My Oral Submission to the Health Select Committee on the Health (Fluoridation of Drinking Water) Amendment Bill. If passed, this bill would introduce mandatory water fluoridation throughout New Zealand. At present, decisions are on the local level and only 27 out of 67 local councils fluoridate their water. With the current ban in most of western Europe against water fluoridation, the current trend is for local authorities to remove fluoride from their water.
Only 11 countries in the world have more than 50% of their population drinking fluoridated water: Australia, Brunei, Chile, Guyana, Hong Kong, the Irish Republic, Israel, Malaysia, Singapore, the United States and New Zealand
I speak in opposition to this bill.
I am a retired Child and Adolescent Psychiatrist certified by the American Board of Psychiatry and Neurology. I have 33 years clinical experience post-training – eight of them for the New Zealand Health Service. I have a subspecialty in child development.
Before moving to New Zealand in 2002, I was also on the clinical faculty at the University of Washington Medical School for over 15 years. As part of this role, I was expected to keep abreast of the medical literature and to demonstrate an ability to apprise scientific studies for their reliability and validity. This was not only in the field of psychiatry, but in the field of genetics, metabolism, neurobiolgy and endocrinology – owing to their major impact on psychological functioning.
The Scandal in US Public Health Research
Based on this background, I wish to alert the select committee to the current scandal in the US in the area of public health research. The scandal largely relates to flawed nutrition research resulting in decades of recommendations by the public health community for people to eat low fat, low salt, high carbohydrate diets. The tragic effect of these recommendations – without a shred of valid or reliable research evidence – is a global epidemic of obesity, diabetes, heart disease and tooth decay.
Much of the research supporting water fluoridation is of a similar vein. The studies typically have a very small effect size, lack vital design features that eliminate observer bias and confuse statistical association with causality. There isn’t a single double blind randomly controlled trial showing that water fluoridation is either safe or effective in preventing tooth decay. Likewise there are no observational studies – where populations are followed over 20-30 years to ascertain the long term effect of drinking fluoridated water.
Fluoride is a Neurodevelopmental Toxin Like Lead and Mercury
In contrast, there are extensive studies suggesting that fluoride – even in the low doses used in water fluoridation is a neurodevelopmental toxin – ie that it has toxic effects on the fetus and in young children as their brains are developing. A 2014 peer-reviewed article about the pandemic of neurodevelopmental toxicity in The Lancet, one of the world’s preeminent medical journals specifically lists fluoride as as one of 12 common neurodevelopmental toxins – along with lead, mercury and PCBs. Fluoride has been identified as a potential neurotoxin largely on the basis of over 100 human studies and even more animal studies indicating that it causes cognitive damage and a range of long term behavioral and psychological problems through continuous exposure during pregnancy and early childhood.
One of the points emphasized in The Lancet is that substances that cause neurodevelopmental toxicity do so at very low doses – doses that are much, much smaller than the doses that cause acute poisoning. For many years the public health community reassured us that a low dose of lead and mercury poisoning caused no harm to human health – a position that has been reversed (after causing significant permanent disability for hundreds of thousands of children) after decades of careful research.
Now public health advocates are trying to convince us that low doses of fluoride are perfectly safe and based on past history I think the public has good reason to be skeptical.
No Research Evidence on Maximum Safe Dose
The problem with this approach – and the main argument that has caused all western European countries except Britain and Ireland to ban water fluoridation – is that there has been absolutely no research to determine what the maximum safe fluoride dose is, especially in vulnerable populations, such as those with kidney failure or infants whose ONLY food intake is formula prepared with fluoridated water.
All existing research focuses on the concentration of fluoride in drinking water, with recommendations ranging between 0.7 to 1.0 parts per million. The problem with focusing on concentration is the daily dose individuals receives varies greatly depending on how much tap water they drink, whether they concentrate it via cooking and other sources of fluoride in the diet. Tea is a major source of fluoride and Kiwis are great tea drinkers – which means they consume substantial additional fluoride in this way.
The prevailing sentiment in Europe is that when governments claim low doses of fluoride are safe, they have an absolute obligation to produce research evidence demonstrating the dosage at which daily exposure becomes unsafe before they force an entire population to consume it daily in their tap water.
This is also the main argument that persuaded New Plymouth District Council to remove the fluoride from our water in 2011 – like hundreds of local authorities in other English speaking countries that still fluoridate water. The New Zealand government most definitely has the same obligation to the New Zealand people.
photo credit: tankgirlrs Florine[F]9 via photopin (license)