Mary Byrne, the convener of the anti-fluoridation activist group Fluoride Action Network of NZ, is promoting “alarming information” about incidence of neural tube developmental defects like spina bifida with the implication they are caused by community water fluoridation. Her authority for this is Declan Waugh!
Any critical examination of Waugh’s claims on fluoridation (and there are many) would show him to be the last person one should trust on the issue. Unfortunately, though, he does seem to fool some people – using a mixture of extensive, but misleading, citation of scientific papers and claims about the high incidence of many illnesses in the Republic of Ireland. Anti-fluoride activists love to quote him as “scientific proof” for their own extreme claims and, worryingly, the Hamilton City Council was persuaded that he is indeed a reliable “expert” – citing one of his reports in the list of 10 documents which convinced them to stop fluoridation last year (see When politicians and bureaucrats decide the science).
Very often simple checking will show his claims about the incidence of illnesses are actually completely wrong, and the scientific papers he cites don’t actually say what he claims. Completely dishonest but it seems you can fool some of the people some of the time with fancy sciency-looking reports. Especially if your citations are so intimidatingly extensive few readers have the energy to check them.
Here I will take apart the fear mongering he is currently promoting over spina bifida and similar neural defects.
The incidence of neural defects in Ireland
The “alarming information” on incidence of neural defects in The Republic of Ireland he relies on is a paper by McDonnell et al (2014), Neural tube defects in the Republic of Ireland in 2009–11. The authors concluded:
“The incidence of NTDs [neural tube defects] in the Republic of Ireland appears to be increasing. Renewed public health interventions, including mandatory folic acid food fortification, must be considered to reduce the incidence of NTD.”
A press release from the UCD School of Medicine and Medical Science in Dublin put this in context:
“This comprehensive national audit over three years found that the incidence of neural tube defects (NTDs) increased slightly during the period studied, reversing the trend of the previous ten years.
NTD incidence had increased from 0.92/1 000 in 2009 to 1.17/1 000 in 2011. And nowhere was fluoride implicated as a cause of this.
So no basis for Waugh’s fear mongering and implication of community water fluoridation as the cause. However, I imagine the average anti-fluoride activist would be aghast at the idea of a social health policy involving mandatory folic acid food fortification and would campaign against it.
Manufacturing a link to fluoride
Declan Waugh manufactures a link of NTDs to fluoride and community water fluoridation in two ways:
1: The old trick of using a brief report from an area of high dietary fluoride intake. In this case the paper of Gupta et al (1994). This brief 2 page report studied children suffering dental and skeletal fluorosis in India. Drinking water concentration was high (4.5 to 8.5 ppm compared with the recommended 0.7 for community water fluoridation). Fourteen of the 30 children studied showed spinal bifida occulta (the mildest form which usually presents no problems) on X-rays but not on clinical examination.
Although the incidence in this small sample is higher than the 20% normally found in average spines the number of subjects is low so no conclusions are possible. In fact, all the authors did was to propose “a randomised controlled study to evaluate a possible correlation between spina bifida and high fluoride intake.” The also pointed out that they could not find any literature reports correlating spina bifida with fluoride.
So all pretty speculative – but enough for a desperate anti-fluoride “authority” like Declan Waugh to do a bit of scaremongering.
2: Waugh goes out of his way to suggest a mechanism for community water fluoridation causing neural tube defects – fluoride reduces folic acid concentration in the body! And he manages to cite a couple of scientific papers to support his ideas. Problem is – they don’t.
He argues in a 2012 report (which he describes as his “main report”) that “Fluoride is known to be an inhibitor of enzymatic activity and research has identified fluoride as an inhibitor of homocysteine hydrolase363“ and this causes a decline in folic acid levels.
The cited paper is Mehdi S, Jarvi ET, Koehl JR, McCarthy JR, Bey P. The mechanism of inhibition of S-adenosyl-L-homocysteine hydrolase by fluorine-containing adenosine analogs. J Enzyme Inhib. 1990;4(1):1-13.
Waugh is citing work using “fluoride-containing adenosine analogs” to make the claim about the fluoride anion. Specifically, the compounds (Z)-4,5′-Didehydro-5′-deoxy-5′-fluoroadenosine, 5′-deoxy-5′-difluoroadenosine, and 4′,5′-didehydro-5′-deoxy-5′-fluoroarabinosyl-adenosine – not fluoride.
Declan Waugh has just pulled out any old citation referring to fluoride – maybe he hasn’t even read past the title of the paper.
Yet the tame alternative health media make the claim that “amongst the international scientific community, Waugh is now regarded as a leading expert on the subject!”
That reminds me of the local anti-fluoridation activists who continually describe Paul Connett, from the sister activists organisations Fluoride Alert, as a “World expert on fluoridation!”
Actually, Waugh gave the show away in his 2013 report when he said:
“To my knowledge no study has ever been undertaken to examine if fluoride exposure combined with nutritional status may be a contributory factor to the alarming levels of congenital defects in fluoridated compared to non-fluoridated countries.”
But as is often the case with these sorts of admissions, the very lack of evidence appears to be used to infer a cause. He is advancing the fallacy that the lack of evidence really means the evidence is there but just hasn’t been found yet – probably because evil scientists are conspiring to prevent the necessary research.
The old trick of making a wild claims, suggesting something as a possibility and then promoting the idea as some sort of scientifically proven fact in his scaremongering.