Category Archives: science

Fluoridation: members of parliament call from submissions from scientific and health experts

The new community water fluoridation legislation is now on the way in the New Zealand parliament. The Health (Fluoridation of Drinking Water) Amendment Bill was introduced on Tuesday and the parliamentary health committee has invited submissions.

It’s worth watching the videos of the twelve speakers in the first reading. These give an idea of how the legislation will be received by the different political parties. They also give an impression that members of our parliament are well aware of the tactics of the anti-fluoride pressure groups – they fully expect to be inundated with irrelevant and pseudoscientific submissions. But they are also aware that the science currently finds community water fluoridation to be both effective and safe.

After watching the debate these are my initial conclusions:

  1. The bill has almost unanimous support. Only New Zealand First voted against it.
  2. Many of the speakers see the legislation as only a little better than the current situation. The describe it as a half-way house – kicking the can down the road. District Health Boards (DHBs) will be subjected to the same uninformed or misleading pressure that the councils are at present. The government should have gone the whole hog and handed over responsibility for fluoridation decision to the Ministry of Health.
  3. All the speakers declared their support for the science that shows community water fluoridation effective and safe. Most showed they are aware of, and accept, the New Zealand Fluoridation review commissioned by the Royal Society of New Zealand and the Office of the Prime Minister’s Chief Science Advisor.
  4. None of the speakers showed any support for the arguments or activities of anti-fluoridation campaigners. In fact, there were many derogatory comments made about tin foil hats, etc.
  5. New Zealand First is opposed because they prefer that communities make fluoridation decisions by referenda and are calling for these referenda to be binding. They criticised those councils like Whakatane and Hamilton that had ignored the wishes of the community.

Health Committee calling for submissions

The Parliamentary health select committee has called for submissions on the bill. Written submission will be accepted until February 2, 2017.

Information on making a submission is available on the Health (Fluoridation of Drinking Water) Amendment Bill website. And you can make your submissions online.

You can also give notice that you wish to make an oral submission to the Health Committee.

Possible issues of contention

From what speakers in the debate had to say I do not think the anti-fluoride lobby will get much sympathy. MPs are expecting the usual deluge of submissions from them but know from experience how worthless they will be.

However, several MPs stressed they did welcome submissions and particularly encouraged submissions from scientific and health experts. The Royal Society of NZ and the Prime Minster’s Chief Scientific advisor may be specifically invited to make submissions.

The bill is not really about the science, however, and MPs expect that the real content – the processes for making fluoridation decisions and the body responsible for these, should be thoroughly discussed.

I expect there will be a strong push to strengthen the bill by moving responsibility to central government, the Ministry of Health, as MPs still see problems with DHB responsibility.

The issue of community consultation should also come up – particularly as New Zealand First is promoting the idea of binding referenda in communities. As it stands the bill does not define how consultation should occur so this may well be made more specific.

The Green Party seems keen to introduce mechanisms for better informing of the public about the science behind fluoridation. They are conscious that the anti-fluoride groups are fear-mongering on this issue and feel that this can be countered by better information. If this is discussed in depth in the hearings there may well be some interest in defining more specifically how government updates its understanding of the research on fluoridation and how they disseminate new research results to the public.

A role for you, the reader

Well, the process is underway. If you have views or concerns on the bill or on the decision processes involved with fluoridation now is the time to put pen to paper, punch away on your computer keyboard, or prepare for making an oral submission to the health committee. If you want advice on how to do this have a read of Making a Submission to a Parliamentary Select Committee and the linked documents.

Remember, written submissions are accepted until February 2, 2017, and we would expect the Health committee hearings to start soon after that.

Similar articles

Leader of flawed fluoridation study gets money for another go

christine-till

Professor Christine Till has been given a $300,000 grant to test for harmful effects of fluoride.

Malin and Till (2015) published research indicating a relationship between fluoridation and Attention Deficit Hyperactivity Disorder (ADHD). However, that study was flawed because it omitted important confounders. When these are included the relationship disappears.

I analysed that study in my article ADHD linked to elevation not fluoridation where I showed the relationship of ADHD to elevation was much more important than fluoridation. Huber at al., (2015) published work confirming the relationship of ADHD with elevation. So, obviously, elevation is an important confounder and  Malin and Till (2015) did not consider it in their study.

My own analysis indicated that there were a number of other confounders which are related to ADHD – with correlations similar to (eg., educational attainment, proportion of the sate’s population older than 65  and Per Capita personal income) or better (mean state elevation, home ownership and % living in poverty ) than that for fluoridation. That rings alarm bells – why consider only one factor (fluoridation) if there are other factors which appear equally or more important? Isn’t that confirmation bias? (I concede that Malin and Till did include a socioeconomic measure in their statistical analysis – but this was clearly not enough).

I tested the relative importance of the different facts using multiple regression and – sure enough – found that once a few important confounders were included water fluoridation could not explain any of the variance in ADHD! The statistically significant factors were mean elevation, home ownership, and poverty. The contribution of fluoridation was not statistically significant in this multiple regression.

A model including mean state elevation, home ownership and poverty explains about 45% of the variance in ADHD – much better than fluoridation could (Malin and Till explained 27 -32% for the fluoridation data).

Now, I read that Professor Till has been given research finds to have another go and possible harmful effects of fluoride. (see York professor leads study that could help answer fluoride safety questions). She plans to look at data from a Canadian investigation of pregnant women exposed to  contaminants. She says:

“Our study employs a prospective design that includes biomarkers of exposure to fluoride, detailed assessment of potential confounders, a comparison group, and the use of sensitive cognitive and behavioural measures that have been collected in one of the world’s most comprehensively characterized national pregnancy cohorts (MIREC).”

Now, I am pleased she aspires to a “detailed assessment of potential confounders” but wonder how detailed this will be after the problems with the Malin and Till (2015) study.

I have not yet seen any published response to the Malin and Till paper – maybe the cost of publication (US$2020) that journal is discouraging critics. It certainly discouraged me (I do not have institutional support for publication costs). Nevertheless, I hope professor Till has been acquainted with some of the criticism of that paper so that she can pay more attention to important confounders in the coming work

We can draw a few lessons from this.

Be careful of published statistical relationships

These days it is so easy to hunt down data and do this sort of exploratory statistical searching for significant relationships. But a statistically significant relationship is not evidence of a real cause. For example, there is a strong relationship between the sales of organic produce and prevalence of autism – but I have yet to hear anyone seriously suggest the relationship is at all causal.

But the scientific literature is still full of such studies – and I guess the motivated author can easily find arguments and other data in the literature that they, at least, feel convincing enough to justify publication.

Refereeing of scientific papers is, on the whole, abysmal

All authors have a pretty good idea of which journals, and reviewers, will be friendlier to their work – and which would be antagonistic. It is only natural tosubmitt to the friendlier journal.

Unfortunately, the Malin and Till paper was submitted to a journal with editors known to be friendly to a chemical toxicity model of cognitive deficits. Further, it turns out that the reviewers chosen for the paper were also supportive of such an approach.

While one reviewer did suggest including lead as a possible confounder (again showing a chemical toxicity bias) none of them suggested consideration of other confounders more likely to be connected with ADHD.

I discussed the editorial and reviewer problems of the Malin and Till paper in . (The journal, Environmental Health, has a transparent peer-review process which provides access to the names and reports of the reviewers.)

Again – another example of readers beware – even readers of scientific papers in credible journals.

Similar articles

Anti-fluoride claims often not relevant to New Zealand

xiang-Endemic fluorosis

Much of the anti-fluoridation propaganda used by activists relies on studies done in areas of endemic fluorosis. Slide from a presentation by Q. Xiang to an anti-fluoride meeting organised by Paul Connett’s Fluoride Action Network in 2014.

As we head towards the parliamentary consideration of new legislation on fluoridation in New Zealand the anti-fluoride groups are building a campaign to oppose the transfer of responsibilities from local councils to District Health Boards. So, their Facebook pages are promoting myths that fluoridation is dangerous to health – and we expect this to intensify as parliament moves into its Health Committee hearings on the bill.

Also expect that the local anti-fluoridation groups, and their backers, will bring out tame “experts” to make presentations to the parliamentary Health Committee and to public meetings.

Has Connett lost his effectiveness in New Zealand campaigns?

Maybe (once again) Paul Connett or Bill Hirzy who are paid propagandists from the US Fluoride Action Network. An activist group financed by the US “natural”/alternative health industry. But perhaps these two are “old hat.” Connett has been making regular visits to Australia and New Zealand during the Southern Hemisphere summers for some time now and the locals have got a bit tired of him. Bill Hirzy accompanied him on last years summer vacation and really didn’t contribute much to the campaign. Thames overwhelmingly supported fluoridation in their referendum last year (see Thames voters decisively support fluoridation) – despite the highly publicised opposition by Connett and Hirzy).

A possible new anti-fluoridation “expert?”

susheela

Poster for an anti-fluoride meeting in Region of Peel, Canada. Image credit: Reiki with Christine

Perhaps local activists recognise this because they are floating ideas of bringing out a new “expert” – Dr A. K. Susheela. She might also have more credibility than either Hirzy or Connett – because, unlike them, she has actually published scientific papers on fluoride. In fact, she is the executive director of India’s Fluorosis Research and Rural Development Foundation – a small non-government organisation based in Delhi. The purpose of the foundation is to encourage awareness of fluorosis in both medical and local Indian communities to curb the spread of this crippling skeletal disease in India.

Susheela has also been doing  the circuit of anti-fluoride campaign meetings in North America (see, for example, ‘Fluoride is a deadly poison’ Peel’s water fluoridation committee has heard). As the poster above indicates, she is being promoted as an expert on fluoride toxicity and fluorosis.  But please note – this does not make her an expert on community water fluoridation.  All her work has concentrated on areas of endemic fluorosis – where dietary intake of fluoride is much higher than in fluoridated areas of New Zealand.

In a 1999 article for UNICEF (Susheela, A. K., Mudgal, A. (1999). Fluoride in water : An overview. UNICEF WATERfront, (13), 11–13.) she admitted:

“According to 1984 guidelines published by the World Health Organization (WHO), fluoride is an effective agent for preventing dental caries if taken in ‘optimal’ amounts.”

She went on to described the WHO recommendations for fluoride in drinking water:

“Water is a major source of fluoride intake. The 1984 WHO guidelines suggested that in areas with a warm climate, the optimal fluoride concentration in drinking water should remain below 1 mg/litre (1ppm or part per million), while in cooler climates it could go up to 1.2 mg/litre. The differentiation derives from the fact that we perspire more in hot weather and consequently drink more water. The guideline value (permissible upper limit) for fluoride in drinking water was set at 1.5 mg/litre, considered a threshold where the benefit of resistance to tooth decay did not yet shade into a significant risk of dental fluorosis.”

For comparison, the target fluoride concentration for community fluoridation in New Zealand is about 0.7 – 1.0 mg/litre. The natural levels of fluoride in New Zealand’s drinking water are even lower. There is no significant risk of skeletal or dental fluorosis of concern due to CWF, or natural levels of fluoride,  in New Zealand.

Dr Susheela has no expertise in the area of community water fluoridation – or areas of the world where drinking water fluoride levels are similarly very low. Perhaps this is why she made the mistake of including Australia and New Zealand among countries where fluorosis is endemic in the above article which included the map below.

susheela-unicef

Dr Susheela is mistaken about fluoride in New Zealand and Australia. Map from her article 

Fluoride Freee NZ disingenuously used this mistake to claim that New Zealand suffered from endemic fluorosis – and cited UNICEF in support.  I would hope that Dr Susheeela, if she does come to New Zealand to campaign against the upcoming fluoridation bill, publicly admits and apologises for this  mistake.

Conclusion

We are used to anti-fluoride campaigners misrepresenting the scientific research on the efficacy and possible health effects of community water fluoridation. But we should also be wary of their claims derived from research in areas of endemic fluorosis where dietary intake of fluoride is much higher than in New Zealand. This includes studies on possible IQ effects and skeletal fluorosis.

The research may be respectable – but the findings are just not relevant to countries like New Zealand where the drinking water fluoride concentrations (in fluoridated and unfluoridated areas) is much lower.

Similar articles

 

Fluoridation not associated with hip fracture, heart attacks of osteosarcoma – new study

sweden

A new Swedish study confirms fluoride does not increase risks of hip fracture, myocardial infarction, or osteosarcoma.

Community water fluoridation appears to have no association with increased risk of hip fracture, myocardial infarction or osteosarcoma.

That’s the conclusion from a new Swedish study. And these conclusions agree with most findings from earlier studies.

Peggy Näsman describes this new study in her PhD thesis:

Näsman, P. (2016). Epidemiological studies of fluoride exposure and hip fracture , myocardial infarction and osteosarcoma.

She used Swedish nationwide population-based registers for her investigations.

Sweden does not use community water fluoridation but its drinking water contains fluoride at various levels, including optimum or even higher concentrations. So Swedish population data are ideal for looking at possible links between the level of fluoride intake and specific health effects.

Näsman found no association between fluoride exposure level and risk of hip fracture using a  cohort of 452,824 eligible people with an exposure to the same drinking water source from birth. The drinking water fluoride levels  ranged between <0.1 and 2.7 mg/L . Similarly, she found no association between fluoride level and the risk of osteoporotic (low-trauma) hip fracture.

However, stratified analyses suggested that fluoride exposure in people younger than 80 years of age was, in fact, associated with a decreased risk for hip fracture.

There was also no association between fluoride exposure level and risk of myocardial infarction using a cohort of 455,619 eligible people with an  exposure to the same drinking water source from birth.  The drinking water fluoride levels  ranged between <0.1 and 2.7 mg/L . There was also no association with fatal and non-fatal myocardial infarction.

Finally, Näsman found no association between drinking water fluoride exposure and risk of osteosarcoma using a case-control study consisting of 363 eligible osteosarcoma cases identified in the Swedish Cancer Register, and 1,815 control subjects randomly selected from the Total Population Register. Here the drinking water fluoride levels ranged between 0.03 and 2.75 mg/L.

Anti-fluoridation campaigners often cite cherry-picked studies based on unreliable work or small numbers of subjects to argue that community water fluoridation is harmful. They have specifically claimed fluoridation causes increased risks of hip fracture,myocardial infarction, and osteosarcoma. However, the bulk of the scientific literature does not support these claims and this study once again confirms that.

Näsman is publishing her findings in three scientific publications:

Näsman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study. J Dent Res. 2013 92(11):1029-34.

Näsman P, Granath F, Ekstrand J, Ekbom A, Sandborgh-Englund G, Fored CM. Natural fluoride in drinking water and myocardial infarction: a cohort study in Sweden. Science of the Total Environment. 2016 562:305-11.

Näsman P, Granath F, Ekstrand J, Ekbom A, Sandborgh Englund G, Naimi- Akbar A, Fored CM. Natural fluoride in drinking water and osteosarcoma: a case-control study in Sweden. [Submitted]

Similar articles

Anti-fluoridation activist Paul Connett has a senior moment about our debate

Paul Connett, from  the US anti-fluoride group, the Fluoride Action network, was interviewed today on the Radio new Zealand’s Jesse Mulligan programme. You can listen to the interview at Complaints against anti-fluoride ads not upheld.

jesse

Jesse Mulligan interviewed Paul Connett about his anti-fluoride views

Unsurprisingly, Paul presented the same  tired old arguments against community water fluoridation. And I can understand why he should once again promote his own anti-fluoride book. After all, it has 80 pages of references (most of them broken links to Fluoride Action Network web pages)! And it is surely natural for an author to be proud of their book.

But he seems to suffer from senior moments, or at least memory blocks, when he claims that the arguments in his book have never been confronted. That people refuse to debate with him about these arguments.

Has he really managed to eradicate all memory of our rather long on-line debate about those very arguments? He specifically required that our debate have the format of him advancing arguments from his book and that I would respond to them.

The full debate is available here (see Fluoride Debate) or it can be downloaded as a pdf document (see The fluoride debate). It’s a useful document – about 212 pages long – fully referenced and Paul’s arguments are presented completely unedited – just as he presented them.

I know Paul was unhappy at how the debate went. Since then he has asked me never to contact him again and I was immediately banned from commenting on all the local anti-fluoride websites and Facebook pages. I have also been blocked from commenting on the US Fluoride Action Network’s Facebook page.

OK, I can understand Paul may have felt disappointed with his response to my debunking of his claims – but to pretend the debate never happened?

Interestingly, this is not an isolated behaviour by anti-fluoride activists. Local anti-fluoride people have also made similar claims that no one will debate with them. However, they seem to run quickly in the opposite direction when they do get a response to their offer to debate. Stan Litras is one example where time and time again I have critiqued his anti-fluoride claims and offered him a right of reply. He always refuses but still publicly claims that no one will debate with him.

Paul lost it a bit in his interview today when Jesse mentioned the NZ fluoridation review carried out by the Royal Society of NZ and the office of the Prime mInister’s Chief Science Advisor. He made a few ill-advised disparaging comments which came across as shrill when compared with the explanations from Sir Peter Gluckman, the Prime Ministers Chief Science Advisor, who was given the opportunity to respond to Paul’s criticisms.

The Interview and Sir Peter’s response is worth listening to. You can download it or listen to it at Jesse Mulligan, 1–4pm.

Similar articles

 

But will it stand up in court?

mh17_missile_impact_-_dutch-webm

MH17 tragedy. Arguments remain about the model of missile used, the location where it exploded and its launch site

The joint investigation team (JIT) responsible for the criminal investigation of the downing of Flight MH17 over Ukraine in July 2014 have delivered the preliminary results of their investigation.

Wilbert Paulissen, the head of the Dutch National Detective Force announced their findings at a press conference in the Dutch city of Nieuwegein, saying:

“We have no doubt whatsoever that conclusions we are presenting today are accurate.”

The important question, though, is not the beliefs or conviction of the JIT spokesperson – but whether or not a court of law will accept these conclusions.

The scenario

The JIT has often been accused of deciding on the scenario they would investigate early in their investigation and subsequently restricted their investigation to that scenario – despite claims to the opposite. In other words, not giving proper consideration to other possibilities.

The presentation is online at Presentation preliminary results criminal investigation MH17 28-09-2016.” It  asserts:

“The BUK-TELAR that was used was brought into Eastern Ukraine from the territory of the Russian Federation.”

They rely on “intercepted telephone conversations and videos and photographs on the social media” for this assertion. Readers who have followed the social media discussion will not be surprised to find this scenario is exactly the same as that advanced by Bellingcat – a controversial site run by British journalist and blogger Eliot Higgins (formerly known Brown Moses). This site is well known for advancing apparently plausible but cherry-picked information promoting Higgin’s political arguments against Syria and Russia.

The problem is that having decided on this scenario last year, the JIT’s search for evidence involved the presentation on social media of a video outlining the scenario and asking residents in the area if they could contribute any evidence. It seems no other credible scenarios were  investigated.

The Ukrainian Army had many BUK systems and missiles in the area. I would have thought these should have been given at least as equal consideration – especially compared with an implausible scenario which involved very tight movement of  a system from the Russian Federation and its return to account for the fact that intelligence agencies had reported just days before the crash that the separatist groups did not have any such missile systems (see Flight MH17 in Ukraine – what do intelligence services know?)

As it stands a court may consider the sort of evidence promoted by Bellingcat and the JIT regarding this scenario as circumstantial at the best. Especially if JIT continues to base their scenario on “classified” US information they cannot reveal to the court. And how will the JIT respond to defence lawyers asking if they had catalogued all the BUL systems and accompanying missiles in possession of the Ukrainian Army at the time?

The other press conference

For some balance, I checked out another press conference occurring at a similar time today – that given by technical experts from the manufacturer of the BUK missile system – Almaz-Antey. Unfortunately, you are unlikely to see that press conference on our main-stream media.

Here is a video from this press conference – I appreciate it is hard to follow technical information presented in a foreign language and relying on translators – but it is worth watching and thinking about.

Credit: MH17 Malaysian Facebook feed.

Almaz-Antey, of course, does not have any responsibility to determine what the real scenario was and who was responsible. But they do have the technical skills to evaluate conclusions being drawn about the missile system, its detonation near the aircraft and its launch site.

Here they repeat data presented last year evaluating the conclusions drawn by the Dutch Safety Board in their final report. They also carried out an experiment testing these conclusions using a real missile and aeroplane fuselage. They found  that the Board was mistaken – holes and marks on the experimental fuselage did not correspond to those on the MH17 wreckage – and concluded that the missile used was actually an older version (not in the current Russian service but still used by the Ukrainians), that the detonation took place differently to what the Board had concluded and, therefore, the launch site could not be in the region the Board had concluded.

The primary radar data discussed was new – having been recently found among calibration data stored by a subsidiary company. This data could not find any record of a missile on a trajectory assumed by the Dutch Safety Board – and their estimate was that if a missile had been on that trajectory for the required time the chance of it being recorded in the primary radar data is more that 99%.

Unfortunately, that primary radar was not capable of recording any signal from the different trajectory and launch site indicated by the Almaz-Antey analysis of fuselage damage on MH17.

The company has passed on this information to Russian investigators who, I understand, have in turn passed it on to the JIT.

Conclusion

So, I am not convinced that the JIT has produced a case that will stand up in court. if they included further information – such as a survey of the BUK systems known to be in Ukraine at the time, and actual satellite data the US claims to have – then their circumstantial case may be more credible.

As for the Almaz-Antey information – I find it technically credible. But of course, that can only be tested by people with the same level of expertise. Until that is done it should not be rejected out of hand as the Dutch safety Board (and the JIT) appear to have done.

Let’s note that Wilbert Paulissen said: “there was conclusive evidence that a missile from the Russian-made Buk 9M38 missile system downed the passenger flight on July 17, 2014.” This relates to the missile system and should not be opportunistically interpreted to mean the JIT has “conclusive” evidence for the Bellingcat scenario they are pursuing.

I think most people now accept that a BUK missile system was the most likely weapon used. Tthe arguments are about the model of the missile, the detonation point and the launch site. I cannot see any credible argument from the JIT for their claims on these aspects to be conclusive.

Update

Here is the video of the JIT presentation referred to at the beginning of the article. It is quite difficult to follow (foreign language, translators and the problem of sound levels of each) but I managed to stick with it to the end.

The first half essentially follows the text linked to above (Presentation preliminary results criminal investigation MH17 28-09-2016) but the last parts are interesting with statements from the countries involved (illustrating the political nature of the event) and the questions.

The video confirms for me that the JIT investigators had started with a preferred scenario and are not willing to consider others. I can’t see this standing up in court – if it ever gets to a reputable court.

Similar articles

 

Flogging a dead horse – anti-fluoridationists lose in court again

flooging-horse-certificate

This certificate should be awarded to New Health NZ, the NZ Health Trust and the anti-fluoridation movement for not knowing when to give up on the “fluoridation is medicine” myth.

The NZ Court of Appeal has rejected the latest legal attempt by New Zealand anti-fluoridation campaigners to hinder community water fluoridation. You can read a summary of the ruling in the Court’s press release – New Health v South Taranaki District Council. The full Court of Appeal ruling can also be downloaded.

Of course, you might find it boring – it is full of legalese. The appeals (there were three and all were rejected) themselves were  about details – the definition of a medicine and the right of governments to make regulations. But readers might want to reflect on who took the legal action and who paid for it.

follow-the-money

New Health NZ took the High Court actions and appeals. It is an incorporated society set up in 2005 by the The New Zealand Health Trust. This Trust is the lobby group for the “natural”/alternative health industry in New Zealand and is financed by that industry. So, in effect, this legal action was taken by the alternative health industry – and paid for by this industry – which is big business.

We can get some idea of the costs involved from the financial statements of the NZ Health Trust (strangely registered as a charity) and New Health NZ (statements available on the society’s register). Unfortunately, the latest statements only provide information for the 2014 and 2015 financial years – but the legal action is several years old so you can get an idea of the money flows involved.

The NZ health Trust appears to receive grants in the hundreds of thousands per year from the alternative health industry($250,000 in 2014 and $190,000 in 2015). In its turn, it distributed “grants & donations” in the hundreds of thousands (125,000 in 2014 and $130,000 in 2015).

nz-health-trust

New Health NZ received grants of around $100,000 per year ($100,00 in 2014 and $95,000 in 2015). It paid out similar amounts in “Professional and Consultancy Fees” ($95,156 in 2014 and $95,124 in 2015).

new-health-nz

These amounts are of the order required for the legal actions taken by this group.

So here we see a money flow from the “natural”/alternative health industry, through the New Zealand Health Trust to New Health NZ to pay for legal attempts to halt community water fluoridation.

At least, this time, New Health NZ was ordered to pay costs – a sure sign that the court believes their legal actions no longer have any community value.

A sign that they should stop promoting their myth that community water fluoridation is a medicine – they should stop flogging that dead horse.

Similar articles

Fluoridation & democracy: Open letter to DHB candidate Andrew Buckley

Community water fluoridation looks like becoming a hot topic in October’s elections to District Health Boards. Anti-fluoride candidates should stop preventing open discussion and critique of their unscientific claims.


Legislation transferring fluoridation consultation and decision-making tasks from councils to district health boards (DHBs) will probably be introduced into New Zealand’s parliament next year. Anti-fluoride activists are preparing for this by transferring their attention from councils to District Health Boards. In particular, they are standing candidates for elections to DHBs in October’s elections.

andrew-buckley

Andrew Buckley is standing for the Waikato District Health Board. He calls for open debate on the fluoridation issue but will not allow any critique of his claims in his web page discussion.

Andrew Buckley is a retired osteopath who is standing for the Waikato DHB. He is making community water fluoridation a central issue of his campaign and presented his views in a blog article – Fluoridation and democracy – and in a press release.

I welcome candidates who make their views clear on issues like this during their campaign where they can be discussed. But the problem with Andrew is that he does not seem to either want to discuss his claims or allow any discussion of them in the comments on his article. I contributed a comment which dealt with his claims point by point but he has not allowed it to appear – despite showing supportive comments from many of the usual anti-fluoride brigade.

This anti-democratic behaviour is ironic given that he was arguing for democracy and open debate on the issue. It is also deplorable that he prevent this open debate during an election campaign where he is making community water fluoridation a central issue.

As he won’t allow proper discussion on his web page I have put my comments into an open letter to Andrew. I, of course, offer him the right of reply here and welcome any contribution he can make to the discussion here.


Hi Andrew,

I welcome your declarations that you are “not pro- or anti-fluoridation as a matter of principle”  and decisions about community water fluoridation (CWF) “simply cannot and should not be made on the basis of hearsay and urban legend.”  However, the claims you make in this article (Fluoridation and democracy“) suggest you may have succumbed a few urban legends and been influenced by hearsay yourself.

Let’s consider some of your claims:

Hamilton City Council’s fluoridation fiasco

You claim the “Hamilton City Council councillors voted unanimously to stop” CWF – but that is just not true.

In June 2013 the council voted 7 to 1 (with several imposed abstentions) to stop CWF. There was public opposition to this decision as it ignored polling and a previous referendum result showing community support for fluoridation. A new referendum held along with the October 2013 local body elections again showed overwhelming public support for CWF and in March 2014 the council voted 9 to 1 in favour of reinstating CWF.

You claim the Hamilton City council “delivered a scathing commentary on the practice of fluoridation.” Could you identify that document and link to it? I am completely unaware of such a document despite having followed the issue closely at the time and having discussed the scientific basis of CWF with several councillors. My impression was that individual councillors were incapable of discussing the issue and, in fact, several councillors were very hostile towards science and scientists and very rude to correspondents as a result. I thought that highly disturbing for councillors in a city which houses several very reputable scientific institutions. But it seemed their stance, and emotive response, had more to do with pre-election political infighting than any appreciation of the science.

Are anti-fluoride claims validated?

You claim “validated claims of the multitude of opponents to water fluoridation [are] not refuted by sound supportive evidence in public debate.” Again not true.

Anti-fluoride activists like Paul Connett, Stan Litras, etc., often claim this but refuse to debate the issue themselves. I had one on-line debate with Paul Connett in 2013/2014 where (I believe) every claim he made was soundly refuted. You can find the record of that debate on my blog (Fluoride debate) or a pdf version of Fluoride Debate  from my publications on ResearchGate . This is quite substantial and covers most issues that are raised by opponents of CWF.

The claims made by opponents of CWF have not been scientifically validated and are often based on misinformation or distortions of the science. It is telling that since my debate with Paul Connett he has simply refused every opportunity I have offered him for a right of reply to my articles where I have critiqued his claims (see for example Misrepresenting fluoride science – an open letter to Paul Connett“). Similarly, Stan Litras has refused my offers of a right of reply in similar situations.

What about this “multitude?”

You are incorrect in using the word “multitude” as recent referenda have shown in New Zealand. This was confirmed in more detail by the NZ oral health survey as reported in this paper:

Whyman, R. A., Mahoney, E. K., & Børsting, T. (2015). Community water fluoridation: attitudes and opinions from the New Zealand Oral Health Survey. Australian and New Zealand Journal of Public Health.

I discussed date from this paper in my article Anti-fluoride propagandists get creative with statistics. The graph below summarises the data:

While support for CWF may not appear as massive as recent referenda results show (which don’t record the undecided), the fact that only about 10% of people are strongly opposed (and another 5% somewhat opposed) to CWF in the survey. This does suggest your use of the word “multitude” is an exaggeration.

The opponents of CWF may be very organised and vocal (a fact which has led councils to see the fluoridation issue as a poisoned chalice) but they basically represent the minority ideological and commercial interests of the alternative health industry – which in many cases funds their work and give avenues for their propaganda.

WHO data misrepresented

You claim “according to the World Health Organisation, [there is] an equal reduction of dental caries in countries throughout Europe, irrespective of whether there is water fluoridation or not” is just not true. You have blindly accepted a popular anti-fluoride urban legend.

In fact, the WHO data show different reductions of dental caries for different countries. The reductions are just not equal. Here is the graph that anti-fluoride activists often use to promote this urban legend:

Slide from Paul Connett’s 2016 New Zealand presentation

There is actually very little data for each country in this graphic (hence the predominance of straight lines). The bigger problem is that no sensible comparison can be made between countries without taking into account the multitude of factors which influence tooth decay and which vary from country to country and year to year. Surely that is obvious?The more sensible and scientifically accepted approach is to compare fluoridated and unfluoridated areas within countries. I discussed this in my article

The more sensible and scientifically accepted approach is to compare fluoridated and unfluoridated areas within countries. I discussed this in my article Misrepresenting fluoride science – an open letter to Paul Connett and illustrated it with the WHO data for Ireland where fluoridated and unfluoridated areas are compared:

People like Paul Connett and his followers promote this urban legend again and again – despite having been shown why it is wrong (for example in my debate with Connett). They are knowingly promoting a distortion of the facts.

CWF a “medicine?”

You ask “Why was fluoride removed from the medicines list . . ?” but CWF was never on a “medicines list” as you would be aware if you had read the High Court ruling in the case brought by the “natural”/alternative health industry lobby group New Health NZ against the South Taranaki District Council.

I refer to this in my article Corporate backers of anti-fluoride movement lose in NZ High Court but you could also read Justice Hansen’s  judgment. This was confirmed in Justice Collin’s ruling on the subsequent appeal (see Another legal defeat for NZ anti-fluoridation activists).

The concentrations of fluoride used in CWF are below that required for listing. As Justice Collins determined:

“when fluoride is added to domestic water supplies within the maximum allowable concentration of 1.5 mg/l the concentration of fluoride in domestic water supplies will be well below the concentration threshold required for fluoride to be a medicine in Schedule 1 of the Regulations.”

and

“ . . fluoride would be a medicine under the Act if it was added to domestic water supplies in concentrations of 10 mg/l or more.”

The only change to regulations was to introduce a clause clarifying that when chemicals like sodium fluoride, fluorosilicic acid or sodium fluorosilicate are used for CWF they are not considered a medicine. A clarification, not a change.

Why transfer decision and consultation on CWF to DHBs?

You ask why the Minister of health has “decided to take the decision away from local authorities and give it to DHBs to decide?”

As you are a candidate for election to a  DHB you have a responsibility to consult the official documents outlining reasons for the proposed changes. I suggest you read Proposed legislative changes: decision-making on the fluoridation of drinking-water supplies,  Transferring decision-making on the fluoridation of drinking-water from local authorities to district health boards the cabinet paper Decision-making on the fluoridation of drinking-water supplies).

I also suggest you refer to discussions at the Local Government NZ conferences and individual council statements requesting that central government take responsibility for CWF decisions and consultations away from councils. As they have often argued, they do not have the expertise to consider the science involved and feel that they are unfairly exposed to a highly organised minority of ideologically and commercially motivated activists.

Questions for you, Andrew

Do you think a body like the elected DHB or local body councils are the appropriate place to make decisions about the science of health issues like CWF? After all, they do not have the expertise and surely such scientific decisions are not made by the board on other health issues relevant to all the procedures carried out in a hospital. Don’t you think that DHBs and Councils should instead rely on the best up-to-date reviews of the science by a body like the Royal Society of NZ?For example:

For example:

Eason, C., & Elwood, JM. Seymour, Thomson, WM. Wilson, N. Prendergast, K. (2014). Health effects of water fluoridation : A review of the scientific evidence.

Surely the task for board member on this issue is to receive such up-to-date reviews, together with data from staff on the oral health issues in the area and the feasibility and likely efficacy of CWF. On top of that, they should take into account the balanced views of the community – using polls or referenda. This should then allow them to make an informed decision about any proposal for or against CWF in their region.

Getting bogged down with the activist claims and counter claims and their propaganda based on misinformation and distortions of the science (as happened initially with the Hamilton City Council) is certainly not a responsible approach.

Andrew, you criticised the democratic processes of the DHB for which you are standing. I cannot judge if your complaints are sincere as I have not see the full picture. But I certainly support your conclusion about this issue:

“I believe we must follow democratic process and proper debate.”

So, why have you denied the democratic process with your blog article Fluoridation and democracy? You did not allow my comment, which covered the areas above, while at the same time allowing comments from known anti-fluoride activists slavishly praising you for your article?

Does this illustrate the sort of rejection of open and democratic discussion you will follow if you are elected?

I believe voters have a right to know how you have purposely acted to prevent open discussion while hypocritically calling for it.

Surely that is a reason not to vote for you in the October elections?

Finally, Andrew, I offer you a right of reply to my open letter. I am willing to post a reply for you here. After all, I do support open discussion of the CWF issue and, particularly, I am keen that these “urban legends” and “hearsay” be properly debunked and their promoters exposed.

I look forward to a fruitful good-faith discussion.

Kind regards,

Ken Perrott

Similar articles

Dissecting pseudoscientific and political propaganda

Tactics used in anti-science and pseudoscience propaganda are essentially the same as used in political propaganda.

Everyone has their own ideological and political starting points – and none of us are really rational, even when we think we are. So we shouldn’t be surprised to find we are fully  in agreement with some people on one issue but on the opposite sides of the fence with the same people on other issues.

I often find this  in my on-line discussions . Some of my “allies” in the fight against pseudoscience (for example, in debunking anti-fluoride propagandists) will become my “opponents” when I discuss issues like the war in Syria. (I use quote marks because I do not feel any enmity towards discussion partners when the discussion is civil).

Nevertheless, I do not consciously separate my approaches to science and politics (and I guess my discussion partners would make the same claim). People can often be more resistant to anti-science propaganda because claims can be tested against reality. This is sometimes harder to do with political issues but if we don’t try we can be fooled by political propaganda. So, a recent article –  Dissecting the Propaganda on Syria – appealed to me as I immediately recognised that the tactics used by propagandists against the Syrian government are essentially the same as those tactics used by anti-fluoridation propagandists.

The article identifies three propaganda tactics:

1: Demonise the enemy

Those pushing pseudoscience do this continually. Scientists are claimed to be only in it for the money. How often do we hear the chant “follow the money” (and how hypocritical is this considering many of these propagandists are making money out of the “natural”/alternative health industry.

paul-connett

Anti-fluoride campaigner Paul Connett regularly charges NZ scientists with fraud – but he fraudulently distorts the evidence to do so.

Honest scientists are accused of fraud and researchers whose work contradicts the propaganda are personally attacked.

On Syria, we continually hear about the Syrian “regime” and its “brutal dictator” – despite the fact that the Syrian government and president have been elected. Words like “regime” instead of “government” are a way of demonising.

Responsibility for all the deaths in this war is often attributed solely to President Bashar al-Assad. This is absurd as these deaths also include those fighting on the government’s side. As the article says:

This propaganda “deems Assad responsible for everything, including the killing of Syrian soldiers by the armed opposition. This opposition, which is financed and armed by Saudi Arabia, Qatar, Turkey and the U.S., includes extreme jihadist groups, including Al Qaeda’s longtime affiliate and the Islamic State. Yet, none of the leaders supplying these rebels – in defiance of international law – bears any blame for the death and devastation of Syria, according to” the propaganda.”

This demonisation of Assad is part of the interventionist strategy of “regime change.” We saw it before in Iraq and Libya. Liberal intervention to correct a wayward government appeals to many, and fools even more. After all, it is easy to find fault with the governments and leaders in these countries. But those who want regime change in Syria do everything to protect the regimes and leaders of other countries, like Saudi Arabia, with far greater violations of human rights. And the “regime change” doctrine violates the fundamental rights of people to decide their own government and leaders.

nazi-fluoride-myth

What better way to demonise advocates of community water fluoridation than to compare them to Hitler?

In a parallel way those anti-fluoride propagandists who demonise honest scientists can easily be found to be guilty of the very charges they lay against others. Aren’t these propagandists often paid shills for big business – the “natural”/alternative health industry? And don’t they frequently misrepresent and distort the science? Are they not the ones who should be charged with fraud?

2: Romanticise the opposition

Anti-fluoride propagandists continually describe themselves as fighters for truth who have “done their research.” They are fighting for natural, pure, food and water and against the wicked big business “fluoride industry” which is disposing their contaminated waste by dumping it in our water supply. And how often do we get the David vs Goliath analogy – even when it is the anti-fluoride activists who have dominated submissions to local bodies?

On Syria, our mainstream media

“portrays the conflict as a “civil war” which began with peaceful democracy-loving Syrian revolutionaries who were ruthlessly repressed by a brutal regime.

In reality, there was a violent faction from the start. In the first protests in Deraa, seven police were killed. Two weeks later there was a massacre of 60 security forces in Deraa.

In Homs, an eyewitness recounted the situation: “From the start, the protest movements were not purely peaceful. From the start I saw armed demonstrators marching along in the protests, who began to shoot at the police first. Very often the violence of the security forces has been a reaction to the brutal violence of the armed rebels.”

In the first two months, hundreds of police and security forces were killed. Yet, . . . the West’s mainstream media, ignores this reality because it clashes with the desired image of white-hatted protesters being victimized by a black-hatted government.”

baath-party

Violence against the Syrian government occurred even during the early demonstrations.

This romanticisation is hardly suprising when we realise that most of our information on the Syrian war is coming from rebel or terrorist sources – or sources sympathetic to antigovernment fighters. Al Jazeera has reporters embedded in  “rebel”/”terrorist” militia forces. And so often our news reports cite “activists” or sources like the Aleppo Media Center, White Helmets, or the Syrian Observatory for Human Rights which are sympathetic to the rebels.

Similarly, anti-fluoride propagandists very often cite sources from their own anti-science side. Their hope is that their reliance on sources such as “NaturalNews”, The Health Ranger, the Fluoride Action Network and Mercola, and continuous promotion of articles from those sources, can be translated into a similar acceptance by our mainstream media.

3: Attack anyone who questions the dogma

Many health professionals who recognise community water fluoridation as a safe and effective social health measure refuse to speak up in its defence because this can lead to personal attacks. A dentist who recently took issue with the misinformation being promoted by an anti-fluoride group was told in an anonymous personal letter:

“How dare you try to shut the truth down, people like you are a total insult to the art of Dentistry.”

And that is a mild example. How often are people who attempt to inject some logic and fact into this argument accused of being “shills?” Or attacked in a memes on social media – almost always from behind a wall where they are banned from participating in the discussion or answering their critics.

Similarly, those who attempt to debate the “party line” on Syria are often accused of being “Asad supporters” or worse. I was recently described as being a “fanatical follower of the Soviet camp” when I attempted to argue that there are child casualties in the government-held west Aleppo as well as in the “rebel”terrorist” held east Aleppo. (Some readers may object to my use of the word “terrorist” in this context – but the fact is the anti-government “Army of Conquest” which unites all the “rebels forces” in the current battle for Aleppo is led by Al Nusra – officially recognised as a terrorist organisation by the Russian Federation, USA and the United Nations).

Such attacks are simply a way of shutting down honest discussion of this conflict. A way of preventing information undesired by our political leaders from getting through the propaganda we are exposed to. Such attacks are really just a neo-McCarthyist tool in the information war.

Anti-fluoride propagandists and their allies in the “natural”/alternative health industry use exactly the same tactic. By attacking and labelling honest scientists and others who attempt to debunk the pseudoscience propaganda they hope to intimidate people and raise doubts about the science. We have seen this before from climate change deniers and creationists. They also use such attacks to raise doubts about the science of evolution and the findings of climate scientists.

Conclusions

This article quotes a leader of the US Veterans of Peace:

The U.S. peace movement has been demobilized by disinformation on Syria.”

I think he is correct. The tactics of demonising the Syrian government and president, of romanticising the “rebels” by selective reporting of history and current events, and of attacking anyone who speaks out against such propaganda, has been very effective in muting opposition to this war and encouraging “regime change.”

While the same tactics being used by the anti-fluoride and similar pseudoscientific or anti-science movements has been less effective for the population at large it still resonates with many.

Such propaganda tactics need to be resisted.

Similar articles

 

An anti-fluoride trick: Impressing the naive with citations

One way to make an article look impressive is to use citations – the more you use, the more impressive. Well, so some people think.

citations

Some of the over 140 references in Geoff Pain’s article. These references impress some people but are irrelevant to Pain’s arguments.

Again and again I find anti-fluoridation campaigners refer to the number of references in an article or book as a sign of scientific credibility. Paul Connett often promotes his anti-fluoride book by referring to its 80 pages of references. And in a recent on-line discussion where I criticised an article by the anti-fluoride campaigner Geoff Pain I was told that it contained over 140 references, as if that was the end of the story – his article must be valid!

Pain’s article is Fluoride causes heart disease, stroke and sudden death.” It’s one of series of propagandist articles which he has placed on the Researchgate we site. That website also impresses the anti-fluoride people as they think it gives the articles the scientific credibility of publication in a scientific journal. But anyone can belong to Researchgate and upload their articles. There is no peer review or any other form of quality control.

Geoff Pain has uploaded a screed of anti-fluoride propagandist articles with titles like :

  • Fluoridation Causes Cancer, so does the Fluoride content of Tea
  • Fluoride causes Death and Disease
  • Toxicity of Fluoride
  • What do you know about Fluoride?/
  • Impact of Fluoride on Women, the Unborn and Your Children
  • Fluoride is a bio-accumulative, endocrine disrupting, neurotoxic carcinogen – not a nutrient
  • Plumbosolvency exacerbated by Water Fluoridation
  • Fluoride Causes Diabetes
  • NHMRC = Politics, Not Science. Australians – Victims of Tragic Fluoridation Experiments
  • Fluoride doped hydroxyapatite in soft tissues and cancer. A literature review.

So you get the idea. With titles like this you will not be surprised to find his Twitter tag is @FluoridePoison. Although he describes some of these articles as “conference papers” they are, of course, talks given to anti-fluoride meetings. He describes the other articles as “technical reports.”

He is a consultant with a science degree and claims to specialise in analytical chemistry. But there is no credible science in his “technical reports” and “conference papers” on fluoride.

Literature trawling

Pain uses the technique of literature trawling that Declan Waugh has made famous in his anti-fluoride articles. This involves searching the scientific literature for any reference to fluoride and possible toxic effects. A technique which produces mostly irrelevant articles – but so what. They just bung the citations into their articles and make unjustified claims. They rely on their readers never to check the references anyway The committed anti-fluoridation person is only impressed by the number of references  – not their relevance.

No-one has the time or interest to completely debunk such articles by going through every single claim and checking every single citation. Nor are such articles worthy of such attention.

So let’s settle for a “partial debunking.” Here I will just take a single central claim in Pain’s article linked to above and check the relevance of his supporting citations. This should be sufficient to show how he misuses citations and misrepresents the science. Readers can draw their own conclusions about the rest of this article and about his other articles.

The claim

He claims a literature search shows “numerous examples of evidence relevant to cardiovascular damage by Fluoride” and cites “[Houtman 1996, Tyagi 1996, Artru 1997, Johnson 1998, Maheswaran 1999, Jehle
2000, Kousa 2004, Bogatchera 2006 and references therein].” So let’s see how relevant those citations are and if they actually support his claim.

Let’s see how relevant those citations are and if they actually support his claim.

Houtman 1996 reported:

” In general, the elements selenium, copper, zinc, chromium, and manganese seem to counteract the development of cardiovascular diseases, whereas cadmium and may be lead seem to stimulate it. Effects of arsenic, silicon and fluorine are unclear and for cobalt absent.”

So no evidence of fluoride causing cardiovascular damage there.

PMSF

The organic phenyl methyl sulfonyl fluoride does not contain fluoride.

Tyagi et al., 1996 (Post-transcriptional Regulation of Extracellular Matrix Metalloproteinase in Human Heart End-stage Failure Secondary to Ischemic Cardiomyopathy“) used the metal chelators  phenanthroline and phenyl methyl sulfonyl fluoride in laboratory identification of bands identified in immunoblot analysis of proteinases extracted from heart tissue. This has absolutely nothing to do with fluoridation or the fluoride anion. Phenyl methyl sulfonyl fluoride is an organic compound and does not contain the fluoride anion.

 

Artru et al 1997 investigated use of anaesthetics sevoflurane and isoflurane and their effect on intracranial pressure, middle cerebral artery flow velocity, and plasma inorganic fluoride concentrations in neurosurgical patients. There was no investigation of cardiovascular damage. The plasma fluoride was derived from breakdown of the anaesthetics – there was no fluoridation involved.

4 ami

4-amidinophenylmethanesulfonyl fluoride

Johnson et al., 1998 does deal with heart-related matters – atherosclerosis, infarction and stroke. But there is no mention of fluoride or fluoridation. Pain has picked up this article in his literature trawling purely because the study used the protease inhibitor 4-amidinophenylmethanesulfonyl fluoride as a reagent. Again, this is an organic chemical – it does not contain the inorganic fluoride species. The study has no relevance to fluoridation.

Maheswaran 1999 (“Magnesium in drinking water supplies and mortality from acute myocardial infarction in north west England“) investigated the relationship between magnesium and cardiovascular problems and found none. Yes, fluoride and other ions were considered as possible confounders but the paper specifically states:

“Calcium and fluoride appeared to have no significant association with mortality from acute myocardial infarction.”

So Pain’s literature trawling has found  a paper mentioning fluoride and cardiovascular problems but it does not support his claim they are related.

Jehle 2000 did research the human coronary artery but again it was produced by Pain’;s literature trawling simply because the investigation used the protease inhibitor reagent phenylmethylsulfonyl fluoride (see comments on Tyagi 1996). Nothing here to do with fluoridation or the inorganic fluoride species used in community water fluoridation.

Kousa 2004 (“Geochemistry of ground water and the incidence of acute myocardial infarction in Finland“) obviously is related to cardiovascular problems and, yes, fluoride was one of the chemical species in water considered. But what do the authors say:

“Fluoride concentrations of around one mg/l in household water may be beneficial . . . In this study one mg/l increment in the fluoride concentration in the drinking water was associated with a 3% decrease in the risk of AMI [acute myocardial infarction ]. “

And they concluded that their findings suggested fluoride played a protective role.

So a success for Pain’s literature trawling – a reported relation between fluoride and cardiovascular problems – but the opposite to what Pain claim. And he didn’t bother mentioning  this, did he? How honest is that?

Bogatchera 2006 does not seem to relate at all to cardiovascular issues, but sodium fluoride was used to stimulate bovine cells. The concentration of sodium fluoride used was 20mM – equivalent to 380 ppm fluoride. Well above concentrations found in drinking water and the recommended optimum level of 0.7 ppm. Not at all relevant to community water fluoridation and it simply does not support Pain’s claim.

Well, that’s enough. I am not going to search Pain’s “references therin.” Nor will I bother with any of his other claims or cited references. I think you get the picture.

Conclusions

Geoff Pain

Anti-fluoride campaigners always promote people like Paul Connett and Pain as “renowned” or “world experts.” They aren’t

People like Geoff Pain promote themselves as “renowned” experts on community water fluoridation – but they simply aren’t. Surely the dishonest way Pain has used citations in the article considered here illustrates this. And we can be sure that he has approached his other fluoride articles in the same way.

So there is a warning. Just don’t be impressed by large numbers of references. Check them out – or at least check some of them out. If you find the references you check do not support the claims being made, or are maybe even completely unrelated to the claims, then draw the obvious conclusions.

NOTE: I am contacting Geoff pain to offer him the right of reply here and a chance to enter into any discussion.

Similar articles