Category Archives: New Zealand

Facts about fluorosis – not a worry in New Zealand

This sort of serious dental fluorosis does not occur in New Zealand

A recent issue of the Fluoride Exposed Newsletter gives us the facts about dental fluorosis – a subject very often misrepresented by opponents of community water fluoridation.


Ever notice how words ending with “-osis” sound a bit scary?  That’s because “-osis” is a suffix (from the Greek) commonly used to describe disorders or abnormal states. Tuberculosis, multiple sclerosis…no fun. Those are serious.

Dental fluorosis is one of those things that sounds scarier than it actually is… at least if you live in a country like the good old U.S. of A., where public health and environmental protection agencies and organizations have made the scary kind of dental fluorosis (severe dental fluorosis) exceedingly rare.

Dental fluorosis is a little like blood pressure.  When it’s low, you’re good – in fact, mild dental fluorosis can protect your teeth from cavities.  Moderate dental fluorosis describes the appearance of tooth enamel when kids get exposed to a bit too much fluoride.  Changes range from barely visible white spots or streaks (in most cases) to white spots that are a cosmetic concern.  Severe forms involve staining and pitting.  These severe forms of fluorosis are super rare in the U.S. – because we have those protections we mentioned. In the States, we make sure fluoride isn’t too low or too high in drinking water.  It’s only in regions such as rural India, China, and the African Rift Valley, where severe dental fluorosis commonly reaches an actual disease state and affects tooth health and function.  But in the U.S., fluorosis is one of those things that’s not as scary as it sounds.

As you may already know, fluoride gets into your tooth enamel during the remineralization process and forms a super compound called fluoroapatite that resists decay.  For this reason, our dentists want us to get fluoride, ideally through drinking water and fluoride toothpaste.  Or if you’re in a community without fluoridated water, there are dental treatments and dietary supplements you can get.

But if a child who’s still developing teeth gets too much fluoride, dental fluorosis can occur while the teeth are still forming under the gums.  Data from the National Health and Nutrition Examination Survey (1999-2004) tells us that less than one-quarter of persons aged 6-49 in the United States had some form of dental fluorosis.

They even made a chart that shows the severity level of those affected:

Note: One interesting factoid: In this study, the rate of fluorosis for teenagers aged 12-15 was forty percent! That’s significantly higher than the rate for all age groups taken together.  It’s a data point we’ll be keeping an eye on in future studies.

According to the American Dental Association (ADA), the mild and moderate forms of dental fluorosis we have in the U.S. do not negatively affect the health of your teeth. It’s actually even correlated with some good things.  For example, rates of dental fluorosis are higher in kids whose teeth are more resistant to tooth decay.  Makes sense, right?

That said, we can make sure a child’s amount of fluoride is “just right” – enough to provide cavity protection, but not enough to cause visible changes in the tooth enamel.
5 ways to prevent kiddos from ingesting too much fluoride:

    1. Don’t give kids fluoride supplements if your drinking water is already at or above the recommended fluoride concentration of 0.7 mg/L.  You can find out if your water system fluoridates and at what level from this cool site from the CDC: https://nccd.cdc.gov/DOH_MWF/Default/Default.aspx.  Or call your water utility provider.
    2. If your drinking water contains greater than 2 mg/L of fluoride, children 8 years and younger should use an alternative source of drinking water.  A little less than 1% of Americans on public water systems have fluoride above this level.
    3. If you have well water, have it tested for fluoride levels, and again, use an alternative source for kids if fluoride is more than 2 mg/L.  Use an alternative source for everyone in the family if it tests at or above 4 mg/L.
    4. Use only a rice-grain-sized amount of fluoride toothpaste to brush kids’ teeth if they’re younger than 3.
    5. For kids who are 3-6 years old, use a pea-size amount of fluoride toothpaste, and supervise these preschool kids when they brush so they don’t swallow too much fluoride toothpaste.

So that’s it! Dental Fluorosis: it’s a scary name, but not a big worry in the U.S.

Whew! One less “-osis” to freak out about!

Subscribe to the Fluoride Exposed newsletter.

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Cassini plunges into Saturn tonight – a grand finale

Starting at 10.31 pm NZ time tonight

Key Events

Sept 15:

10:31a.m. UTC (3:31 am PDT) – Cassini’s final entry into Saturn’s atmosphere begins

10:32 a.m. UTC (3:32 a.m. PDT) – Spacecraft loss of signal comes one minute later

11:55a.m. UTC (4:55 a.m. PDT) – Predicted final loss of signal on Earth

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August ’17 – NZ blogs sitemeter ranking

Image Credit: The Popularity of the Blog

Please note: Sitemeter is no longer working so the total number of NZ blogs in this list has been drastically reduced. I recommend anyone with Sitemeter consider transferring to one of the other meters. See  NZ Blog Rankings FAQ.

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 August 2017. 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

Subscribe to NZ Blog Rankings Subscribe to NZ blog rankings by Email Find out how to get Subscription & email updates Continue reading

Are we all anti-fascist now?

US neo-Nazis and fascists supporters march in Charoltsvill, USA.
Image credit: Alejandro Alvarez/News2Share via Reuters

Wouldn’t that be nice? What if the current almost universal condemnation of fascism by the main stream media and social media commenters were genuine.? That it represents an abhorrence for fascism and its modern supporters who attempt to revive it – and not just partisan politics.

Because fascism is abhorrent. And it does have its modern apologists, even revivalists. It is not new, even in the US, and people shouldn’t be surprised at its manifestation in Charlottesville.

After all, we have seen similar actions in other parts of the world – in parts of the world which understandably understand fascism and its consequences far better than the average US citizen does.

Thousands of nationals, neo-Nazis and pro-fascists march in Kiev, Ukraine, on the anniversary of the birth of Nazi collaborator Stepan Bandera.
Image credit: South China Morning Post.

Yes, I know. Our media tends to treat the marchers in Kiev and Riga as “freedom fighters” and not what they really are – supporters of  Nazi collaborators and those organisations derived from them which still exist today and play a role in the politics of those countries. But, unlike the USA, those collaborators were responsible for thousands of deaths of their fellow citizens(see my article Don’t put all the blame on the Germans – a lesson from World War II).

Supporters of Latvia’s Waffen-SS legion hold an annual commemoration Nazi SS division formed from Latvians during World War Two. Image Credit: The Telegraph.

 

Sculpture of the “Unbowed man” at the Khatyn Memorial site near Minsk in Byelorussia. The sculpture depicts Yuzif Kaminsky, the only adult to survive the massacre by Ukrainian Nazi groups, holding his dead son Adam.
Image credit: John Oldale.

Which brings me to my real message – my suggestion for action

Why not take advantage of this new-found anti-fascist feeling? Rather than let the lessons of Charlotteville disperse and die out why not do something meaningful and specific? Something that might last. And something with an international influence.

My suggestion – the US should change its stance next time the regular United Nations General Assembly resolution on “Combating the glorification of Nazism, neo-Nazism and other practices that contribute to fuelling contemporary forms of racism, racial discrimination, xenophobia and related intolerance” comes up.

The resolution expresses concern about the fact that in some countries, famed Nazi movement leaders and former members of the SS are honoured, and monuments to fighters (e.g partisan heroes) against fascism are demolished or subjected to desecration. It calls on states to pass legislation prohibiting the denial of crimes against humanity and war crimes during the Second World War.

It was last passed in November 2016. Then the only countries voting against the resolution were Ukraine, the United States and Palau!

Just imagine, if the US goes with its current anti-fascist feelings it could, at last, vote for this resolution. Of course, Palau as a client state will also automatically reverse its vote.

As for Ukraine – well, who could say the country is such a mess. Chances are the current government in Kiev may not be in power next time the vote occurs. But, unfortunately, the extreme nationalist and neo-fascist forces which seem to dictate affairs in that country will still be around.

But what about closer to home

Can not New Zealand also learn from the current anti-fascist feelings emanating from the USA? New Zealand traditionally takes the cowards way out and abstains on this resolution. Apparently aligning itself with the 131 countries supporting the resolution in 2016 would have caused too much displeasure from the USA – something we still seem to be afraid of. So we joined the group of 48 countries that abstained.
But, I guess, if the USA changed heart and voted for the anti-fascist resolution we would meekly snap into line and also vote for it.

A job for the US (and NZ) House of Representatives?

OK, the current US president may be even less willing than previous presidents to take a real international stand against fascism. But don’t we have some recent history that might provide a solution. Why don’t the US Congress and Senate follow on from their recent almost unanimous resolutions constraining the president in his handling of international affairs?

They made it impossible for President Trump to take any action on sanctions against Iran, North Korea and the Russian Federation without a decision from Congress.

So why not a near unanimous Congressional resolution demanding the USA in future votes for this resolution in the UN General Assembly? A resolution that prevents the US Ambassador from voting against it again without a decision from Congress?

Perhaps the New Zealand Parliament could place a similar restriction on our representatives at the UN

After all, aren’t we all anti-fascist now?

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Local anti-fluoride activists tell porkies yet again

FFNZ confuses lack of low fluoride studies on rats with human studies

Well, I suppose that’s not news. A bit surprising, though, because they are claiming the absence of research on fluoridation and IQ – which sort of conflicts with the previous attempts to actually condemn and misrepresent the actual research on fluoridation and IQ.

Fluoride Free NZ’s (FFNZ) face book page is claiming:

Would you be interested to know that no studies have been conducted on fluoridated water at 0.7ppm to determine whether there is IQ reduction? The National Toxicology Program are currently completing research to fill this gap. You would have thought that they would have done this in the 1950s before starting the fluoridation program wouldn’t you?

There have actually been three recent studies from three different countries which have specifically investigated the claim of an effect of fluoridation on IQ – and, unsurprisingly, all threes studies showed there was no effect.

Here are those studies:

New Zealand

Broadbent, J. M., Thomson, W. M., Ramrakha, S., Moffitt, T. E., Zeng, J., Foster Page, L. A., & Poulton, R. (2014). Community Water Fluoridation and Intelligence: Prospective Study in New Zealand. American Journal of Public Health, 105(1), 72–76.

In fact, anti-fluoride activists in the US, as well as New Zealand, have campaigned against this study. Their major criticism is that the study also included the effect of fluoride tablet use. They argue that this makes the unfluoridated control group useless because many participants will have consumed fluoride tablets. However, they ignore the fact that the statistical analysis corrected for this but still found no statistically significant difference in IQ of children and adults from fluoridated and unfluoridated areas.

Sweden

Other critics of the Broadbent et al. (2014) study have raised the issue of experimental power because of the numbers of people in the study. This could be a valid issue as it would determine the minimum effect size capable of being detected. Aggeborn & Öhman (2016) made that criticism of Broadbent et al., (2016) and all other fluoride-IQ studies. Their study is reported at:

Aggeborn L, Öhman M. (2016) The Effects of Fluoride in the Drinking Water. 2016.

Aggeborn & Öhman (2016) used much larger sample size than any of the other studies – over 81,000 observations compared with around 1000 or less for the commonly cited studies. It was also made on continually varying fluoride concentrations using the natural fluoride levels in Swedish drinking waters (the concentrations are similar to those in fluoridated communities), rather than the less effective approach of simply comparing two villages or fluoridated and unfluoridated regions. The confidence intervals were much smaller than those of other cited fluoride-IQ studies. This makes their conclusion that there was no effect of fluoride on cognitive measurements much more definitive. Incidentally, their study also indicated no effect of fluoride on the diagnosis of ADHD or muscular and skeleton diseases.

Canada

Another recent fluoridation-IQ study is that of Barbario (2016) made in Canada:

Barberio, AM. (2016). A Canadian Population-based Study of the Relationship between Fluoride Exposure and Indicators of Cognitive and Thyroid Functioning; Implications for Community Water Fluoridation. M. Sc. Thesis; Community Health Sciences, University of Calgary.

This study also had a large sample size – over 2,500 observations. This reported no statistically significant relationship of cognitive deficits to water fluoride.

Incidentally, Barberio (2016) also found there was no evidence of any relationship between fluoride exposure and thyroid functioning. That puts another pet claim of anti-fluoride campaigners to rest.

Animal studies

So much for NZFF’s claim that “no studies have been conducted on fluoridated water at 0.7ppm to determine whether there is IQ reduction.” But, just a minute, they are quoting the National Toxicology Program (NTP):

“No studies evaluated developmental exposure to fluoride at levels as low as 0.7 parts per million, the recommended level for community water fluoridation in the United States. Additional research is needed.”

But they omit the next sentence from the quote:

“NTP is conducting laboratory studies in rodents to fill data gaps identified in the systematic review of the animal studies.”

The NTP is discussing the research with animals, mainly rats, where effects of fluoride on the cognitive behaviour of the test animals have been reported but the fluoride concentrations are very high. And NTP’s assessment base on the review of the literature found only “a low to moderate level of evidence that the studies support adverse effects on learning and memory in animals exposed to fluoride in the diet or drinking water.” Hence the need for more research.

As part of the NTP’s research, which is currently underway, there are plans to extend studies to low fluoride concentrations more typical of that used in community water fluoridation.

The high concentrations used in animal studies is a major flaw in the anti-fluoride activist use of them to oppose community water fluoridation. For example, Mullinex et al (1995) (very commonly cited by anti-fluoride campaigners) fed test animals drinking water with up to 125 mg/L of fluoride (concentrations near 0.8 mg/L of fluoride are used in community water fluoridation).

While it is unlikely that the NTP research will find any significant effects of fluoride on the cognitive behaviour of rats at the low concentrations used in community water fluoridation the anti-fluoride campaigners have their fingers (and probably toes as well) crossed.

NTP will begin publishing the results of their new research next year (see Fluoride and IQ – another study coming up).

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July ’17 – NZ blogs sitemeter ranking

SiteMeter “permanently retired.” Image credit: David Melin.

Well, Sitemeter seems to have finally died.

According the CurrentlyDown.com it has been down since July 5 and the image above taken from Twitter indicates it has been permanently retired. This follows many problems in the past so it appears unlikely to appear again.

My advice to those who have been using Sitemeter is to consider replacing it with Statcounter or a similar counter. Have a look at the NZ Blog Rankings FAQ. for advice on this. 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.

So this month’s list is greatly reduced. At last count, there were about 45 NZ blogs on the ranking list using Sitemeter.

Here are the rankings of New Zealand blogs with publicly available statistics for July 2017. 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

Subscribe to NZ Blog Rankings Subscribe to NZ blog rankings by Email Find out how to get Subscription & email updates Continue reading

Don’t rely on sources – follow the evidence

CNN pushes this mantra but many believe they promote fake news

When scientists evaluate published research we are more interested in evidence than in conclusions. In fact, the same evidence may lead scientific readers to different conclusions. That’s not surprising as in the real world no research project is able to consider all the theoretically possible evidence. Readers may, in fact, have other evidence. Or they may detect faults in authors’ interpretations.

I think this is a good thing. Considering the evidence allows competent critiques to be made and encourages knowledge to advance.

However, it annoys me that when we move outside the scientific environment we have to deal with situations where evidence may rarely be considered. People indulge in debating conclusions often with no regard to evidence. In fact, debaters seem to rely more on the real or perceived authority of their sources to support or discredit an argument, than on the evidence.

That’s just lazy. Source authority proves nothing and I would like to think that my discussion partners are capable of coming to a more reasonable position when they are forced to actually consider the evidence.

Both sides are guilty

Unfortunately, both supporters and opponents of a scientific viewpoint or consensus fall into this trap. Take the “fluoridation debate.” It annoys me that some supporters of the scientific viewpoint will respond to an opponent by disparaging their sources. The fact that the opponent is citing the activist Fluoride Action Network, the “Fluoride” journal or one of the shonky pay-to-publish journals where anti-fluoride activists sometimes get published does not, in itself, discredit their argument. On the other hand, if the actual evidence involved in those reports were discussed it might just be possible for the faulty conclusions to be exposed.

On the other hand, how often have I heard opponents of community water fluoridation reject the authority of scientific journals or published research because the workers were paid by the government (we must all get a wage from somewhere) or the journal or conference received industry sponsorship? I am not at all impressed by the refusal to consider the real evidence implied by falling back on disparaging sources.

The other tactic of supporting a claim by pointing to the high authority of the source is also repugnant. Even researchers and journals we generally consider “reputable” can still publish flawed work and even rubbish.

One of the most common arguments used by anti-fluoride campaigners is that the highly respectable, authoritative journal “The Lancent” has “officially” declared fluoride to be a “neurotoxin.” This is wrong on so many counts. The Lancet publishes research papers. It is not in the business of making official declarations on toxic compounds. The paper referred to did not describe fluoride as a “neurotoxin” – that word is inappropriate for describing a chemical of inorganic origin. The work cited in that paper was from areas of endemic fluorosis mainly in China and is not relevant to community water fluoridation. And the paper itself was not justified in making the limited conclusions it did on such poor evidence. I have discussed the paper more fully in Repeating bad science on fluoride.

The odds are, of course, that those activists citing this paper in such a manner have not actually read the paper – a common problem with people who rely on the authority of their sources rather than evidence. In fact, they are probably not at all interested in the details in most cases.

My point is reliance on authority is not a valid supporting argument any more than disparaging a source is a valid opposing argument. We should always follow the evidence – and rely on that evidence for our arguments in such discussions.

The political arena

This problem is even worse in the political sphere where so often we actually do not have evidence to fall back on. In fact, this situation seems to have got a lot worse of late where, for one reason or another, facts and evidence seem to be the last thing in the minds of “reporters” – or at least those who are continually telling us what we should think.

Unfortunately, discussion of political issues often leads people to claim they are using what they think as “reliable sources” or disparaging an opponent’s argument by claiming they are using “unreliable sources.” In fact, people who should know better, seem to often support their claims against any criticism by claiming it came from a “reliable source” or “authoritative source.” And these people who should know better will often resort to “attacking the messenger.” Criticising or rejecting information because it was reported by what they consider an “unreliable source.” The facts or evidence seem to be forgotten.

This can get pretty silly. I once had to confront the argument of a discussion partner who rejected the video recording of a statement made by a spokesperson for the US Department of State because it was part of a piece of RT news coverage! Especially silly as the video recording was probably an official one made by staff of the Department of State.

How often do we see people promoting partisan claims about the political hysteria in the US or the war in Syria by using sources like the Washington Post, New York Times, CNN or Al-Jazeera? Sources they claim are “reliable?” In my article  I described how the New Zealand Ministry’s of Foreign Affairs and Internal Affairs carried out “due diligence” on the White Helmets organisation they were planning to give money to by referring simply to a report from Al-Jazeera. No attempt to dig deeper, to evaluate the veracity of the Al-Jazeera reports or to follow-up other sources critical of the White Helmets. Yet Al-Jazeera has a reputation for supporting “rebels”/”terrorists” in Syria. It is shocking that a New Zealand ministry was not prepared to make a more sensible judgment.

On the other hand, how often do we see people disparaging information or claims about the current US political hysteria or the war in Syria which with they disagree because it was reported by Sputnik, RT or one of a host of other “alternative” news sources?

Both sides of a political argument now denigrate the sources used by the other side as promoting “fake news.” And, to an extent, each side is probably right as every news sources these days has its own point of view – its own bias.

Reader beware – use a range of sources

Unfortunately, many readers seem more interested in confirming their own biases than dealing with real facts or evidence. Understandably these people will select the news source that suits them. That’s OK if you simply want to follow the “party line.” But it is lazy because it avoids any intelligent or critical analysis.

It is incumbent on the rest of us who are more interested in real facts and in drawing more credible conclusions to make an effort to consult a range of news sources and to critically analyse the claims, opinions and information we get from them. I believe that in today’s world there is no such thing as an authoritative or reliable source when it comes to political information. All the media – the “established mainstream media” as well as the “alternative media” are equally capable of publishing and promoting fake news.

We need to be aware of this, be prepared to use a variety of sources to avoid the “party line” problem, and critically analyse what we read so we can separate facts from opinions and unsubstantiated claims.

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June ’17 – NZ blogs sitemeter ranking

Image credit: How to Write SEO-Friendly Blog Posts Your Audience Will Read – and Love

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 June 2017. 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

Subscribe to NZ Blog Rankings Subscribe to NZ blog rankings by Email Find out how to get Subscription & email updates Continue reading

Fluoridation: What’s happening with the New Zealand legislation?

The second reading of the fluoridation bill is now on the order paper for the current parliament. Public submissions have been heard, the Health Committee has reported back to the House and the Ministry of Health (MoH) has provided its own responses to submissions.

Of course, we don’t know yet what the final Act will be like exactly. But the submissions, the committee report, and the MoH responses give us some idea of likely changes to the original bill.

Submissions

I have described before how the anti-fluoride activist groups organise to deluge consultation processes with their submissions. This was certainly the case here and their submissions accounted for most of those opposed to the Bill.

However, because the legislation is about the decision-making process and not the scientific or ethical validity of social health policies simple opposition to fluoridation was irrelevant  – outside the scope of the bill. This was true of most submissions (85%) and these should be considered a waste of every bodies time.

I am surprised the anti-fluoride organisations organising this submission campaign chose to take such an irrelevant approach. Surely if they had put a bit of thought into their efforts they could have directed their submission at relevant aspects such as the consultation process, the decision-making body and the question of referenda.

That said, a small number of the anti-fluoride submissions did address aspects of the bill and these were considered by the Health Committee and the MoH.

Putting aside the anti-fluoride submissions which did not address the bill, 20% percent supported the Bill and 80% opposed to the Bill as currently drafted. Most supported extending fluoridation cover, but disagreed with specific parts of the Bill and suggested changes.

The legislation does not mandate fluoridation

This is a common misunderstanding promoted by anti-fluoride campaigners – obviously attempting to use scare-mongering to motivate their supporters. For example, Fluoride Free NZ formally names the legislation the Mandatory Fluoridation Bill which is dishonest – the correct name of the bill is Health (Fluoridation of Drinking Water) Amendment Bill.”

The bill transfers decision-making from local bodies to District Health Boards (DHBs) – but it does not require DHBs to make a decision about fluoridation. That is up to local DHBs and local conditions such as dental health, likely advantages and establishment costs.

Consideration of other health factors

A number of submitters expressed concern that while the bill requires DHBs to consider dental health effects, consideration of other possible health issues is not provided for. However,  the response from the MoH to this is:

“While DHBs are required to consider the evidence in relation to oral health, DHBs are not prevented from considering other factors, including the effect of fluoridation on overall health. However, officials do not consider it necessary for the Bill to require DHBs to consider these other factors.”

So, consideration of other health factors will depend on specific situations, the board members or public interest. Importantly, DHB’s are not prevented from considering wider health aspects.

Considering the science

I was interested to see that:

” The Ministry of Health is currently exploring options for the ongoing monitoring and assessment of research on fluoridation within the Ministry to align with the implementation of the Bill.”

The MoH sees this as carrying on the role formerly played by the now disbanded National Fluoridation Information Service. But this also goes some way to satisfying a suggestion in my own submission that the assessment of research on fluoridation is carried out by some sort of central expert body (see Fluoride, coffee and activist confusion). My concern was that the DHBs are not really suitable bodies for making expert reviews of the literature and evaluating the current state of the science. Handing this over to a central body could also prevent boards being deluged with misinformation and unsupported claims about the science – a feature of local body consultation which caused so much trouble to councils.

It was the pressure of submission campaigns including misrepresentation and false claims about the science which drove local bodies, who do not have the expertise to consider the science, to request a change to the legislation. DHBs will confront the same situation unless they can direct scientific consultation to a central expert body.

Community consultation

Many submitters (12%), both for and against fluoridation, suggested the bill should specifically require DHBs to consult the community about fluoridation decisions. While the bill did not make such specific requirements it also did not prevent such consultation.

In practice, public consultation will depend on the level of demand for it. It is up to DHBs to decide when consultation is appropriate and there is already a regulatory requirement for DHBs “to foster community participation in health improvement” which could cover that.

There is also provision for the Minister to describe a fluoridation decision as a “significant service change” which would require DHBs to undertake community consultation on regional service plans including fluoridation.

So, the anti-fluoride activist claims of denial of community consultation is wrong. While consultation is not specifically required it is not prevented by the bill and will depend on the level of public interest.

Engagement with local authorities

The health committee is recommending the bill be amended to explicitly require DHBs to consider the views of the drinking water supplier. This accommodates suggestions made by some local bodies who feared the imposition of decisions without considering their local situations.

However, the committee also suggested an amendment to make clear that engagement with local authorities does not require them to consult communities. The DHB which makes the ultimate decision would have that responsibility where necessary.

The Committee also suggested “the Government consider whether
it intends to contribute funding towards the costs of establishing fluoridated water supplies” because there is a “moral hazard arising from the DHBs making a decision that will impose costs on local authorities and ratepayers.”  It looks like the Government has accepted this point as they have already made $12 million dollars available to local bodies setting up new fluoridation systems (see Government commits $12m to help councils cover costs of fluoridation in water supplies.).

Provision of non-fluoridated alternatives

Some local bodies have already introduced “fluoride-free” taps at the request of local anti-fluoride campaigners., The MoH is suggesting an amendment to the bill to make clear that “DHBs can direct local government water supplies in their region on a supply by supply basis if they wish.”

This could make it possible for specific local supplies, like Petone in the Hutt region or some supplies in Christchurch to remain unfluoridated if their communities demand it even if a decision is made to fluoridate a region.

The DHB or the director general of health?

Many of the submitters opposed to the bill in its present form suggest that the decision-maker should not be the DHBs but the Director-General of Health or central government. This is because of the likely low expertise of DHB members, low voter turnout for DHB elections and concerns of legal challenges to DHB decisions. There was also the expressed belief that the anarchic and dishonest coordinated submission campaigns previously experienced by local bodies would simply be transferred to the DHBs.

Some submitter proposed that fluoridation be mandatory thereby removing the need for an elected body to be responsible for the decision making.

The committee report and response from the MoH show that parliament will probably stick with the DHBs as the decision maker. There are some advantages in this (the DHB have responsibilities in health areas) and the proof of the pudding will be in the eating. Will the DHB approach to consultations be able to successfully give more credence to credible and peer-reviewed science than the misinformation and distortions of science promoted by anti-fluoride campaigners?

Possibly. I hope so.

Conclusions

Despite the anti-fluoride campaigns and the resulting deluge of misinformed or misleading submissions, the submission process has been successful. Problems in the current wording of the bill were identified and reasonable solutions to these problems have been advanced.

We should now see how MPs react to the bill and the recommended changes in the second reading. Anti-fluoride activists have carried on an intensive campaign of emails, letters and representations aimed at MPs. On the whole, this will have been counterproductive as MP are surely aware this bill is not about the science or ethics of fluoridation but simply the decision-making process.

I am picking that these campaigns have produced more heat than light and will have little influence on the progress of the bill. However, I do expect a lot of teeth-grinding, hairpulling, garment rending, lamentations that democracy doesn’t work or that various MPs should be shot or otherwise disposed of from anti-fluoride campaigners. This is already happening and will no doubt intensify when the final bill is passed into law.

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May ’17 – NZ blogs sitemeter ranking

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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 2017. 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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