Child IQ in countries with endemic fluorosis imply fluoridation is safe.

Anti-fluoride activists love to point out that people living in endemic fluorosis areas in countries like China suffer all sorts of health problems, including lower IQ. But studies of these areas show no lowering of IQ in the low fluoride areas relevant to community water fluoridation.

I have completed a detailed analysis of all the 65 studies the Fluoride Action Network (FAN) lists as evidence that community water fluoridation (CWF) is harmful to child IQ. The full analysis is available for download as the document Analysis of FAN’s 65 brain-fluoride studies.

In this article, I discuss the studies in the FAN’s list (see “FLUORIDE & IQ: THE 65 STUDIES”) which compare child IQ in areas of “low” and “high” fluoride in countries like China, Mexico, Iran, Egypt, and India where fluorosis is endemic. In fact, all these studies either assume or provide evidence that fluoride at the concentrations used for CWF is harmless.

IQ differences for “high” and “low” fluoride areas

FAN was really dredging through very poor research to find these studies. In fact, FAN had to go to the trouble of translating many of these studies because they were obscure and not available in English.

Of their 65 studies, 17  do not provide data for fluoride intake or for drinking water fluoride concentrations. Instead, they simply describe the “high” areas as endemic fluorosis areas or areas where people suffer severe dental or skeletal fluorosis. Several of the studies used “control” groups from areas of “slight” fluorosis or dental fluorosis in contrast to skeletal fluorosis.

Another 29 studies did provide water fluoride concentrations for the “low” fluoride and “high” fluoride areas. This data is useful as it enables us to consider how relevant the results are to CWF. I have summarised the data in Figure 1.

The take-home message from Figure 1 is that while these 29 studies do show a decrease in child IQ in areas of “high” fluoride those areas are not relevant to CWF. In fact, the only relevance to CWF are the areas of “low” fluoride where there is the implicit assumption that child IQ is not affected. We can also assume this is the case for the 17 studies which do not provide details of fluoride exposure.

Figure 1: Comparison of water fluoride levels in “high” and “low” fluoride areas of 29 of the FAN studies and in areas where CWF is used.

So these 46 studies heavily promoted by FAN over recent years do not show any harm from CWF – in fact, all these studies implicitly assume there is no negative effect on child IQ at the “low” fluoride levels studied – and these are the areas most relevant to CWF. A simple consideration of the health problems faced by people living in areas of endemic fluorosis should have made it obvious that the data for high fluoride areas is simply not relevant. Consider these figures from Das et al (2016) – one never sees people like this in areas where CWF is used:

Dental fluorosis case found in the study area (age: 12, sex: male). Das et al (2016)

Skeletal fluorosis case found in the study area (age: 17, sex: male). Das et al (2016)

FAN is simply silly to suggest these studies, and especially the results for the “high” fluoride areas, area at all relevant to CWF.

Mind you, Paul Connett, FAN Director, likes to draw attention to one of these studies where he claims the “high” fluoride area has a drinking- water fluoride concentration of 0.81 mg/L which is similar to that for CWF. He is simply dredging the data (and ignoring all the other studies he cites)  to make this claim. The study he refers to was made in an area of iodine deficiency and is extremely weak – simply and half pages in a Chinese newsletter. Have a look for yourself – Lin et al (1991).

In a future article, I will discuss the studies in FAN’s list which compare IQ for children from fluoridated and unfluoridated areas.

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