for example, since as the National Research Council wrote in 2006, “The conclusion from the available studies is that sufficient fluoride exposure appears to bring about increases in blood glucose or impaired glucose tolerance in some individuals and to increase the severity of some types of diabetes … [at] serum or plasma fluoride concentrations of about 0.1 mg/L or greater… In addition, diabetic individuals will often have higher than normal water intake.”
medwoman…
[quote]Lack of evidence of harm however is at least as suggestive of safety as is the suggestion of potential harm without
substantiating evidence. We can disagree on this, but many of the articles cited on your link either pose only the suggestion of potential harm, or have limitations many of which make them irrelevant to our situation. [/quote]
I doubt that you have even begun to scratch the surface in your analysis of the hundreds of studies at [url]http://www.fluoridealert.org/researchers/health_database/[/url] and [url]http://www.fluoridealert.org/researchers/fan-bibliography/[/url]. There is indeed ample evidence of harm from fluoride. And no, the hundreds of citations at fluoridealert.org are not “irrelevant to our situation.”
The precautionary principle posits the notion that when there is reasonable doubt about safety, we should err on the side of caution, and not insist on absolute evidence of harm before eliminating or rejecting a substance or practice. If there is uncertainty, yet credible scientific evidence or concern of threats to health, precautionary measures should be taken . In other words, preventive action should be taken on early warnings, even though the nature and magnitude of the risk are not fully understood.
The precautionary principle puts fluoride promoters in a very awkward position, and causes them to make extreme statements that are difficult or impossible to defend. An example of this would be the statement you made regarding the Harvard meta-analysis that investigated the relationship between fluoride and IQ. The Harvard scientists who authored the peer-reviewed, published study stated [url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491930/[/url] “Although the studies were generally of insufficient quality, the consistency of their findings adds support to existing evidence of fluoride-associated cognitive deficits, and suggests that potential developmental neurotoxicity of fluoride should be a high research priority.” And, “In conclusion, our results support the possibility of adverse effects of fluoride exposures on children’s neurodevelopment.” You stated [url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7277:would-a-vote-on-fluoridation-accomplish-anything&catid=60:water&Itemid=92&cpage=60[/url] (emphasis mine)[quote]However, this meta analysis using poor quality studies [u][b]does nothing what so ever to suggest any harm[/b][/u]… [/quote] I took great exception to your statement that it does “nothing what so ever to suggest any harm.” However, fluoride promoters have to make such extreme statements, because to admit that any study does indeed suggest [i][u]any harm whatsoever[/u][/i] is to invite the demise of water fluoridation programs, since such programs are indefensible when there is [u][b]any[/b][/u] evidence of harm.
This is the reason that pro-fluoridation presenters made such extreme statements at the April Water Advisory Committee meeting. They expressed no reservations about the safety and effectiveness of water fluoridation; they issued no caveats and suggested no doubts. They said that there are absolutely no dangers and that there is [u][b]no debate[/b][/u] on the matter. Such extreme statements are important when fluoridation is being aggressively promoted. Promotion does not sit well with uncertainty. Neither does the precautionary principle.
There is ample scientific evidence of harm, and water fluoridation programs should be halted in accordance with the precautionary principle.
medwoman….
Here you go again, in your analysis of the Feltmann article.
[quote]1) The dosage amounts were higher than those one would encounter at our proposed level of fluoridation. [/quote]
Yet again, you make these statements that completely ignore the concept of “margin of safety.” I will say it to you again: [u][b]Margin of safety is a deeply rooted cornerstone in all modern risk assessments, yet you act as if you don’t even know the concept exists. [/b][/u]
It is not sensible to deliberately add fluoride to our drinking water to bring the level of fluoride in our water up to .7 ppm. That implies a margin of safety which is absurdly low by toxicological standards. Acceptance of such a small margin of safety indicates a cavalier disregard for public health.
Ms. Kandel notes that meta-analyses are often used to aggregate studies so that effect sizes can be pooled and possibly indicate a truer effect size. Unfortunately, when you have poor studies to begin with, no amount of meta-analyzing can make an effect appear out of thin air (or water, in this case). The study cited (usually called the Harvard study because the first author is from there) is a poor example of meta-analysis. The authors themselves admit right up front in the discussion that the studies they aggregated were of uneven and even poor quality. They make matters worse by suggesting that their results may be within the margin of error of the IQ tests used. These limitations doom any broad generalizations that can be made from this one study. And there have not been anymore attempts like this one. One could suppose that is because there is nothing there to measure. Opponents of fluoridation have used this weak evidence to suggest that there is an affect of fluoridation on IQ. The evidence simply does not stand. Reliance on one study (even though it aggregates 20+ others) does not prove the point. If it had been done here in the U.S. and compared non-fluoridated with fluoridated populations, that would be a different story.
Adrienne
[quote]Medwoman,you oppose a precautionary principle, many of us support it. [/quote]
I do not oppose a precautionary principle. Where we differ is that I believe that there is ample evidence of safety of fluoride at the proposed level and you apparently do not.
I am not opposed to more research. As a matter of fact, I strongly support more research regarding all of the potential benefits and risks associated with fluoride. I also am aware that there are limitations on the amount of dollars available for research and therefore feel that those precious research dollars should be spent where they will have the greatest impact. Therefore it makes a great deal of sense to me for countries such as China and Iran with their very high naturally occurring levels of fluoride in the water to spend money on this kind of research. As Choi
et al have pointed out, it makes little sense to do these kinds of studies in countries where the level rarely exceeds 1 ppm. Likewise, I consider that the bone fluoride studies comparing fluoride levels in bone with osteosarcoma with bone free of osteosarcoma done by Chin et al to provide enough reassurance that this does not need to be revisited. As I stated at the WAC, there is no substantive evidence that fluoride at the proposed level is a fetal neurotoxin. I have asked Alan for primary sources as regards hypersensitivity and so far have only a single abstract.
I have not reviewed the primary, peer reviewed literature with regard to endocrine function and thus have not chosen to speak to this issue. I have only consulted with my Internal Medicine colleagues three of whom did not feel there was evidence of concern, however, they are not endocrinologists. My intent is to consult with my endocrine specialist colleagues. If you are aware of any such articles, you could save me a lot of time by sending me the references.
rdcanning…
[quote]And there have not been anymore attempts like this one. One could suppose that is because there is nothing there to measure. [/quote]
Oh come on. Four more studies found an association between fluoride and reduced IQ in 2012 [url]http://www.fluoridealert.org/studies/brain01/[/url]
From fluoridealert.org [url]http://www.fluoridealert.org/issues/health/brain/[/url]
[quote]Fluoride’s ability to damage the brain is one of the most active areas of fluoride research today. In the past three decades, over 100 studies have found that fluoride exposure can damage the brain. This research includes:
Over 40 animal studies showing that prolonged exposure to varying levels of fluoride can damage the brain, particularly when coupled with an iodine deficiency, or aluminum excess;
37 human studies linking moderately high fluoride exposures with reduced intelligence;
19 animal studies reporting that mice or rats ingesting fluoride have an impaired capacity to learn and remember;
12 studies (7 human, 5 animal) linking fluoride with neurobehavioral deficits (e.g., impaired visual-spatial organization);
3 human studies linking fluoride exposure with impaired fetal brain development.
[/quote]
tleonard
[quote]They expressed no reservations about the safety and effectiveness of water fluoridation; they issued no caveats and suggested no doubts. They said that there are absolutely no dangers and that there is no debate on the matter[/quote]
This is simply not a true statement. Perhaps you were not there at the presentation of the proponents of fluoridation when I made my first 3 minute statement. At the start of the current debate, I made very clear that I had started out neutral on this subject. I explicitly stated that I felt that a fair hearing of all concerns was important and should be addressed. I have read with a great deal of care those articles that the opponents have specifically suggested to me as well as a large number of articles from peer reviewed journals not suggested to me by either side. Both of my presentations have addressed doubts and why I do not think that the one’s I addressed were of concern. I have also been careful to state why, when I do not feel there is a lingering concern about an issue that has been raised. Perhaps you were not hearing the repeated comment that there is universal agreement that
excess amounts of fluoride are associated with fluorosis.
It is true that I have not addressed every point that you have raised, just as you have not addressed all that I have raised, or even at any point conceded that any of my points might have some validity. Perhaps you, like I, do not see a need to address every point and choose to remain within the limits of our own knowledge. I thoroughly respect that position and will not make a statement if I can not substantiate it myself or with a credible consultant who I consider an expert in the field.
Medwoman….
I said [quote]This is the reason that pro-fluoridation presenters made such extreme statements at the April Water Advisory Committee meeting. They expressed no reservations about the safety and effectiveness of water fluoridation; they issued no caveats and suggested no doubts. They said that there are absolutely no dangers and that there is no debate on the matter. [/quote]
My statement is absolutely true. Your statement can be viewed here [url]http://archive.cityofdavis.org/media/[/url]. Your statement starts at 57 minutes 42 seconds. Note that you were not one of the pro-fluoride presenters. You were simply one of the public commenters. I was specifically talking about the pro-fluoride [u][b]presenters[/b][/u].
You are correct that presenters mentioned fluorosis. But perhaps you were not hearing that presenters who mentioned fluorosis also were exceedingly adament that fluorosis is only a [u][b]cosmetic[/b][/u] concern. They were wrong. Fluorosis is an indication of a systemic adverse effect on the body. It is the result of fluoride’s interference with growing tooth cells. What other developing tissues may have been affected while the tooth cells were being damaged? Of particular concern are the skeletal system, the brain, and the endocrine system, where damage could be happening without visible telltale signs. Fluoride promoters offer no evidence that other tissues have not been affected while dental fluorosis is occurring.
references, per medwoman’s request:
National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards, Chapter 7. 2006. They address the pineal gland and glucose tolerance.
Hosur (2012): Dental Fluorosis & Thyroid Hormones. http://www.ncbi.nlm.nih.gov/pubmed/22509122/ The good news here is all subjects but one had acceptable levels of all hormones. The concern warranting further study, as visible in their graph, is that TSH levels were positively associated with fluorosis, with 95.5 percent confidence. I would like to see a follow up study with varied and recorded lengths of time of exposure to fluoridated water to see if people with a lifetime of exposure get more thyroid illness as they age.
Dose-response IQ study: http://www.ncbi.nlm.nih.gov/pubmed/21237562
Adrienne
Thank you for the references. I appreciate your addressing the issue in an evidence based manner.
I do have some comments about the articles you have cited.
First with regard to the Hosur article.
There are a number of issues here that do not make the article either of major concern, nor a source of major reassurance. First the number of subjects is very small. There is no statement of potential confounders, either genetic, familial or environmental. We do not know whether or not these individuals were taking any other medications or substances that could affect endocrine function, nor are we apprised of any other medical conditions that they may have had. There is no statistical analysis provided. There is no statement supporting that there is any clinical significance between the measured levels of any of the three hormones. There is no statement of the authors assessment of the limitations of their study. I agree that there is room for further study.
With regard to the dose -response IQ study, I would need the help of my consultant psychologist to arrive at any realistic appraisal of this article. However, my initial concerns are much the same as those I have stated that I feel apply to any abstract when presented alone. It does not allow for a critical review of the methodology which is very important in deciding the validity of the study.