Chemical watchdog confirms suppressed report but justifies the suppression

Director-General of OPCW Fernando Arias Gonzales admits Douma engineers report was legit and he was part of the FFM – but attempts to justify suppression of the report.

France 24 reports that the head of the Organisation for the Prohibition of Chemical Weapons (OPCW) “has ordered a probe into the leak of an internal paper which queried the body’s findings into a 2018 attack in the Syrian town of Douma” (see Chemical weapons body probes leaked document on Syrian attack). This is yet another confirmation of the authenticity of the leaked document I discussed in Does international chemical watchdog cherry-pick evidence to confirm a bias? Recent documents form the OPCW also confirm that Ian Henderson, the head of the engineering subteam that prepared the suppressed document, was employed by the OPCW (see Remarks of the Director-General at the Briefing for States Parties on Syrian Arab Republic: Update on IIT-FFM-SSRC-DAT).

This should put to rest claims made by some corporate media journalists that the leaked document was fake and manufactured to discredit OPCW findings. Even so, these same journalists are not exactly rushing to repor the issue.

I guess no one who has worked for a large organisation, whether corporate or state owned, can be surprised at the way the OPCW is reacting to the leaked document. Or surprised that an important analysis was supressed leading to questions about the reliability of the final reports.

But the fact this is an international organisation bearing responsibility for monitory and eliminating a whole class of dangerous weapons makes the behaviour very serious. Even worse, the apparent bias in the final report about an incident which supposedly lead to the deaths of so many civilians raises questions about the ethical behaviour of the OPCW. It is very likely a war crime was committed and the OPCW has not only failed in its role to objectively elucidate the evidence of this crime but actively worked to prevent attributing blame to the likely instigators of the crime. Instead the OPCW appears to have succumbed to political pressure from NATO-aligned countries to blame an innocent party.

Alleged victims of chemcial attack in Douma, Syria. Who was responsible for these deaths? Image credit: New York Times – Most Chemical Attacks in Syria Get Little Attention. Here Are 34 Confirmed Cases.

Given the seriousness of this matter, it is pleasing to see that the media is starting to provide some coverage of the document suppression – although very belatedly and in a very limited matter in the case of the corporate mainstream media. I hope the truth comes out and I hope, as a result, steps are taken to reform OPCW procedures to limit this sort of political interference.

However, in this post, I will just deal with an attitude expressed by the OPCW which displays a very unscientific attitude to their work. The idea that evidence should be selected to support a conclusion – rather than the conclusion be based on all the evidence.

Director-General of OPCW admits the legitimacy of engineers’ report

The video above shows Fernando Arias Gonzales, the Director-General of OPCW, admitting to the legitimacy of the engineers’ report and attempting to justify the fact its findings were excluded from the final report. I described the findings of the suppressed report in Does international chemical watchdog cherry-pick evidence to confirm a bias?

Briefly, whereas the final OPCW report provided evidence for the finding that the chlorine cylinders had been dropped from the air, the suppressed engineers’ report found it far more probable that the cylinders had been placed manually.  Considerations of the sizes of the ceiling holes, the possible velocities of the cylinders and damage to them, and surrounding damage were considered in the suppressed report.

Whereas other external engineers were later consulted by the OPCW and provided arguments justifying air-delivery I would expect an objective report would include all the analyses and information available. On those grounds alone the Director-General’s arguments for suppression are very suspect and do nothing to alleviate the subsequent loss of credibility of his organisation.

But to me it is worse – his comments are scientifically unethical.

“But sometimes it does not fit to the conclusion”

How can a report be considered credible if evidence contradicting its conclusion is omitted? Fernando Arias Gonzales does nothing to preserve the integrity of his organisation when he says of evidence – “But sometimes it does not fit to the conclusion.”

His statement implies that in this case the writers of the report started with a conclusion and then selected only that evidence which could support their pet conclusion.

That is scientifically unethical and displays probable political pressure.

Hiding behind possible attribution

In a formal statement from the OPCW the Director-General provides yet another justification for the report’s suppression:

“The document produced by this staff member pointed at possible attribution, which is outside of the mandate of the FFM with regard to the formulation of its findings. Therefore, I instructed that, beyond the copy that would exclusively be kept by the FFM, the staff member be advised to submit his assessment to the IIT*, which he did, so that this document could later be used by the IIT.”

But this is just incredulous. The final report presented only the evidence supporting air delivery of the two chlorine cylinders. The suppressed report presented evidence which did not support air delivery but was consistent with the cylinders being placed manually.

Neither the engineer’s report nor the final report mentioned any attribution – although of course attribution could be inferred. By arguing for air-delivery the final report can be seen as possible laying the blame on the Syrian state forces which used helicopters in the area.  Manual placement provides for possible attribution to the jihadist forces and a staged event. But neither of these are stated directly and it is disingenuous for the Director-General to claim, the suppressed report “pointed at possible attribution” but the final report didn’t.

Really, the Director-General’s statement has only dug a deeper hole and further reduced the credibility of the origination and its past and future reports.

*IIT –Investigation and Identification Team. This has been set up by the OPCW Secretariat to identify “the perpetrators of the use of chemical weapons in the Syrian Arab Republic.” However, it does not have full support from OPCW members and its establishment is controversial.

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Does international chemical watchdog cherry-pick evidence to confirm a bias?

Organisation for Prohibition of Chemical Weapons headquarters in The Hague. Image credit: Prensa Latina Ready Syria to Cooperate with Organization Against Chemical Weapons

Multinational bodies, like the Organisation for Prohibition of Chemical Weapons (OPCW) usually have authority and appearance of objectivity because of their international and representative nature. But I have been disappointed with some of the OPCW reports because they relied on hearsay and appeared to suffer bias. They also usually lack transparency and suffer from lack of data. I have discussed some of this in my articles Another shonky OPCW chemical incident report on Syria and OPCW on Salisbury poisoning – one step forward, two back?

It is probably inevitable that a theoretically objective  or non-partisan organisation will, in practice, be influenced by political and geopolitical interests. Even so, I am shocked to discover that The OPCW may have resorted to cherry-picking evidence for their Final Report of the OPCW Fact-Finding Mission (FFM) on the alleged chemical attack in Douma on 7 April 2018, released on 1 March 2019.

Paul McKeigue, David Miller and Piers Robinson who are members of Working Group on Syria, Propaganda and Media, revealed the cherry picking in their report Assessment by the engineering sub-team of the OPCW Fact-Finding Mission investigating the alleged chemical attack in Douma in April 2018.

OPCW sidelines its own fact-finding engineers

Specifically the Final OPCW report ignored the findings of their own Fact-Finding Mission (FFM) Engineering Subteam that was part of the original investigation on the ground. Instead, the OPCW later contracted unidentified experts who provided the engineering analyses included in the final report.

These unidentified experts produced a different conclusion to that reached by the FFM engineering subteam as described in a leaked dcouyment from the subgroup (Engineering-assessment-of-two-cylinders-observed-at-the-Douma-incident-27-February-2019-1). That, in itself, is not surprising – consider how in criminal cases prosecutors and defence can produce their own experts to make completely opposite arguments.  But the OPCW should have at the very least acknowledged the two different conclusions from the two different groups. They should also have given more weight to the conclusions of the own subteam who were involved in the initial investigations rather than the contracted experts who relied only on second-hand data (and were possibly given a more limited mandate).

I wrote about the interim report on this alleged chemical attack and its misrepresentation by corporate media in my article Blatant misreporting of latest OPCW report on chemical weapons in Syria. The interim report considered the allegation that a chemical weapon had been used and concluded:

“No organophosphorus nerve agents or their degradation products were detected, either in the environmental samples or in plasma samples from the alleged casualties.”

The notorious chlorine gas cylinders

However, it left open the possibility that chlorine gas had been used and this was considered in the final report which considered the two chlorine gas cylinders found at the site of the alleged chemical attack.

The two engineering reports relate to these chlorine gas cylinders. Whereas the original Fact-Finding Mission engineering subteam concluded that the chlorine gas cylinders had most probably been manually placed at the scene the anonymous experts later contracted by the OPCW appear to favour an explanation involving delivery by an aircraft.

From the report of the engineering subteam of the fact-finding mission – (Engineering-assessment-of-two-cylinders-observed-at-the-Douma-incident-27-February-2019-1)

The arguments and conclusions of the anonyous contracted enegineering experts are contained in the final report – Report of the Fact-Finding Mission Regarding the Incident of Alleged use of Toxic Chemicals as a Weapon in Douma, Syrian Arab Republic, on 7 April 2018.

LOCATION 2

The above propaganda video from the White Helmets (allied with the jihadists in Douma) illustrates the position of this gas cylinder on a roof adjacent to a crater.

The anonymous contracted experts concluded the cylinder had been dropped onto the roof with sufficent kinetic energy to create the crater but not penetrate the roof. However the OPCW FFM subteam concluded from their modelling:

“that the alleged impact event or events leading to observed vessel deformation and concrete damage were not compatible.

A criss-cross pattern on the paintwork of the cylinder body, that had been attributed by some observers to the cylinder falling through the wire mesh, was inconsistent with the near-vertical angle of incidence that would have been required to create the crater.

Experts consulted to assess the appearance of the crater took the view that it was more consistent with a blast (from a mortar round or rocket artillery) than with an impact from the falling object. Similar craters were present in concrete slabs on top of nearby buildings.”

They concluded that the cylinder had more probably been manually placed in the location rather than dropped from an aircraft.

LOCATION 4

This cylinder has always appeared strange, lying on a bed in a room that was relatively undamaged.

The anonymous contracted experts concluded (or maybe assumed) the cylinder had been dropped from the air and come through the ceiling to land on the floor where it subsequently bounced onto the bed (see image below from the OPCW final report).

However the FFM engineering subteam concluded from their analyses and modelling:

“that the cylinder with intact valve and fins attached could not have fitted through the hole in the roof:

it was not possible to establish a set of circumstances where the post-deformation cylinder could fit through the crater with the valve still intact (whether or not an end-cap was assumed to have been fitted at the front end of the cylinder), and the fins deformed in the manner observed.”

Conclusions

I can understand how different assessment teams can come to different conclusions and it could well be that the anonymous contracted experts were asked to assume that the cylinders had been dropped and to model possible trajectories and dmagge. In contrast the intial FFM engineering team considered alternative hypotheses as well as air-dropped cylinders and specifically proposed the alternatives in their report.

Such modelling and conlcusions can’t help but involve a degree of speculation so it does not concern me that different conclusions were drawn. But I am very concerned that the OPCW final report ignored the findings of their own FFM engineering subteam. This indicates a degree of bias which should be unacceptable for such an international body.

The authors from the Working Group on Syria, Propaganda and Media go as far as describing the issue as the hijacking of OPCW concluding:

“The new information we have removes all doubt that the organization has been hijacked at the top by France, UK and the US. We have no doubt that most OPCW staff continue to do their jobs professionally, and that some who are uneasy about the direction that the organization has taken nevertheless wish to protect its reputation. However what is at stake here is more than the reputation of the organization: the staged incident in Douma provoked a missile attack by the US, UK and France on 14 April 2018 that could have led to all-out war.

The cover-up of evidence that the Douma incident was staged is not merely misconduct. As the staging of the Douma incident entailed mass murder of civilians, those in OPCW who have suppressed the evidence of staging are, unwittingly or otherwise, colluding with mass murder.”

Other commentary on the OPCW FFM Engineering subteam report:

• • Assessment by the engineering sub-team of the OPCW Fact-Finding Mission investigating the alleged chemical attack in Douma in April 2018.
  • Syria – OPCW Engineering Assessment: The Douma ‘Chemical Weapon Attack’ Was Staged
  • Leaked Document Pokes More Holes In Establishment Syria Narrative

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Preempting the annual misrepresentation of NZ dental health data by anti-fluoride activists

Dental therapist Heather Dalton examines an Avondale College student in Auckland in 2010. Image credit: Te Ara: The Encyclopedia of NZ.

The latest NZ school dental service data again confirms that community water fluoridation is effective.  The data show benefits of up to about 30% improvement in oral health. But, anti-fluoride activists will, once again,  reject this evidence and instead cherry-pick the data to support their claims.

The NZ Ministry of Health (MoH) has posted the latest summary of child dental health collected by the dental health service. So it is time for local anti-fluoride activists to indulge in their annual activity of cherry-picking and misrepresentation to claim the data “proves” community water fluoridation (CWF) is ineffective (see my comment on last year’s misrepresentation – Anti-fluoridationists misrepresent New Zealand dental data – an annual event).

I haven’t seen this year’s expected press release from Fluoride Free NZ. I may have missed it or perhaps they haven’t got their A into G yet (although there is a bit of notice on their Facebook page). Nevertheless, I will post here my annual analysis of the data.

My comments are much the same as last year – the data has not really changed. But first an explanation of how the data should be used

Nature of the MoH dental health data

The published spreadsheets are simply records of dental health (% caries free and mean Decayed, Missing and Filled Teeth (DMFT and dmft) for 5-year-olds and year 8  children. There has been no selection of children to give representative data. Distortion due to ethnic and socioeconomic factors has not been taken into account.

Data are presented for all children – (Total), Maori, Pacific Island and “Other.” I have previously explained that the Total data is distorted by ethnic factors – different ethnic groups have differences in oral health, irrespective of fluoridation. In particular, the predominance of Pacific Island children in fluoridated areas distort the “Total” data – 85% live in fluoridated areas. Pacific Island children comprise about 15.1% of children in fluoridated areas but only about 3.2% of children in non-fluoridated areas.

Because Pacific Island children generally have poorer health they increase the value of dmft/DMFT and lower the value of caries-free % in the fluoridated areas in the Total figures. Therefore the “Other” figures are more reliable than the “Total” figures for interpretation.

The 2017 data

You can download the two spreadsheets, and the spreadsheets for earlier years, from the MoH website – Age 5 and Year 8 oral health data from the Community Oral Health Service). I will just give the overall New Zealand data for Māori and “Other” (this is all except Māori and Pacific Island).

As explained above the “Total” data is misleading because of ethnic effects and the data for Pacific Island is poor because only a small number resided in non-fluoridated areas.

5-Year Old Children

Clearly, the overall data suggest a benefit of fluoridation to Maōri and “other” children – about 14% for “Other” and 25% for Māori children (using the data for mean dmft).

Year 8 Children

Again the data suggests that fluoridation has been beneficial to Māori and “Other” children. The DMFT data suggest a benefit of about 30.5% for Māori and 26% for “Other” children.  Even the %Caries free data indicates benefits of about 16% and 11% for Māori and “Other” children respectively.

Changes over time

It’s worth considering more than one year. This overcomes, to some extent, variations in the data. It may also be helpful in assessing if the effectiveness of CWF is changing.

However, there is a proviso. Let’s not forget this is simply raw data from the school dental service. While I have corrected for ethnic differences I have no way of correcting for other differences. Socioeconomic effects may change over time. Another important factor is that, at least in some regions, dental health authorities are targeting children form non-fluoridated areas with extra treatments like fluoride tooth varnishes. Ideally, a controlled experiment would take all these factors into account.

I will just take one example – the DMFT data for year 8 children.

The table shows the mean values of %Caries free and DMFT of year 8 children over the periods 2005-2017 and 2013-2017.

Year 8 Children	Māori	“Other”
%Caries Free
Mean 2005-2017	24.2	13.4
Mean 2013-2017	15.6	8.8
MDFT
Mean 2005-2017	31.3	24.7
Mean 2013-2017	30.1	22.2

This data shows that the oral health of both Māori and “Other” children have improved over time irrespective fluoridation. But there is still a difference between fluoidated and unfluodiated areas indicating fluoridation is having a benefit over and above other factors contributiong to oral health improvement.

The differences due to fluoridation seem to be diminishing. However, my comments above are relevant here. This could be due to extra fluoride treatments targeting children from non-fluoridated areas.

It’s obviously a factor for health authorities to consider but limitations in this data should be kept in mind and other sources of information also considered.

Conclusions

Once again the MoH school dental service data show benefits from CWF. But don’t expect anti-fluoride activists to accept this. I expect they will indulge in their usual cherry-picking of the data to confirm their biases.

Fluoridation: Another study shows stopping fluoridation bad for child tooth decay

Stopping community water fluoridation in Alaska’s capital city, Juneau, caused an increase in child tooth decay

In the last week, Windsor in Ontario, Canada, voted to reinstate community water fluoridation (CWF) 5 years after it was stopped because of opposition. This time the City Council was swayed by the Windsor-Essex County Health Unit’s Oral Health 2018 Report which found the percentage of children with tooth decay or requiring urgent care increased by 51 per cent since fluoridation had stopped.

Now a new study reports similar increases in child tooth decay after stopping CWF in the Alaskan capital, Juneau. This paper reports the study results for Juneau:

Meyer, J., Maragaritis, V., & Mendelshon, A. (2018). Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska. BMC Oral Health, 18:215

Juneau – an ideal community for the study

Juneau maintains all the modern conveniences and standards expected of a capital city but has little in-and-out migration or travel from neighboring countries as it is accessible only by plane or sea. This reduces confounding effects due to population changes, only about 0.006% per year during the study period.

Use of fluoridated toothpaste is widespread and CWF was available to 96% of residents before it was stopped in January 2007.

The researchers compared child oral health data in 2003 (when children were exposed to optimum levels of fluoride: 0.7 – 1.2 mg/L) with that in 2012, 6 years after CWF ceased. During those six years, exposure to fluoride was suboptimum: <0.065 mg/L.

The data used for the study was from Medicaid dental claims records. This means the study population was made up of residents living at near poverty conditions. This limited confounding effects from higher-income groups.

Cessation of CWF resulted in increased child tooth decay

The findings were clear and statistically significant. The number of caries-related dental procedures increased after cessation of CWF.

For all children and adolescents (ages 0 – 18 years) the number of procedures increased by 16%. But binary logistic results indicated “the odds of a child or adolescent undergoing a dental caries procedure in 2003 was 25.2% less than that of a child or adolescent in the suboptimal CWF group.”

The effects of CWF were even greater for children aged 0 – 6 years who had never experienced the advantages of exposure optimum fluoride levels. The number of caries-related dental procedures in this group increased by 63%. However,  binary logistic results indicated “the odds of undergoing dental caries procedures under optimal CWF conditions was 51% less than that for a child of the same age in 2012 under suboptimal conditions.”

CWF cessation increased dental treatment costs

The researchers obtained dental costs from the Medicaid dental claims records so were able to make estimates of the effects of CWF on the financial costs to the community. After adjusting for inflation this data showed that the increased annual cost per person of ages 0 – 18 years due toi cessation of CWF increased by $162, a 47% increase. The corresponding increase for children 0 – 6 years was %303, a 111% increase.

Conclusions

While this study had several advantages over similar studies because of reduced confounding effects due to migration and socioeconomic factors this may also be seen as a limitation when trying o extend to findings to more socially heterogeneous communities. However the authors conclude it does provide stong evidence supporting:

“current evidence that even in modern conditions with widely available fluoride toothpaste, rinses, and professionally applied prophylaxis, CWF is associated with population benefits, including cost effectiveness and caries prevention.”

They also conclude from their results that:

“CWF cessation promoted a marked increase in the number of caries-related procedures and treatment costs for Medicaid-eligible children and adolescents aged 0–18 years. Additionally, the results indicated that children in the younger age group cohorts underwent more dental caries procedures than the older age group cohorts, who had benefited from early childhood exposure to optimal CWF.”

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Protection of teeth by fluoride confirmed – yet again

 

Fluoride protects teeth from the attack of acid and microbes. Figure from Faidt et al., (2018)

The protective role of fluoride in teeth has been confirmed, yet again. A new study nicely demonstrates how incorporation of even a small amount of fluoride into the surface layer of teeth protects them from the acid attack which leads to tooth decay.

Researchers measured the ablation, or loss of surface material from hydroxyapatite before fluoridation and after fluoridation. It showed a clear difference due to inhibition of ablation by fluoride.

The research findings are published in:

Faidt, T., Friedrichs, A., Grandthyll, S., Spengler, C., Jacobs, K., & Müller, F. (2018). Effect of fluoride treatment on the acid-resistance of hydroxyapatite. Langmuir

Measuring ablation

Samples were etched with a sodium acetate buffer at pH 4.5 which simulated the effect of an acid attack on teeth resulting from the formation of acid when sugars are microbiologically decomposed in the mouth. The degree of ablation was measured using atomic force microscopy (AFM). Part of the sample surface was coated with a gold layer to prevent acid attack and give a reference surface.

Fluoridated surfaces, submerged for five minutes in a sodium acetate buffer at ph 6.0 cotnaining 500 mg/L of sodim fluoride, were compared with unfluoridated surfaces.

Results

Interestingly, the AFM height images showed there were two different areas of the hydroxyapatite surface when it came to ablation – a fast etching area and a slow etching area. The authors attributed this to the different orientations of crystallites in the hydroxyapatite sample. The image below is for an unfluoridated sample

Ablation of  fluoridated samples was quite different – no ablation occurred until after 330 seconds – the image below is for a fluoridated sample

The paper summarises the results for the fluoridated and unfluoridated surfaces and the different ablation rates due to crystallite orientation in this figure:

The crystallites that etched slowly (Z2) in the unfluoridated sample did not etch at all in the fluoridated sample. The more rapidly etching crystallites (Z1) did etch in the fluoridated sample but only after a delay.

The authors concluded that some of the fluoride in the surface layer of the fluoridated samples could eventually be removed by soaking in the acid buffer – but only after a delay. This was confirmed by an analysis of the surface concentrations of Ca, P, O and F using X-ray photoelectron spectroscopy (XPS) – see below:

Thickness of the fluoridated surface layer

The authors recall:

“In a former study, we revealed that the thickness of the HAp layer that can be loaded with fluoride is in the range of only a few nanometers (24, 25), even if loaded under optimal conditions (25). “

So – a very thin layer. One that some anti-fluoridation commenters claimed insufficient to give any protection. As the authors say

” the question arose whether such a thin layer would actually be capable of protecting the surface against acid attacks. “

But, their results definitely show that this thin layer does offer protection. I am sure critics will quickly point to the fact that the experimental study showed the removal of some of the fluoride after about 400 seconds. But this removal should be seen in the light of the dynamic system in the oral cavity where the pH of saliva is changing, dropping due to sugar decomposition and then rising again. The presence of fluoride, together with phosphate and calcium in saliva also leads to repair of areas where acid attack has occurred.

Conclusions

This experimental work confirms the protective role of fluoride in saliva for existing teeth – despite the fact that the fluoridated layer may be extremely thin – of the order of a few nanometers. While some of the fluoride in the surface layers is eventually removed the presence of fluoride in saliva helps replenish these layers and repair areas of acid attack.

The authors conclude their results provide:

“evidence that already thin and low concentrated fluoridated layers have a large effect on the acid resistance of HAp [hydroxyapatite]”

They combine these finding with results from a previous study of theirs showing fluoridation reduced adhesion forces of bacteria on hydroxyapatite (HAp) to finally conclude:

“the caries-preventive effect of fluoride is an interplay of at least two mechanisms: a reduction of the solubility and a reduction of the bacterial adhesion force.”

Hence the figure at the top of this article.

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Fluoridation and ADHD: A new round of statistical straw clutching

“To clutch at straws – the act of reaching for a solution no matter how irrational or inconsequential.” Source: Advanced Vocabulary for English Language Learners

Anti-fluoridation activists are promoting a number of new scientific papers they argue support their campaigns. But one has only to critically read these papers to see they are clutching at straws. Their promotion relies on an unsophisticated understanding of statistics and confirmation bias.

I will look at one paper here – that of Bashash et al., (2018) which reports an association between maternal prenatal urinary fluoride and prevalence of child ADHD.

The paper is:

Bashash, M., Marchand, M., Hu, H., Till, C., Martinez-Mier, E. A., Sanchez, B. N., … Téllez-Rojo, M. M. (2018). Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years of age in Mexico City. Environment International, 121(August), 658–666.

I discussed an earlier paper  by these authors – Bashash et al., (2016) which reported an association between maternal neonatal IQ fluoride and child IQ – (also heavily promoted by anti-fluoride activists) in a number of articles:

• Fluoride, pregnancy and the IQ of offspring,
• Maternal urinary fluoride/IQ study – an update,
• Anti-fluoridation campaigners often use statistical significance to confirm bias,
• Paul Connett “updates” NZ MPs about fluoride?,
• Paul Connett’s misrepresentation of maternal F exposure study debunked,
• Mary Byrne’s criticism is misplaced and avoids the real issues,
• A conference paper on the maternal neonatal urinary fluoride/child IQ study has problems, and
• A more convincing take on prenatal maternal dietary effects on child IQ.

Promotion of the new paper by anti-fluoride activists suffers from the same problems I pointed out for their promotion of the earlier paper. In particular it ignores the fact that the reported relationships (between maternal neonatal urinary fluoride and cognitive measure for children in Bashash et al., 2016, and prevalence of child  attention deficit hyperactivity disorder – ADHD – in Bashash et al., 2018) were very weak and explain only a very small amount of the variation. This raises the possibility that the reported weak relationships would disappear if significant risk-modifying factors were included in the statistical analyses.

Bashash, et al., (2018)

Whereas the earlier paper considered measures of cognitive deficits in the children the current paper considers various measurements related to ADHD prevalence among the children. These include parent rating scales (CRS-R). Three were ADHD-related scales from the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Inattention Index, Hyperactivity-Impulsive Index and Total Index [inattentive and hyperactivity-impulse behaviours combined]). They also include several other indexes related to ADHD.

A number of computer-assisted indexes (CPT-II) were also determined.

Most indices were not significantly associated with maternal prenatal urinary fluoride. However, the authors reported statistically significant (p<0.05) relationships for indices of Cognitive Problems + Inattention, ADHD Index, DSM Inattention and DSM ADHD Total.

The data and the relationships were provided in graphical form – see figure below – taken from their Figure 2:

There is obviously a wide scatter of data points indicating that the observed relationships, although statistically significant, explain only a small part of the variation in the indices.

So, just how good are the relationships reported by Bashash et al., (2018) in explaining the variation in these ADHD-related indices? I checked this out by digitally extracting the data from the figures and using linear regression analysis.

Index	% Variance explained
Cognitive problems + Inattention	2.9%
ADHD Index	3.1%
DSM Inattention	3.6%
DSM ADHD Total	3.2%

In fact, these relationships are extremely weak – explaining only a few per cent of the observed variation in the ADHD related indices. This repeats the situation for the cognition-related indices reported on the Bashash et al., (2016) paper (see Maternal urinary fluoride/IQ study – an update).

The fact these relationships were so weak has two consequences:

1. Drawing any conclusions that maternal neonatal fluoride intake influences child ADHD prevalence is not justified. There are obviously much more important factors involved that have not been considered in the statistical analysis.
2. Inclusion of relevant risk-modifying factors in the statistical analysis will possibly remove any statistical significance of the relationship with maternal urinary fluoride.

Credible risk-modifying factors not considered

Bashash et al., (2108) do list a number of possible confounding factors they considered. These did not markedly influence their results. however, other important factors were not included.

Nutrition is an important factor. Malin et al., (2108) reported a signficant effect of nutrition on cognitive indices for a subsample of the mother-child pairs in this study (see A more convincing take on prenatal maternal dietary effects on child IQ).

Their statistical analyses show that nutrition could explain over 11% of the variation in child cognitive indices indicating that nutrition should have been included as a possible risk-modifying factor in the statistical analyses of Bashash et al., (2016) and Bashash et al., (2018). I can appreciate that nutrition data was not available for all the mother-child pairs considered in the Bashash et al., papers. However, I look forward to a new statistical analysis of the subset used by Malin et al., (2108) which includes prenatal maternal urinary fluoride as a risk-modifying factor and tests for relationships with child ADHD prevalence.

Could the reported weak relationship disappear?

Possibly. After all, it is very weak.

The problem is that urinary fluoride data could simply be a proxy for a more important risk-modifying factor. That is, urinary fluoride could be related to other risk modifying factors (eg. nutrition) so that the relationship with urinary fluoride could disappear when these other factors are included.

I illustrated this for a earlier reported relationship of child ADHD prevalence with extent of fluoridation in US states (see Perrott 2017 – Fluoridation and attention deficit hyperactivity disorder – a critique of Malin and Till (2015)). In  that case the relationship was much better than those reported by Bashash et al., (2016) and Bashash et al., (2018) – explaining 24%, 22% and 31% of the variance in ADHD prevalence for the years 2003, 2007 and 2011 respectively. The relationships are illustrated in their figure:

Relationships between water fluoridation (%) and child ADHD prevalence for 20013 (red triangles), 2007 (blue diamonds) and 2011 (purple circles). Malin & Till (2105)

Yet, when other risk-modifying factors (particularly mean state elevation) not considered by Malin & Till (2015) were included in the regression analyses there was no statistically significant influence from fluoridation prevalence. In this case fluoridation prevalence was related to altitude and was simply acting as a proxy for altitude in the Malin & Till (2015) regression.

Conclusion

As the authors admit, this study:

“was not initially designed to study fluoride exposure and so we are missing some aspects of fluoride exposure assessments (e.g., detailed assessments of diet, water, etc.).”

However, they do say these “are now underway” so I look forward with interest to the publication of a more complete statistical analysis in the future.

There are other problems with the data (for example the paucity and nature of the urinary fluoride measurements) and these are the sort of issues inevitably confronting researchers wishing to explore existing data rather than design experimental protocols at the beginning.

Readers should therefore always be hesitant in their interpretations of the results and the credibility or faith that they put on the conclusions of such studies. The attitude should be: “that is interesting – now let’s design an experiment to test these hypothetical conclusions.”

The problem is confirmation bias – the willingness to give more credibility to the findings than is warranted. Scientists are only human and easily succumb to such biases in interpreting their own work. But this is even more true of political activists.

The reported relationships are weak. Important risk-modifying factors were probably not included in the statistical analyses. The observed relationships may simply mean that urinary fluoride is acting as a proxy for a more important risk-modifying factor (like nutrition) and the weak relationship may disappear when these are considered.

So scientific assessment of this study will be extremely hesitant – interpreting it, at best, as indicating need for more work and better designed research protocols.

But, of course, political activists will lap it up. It confirms their biases. Political activist organisations like the Fluoride Action Network are heavily promoting this paper – as they did with the earlier Bashash et al., (2016) paper.

But they are simply clutching at straws – as they often are when using science (or more correctly  misrepresenting and distorting the science) to support their political demands.

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Flight MH17 tragedy in Ukraine – new evidence

New evidence presented at Russian Ministry of Defence press conference, 17 September 2018.

In July 2014 the Malaysian Airline Flight MH17 was shot down over eastern Ukraine. All 283 passengers and 15 crew died. A Dutch-led international Joint Investigation Team (JIT) has been investigating the tragedy with the aim of determining criminal blame.

Update: Facebook took it upon themselves to censor my timeline and remove the Facebook post of my article. It seems their fact-checkers at the Atlantic Council have judged this information as “not following community standards”

Bit of a lesson there.

 

The JIT produced a preliminary report in 2016 (see But will it stand up in court?) and updated this with new evidence at a press conference last May 24. At the conference they revealed the serial number of the missile which shot down the plane and made a general appeal for people who might have information on this to come forward. At a Press Conference this week the Ministry of Defence (MOD) of the Russian Federation has responded with information from the manufacturer’s log books about this specific missile.

This appears to be the most concrete evidence to date which could be used to lay credible blame for the tragedy.

The JIT reveals serial numbers of the missile and appeals to the public for information about it.

While the JIT May 24 statement laid the blame on the Russian Federation, their evidence was rather subjective – relying on subjective interpretation of markings on vehicles in videos available online. “Open source” evidence. In contrast, the Russian MOD was specific and taken from archived information from the missile manufacturer.

In a way, this is rather unique because this information was understandably classified. Presumably, Russian officials have been active in the period between May and September locating the log books, interviewing relevant staff members from the time of production and going through the bureaucratic procedures required to declassify the material.

The new evidence

The video of the Russian MOD press conference above summarises three pieces of evidence the Russians have made available:

1: The most convincing evidence is the date of manufacture of the specific missile (December 1986) and its transport to the military unit where it was deployed. The records show it was deployed to a unit based near Lvov in the then Ukrainian Socialist Republic. It had never been returned to Russian territory.

I think that evidence is solid. The MOD spokesperson said the information has been passed onto the JIT and if they ask to inspect the archives they will be invited to Moscow to do so. He also made the point that the Russian side has asked the JIT to request the log books of the Ukrainian military unit which has been in possession of that missile and reveal its movements and location during July 2014.

2: Analysis of the video material the JIT had relied on to support their conclusion that the missile came from the Russian 53rd Anti Aircraft Missile Brigade based near Kursk in the Russian Federation. That video material had initially been compiled by Bellingcat, a suspect internet group now allied with NATO. The JIT conclusion relied on subjective tracking of markings on a BUK unit and its transporter and claimed to track it through its journey.

JIT open source video evidence supporting their conclusion that the BUK unit came from Russia

Russian experts have analysed these videos and shown problems with lighting and perspective indicating they have been faked. Something as simple as placing an image of a BUK unit into an existing video.

Their analysis seems credible, but obviously, this is the sort of thing which could be debated between experts in a court.

3: A recording of a telephone conversation made in 21016 where Ukrainian Armed Forces Col. Ruslan Grinchak refers to the tragedy in a way that implied it was caused by the Ukrainian armed forces. This person was in charge of airspace over the Donetsk region at the time of the tragedy.

This evidence relies on interpretation so is less convincing by itself.

Conclusion

The new evidence resulting from the discovery of the missile serial numbers by the JIT looks conclusive. As Russian Lieutenant General Nikolai Parshin told reporters the archives show:

“the missile was assembled on December 24, 1986, and delivered by rail to the military unit number 20/152, officially named the 223rd Air Defense Missile Brigade. It was deployed to the Ukrainian Soviet Socialist Republic’s Ternopol Region, which was part of the Subcarpathian Military District.”

Unless archive evidence in the possession of the Ukrainian armed forces can show that the missile was subsequently exported back to the Russian Federation there seems no doubt that Flight MH17 was shot down by a Ukrainian missile.

However, much more has to be done to apportion blame. There is still the possibility that this particular BUK unit was in the hands of the separatist forces in the Donetsk or Lugansk regions (although Dutch Intelligence reports at the time indicated any BUK units in the hands of separatists were not functioning -see Flight MH17 in Ukraine – what do intelligence services know?).

What is clear is that the ball is now back in the hands of the JIT, and more specifically, the Ukrainian armed forces. The JIT should now demand archived information on the locations, servicing and possession of this specific missile in the period between 2086 and July 2014.

Of course, as in other aspects of this investigation, the Ukrainian side may claim that records do not exist or have been destroyed. I do not think that is good enough and such lack of cooperation has already damaged the reputation and reliability of the JIT. Ukraine, as possibly one of the suspects, should never have been given membership of the JIT where it can influence the investigation and exert veto power over the dissemination of findings.

Perhaps reporters should now be asking the Ukrainian military to go away and find this specific missile and hold their own press conference where they can expose the serial number of the one they have in their possession.

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Novichock detection and the Salisbury tourists

Image credit: EU Today.

The Salisbury novichok poisonings are a real can of worms. Media coverage is obviously politically, rather than scientifically, driven. Social and mass media reporting is highly partisan and the scientific components and reports (which are mostly classified) can become slaves to the particular political masters. I find the whole drama a mystery and certainly do not want to tie myself to any of the conspiracy theories, official or otherwise, that are floating around. It’s probably a subject to keep well away from.

However, one aspect intrigues me – the claimed identification of novichock residues in the London hotel room used by the Russian duo, Alexander Petrov and Ruslan Boshirov. In particular, is the identification of the material reliable and, further, is the reporting of this identification factual and reliable?

Media reporting: This generally assumes a positive identification, although at trace levels. The Sun, for example, reported:

“Petrov and Boshirov stayed in the City Stay Hotel in Bow, East London, during their time in the UK.

Cops searching their room two months later on May 4 are said to have discovered minute traces of Novichok, a high-grade military nerve agent created by Soviet scientists.”

And later:

“police found traces of Novichok in the hotel room in which the pair stayed for two nights.”

Similarly, the Independent reported:

“Investigators later found traces of novichok in their room at the City Stay Hotel.

They said the amount was too low to present a health risk but are appealing for any hotel guests who stayed there between 4 March and 4 May to contact investigators.”

Since Petrov and Boshirov surfaced and were interviewed the media coverage has become even more partisan and the discovery of these traces of novichock is being portrayed as even more definite.

The police report: In the absence of an official scientific report of the analyses this is the best we have to go on:

“On 4 May 2018, tests were carried out in the hotel room where the suspects had stayed. A number of samples were tested at DSTL at Porton Down. Two swabs showed contamination of Novichok at levels below that which would cause concern for public health. A decision was made to take further samples from the room as a precautionary measure, including in the same areas originally tested, and all results came back negative. We believe the first process of taking swabs removed the contamination, so low were the traces of Novichok in the room.

Following these tests, experts deemed the room was safe and that it posed no risk to the public.”

This raises more questions, for the scientifically inclined, than the answers, seemingly, provided:

• How many samples were taken – 2 positives is probably a low proportion of the total measurements?
• Where were the sample sites located in the room
• How do the low levels reported compare with the detection limits for the methods used?
• Was the decision to take further samples based on lack of confidence in the results form the first sampling?
• Again, how many further samples were taken and from what sites in the room?

I suspect that the two positive detections were probably false positives which the analyst had low confidence in. It is likely many samples were taken from the room so that two positives near, or at, the level of detection is not a good result. I suspect experts would challenge this evidence in court.

Absence of evidence is not proof of innocence

I should stress that in questioning the results I am not trying to argue for the innocence of the two guys. After all, a true professional would not have contaminated the hotel room. If the evidence is genuine, though, it may be more suggestive of a non-professional or non-state actor than a professional hitman.

The problem, though, at this stage is that all the other evidence made public is circumstantial and unlikely to stand up in court. The claimed positive detection of novichock-type compounds in the hotel room could be the key to a successful conviction so any doubts should be removed.

Novichock compounds

The following presents my views on the problems of detecting novichock compounds at low levels and why I think we should not accept the current media reports as positive evidence. A court would have to look very critically at the actual data and detection methods used. At the moment the political and police statements could be expressing far more confidence in the reported findings than is actually warranted by the real evidence.

An Iranian paper from two years ago, Hosseini et al., (2016) provides information on the synthesis, structure and detection of novichock-type compounds. It is probably the most up-to-date information publicly available and its citation is

Hosseini, S. E., Saeidian, H., Amozadeh, A., Naseri, M. T., & Babri, M. (2016). Fragmentation pathways and structural characterization of organophosphorus compounds related to the Chemical Weapons Convention by electron ionization and electrospray ionization tandem mass spectrometry. Rapid Communications in Mass Spectrometry, 30(24), 2585–2593.

The paper describes the micro-synthesis of two compounds that are listed under Schedule 2.B.04 of the Chemical Weapons Convention. These are:

• Compound 3: N-[Bis(dimethylamino)methylidene]-P-methylphosphonamidic fluoride, and
• Compound 4: O-alkyl N-[bis(dimethylamino)-
  methylidene]-P-methylphosphonamidate Novichok derivatives

The figure shows the chemical structures of these compounds.

The F atom in compound 3 is replaced by an organic group (R) to form the novichok derivative. As this can be either of a wide range of organic groups (the authors list nine different groups for derivatives they synthesised) the novichock-type compounds include a range of different chemicals with differing levels of toxicity.

This is why more official reports on the Salisbury poisonings refer to novichock-type nerve agents and not just novichock.

Before any clever reader decides to use this paper to synthesize their own samples of these or similar compounds I must stress the warning provided by the authors:

“It should be noted that, due to the extreme toxicity of these materials, the separation and purification of CWC-related chemical are very difficult and therefore should be carried out only by a trained professional in an efficient fume cupboard equipped with an active charcoal filtration system.”

Detection of novichok-type compounds

Mass spectrometry methods are used for detection. This involves breaking up the molecules into fragments using an electron ionizer (EI). These molecular fragments are then separated according to mass and charge and the amounts of each detected in a mass spectrometer (MS) to produce an EI-MS spectrum.

Each compound has its own “fingerprint” – a pattern of peaks defined by the mass/charge (m/z) of each molecular fragment and the relative intensity of each peak. The figure below shows the EI-MS “fingerprints” for compound 3 and the O-ethyl derivative of compound 4.

We can see why the detection of a compound relies not only on a single peak but also other characteristic peaks and their relative sizes.

For example, the largest peak (H) at m/z = 71 occurs in both compounds. This is because the molecular fragment (see the chemical structure to the right) responsible for it is produced by ionization of both compounds. So that peak cannot be used alone to differentiate between the two compounds. Identification of a specific compound requires locating all the major characteristic peaks and ensuring their relative intensities are correct.

This is straightforward where the compounds are available at relatively high concentrations and the combination of mass spectroscopy with gas or liquid chromatography helps to remove some of the background chemicals. The ability of UK experts to conclude that the type of novichok used to poison the Skripals is the same as that in the fake scent bottle used by the second victims (Dawn Sturgess and Charlie Rowley) means that they were able to recover samples containing the nerve agent at sufficiently high concentrations.

But, at low concentrations one may simply not be able to find all the characteristic peaks, and identification using just the most intense peaks is not so reliable. For example, compounds 3 and 4 could not have been differentiated at low concentrations if all that could be detected were very small peaks at m/z =  71, 135 and 150. Yet that is the situation when searching for trace levels and one is always conscious that the peaks that are detected could be due to low levels of a completely different compound.

Conclusions

I suspect the description of the two possibly positive samples in the London Hotel as trace levels or “at levels below that which would cause concern for public health” were interpretations driven by “wishful thinking” and exaggerated confidence and not surety. After all, scientists often face such pressures when their political masters are looking for results to fit a preconceived narrative. It is easy to be persuaded in such situations. And it is tempting for both scientists and police to describe their findings in a more confident way when presenting to the media than they would during peer discussions in the laboratory or office.

My suspicions are supported by the fact that the total number samples taken from this hotel room must have been quite large so that makes the reliability of the positive values at such low levels for only two samples quite suspect (although information on locations of sampling sites would help this interpretation).

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A more convincing take on prenatal maternal dietary effects on child IQ

Image credit: Nutrition and Pregnancy: Choline For Baby’s Development

Prenatal maternal nutrition is more likely to influence child cognitive abilities than fluoride. A new paper shows this by considering the effects of good or bad prenatal nutrition for the women in the Basash et al., (2016)  study that anti-fluoride campaigners promote. The new data shows that nutrition is more important than fluoride.

The Bashash et al. (2016) reported a weak relationship between prenatal maternal urinary fluoride and child cognitive outcomes or IQ (see Fluoridation: “debating” the science?). Anti-fluoride campaigners latched on to the paper because it seems to offer critical “evidence” for their claims that community water fluoridation lowers IQ. They argue that IQ, rather than the risk of dental fluorosis, should be the main consideration when considering community water fluoridation.

But a new study shows that prenatal maternal nutrition is a better predictor of neurodevelopmental outcomes for children than is urinary fluoride. This study used data from the same set of Mexican women/child pairs as Bashash et al., (2016).

Here is the citation for the new study:

Malin, A. J., Busgang, S. A., Cantoral, A. J., Svensson, K., Orjuela, M. A., Pantic, I., … Gennings, C. (2018). Quality of Prenatal and Childhood Diet Predicts Neurodevelopmental Outcomes among Children in Mexico City. Nutrients, 10(8), 1093.

Misrepresentation  of the Bashash et al., (2016) study

I have dealt with this in a number of articles. Basically my argument was not with the study itself (although it obviously lacks consideration of important risk-factors in it statistical analysis) but with the way anti-fluoride activists use it to draw unwarranted conclusions.

A key problem they ignore is that the relationships reported by Bashash et al., 2016 can explain only about 3% of the variation in the cognitive measurements. This strongly suggests that the relationship with prenatal urinary fluoride would probably disappear if more important risk-modifying factors were included in the statistical analysis. My article “Predictive accuracy of a model for child IQ based on maternal prenatal urinary fluoride concentration.”  explains this and is available online.

The new Malin et al., (2108) study now provides some risk-modifying factors, specifically diet, which explains the data better than does urinary fluoride.

Readers wishing to refer back to my earlier posts on misrepresentation of the Bashash et al., (2106) study can read:

• Fluoride, pregnancy and the IQ of offspring, 
• Maternal urinary fluoride/IQ study – an update, 
• Paul Connett’s misrepresentation of maternal F exposure study debunked,
• Mary Byrne’s criticism is misplaced and avoids the real issues, and
• A conference paper on the maternal neonatal urinary fluoride/child IQ study has problems

Diet as a predictor of neurodevelopmental outcomes

The statistical analyses in this new paper are quite complex because the authors considered nutrient mixture and not simply each nutrient in isolation. Their argument for this is that we consume nutrients as mixtures and that interactions between nutrients is always possible.

The study, therefore, looked at the relationship of different neurodevelopmental outcomes in the children with prenatal maternal diet. Initially the authors considered the predictive ability of nutrition by considering “good” or “bad” diets based on U.S. dietary guidelines.

A bad diet during pregnancy may harm your future child’s neurodevelopment. Credit: © ivanmateev / Fotolia

Good maternal prenatal nutrition had a significantly positive effect on all the neurodevelopmental outcomes measured. In contrast, poor nutrition had a significantly negative effect on all the outcomes (see table below). Weighted Quartile Sums (WQS) were used to create indices for the individual diets.

I compared the predictive ability of prenatal maternal nutrition used here with the prenatal maternal urinary F approach used by Bashash et al., (2016) using data digitally extracted from their supplemental figures (S1 and S2 – see below). This was for the verbal development score of the children. Unfortunately, this was the only individual data presented.

Clearly, there is a lot of scatter in the data – to be expected where a number of risk-modifying factors are involved. However, the data showing a positive effect of good maternal prenatal nutrition on the verbal score of the children explains 7.1% of the variation. The data for poor prenatal nutrition explains 11.2% of the variation.

Compare this with the predictive ability of the data present by Bashash et al., (2016) where maternal prenatal urinary fluoride could only explain 3% of the variation of the child cognitive scores (see Maternal urinary fluoride/IQ study – an update).

Malin et al., (2018) were able to show which nutrients contributed most to the positive or negative neurodevelopmental outcomes of the children. They concluded:

“mothers who consumed more nutritious diets during pregnancy tended to have children with more favorable neurodevelopmental outcomes, while mothers who consumed less nutritious diets and/or higher levels of sodium, saturated fat, and/or sugar during pregnancy tended to have children with poorer neurodevelopmental outcomes. This suggests that the consumption of more comprehensively nutritious prenatal diets favorably affects child  neurodevelopment, while the consumption of less comprehensively nutritious prenatal diets may hinder it.”

Individual nutrients affected specific neurodevelopmental factors but they reported that prenatal dietary thiamine, vitamin B6, monounsaturated fats, fibre and calcium had beneficial effects. In contrast, lower monounsaturated fat, lower thiamine, lower fibre and higher saturated fat were associated with lower neurodevelopmental scores for the children.

Conclusions

If anti-fluoride activists are really concerned about child IQ and other aspects of child neurodevelopment then they should be campaigning on the importance of nutrition during pregnancy and stop diverting us by scaremongering about community water fluoridation.

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Fluoridation: “debating” the science?

How the anti-fluoride activist envisages their debate challenge – their hero standing up against the might of the health authorities. Image credit: From the Coliseum to the Cage

New Zealand last week saw another “debate challenge” from anti-fluoride activists. But are their regular challenges serious? And do gladiatorial “debates” before partisan audiences have any value in science anyway?

These people often back away when their bluff is called. Their challenges have more to do with political tactics than any elaboration or clarification of the science. They appeal to the macho and combative attitudes of the intended audience.

One thing for sure, such “debates” do not advance scientific knowledge one iota – nor are they meant to.

The anti-fluoride hero is always victorious in the eyes of the partisan and faithful audience. Image credit: The Real Lives of the Gladiators of Rome – The Unfathomable Sport of Life and Death

Three Wise Men – the anti-fluoride activists Paul Connett, Declan Waugh and Vivyian Howard – visited New Zealand last week. Fluoride Free NZ (FFNZ) advertised these activists as “international experts . . .  “sharing the latest research.” Of course, the implications that these activists actually do any original research on fluoridation or what they were sharing was their own research were completely false.

 

This was just another one of those annual visits from Paul Connett (head of the US Fluoride Action Network) and his mates with the aim of misrepresenting and distorting the science so as to promote the political campaigns of the local anti-fluoridation brigade.

Anti-fluoride campaign puts all its eggs in the IQ basket

New Zealanders are rather tired of this sort of activism but the visit does represent an escalation. This year Three Wise Men, a few years back Two Wise men (Paul Connett and  Bill Hirzy) and before that just one wise man (Paul Connett). Is this a sign of increasing desperation as New Zealand moves ever so slowly to handing over decisions on community water fluoridation to District Health Boards? Or is it a sign of increased funding of the Fluoride Action Network and associated activist groups by the “natural”/alternative health industry? After all, it must cost a bit to send three spokespersons around the globe for just two meetings.

One thing I take from this activity is that the anti-fluoride movement has decided to put all its eggs in one basket – the IQ story. They won’t stop blaming fluoridation for all the ills of the world – from obesity to gender confusion. But they are deliberately making a determined effort to bring their IQ story onto centre stage.

The real experts and all the research indicate the main possible negative health effect which must be considered when planning introduction of fluoridation is mild forms of dental fluorosis. In contrast, anti-fluoride activists in the USA and NZ are attempting to present the main health effect that must be considered is a claimed decline in IQ.

The FFNZ advert shows this is the message the Three Wise Men were promoting in New Zealand. But the “latest research” they were “sharing” was not theirs but that of Basash et al., (2016). Or, rather, they were sharing a misrepresentaion and distortion of that research to fit their scarmongering claims.

I won’t repeat my analysis of the Bashash et al., (2016) paper and its misrepresentation here – readers can refer back to my articles:

• Fluoride, pregnancy and the IQ of offspring, 
• Maternal urinary fluoride/IQ study – an update, 
• Maternal urinary fluoride/IQ study – an update, 
• Maternal urinary fluoride/IQ study – an update, 
• Paul Connett’s misrepresentation of maternal F exposure study debunked,
• Mary Byrne’s criticism is misplaced and avoids the real issues, and
• A conference paper on the maternal neonatal urinary fluoride/child IQ study has problems

A draft of my article critiquing the Bashash et al., (2016) paper, “Predictive accuracy of a model for child IQ based on maternal prenatal urinary fluoride concentration.” is also available online.

The predictable debate challenge

No visit by Paul Connett would be complete without a challenge to debate the science with him. He is frustrated with the fact that his audiences are almost completely faithful anti-fluoride activists. The academics, experts and health authorities did not turn up to his meeting at Otago University so he claims “they don’t feel any obligation whatsoever to debate the science” and ”to simply ignore us is unacceptable” (see Anti-fluoride campaigner invites university debate).

Similarly, he blamed others and claimed his anti-fluoride message was being ignored when only three MPs turned up for his meeting at the NZ Parliament Building last February. That was disingenuous as he had been given plenty of time for a presentation to the Health Committee during the consultations on the Fluoridation Bill last year. And MPs are regularly bombarded with huge amounts of propaganda from anti-fluoride activists. Obviously, MPs feel so inundated with such propaganda that they see no need to attend yet another meeting to hear the same old message.

Connett’s challenges to “debate the science” in front of a partisan audience have more to do with political propaganda and enthusing activists than with science. He knows scientific knowledge does not progress by holding gladiatorial circuses. It progresses by long, careful and detailed research, publication and peer review.

Neither of these Three Wise Men has performed any original research on community water fluoridation but they can still make their input via the peer review process – which include post-publication peer review via critiques of published papers.

To be fair, Connett and other members of the Fluoride Action network have occasionally presented such critiques. Two examples come to mind – the studies of  McLaren et al., (2016) and of Broadbent et al., (2015). These were critiqued in responses published in these same journals by a number of opponents of fluoridation. The original authors responded in the same journals. Arguments and extra data were presented in the responses and the science is better off for those critiques.

But science does not gain one iota from Connett’s attacks on the New Zealander Broadbent and other researchers in the media or in his meetings with the faithful. Such attacks and macho comments, often bordering on ad hominem, only discredit the attacker. They are not the way to discuss science and yet Paul Connett and his supporters challenge genuine scientists to participate in such “debates’ which are nothing more than testostorone-laden slanging matches.

A farcical example of a debate challenge

This time around I got personally involved because I called the bluff of activists making yet another debate challenge. It came out of an online discussion where I was attempting to correct some mistaken claims made by anti-fluoride activists. Here is the challenge:

Screenshot of my invite – just as well a have this as this Facebook page subsequently deleted the invitation and all comments I had made. I am officially a nonperson there.

A game of chicken followed where I attempted to get Fluoride Free NZ (FFNZ) and Paul Connett to formally stand behind the challenge. Chicken because I recognised it was a game. I had a scientific exchange (“debate”) with Paul four years ago – I think it was useful and I believe this is how good faith scientific discussions should take place (see Connett & Perrott, 2014: The Fluoride Debate for the full exchange). But Paul had made clear to me some time ago that he wanted no further contact with me.

Sure enough, FFNZ very quickly retreated from the possibility they had offered of a one on one debate. I emailed FFNZ:

“I think a one on one exchange would be best and as Paul and I have similar expertise he would be the logical discussion partner.”

Their response:

“No we will only agree to two on two.”

Paul confirmed that he would not debate one on one with me. I accepted a two on two “debate” but pointed out it was their responsibility, not mine, to organise the speakers. If they were not prepared to do that I suggested a two on one “debate” (especially as being the only speaker on one side this would give me extra presentation time) but made clear that I would effectively ignore Vyvyan Howard because our expertise did not cross over. (Vivyan agree with me that as he is a pathologist “you are correct that a direct discussion between us would be unbalanced.”)

I also made clear I would not tolerate any attempt to use that format to argue that I was isolated and could not find anyone else in New Zealand to support my arguments (an implication Paul made in our email exchange, and, of course, a claim being parroted by his supporters on social media).

Paul then formally withdrew. A pity as I love Wellington and was looking forward to a visit at someone else’s cost.

So a farce, But wait. there is more. The Facebook page, Rethink Fluoride, deleted their invitation to this “debate.” They then followed by deleting all my comments on their posts. Rather ironic as I had a few days before congratulated them by allowing open comments, and in particular allowing scientific comments – something all other anti-fluoride Facebook pages refused to allow.

Conclusion

Debate challenges by anti-fluoride activists are never genuine. They do not wish to discuss the science – they are simply using the challenges to enthuse their true-believing supporters. It is a form of attack on genuine researchers and health experts.

There is a time and place for good faith scientific exchange – post-publication peer review, for example, can give a genuine avenue for any real critiques to appear and be considered. Testosterone-laden gladiatorial debates before partisan audiences do not.

Anti-fluoride activists are disingenuously using these “debate challenges” to imply that experts and researchers have no confidence in their science and are afraid. It’s simply a macho tactic which often descends into ad hominem attacks.

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