FAN Bulletin 1045

Feb 12, 2009

Below we continue with our series on statements form some of the professionals, and others, sent to the South Central Strategic Health Authority board which is considering whether to fluoridate Southampton (UK) and surrounding communities. Their decision is to be made public on Feb 26.

But first, some sad news. Professor J. B. Neilands from Berkeley, California, who signed that Professionals’ Statement calling for an end to water fluoridation, has recently passed away (obituary at http://mcb.berkeley.edu/news-and-events/research-news/professor-emeritus-joe-neilands-has-died).

For those who admired the work of Joe Neilands, on so many fronts, please send a little note to Juanita his wife of 50 years at  .

Paul Connett

Statement from Dr. Iain J. Robbé, public health physician, UK

Dear Mr Howell,

My name is Dr Iain J Robbé and I am writing in a personal capacity to you from Wales in the hope that you will reject the proposal coming before the South Central Strategic Health Authority on February 26th 2009 to fluoridate central Southampton and some adjacent areas.

I am a public health physician and one of more than 2100 professionals who, after studying the information contained in the National Research Council report “Fluoride in Drinking Water” (NRC, 2006) and other evidence, are calling for the rejection of plans to implement water fluoridation and for an end to fluoridation in those places where it currently occurs.

I believe that fluoridation is a high risk intervention with a weak ethical rationale hence I am appealing to your scientific integrity and the need to protect the public’s health. It seems that many people are watching the situation in Southampton and your decision will have wide repercussions.

I should be grateful if you could please acknowledge that you have received this letter.

Yours sincerely

Dr Iain J Robbé, BSc, MSc (PHM), MSc (MEd, distinction), MB, BS, MRCS, LRCP, FFPHM
Public Health Physician

Statement from Dr. John Beard, Cambridge, UK

Dear Martin Howell,
 
I am writing to you as a concerned retired scientist to congratulate you and to thank you if you are disinclined to support the current proposal before the Strategic Health  Authority to fluoridate the water supply in the Southampton area - the  decision on which I understand will be made public on February  26.
 
If on the other hand you are presently inclined to support the proposal then I would strongly urge you to reconsider.  I must declare an interest in that my son lives and works in Southampton and, like most parents, I would do anything I possibly can to protect him from the  inherent dangers of such a course of action - however the effects of such an  action will adversely impact many thousands of others which is why I am a signatory to the Worldwide Professionals’ Statement calling for an End to Fluoridation wherever it occurs.
 
The issue here is quite simple.  As a microbiologist I spent many years working with pathogenic bacteria capable of causing severe and often fatal enteric fevers of one  kind or another - such as typhoid, paratyphoid, cholera, and dysentery, and saw at first hand the devastation they could cause.  There is no question that most of these terrible diseases have their origins in contaminated water supplies, and without pre-treatment of the water to bring it up to safe, drinkable standards our civilisation would have remained in the dark ages.  So ethically we should have no problems with the procedures involved.
 
However, using the water supply as a medium for mass-medication is an entirely different ethical problem - in fact it is completely unacceptable, whatever the substance, and whatever the scientific basis.  Mass-medication means there is no escape for small babies, elderly people, healthy adults, you, me and everyone in between. So the argument should stop there, without even considering whether fluoridation is beneficial to the majority or not.
 
If, despite that, you and/or any of your colleagues have logically moved on in their thinking to the point where they are actually basing their decision on whether or not fluoride is a good thing to add to the water supply then I have to point out that for over 50 years there has been no creditable scientific evidence gathered to support the idea…

Today it is extremely difficult, certainly in the UK, to purchase a non-fluoride toothpaste as you will know if you have ever tried, so the addition of fluoride to the water supply is not even necessary for those who wish to take advantage of its “benefits”.  So the argument again should stop right there for those who might wish to discount the ethical difficulties.
 
I desperately hope and trust that you will join with us in rejecting any move to mass-medicate the population, and I would thank you most profusely for doing  so.
 
Yours sincerely
 
Dr John  Beard
Cambridge,  UK

Statement from James Beck, MD, PhD, Professor Emeritus of Medical Biophysics, University of Calgary, Alberta, Canada.

Dear Mr. Howell:

I am a physician and scientist (M.D., Washington University School of Medicine, St. Louis, Missouri, USA; Ph.D., University of California, Berkeley, Department of Physics, degree in biophysics; Professor Emeritus of Medical Biophysics, University of Calgary, Alberta, Canada) who has studied the issues of fluoridation of public water supplies over the last eight years, emphasizing the study of primary scientific literature on efficacy of fluoridation as a preventative of dental caries and of the toxicities of hydrofluorosilicic acid and its derivatives on addition to water.

I understand that you are facing a decision on fluoridation. My studies lead me to believe that your decision is both critical and difficult. It is critical because fluoridation is a significant risk factor for the people subjected to it, especially infants and young children, young males, persons with kidney or thyroid disease, and older persons. It is difficult because there is such strong advocacy from individuals and organizations which generally fail to offer any substantial justification for it and because opponents are often unfairly dismissed simply because they are fewer than advocates.

I will not give you all the evidence I have uncovered on the issues of efficacy and toxicity as I understand that you have that from Dr. Paul Connett in his meticulous and responsible communications to you. Let me just say that the question of efficacy is relatively straightforward. There is no evidence that ingestion of hydrofluorosilicic acid in water is effective in preventing caries. There is clear evidence that it is not effective.

The matter of toxicity is more complex. Everything that Doctor Connett has told you on that is correct and well documented. Moreover simple precaution demands that even just substantial doubt of safety be sufficient to withhold fluoridation. But really there is no doubt in the cases of a number of toxic effects. And, of course, the lack of efficacy makes even the slightest possibility of harm enough to refuse or stop fluoridation.

A third problem with water fluoridation is the inappropriateness of the method of administration. The dosage for an individual is completely uncontrolled because the amount of water drunk in uncontrolled and because the age and size of the recipient is not known. And probably less than 2% of the fluoride in the water is actually ingested and the rest is smeared throughout the environment uncontrolled, even unrecognized.

Then there is the problem of ethicality. The modern standards of medical ethics requires that the recipient of a procedure or medication give informed consent. Informed consent requires individual consultation with a qualified professional who explains the purpose and the possible side effects of the procedure or medication. Further, it is required that the recipient have the right and capacity to stop the treatment at will. It is required that the administration be properly controlled and the effects individually monitored. Fluoridation of a public water supply fails on all these counts.

I suggest to you that you insist on answers to these objections-on efficacy, toxicity, methodology and ethicality-from anyone who advocates fluoridation. And I suggest to you that those answers, should they be offered, must be based on appropriate investigations and presented to you in an appropriate way.

Thank you for your attention. 

James S. Beck, MD, PhD
Professor Emeritus of Medical Biophysics