Permission to have that conversation

In May, Maajid Nawaz presented this important talk at the 2016 Oslo Freedom Forum. It’s important because he attacks the concept that religion, and especially Islam, should be protected from criticism. And especially he attacks the concept that we should not talk about the problem of Jihadism, or Islamic terrorism. We should not avoid calling a spade a spade.

Maajid says the West, and particularly the USA, has it all wrong. The policies of intervention, imposing “democracy” and the killing of terrorist leaders and civilians via bombing and drones, will never solve the basic problem – that extremist jihadism appeals to many Muslims, even western born Muslims.

He is advancing the need to counter jihadist ideologies with alternative moderate policies – but points out this is hardly happening. And how can it happen if people are too “politically correct” to discuss and condemn actions like the stoning of women, female genital mutilation, imposed marriages, etc.

Maajid has the right credentials to back up his message. He is a former member of the radical Islamist group Hizb ut-Tahrir and used to advocate jihadism.  He was imprisoned in Egypt from 2001 and 2006. His experience led him to change his thinking and he left Hizb-ut-Tahrir in 2007, renounced his Islamist past and called for a “Secular Islam“.

Now he is a co-founder and chairman of Quilliam, a counter-extremism think tank that seeks to challenge the narratives of Islamist extremists.

Maajid wrote about his experiences and changes of thinking in his book Radical: My Journey Out Of Islamist Extremism.


More recently he discussed these problems with the atheist Sam Harris. Their discussion is published in the book Islam and the Future of Tolerance: A Dialogue.

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A cynical take on effective speakers

This video is a parody of a TED talk – you know, those talks which often come across very impressively but may not have much in the way of real content.

Or is this just me getting cynical in my dotage? I certainly feel I have an excuse for that.

Source: This Parody Of Every TED Talk Ever Is Absolutely Perfect – Digg

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Richard Dawkins – speech to Reason Rally, 2016

This was Richard Dawkins’ speech to the 20116 Reason Rally in Washington DC last week.

Richard suffered a mild stroke earlier this year and this video shows he is still not fully well. Anyway, too unwell to travel so he presented the speech as a video.

There is nothing new here – he has made all these points before. But these points are well worth repeating, and he makes them so well.

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Chemophobic scaremongering: Much ado about absolutely nothing

much-ado

Sometimes anti-fluoride propagandists end up shooting themselves in the foot. This always seems to happen when they produce “evidence’ that fluoridating chemicals are loaded with toxic heavy metals.

It feels like shooting fish in a barrel to debunk their use of analytical figures because the data they produce always shows them to be completely wrong. I wrote about this before in Fluoridation: emotionally misrepresenting contamination. So, I am effectively repeating myself by discussing the meme image below that Fluoride Free NZ is currently circulating in social media.

Hill lab

Still, this time, I will show how insignificant these analytical figures by comparing the calculated final concentrations in tap water – due to addition of the chemical – with measured concentrations for these contaminants in Hamilton tap water.

Added contaminants as percentage of MAVs

But first – what contribution would this sample of fluorosilicic acid make to the contaminant levels in Hamilton’s tap water – and how do these levels compare with the maximum acceptable values (MAVs) defined in New Zealand’s Drinking Water Standards? The values for the MAVs are published in:

Ministry of Health. (2008). Drinking-water Standards for New Zealand 2005 ( Revised 2008 ) (Vol. 2005). Wellington.

In this table, the “Tap water (mg/L)” data are the calculated final concentrations after addition of the fluoridating agent in the meme. The “%age of MAV” data are these values expressed as a percentage of the maximum acceptable values (MAVs) for the contaminants.

Impurity MAV (mg/L) Tap water calculated (mg/L) %age of MAV
Aluminium 0.1 8.69E-05 0.0869
Antimony 0.02 < 3.56E-07 <0.0018
Arsenic 0.01 1.26E-05 0.1264
Barium 0.7 4.27E-06 0.0006
Cadmium 0.004 2.37E-07 0.0059
Chromium 0.05 4.74E-06 0.0095
Copper 1 1.19E-06 0.0001
Iron 0.2 1.62E-04 0.0810
Lead 0.01 2.37E-07 0.0024
Manganese 0.04 3.56E-06 0.0089
Mercury 0.007 < 1.98E-07 <0.0028
Molybdenum 0.07 < 3.56E-07 <0.0005
Nickel 0.08 3.95E-06 0.0049
Selenium 0.01 < 1.98E-07 <0.0020
Uranium 0.02 2.05E-06 0.0103

Sorry, I have had to use scientific formating for some numbers because the final calculated concentrations in tap water are so low. On average, the calculated concentration  of these contaminants due to the fluoridating agent is about 0.02% of the MAV.  The largest relative contribution is for arsenic – just over 0.1%.

Regulations require that the contribution of contaminants from fluoridating agents should always be less than 10% of the MAV . The actual level of contaminants in this particular sample is well below those regulated maxima.

The Fluoride Free NZ meme is just promoting naive chemophobic scaremongering about absolutely nothing. These activists just haven’t bothered calculating what the analytical data means for the final concentrations in tap water. Or even bothered comparing the data with the regulated maximum amounts allowed for fluoridating chemicals. These values are available in Standard for the Supply of Fluoride for Use in Water Treatment.

Added contaminants as a percentage of concentrations in inlet water and treated water.

Let’s now compare the estimated contribution from contaminants in this sample of fluorosilicic acid to the levels of the very same contaminants in the Hamilton water. I have taken data from this document issued by the Hamilton City Council:

Waikato River and Treated Drinking Water Comprehensive Analysis Report 2013/14

The next table is for samples taken on 18th July 2013 at the intake to the treatment plant (that is the source water before treatment). The “Added FSA%” is the calculated level of impurity resulting from fluoridation expressed as a percentage of the impurity naturally present in the source water.

Impurity Intake (mg/L) Added FSA%
Aluminium 1.68E-01 0.05
Antimony 8.50E-04 <0.04
Arsenic 1.96E-02 0.06
Barium 1.88E-02 0.02
Berylium <1.10E-04 0.18
Cadmium <5.30E-05 0.45
Chromium <5.30E-04 0.89
Copper <5.30E-04 0.22
Iron 2.94E-01 0.06
Lead 1.18E-04 0.20
Manganese 2.15E-02 0.02
Mercury <8.00E-05 <0.25
Molybdenum 3.80E-04 <0.09
Nickel <5.30E-04 0.75
Selenium <1.10E-03 <0.02
Tin <5.30E-04 0.22
Uranium <2.10E-05 9.78
Zinc 8.13E-01 0.00

Now, a similar calculation and comparison – this time “Added FSA%” is the calculated level of impurity resulting from fluoridation expressed as a percentage of the impurity already present in the “treated water” – which is the final tap water. (At this time the Hamilton water supply was not fluoridated).

Impurity Treated (mg/L) Added FSA%
Aluminium 2.04E-02 0.43
Antimony 8.00E-04 <0.04
Arsenic <1.10E-03 1.15
Barium 1.26E-02 0.03
Berylium <1.10E-04 <0.18
Cadmium <5.30E-05 0.45
Chromium <5.30E-04 0.89
Copper 8.00E-04 0.15
Iron <2.10E-02 0.77
Lead 4.82E-04 0.05
Manganese 1.75E-03 0.20
Mercury <8.00E-05 <0.25
Molybdenum 3.70E-04 <0.10
Nickel 3.52E-03 0.11
Selenium <1.10E-03 <0.02
Tin <5.30E-04 0.22
Uranium <2.10E-05 9.78
Zinc 4.82E-03 0.14

The extremely low levels of contaminants – both calculated and already in the intake water and final treated water – mean some of the calculations are rather meaningless. Especially as some of the analysed values are given as less than the detection limit.

However, the very low calculated contribution of contaminants from this fluorosilicic acid sample – usually < 1% of that naturally present – shows how ridiculous the Fluoride Free NZ claims about contamination introduced by fluoridating agents is.

Never trust anti-fluoride campaigners

Fluoride Free NZ is simply scaremongering – relying on naive chemophobia where just the chemical name and analytical data (even where the “<” symbol indicates below the level of detection) seem to scare people.

This example illustrates, once again, that the claims made by anti-fluoride and similar activists should never be accepted at face value. They should always be checked against reliable sources.

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MH17 tragedy – new investigation launched

MH17 front

The cockpit wreckage of MH17. Photo: Dean Mouhtaropoulos/Getty Images

Two years after the shooting down  of the Malaysian commercial airliner (flight MH17) over eastern Ukraine (Donbass), investigators seem no closer to identifying the culprits.  This may seem surprising given the quick recovery of the black boxes and most of the airplane. But, on second thoughts, perhaps not surprising given the regional and geopolitical politics.

But, time is taking its toll on the credibility of the current investigators. Until now the investigation has been handled by the Dutch Safety Board (which published its final technical report last October (see MH17: Final technical report) and the Dutch-led joint investigation team (JIT) which is responsible for a more detailed investigation enabling determination of criminal liability.

Now, the Malaysian government is launching their own independent investigation. In announcing this the Malaysian PM Najib Razak said this would be a joint investigation together with the Russian Federation and its research results would be revealed in October 2016 (see Malaysia to start independent investigation into MH17 tragedy).

Meanwhile, the work of the Dutch Investigating Commission (JIT) will continue and the Minister of Transport in Malaysia has asked that a Russian expert be included in that investigation team. This has upset the Ukrainian authorities  who have responded by asking that the US to prevent the joint Russia/Malaysia investigation. (Why the Ukrainians think the US has any power of arbitration or decision on this issue is beyond me).

Concern about attitudes of current investigators

Apparently the Malaysians are not happy with the current findings of Dutch investigators. The do not see any evidence implicating Russia in the tragedy and had found that  Russia was very supportive during the first days of the crash. They had requested Russia be involved in the official investigation but this was not allowed.

According to the Australian National Review:

“Furthermore, all independent findings of Russian investigators were avoided. After the meeting between the heads of the states, Transport Minister of Malaysia, Liow Tiong Lai sent a letter to the Commission of Inquiry of the Netherlands requesting that Russia be included in the investigations. The request set off an alarm as Malaysia’s claim cannot be refused. This has made international observers suspicious on why Ukraine is reluctant to include Russian experts in the probe team.”

I too am suspicious. Russia has experts who could contribute greatly to the investigation. They have made their own investigation of the crash which deserves proper consideration  because it was carried out by specialists from the manufacture of the likely weapon involved, Almaz-Antey. The final Report of the Dutch Safety Board brushed off these findings without proper consideration (see MH17: Final technical report). Yet the Russian research appeared to make a more evidence-based evaluation of the specific missile used and its likely launch location. This research is very relevant to the ongoing criminal investigation because of its relevance to the specific model of missile used and the launch location.

Russian investigators frustrated

This is frustrating the Russian investigators. In February, Oleg Storchevoy, the deputy head of Russia’s Federal Air Transport Agency, accused the Dutch Safety Board and JIT of “showing no interest” in working with Russia:

“I would like to stress that Russia disclosed all of its available satellite data in the days immediately following the crash,” he wrote, adding that the data it had submitted to the investigation showed “movement and increased activity by Ukrainian BUK surface-to-air missile systems observed within the conflict area in eastern Ukraine one day ahead of the tragedy.”

Includingof Ukrainian experts in the JIT, while at the same time excluding Russian experts, raises suspicions. The Ukrainian Army, together with the rebel authorities in the Donbass region, are the main suspects. In fact, analysis of the intelligence evidence presented to the Dutch parliament (see Flight MH17 in Ukraine – what do intelligence services know?) indicate that the only BUK systems active in Eastern Ukraine at the time of the tragedy were in the hands of the Ukrainian Army.

Because much of the work of the JIT takes place in Kiev, close relationships have formed between the Ukrainian experts and the Dutch and Australian experts. Commentators see this as a problem in making an objective evaluation of the evidence supplied by the Russian Federation and the Ukrainian security and intelligence service, SBU.

Geopolitical prejudices may be preventing proper consideration of Russian data but of more concern is the likely biased information provided by the Ukrainian SBU. Apparently this included telephone wire-tapping data which is very hard to verify without full and open access. Ukrainian authorities are unlikely to give this on security grounds.

There are also problems with US satellite data which the JIT says they have access to – but only in secret. These security factors make it impossible to use such data in a criminal case. Although, politically motivated press releases are great for casting suspicions  – and this has plagued this investigation from the start.

So, I welcome the new investigation by  Malaysia and the Russian Federation.They have declared their willingness to cooperate with the Dutch-led investigators.  Currently, the Dutch-led investigation is being carried out by officials from Australia, Malaysia, Belgium and Ukraine but it would gain more credibility if it included Russian investigators. The Dutch-led team claim they are making good progress and their report is just months away.

Hopefully, this report, and a similar report from the Malaysian/Russian joint investigators due in October, will show some progress which helps bring justice to the families who lost loved ones in this tragedy.

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Fluoridation: News media should check press releases from anti-fluoridationists

A recent ruling from the New Zealand Press Council warns against news media  publishing press releases from biased groups without providing context or seeking comment from any other party. The ruling resulted from a complaint  by Toi Te Ora Public Health Service against the coverage of the fluoridation issue by The Whakatane Beacon. For the full ruling see Source: TOI TE ORA PUBLIC HEALTH SERVICE AGAINST WHAKATANE BEACON.

Specifically, the ruling relates to two articles:

  • “Dentist group dispels dire warning message” provided by Stan Litras, spokesman for Fluoride Information Network for Dentists (an anti-fluoridation group). It asserted the Bay of Plenty DHB claims that increased tooth decay would result from removal of fluoride were not supported by reliable metadata studies.
  • “No Fluoride commonsense to campaigner” gave the views of Jon Burness, Fluoride Free Whakatane spokesman. He claimed reports that Ministry of Health figures show no justification for adding fluoride.

The Press council concludes:

“Importantly both published articles were effectively press releases from interest groups with a particular point of view. As the Council has had cause to comment in two recently upheld complaints (Cases 2478 and 2483) running a press release, without seeking comment from any other party, does not make for a balanced piece of journalism. There are significant dangers in simply regurgitating a Press Release and it does not accord with best journalistic practice unless it is clearly spelt out as a Press Release.”

Media should be wary of misrepresentation

Stan Litras’s press release criticised evidence used by Dr de Wit from the District Health Board and medical officer of Health. It misrepresented de Wet, yet the newspaper failed to put the criticisms and allegations to him. The Press council described this as “a simple failure of journalistic principles.” It added that it “is the obligation of the publication to allow an individual to comment if mentioned or quoted indirectly in an article.”

The Press Council made a similar observation with Jon Burgess’s press release, pointing out that the claims in the article were not put to the Ministry of Health (whose data Burgess was misrepresenting). The council put this specific complaint to one side as it did not have a direct complaint from the Ministry. It did comment, though, “that again this was not the best journalistic practice.”

Anti-fluoridation groups like Litras’s  Fluoride Information Network of Dentists (an astroturf group for Fluoride Free New Zealand) are constantly providing press releases misrepresenting studies and experts. These manufactured press releases are circulated within the international anti-fluoride network and the tame websites and magazines run by the “natural”/alternative health industry. Occasionally they end up being published in more reputable mainstream media outlets where they can do more damage.

It would be nice to think the mainstream news media was sufficiently responsible to actually check out the claims being made by such obviously biased groups. It seems a simple principle to actually check with the experts or organisation whose data is being used in the press release (the Whakatane Beacon slipped up there). But it would also be nice to think that responsible news media attempts to provide balance when they are producing articles critical of scientific findings – even when provided by a maverick scientist into self-promotion. It surely doesn’t take much to work out which expert or institution should be asked for a balancing viewpoint.

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Fluoridation debate: Responding to Tom O’Connor

This is the second article in the debate between Tom O’Connor and me. It is a response to his post Debating fluoridation and tyranny – Tom O’Connor responds).


I think Tom’s concept of “freedom of choice” is confused. He appears to be arguing for his own right to determine a social decision. But that is undemocratic, it imposes an individual’s wish on society.

We all have the freedom to influence, make submissions on, contribute to, etc., a social decision. In the end, that decision is made democratically. The minority does not have the right to use the individual’s “freedom of choice” argument to demand that decision not be democratic.

That is not the ‘tyranny of the majority”  Tom claims because on  most issues the individual still has the “freedom of choice” to make individual arrangments to satisfy their position. No one is being coerced and the individual can take personal responsibility for their own arrangements. This is particular true with community water fluoridation (CWF).

Tom and I have different values or politic outlooks underlying our different attitudes towards CWF.

Opposing values systems

I don’t want to put words in Tom’s mouth but in practically he is opposed to CWF despite the clear social benefits. He is claiming his personal “freedom of choice” is more important than the community’s – or at least the majority of the community.

In contrast, I support CWF because of its social benefits. However, I accept the obligation of governing bodies to consult the community when there is a controversy and support the decisions of the community (I also support the right of individuals and communities to make the wrong decision – within reason, of course).

In the most general terms, these boil down to issues of social responsibility vs individual or personal responsibility. Put simplistically, some would see the conflict a between a “socialist” or “libertarian” perspective. (I apologise for using labels.) These different values systems lead to different understandings of freedom of choice (and of being “forced”).

Given the stand of personal responsibility, as a personal values system, Tom should not need to seek the justification of advancing or questioning facts. He should simply stand on principle, and seek support for that principle. On the other hand, there is an obligation on people arguing for social responsibility. We need to show that the advocated social policy provides a net advantage to the community and/or individuals. If there are no advantages there is no point in such policies and the personal responsibility or “libertarian” position may as well stand.

Tom is welcome to his values system, and he no doubt says the same about me. We live in a pluralist society and most of us accept such differences are handled by the democratic process. I should also add that most people do not adhere to an absolutist “libertarian” or “socialist” approach and prefer a more balanced and sophisticated approach to social issues.

Society usually attempts to balance individual rights/responsibilities and freedom of choice against social responsibility. After all, individual rights and social responsibility are co-dependent. Our individual rights and freedom of choice cannot survive where our freedom, rights, health and well-being are not supported by sensible social policies.

A democratic social decision may appear to result in the loss of that freedom of choice. After all, I can express my freedom of choice to have a Green government, but after the election I have to accept that freedom is put on hold for another three years and in the meantime I have to put up with a National-led government. But that does not deprive me of the freedom to advocate for policies underlining my preference for the Greens – and under MMP such advocacy can be effective even between elections.

Similarly, the minority in a decision on CWF does not lose personal “freedom of choice.” If they are willing to take personal responsibility for their situation they can with very little effort, make personal arrangements. Those with a hangup about fluoride can use to filters or alternatives sources. Those who wish to use fluoride can resort to mouth rises or alternative water sources. In taking these actions we are exerting our freedom of choice.

Tom has stepped outside the ethical issues to argue some statements of fact which need challenging.

Raising doubt and the balance fallacy

Tom asserts:

“Both sides have accused the other of engaging in pseudo-science and scare mongering. Both are, to some extent, probably accurate and in agreement on that point alone. However, where doubts exist, it is probably better to err on the side of caution.”

Putting “both sides” into the same box of “engaging in pseudo-science and scare mongering” is a Clayton’s argument. A claim made without any substantiation but appealing to “balance” nad “fairness. Rather than relying on such “warm fuzzies” Tom should present the examples and evidence if he wishes to make such claims.

Similarly, unsupported claims of doubts and the need for caution can be a way of discounting the science and its quality. Hence, the emotional slogan “if in doubt, leave it out!” Society should make decisions based on evidence, not warm fuzzies and catchy slogans.

We are familiar with the financially and ideologically motivated purposeful raising of doubt on issues like the science regarding tobacco use and climate change.  Merchants of Doubt by Oreskes and Conway provide a good description of such dishonest tactics – and the title is very appropriate.

Drinking water standards

Tom claims:

“The principle responsibility of local authorities, as outlined in the Drinking Water Standards for New Zealand, administered by the Ministry of Health, is to ensure drinking water is as free from all other substances and organisms as possible.”

Where do the standards say that, Tom? My checking of Drinking Water Standards for New Zealand produced these principles:

“all water suppliers have a duty to ensure their water is safe to drink.”

And:

“all drinking-water suppliers providing drinking-water to over 500 people must develop and implement a water safety plan (originally known as a Public Health Risk Management Plan, PHRMP) to guide the safe management of their supply. This quality assurance approach is complemented by the DWSNZ, which specify the maximum acceptable concentrations of harmful contaminants in the water.”

What these standards do is set maximum acceptable values (MAVs) for a whole list of possible “harmful contaminants” – occurring naturally or from the water treatment itself. Think about it – no realistic body would set standards demanding water was “free from all other substances and organisms as possible” – leaving interpretation up to the individual operator!

Of course, individuals may want to lower these MAVs (or even make them zero) – but they are derived from the best available science and practical considerations. If individuals are unhappy they can, of course, challenge the standards. But they do not have the “freedom of choice” to arbitrarily  replace them with their own personal values. They do have the freedom of choice to use other water sources or tap filters. That is the sensible and responsible thing to do, rather than childishly demand a change just to satisfy their own hangup.

Chlorination

This involves additions to water that Tom has absolutely no control over. Why does he not object to that addition on his ethical stance that he has the “freedom of choice” to control what goes into community water supplies?

Personally, I would oppose chlorination  long before I objected to fluoridation because irrespective of whether there is any detectable chlorine “at the end of the process” (there should be),  chlorine can react with naturally occurring organic material to produce possible hazardous or carcinogenic compounds. That is why local authorities check for these in our water.

My city uses UV irradiation for the early disinfection process and only adds chlorine at the end so that the tap water remains organism free. But if I lived in a city where the first disinfection use chlorine I would seriously consider using a tap filter to remove possible hazardous compounds.

Iodised salt

Tom is OK with the “mass medication or treatment” involved in iodised salt because there is “always un-iodised salt as a practical, convenient and affordable option on grocer shop shelves for those who did not want it.”

Does he bother to exert that “freedom of choice” when he shops? Has he even checked the availability of uniodised salt? I checked the other day and my supermarket had plenty of iodised salt but no specifically non-iodised salt. It had boutique salts (even “chemical free” salt) and I imagine the chemophobic shoppers might prefer those products to iodised salt – not realising they also contain iodine.

This can get silly. There are anti-fluoride people who treat their water by reverse osmosis – then replace the removed minerals by adding Tibetan salt which contains fluoride (and is sometimes sold as “chemical-free.”

Folic acid

I would willingly support mandatory folic acid fortification. More countries will probably do this in future because the evidence is pretty clear that it helps prevent the tragedy of neural tube defects. It seems a sensible approach because of the need for folic acid at the stage of pregnancy where the mother may be unaware.

At the moment, New Zealand has a voluntary folic acid fortification system. About 17% of packaged bread was fortified with folic acid in 2012. The industry is working towards fortification levels of 50%  – with at least 25% meant to be achieved by the end of 2014.

Tom, you appear to oppose folic acid fortification. Do you check your bread packaging to check it hasn’t been fortified? I suggest hardly anyone does so.

There are lots of things individuals can have hangups about. Some people object to chlorination. Some to pasteurized milk. Given that society does set standards for our food and water it is inevitable individuals may sometimes have to take personal responsibility and check the food and water they purchase. But I cannot understand the directed concern over fluoride as it is one of the easiest things to check and make personal arrangements for.

While I had plenty of choice at my supermarket if I wanted “fluoride-free” water. I had no choice if I wanted “iodine-free” salt” or unpasteurized milk. If I had a hangup about folic acid I would need to make the effort to carefully scrutinise bread packaging to find “folic-free” bread. And do that often because of plans to increase folic acid fortification of bread over time.

Removal and personal responsibility

Tom really should back up this claim:

“Suggesting that those who object to fluoride in the water they pay their local authority to deliver can obtain alternative supplies from a community tap or buy it from the supermarket is unacceptable. These options are not possible, practical, convenient or affordable for many people.”

What about some monetary figures to claim alternatives are not affordable? Frankly I do not think he has a leg to stand on here as people who choose to opt out of our secular education  and free hospital systems face far bigger financial costs. In my experience most anti-fluoride campaigners already take such steps for themselves and when pressed claim they are speaking up for others less fortunate than themselves. Yeah, right!

Tap filtration practical and convenient. “Fluoride-free” water is readily and cheaply available (more so than unpasteurised milk and non-iodised salt I have found). And the slight inconvenience involved is of little consequence to someone who really believes the anti-fluoride story.

Incidentally, several cities provide “fluoride-free” community taps. the fact these get very little use suggests to me that those who are really concerned already have more convenient arrangements.

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May ’16 – NZ blogs sitemeter ranking

blogging-success-2013-green-wood-1t4tkvs

Image credit: Blogging Discussion with Students 

There are about 300 blogs on the list, although I am weeding out those which are no longer active or have removed public access to sitemeters. (Let me know if I weed out yours by mistake or get your stats wrong).

Every month I get queries from people wanting their own blog included. I encourage and am happy to respond to queries but have prepared a list of frequently asked questions (FAQs) people can check out. Have a look at NZ Blog Rankings FAQ. This is particularly helpful to those wondering how to set up sitemeters. Please note, the system is automatic and relies on blogs having sitemeters which allow public access to the stats.

Here are the rankings of New Zealand blogs with publicly available statistics for May 2016. Ranking is by visit numbers. I have listed the blogs in the table below, together with monthly visits and page view numbers. Meanwhile, I am still keen to hear of any other blogs with publicly available sitemeter or visitor stats that I have missed. Contact me if you know of any or wish help adding publicly available stats to your bog.

You can see data for previous months at Blog Ranks

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New review shows clear economic benefits from community water fluoridation

Sapere

The NZ Ministry of Health has released a new review of the benefits and costs of water fluoridation in New Zealand.* Unlike most reviews I have discussed here dealing with the scientific aspects, the authors of this review say:

“we take an economist’s perspective; we look at the national cost-effectiveness and cost-benefit of fluoridation, and comment briefly on disparities.”

This perspective is, of course, important to the Ministry of Health which must invest its resources efficiently. These considerations were the prime reason the Ministry commissioned the review from the Sapere Research Group.

Readers who want to read the full report (78 pages) can download it from the link – Review of the Benefits and Costs of Water Fluoridation in New Zealand (pdf, 818 KB).

Strong evidence for benefits

The review points out that oral health is still a major issue for New Zealand. Despite considerable improvement over the last 20 to 30 years, “New Zealand remains a relatively high-caries population:”

“The ‘burden’ of the disease from dental decay is equivalent to three-quarters that of prostate cancer, and two-fifths that of breast cancer in New Zealand.”

It finds strong evidence for the benefits of community water fluoridation (CWF):

“A large body of epidemiological evidence over 60 years, including thorough systematic reviews, confirms water fluoridation prevents and reduces dental decay across the lifespan. The evidence for this benefit is found in numerous New Zealand and international studies and reports.”

Its estimates of the benefits of CWF include:

  • “In children and adolescents, a 40 percent lower lifetime incidence of dental decay (on average) for those living in areas with water fluoridation.”
  • “For adults, a 21 percent reduction in dental decay for those aged 18 to 44 years and a 30 percent reduction for those aged 45+ (as measured by tooth surfaces affected).”
  • “48 percent reduction in hospital admissions for treatment of tooth decay, for children up the age of four years.”

The review expresses this cost-saving in material terms:

“We estimate the 20-year discounted net saving of water fluoridation to be $334 per person, made up of $42 for the cost of fluoridation and $376 savings in reduced dental care. In short, there is a 9 times payoff; adjusting the discount rate from 3.5 percent to 8 percent results in a 7 times payoff.”

This estimate is “robust to significant changes in assumptions.” In fact, their “assumptions around dental costs avoided are likely to be at the lower end of what patients face.”

Quality of life benefits

Not surprisingly the review finds significant benefits of CWF to the quality of life estimates.  Interestingly, it makes the point that while most other health interventions require net health spending, the CWF benefits to quality of life arise from net cost-saving because the savings from reduced need for dental treatments are far greater than the costs of fluoridation.

I can understand the need for economists to quantify the quality of life returns on investment but can not, for the life of me, understand how they can take into account the pain and misery of children who suffer from poor dental health. The review does mention an Oral Health Impact profile which attempts to measure “patient discontent from pain, dry mouth and chewing problems.” But I suspect this goes only a short way to quantifying the personal and subjective problems arising from poor dental health.

In particular, I am thinking of the psychological and physical medium and long-term effects. Poor dental health negatively impacts the child’s schooling and must contribute to learning difficulties. This, in turn, will mean childhood poor dental health reduces a person’s future prospects in employment, adult education, social and personal relationships and general happiness.

Conclusion

The benefits of CWF are clear when considered in financial and economic terms and this new review presents these in a clear and convincing way. It will have an important  influence on the decision makers in the Ministry of Health, parliament and the government – especially as they discuss the new legislation required for the transfer of decision-making on fluoridation from councils to district health boards. But there are also personal and subjective benefits which are much harder to quantify to the satisfaction of economists and other bean counters. In the end, those personal and subjective benefits must bring a positive economic return to society as a whole, as well as the individual. If anything, decision makers and politicians should see that the case for CWF is even stronger than that made by the economic considerations in the review.

*Note: The Cabinet papers on the assessment of benefits from fluoridation and the upcoming legislative changes required to transfer decisions to District Health Board have also been released. These papers are very interesting and give an idea of the different factors the government has considered and the likely way the new legislation will go. I recommend any readers searching for more details on this to download the papers from this link:

DECISION-MAKING ON THE FLUORIDATION OF DRINKING-WATER SUPPLIES.

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Debating fluoridation and tyranny – Tom O’Connor responds

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Individual consent – what does it mean and how is it obtained?

This article below is a guest contribution from Tom O’Connor responding to my article Attempting a tyranny of the minority on fluoridation. I invited Tom to discuss the issue here, and offered him a right of reply because I think there is value in discussing the points he raised in his Timaru Courier opinion piece and  that I critiqued in my article.

Unfortunately, in this issue, the scientific arguments are very often a proxy for underlying values issues, at least on the part of opponents of fluoridation. It is in the nature of values issues that there is no “correct” answer (in contrast to arguments about facts). Nevertheless, the values issues are important so I hope they can be developed in discussion here around Tom’s original opinion piece and his response here. In the end, such issues are decided by democratic and political means so open discussion of the issues is important.


Firstly I am not opposed to the use of fluoride to combat tooth decay per se. Nor do I have any “anti-fluoride mates” as you put it. If the government wants to make fluoride freely available there are many ways of doing that without imposing it on everyone.

There are three main elements to the fluoride debate. The first is the efficacy or otherwise of fluoride as a preventative for tooth decay.

The second is the use of reticulated potable water as a means of delivering anything other than clean water to the community.

The third is the issue of mass medication, or mass treatment or mass therapy of people without individual consent and practical convenient and affordable alternatives. Legislating to declare a medical treatment is not a medical treatment simply on the ground that the dose rate is measured in parts per million is one of the most stupid and dishonest things I have ever seen any government do. Many medications are measured in such minute quantities.

The Grey Power Federation objection to the proposed addition of fluoride to potable reticulated water is based on the third element only. We do not have a policy in the first element simply because we do not have the expertise or scientific qualifications to develop such a policy. We have not considered the second element.

That policy has been, in my view, adequately explained in the Timaru Courier opinion piece you refer to. The following comments are therefore mine alone and do not necessarily reflect the opinion of Grey Power members or anyone else.

Efficacy

As you rightly point out there is probably nothing to be gained in participating in the endless argument between proponents and opponents of fluoride as an oral health treatment. Both sides have accused the other of engaging in pseudo-science and scare mongering. Both are, to some extent, probably accurate and in agreement on that point alone. However, where doubts exist, it is probably better to err on the side of caution.

Reticulated water

Territorial local authorities have the responsibility to provide potable water to their communities where no other sources are available or suitable. The principle responsibility of local authorities, as outlined in the Drinking Water Standards for New Zealand, administered by the Ministry of Health, is to ensure drinking water is as free from all other substances and organisms as possible. Using reticulated potable water to convey anything else, be it medical or not, is contrary to that principle.

The use of chlorine to remove micro-organisms and other pathogens is designed to remove unwanted and potentially unsafe matter from drinking. At the end of that process there is not supposed to be any detectable chlorine. That there often is demonstrates the difficulty of getting the addition of trace elements correct. That is a very different matter to the deliberate introduction of an additional substance which many people don’t want.

Mass treatment and individual consent

This is not the first time mass medication or treatment has been introduced in New Zealand. Iodine deficiency, as a cause for goitre, was discovered in the early 1900s and to address the problem table salt was iodised at up to 80mg of iodine per kilogram of salt in 1938. This was accompanied by an extensive public education programme and there was always un-iodised salt as a practical, convenient and affordable option on grocer shop shelves for those who did not want it.

Suggesting that those who object to fluoride in the water they pay their local authority to deliver can obtain alternative supplies from a community tap or buy it from the supermarket is unacceptable. These options are not possible, practical, convenient or affordable for many people.You may also recall a recent proposal to add folic acid to all bread products as a means of addressing a reproductive issue for women. The public outcry which saw that proposal dropped was not solely based on doubts about the efficacy of folic acid but the fact they many people simply did not want their bread medicated with anything for any reason.

You may also recall a recent proposal to add folic acid to all bread products as a means of addressing a reproductive issue for women. The public outcry which saw that proposal dropped was not solely based on doubts about the efficacy of folic acid but the fact they many people simply did not want their bread medicated with anything for any reason.

There are practical and cost effective methods of providing fluoride for those who want it. Forcing it on those who don’t want it is simply unacceptable in a free society.

Tom O’Connor


I will post a response to Tom’s arguments in a few days. Meanwhile, readers are welcome to make their own arguments in the comments section.

Ken Perrott

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