Tag Archives: Fluoride Action Network

EPA comprehensively debunks anti-fluoride claims of a fluoride-IQ effect

FAN propaganda video promoting their petition to the EPA to stop community water fluoridation

The US environmental Protection Agency (EPA) has denied an anti-fluoride petition to ban community water fluoridation. The document outlining its reasons for declining the petition is valuable because it considers all the arguments and evidence presented in the petition and comprehensively shows them to be misleading or even false.

This is a humiliating defeat for the petitioners – the US  Fluoride Action Network (FAN), Food & Water Watch, Organic Consumers Association, American Academy of Environmental Medicine, International Academy of Oral Medicine and Toxicology and Moms Against Fluoridation. FAN, and in particular Michael Connett, had put a lot of work into their petition. The petition is a 76-page document, heavily referenced and, importantly, presenting all the best arguments that FAN could find. FAN did not keep any of their powder dry.

Of course, FAN and their associated international groups, Facebook pages and websites heavily promoted this petition. They had high hopes – Paul Connett himself has argued that their evidence would bring about the complete demise of community water fluoridation within a few years. The local Fluoride Free NZ issued a press release with the heading EPA Petition Could Spell End of Fluoridation claiming “FAN’s assessment provides unequivocal proof that current allowable levels of fluoride are not protective for all members of the population from damage to the brain.” Mary Byrne, their spokesperson asserted:

“Fluoridation belongs to a by-gone era and far too much is now known about adverse health effects for any further consideration on fluoridation to be seriously considered.”

Many anti-fluoridation submissions to the Parliament Health Committee considering changes to fluoridation legislation in New Zealand have relied strongly on the FAN petition – presenting it as the best thing since sliced bread.

Serious consideration

The EPA did give the petitioners arguments serious consideration – as we should expect from such an authoritative organisation. The petition was not rejected out of hand – the EPA’s 50-page document eexaminesthem in detail.

This is what makes the EPA document so available – it considers all the FAN arguments, the scientific papers presented and the evidence claimed. It shows how many of these papers and claimed evidence are misrepresented by the petitioners. It points to the limitations of the studies FAN relies on. It shows how FAN has not even established a case for reconsideration of recommended safe levels for fluoride and explains that the methodology used by FAN, and the recent publication by FAN staff (Herzy et al., 2016 – see Debunking a “classic” fluoride-IQ paper by leading anti-fluoride propagandists), is not valid.

The documents overall assessment of the petition’s arguments is damning:

“The petition has not set forth a scientifically defensible basis to conclude that any persons have suffered neurotoxic harm as a result of exposure to fluoride in the U.S. through the purposeful addition of fluoridation chemicals to drinking water or otherwise from fluoride exposure in the U.S. Still less has the petition set forth a scientifically defensible basis to estimate an aggregate loss of IQ points in the U.S, attributable to this use of fluoridation chemicals. As noted previously, EPA has determined the petition did not establish that fluoridation chemicals present an unreasonable risk of injury to health or the environment, arising from these chemical substances’ use to fluoridate drinking water “

Some specific rejections

The petition argued about 12 points and the EPA responded to all of them. Here are a few extracts.

The central claim of the anti-fluoride petitioners is that  Fluoride is neurotoxic at levels relevant to U.S. population. It cited human studies to support this but the EPA document responded by pointing out “the petition ignores a number of basic data quality issues associated with the human studies it relies upon.”

A central problem is the lack of  consideration of other factors possibly involved in influencing IQ – confounders:

“The petition . . .  does not properly account for the relatively poor quality of the exposure and effects data in the cited human studies (e.g., it appears to give all studies equivalent weight, regardless of their quality). When an association is suggested between an exposure and a disease outcome, the studies need to be assessed to determine whether the effect is truly because of exposure or if alternate explanations are possible. The way to do that is to adjust for potential confounders, such as diet, behavior, and socioeconomic status, in order to appropriately assess the real relationship between the exposures to a specific substance and health effects. In other words, when these confounding factors are potentially present, but not recognized or controlled for, it is not possible to attribute effects to the contaminant of concern (fluoride) as opposed to other factors or exposures. The evidence presented did not enable EPA to determine whether various confounding factors (e.g., nutritional deficiencies) were indeed placing particular subpopulations at a “heightened risk of fluoride .”

The issue of confounders is central to the petitioners claim that recent epidemiological studies corroborate neurotoxic risk in Western populations. The petition cites two studies from Western populations to attempt to corroborate the assertion that exposure to fluoridated water presents unreasonable risks for neurotoxicity. I have discussed these in previous posts – Peckham et al (2015) which claim to show that hypothyroidism is related to fluoridation and Malin & Till (2015) which demonstrated a relationship of ADHD prevalence to extent of fluoridation.

The EPA response says of the Peckham et al (2015) paper that:

“Adjustment for some confounders was considered, including sex and age, but other potential confounders (such as iodine intake) were not assessed. Fluoride from other sources and other factors associated with hypothyroidism were not assessed in this study.”

Iodine deficiency is a well-known factor in hypothyroidism.

The EPA response was relatively kind in its comment on the Malin & Till study:

“Although it is possible that there may be biological plausibility for the hypothesis that water fluoridation may be associated with ADHD, this single epidemiological study is not sufficient to “corroborate” neurotoxic health effects, as stated in the petition. More study would be needed to develop a body of information adequate.”

I showed in my article ADHD linked to elevation not fluoridation that once factors like elevation, poverty, and house ownership were included there was no statically significant relationship between ADHD prevalence and the extent of fluoridation in Malin & Till’s data. That is a clear example how conclusions based on correlations can be completely wrong when confounders are not properly considered.

The petitioners fell back onto their claim that neurotoxic risks of fluoride are supported by animal and cell studies – a common anti-fluoride tactic. However, the EPA document responded by pointing out that the petitioners had misrepresented such studies. It pointed out that these studies had been recently reviewed by the US National Toxicity Program (NTP) and the petitioner’s misrepresentation of the studies:

“do not change EPA’s agreement with the conclusions of the NTP report that their “[r]esults show low-to-moderate level-of-evidence in developmental and adult exposure studies for a pattern of findings suggestive of an effect on learning and memory.”

The petitioners claim susceptible subpopulations at heightened risk from CWF is a common claim of anti-fluoride propagandists. The EPA found this argument unconvincing:

“The data and information provided in the petition do not support the claims that “nutritional status, age, genetics and disease are known to influence an individual’s susceptibility to chronic fluoride toxicity.”

The petition argued there were no established benefits of CWF to public health. The EPA responded by outlining some of the evidence for CWF benefiting oral health and responded to the petitioners claims with:

EPA does not believe that the petition has presented a well-founded basis to doubt the health benefits of fluoridating drinking water.

Despite not showing that community water fluoridation is linked to IQ losses the petitioners asked that because fluoridation covers a large population any harm would affect a large number of people so drinkign water fluoridation should be stopped on those grounds alone. Incidentally, Hirzy et al (2016) promised a future paper where they estimate economic losses to the USA because of fluoridation. I guess they will just ignore the Swedish work that actually shows drinking water fluoride levels are positively related to increased income and chances of employment (see Large Swedish study finds no effect of fluoride on IQ).

The EPA response to this argument:

As noted previously, EPA has determined the petition did not establish that fluoridation chemicals present an unreasonable risk of injury to health or the environment, arising from these chemical substances’ use to fluoridate drinking water. The fact that a purported risk relates to a large population is not a basis to relax otherwise applicable scientific standards in evaluating the evidence of that purported risk.

I like that bit about “relaxing scientific standards.” Doesn’t it just describe the whole approach of the anti-fluoride propagandists to the science?

What now?

According to the rejection letter the Petitioners, the Fluoride Action Network and their ideological mates can appeal the declining of their petition:

“by commencing a civil action in a U.S. district court to compel initiation of the requested rulemaking proceeding within 60 days of the date of this denial letter.”

The letter was dated February 17 – so they have until mid-April to get this underway. Michael Connett – who did the heavy lifting in the preparation of this 76-page petition – is an attorney so may be more capable with such legal action than he appears to be with the scientific arguments.

fluoride-theology

At the moment anti-fluoride propagandists appear more concerned with the theological questions related to leprechauns than they are with the EPA’s rejection of their petition.

At the moment the anti-fluoride groups, including those in New Zealand, are silent. It’s as if they did not receive their rejection letter almost 10 days ago. Perhaps they are busy debating their possibilities – and the public stance on this rejection they will eventually have to take.

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Anti-fluoridationist’s flawed attacks on Calgary study

antiscience-logic-web

Image credit: Why I will no longer approve anti-fluoride dishonesty – New Anthropocene

The anti-fluoride propagandists are at it again – attacking a recently published scientific paper because the reported data does not fit with their own agenda.

The are attacking this paper:

McLaren L, Patterson S, Thawer S, Faris P, McNeil D, Potestio M, Shwart L. (2016) Measuring the short-term impact of fluoridation cessation on dental caries in Grade 2 children using tooth surface indices. Community Dent Oral Epidemiol 2016.

The Fluoride Action Network (FAN) claims the study is “fatally flawed” and that “key data [was] omitted.” The local FAN organisation – Fluoride Free New Zealand (FFNZ) has gone further claiming the study is “basically a fraud.”

Serious (even slanderous) accusations – let’s see if those charges hold up.

What did the study find?

The paper reports changes in dental caries levels of grade 2 children in Alberta, Canada between 2005/2005 and 2013/2014. Two cities were chosen – Calgary (which stopped fluoridation in May 2011 – after having been fluoridated since 1991) and Edmonton where fluoridation started in 1967 and is still in place. This enabled an assessment of the effect of fluoridation cessation on the dental health of children in Calgary.

Dental caries actually increased in both cities but the data shows a larger increase in dental caries where fluoridation had been stopped (Calgary) than where it continued (Edmonton).

mean-defs

defs = decayed, extracted (due to caries) filled primary tooth surfaces.

The change in Calgary (3.8) is greater than for Edmonton (2.1) and the difference is statistically significant.

The above graphic is for all tooth surfaces – similar results were obtained with smooth surfaces only – Calgary change = 2.9 and Edmonton change = 1.6.

Important features of study

There are several important features of the paper and the data reported:

1: Whereas previous cessation studies had used tooth-level data this study used tooth surface-level data. The authors had previously reported tooth level data which showed similar results.

The WHO prefers and recommends tooth surface-level data to evaluate an intervention such as starting or stopping fluoridation because of its greater sensitivity. The study authors used  tooth surface-level data and focused on smooth tooth surfaces which are most likely influenced by fluoride in this age group.

Most earlier fluoridation cessation studies had used less sensitive tooth-level data so this study was a definite improvement

2: A comparison (or “control”) city was used – Edmonton. Many previous cessation studies suffered from not using a comparison community. Interpretation is more difficult without some sort of “control” as changes due to other factors may be important. Factors like different assessment personnel, changes in diet (eg sugar consumption or bottled water), changes in dental health care, etc. It is difficult to take account of all factors but the inclusion of a similar comparison community helps reduce their effects on the results.

Again, this study was a definite improvement over previous cessation studies which had not used a comparison community.

3: Pre-cessation data were collected several years before cessation. The authors list this as a limitation, saying:

“it would have been preferable to have data collected closer to the year of cessation.”

However, this being the real world, the study used the only tooth surface-level data available for Calgary and Edmonton. There was absolutely no question of data being omitted (or “fraud”) that the anti-fluoride campaigners allege.

So how has FAN supported their charges?

Well, basically by retreating from (or ignoring) the advantages of this study – use of tooth surface-level data and use of a comparison community.

1: They use the limitation that the pre-cessation tooth surface-level data was collected several years before cessation to resort to more recent 2009/2010 data. But, importantly, that data is not tooth surface-level and it is for only one city – Calgary! 

So, they claim, the researchers “omitted key data” – the 2009/2010 data – pretending the researchers had  “hidden” it. But that data was not surface-level data. And, far from “hiding,” it the same research group specifically used this tooth-level data in an accompanying  paper:

McLaren L, McNeil D, Potestio M, Patterson S, Thawer S, Faris P, Congshi S,  Shwart L. (2016). Equity in children’ s dental caries before and after cessation of community water fluoridation: differential impact by dental insurance status and geographic material deprivation. International Journal for Equity in Health 15: 24

2: They ignore completely the importance of using a comparison community. Sure, they might claim that no survey was taken in Edmonton in 2009/2010. But they have thrown the baby out with the bath water in their attempt to discredit the research. They have fallen back on the limitation of so many fluoridation cessation studies which rely on cross-sectional measurements at different times without using a control. Worse still, they do this despite the tooth surface-level data for Edmonton showing an increase in dental caries even though there had been no cessation of fluoridation! They are willingly falling into the trap of ignoring all the other factors which could influence the results.

3: The FAN press release attempts to discredit the researchers saying:

“The lead author of the study, Lindsay McLaren, is not an independent scientist on the fluoridation controversy.”

This “damning by association” of researchers with their institutions, the fact that they receive a wage from their employers and that they write articles about their scientific results (which do not support the claims of the anti-fluoridation lobby) is really disingenuous. It’s a way of discrediting any scientist who produces results an anti-science group does not like. (Anti-science groups often use this argument – for example, anti-fluoride activists haver told me I am not “independent” because I once worked as a scientific researcher and,  therefore, cannot be trusted!).

Ironically, they are hanging themselves with their own rope on this one. Their press release makes mileage by quoting an assessment from an “independent” scientist Dr Trevor Sheldon. I checked with Sheldon and he confirmed that he:

“was invited to comment on this by Fluoride Action Network.  I did not have much time to do this but agreed to do so and received no incentive or reward.”

Now, doesn’t that admission  compromise Sheldon as an “independent” commentator? He immediately responds to a request from an activist political organisation, a group funded by the “natural”/alternative health industry – without any qualms! That confirms in my mind the links and political sympathies Sheldon has with FAN that I have long suspected.

It is perfectly normal (and healthy) for credible scientists to disagree with published papers and there are publication mechanisms to do this effectively. For example “letters to the editor” or comments in the specific journal – or even alternative journals. The fact Sheldon chose an almost immediate critique in the newsletter of a political activist group confirms to me that he is not “independent” on this subject and that he, in effect, belongs to the stable of “tame” anti-fluoride scientists FAN makes regular use of in their press releases. People like Bill Hirzy, Kathleen Theissen, Bill Osmunson, Hardy Limeback, etc.

Some other critical details

FAN relied on Sheldon’s evaluation for their main criticism but there are other details in that evaluation which I can comment on.

1: Sheldon would have preferred “a randomised controlled trial where areas are randomly allocated to start/cease water fluoridation.”

Yes, that would have been nice wouldn’t it.But the fact this has never been done – and Sheldon himself has never initiated such a trial – rather indicates how impossible such a trial is. The Cochrane review of community water fluoridation, which anti-fluoride campaigners love to misrepresent, commented on the silliness of such complaints:

But the fact this has never been done – and Sheldon himself (and similar anti-fluoride critics) has never initiated such a trial – rather indicates how impossible such a trial is. The Cochrane review of community water fluoridation, which anti-fluoride campaigners love to misrepresent, commented on the silliness of such complaints:

“particularly for research questions where evidence from randomised controlled trials is never going to be available due to the unfeasibility of conducting such trials. Community water fluoridation is one such area.”

2: He attempts to  extrapolate from tooth-level data to “fill in the gaps” in the tooth surface-level data. This highly speculative analysis allows him to conclude that most of the increase in dental caries shown by children in Calgary occurred before the cessation of fluoridation.

He accuses the researchers of making a “heroic assumption” but it seems to me the assumptions involved in his extrapolation are worse than “heroic.” Yet  the analysis enables him to make conclusions which seem to be derived more from confirmation bias than from intelligent analysis of the data. Especially as he ignored any data from Edmonton.

3:  He comments on problems resulting from population movements, confounding factors, assessment methods and staff differences, sample size differences, etc. But these are common problems when attempting to make sense of existing data. Importantly, these problems and worse, plague the cessation studies that anti-fluoride campaigners continually quote to support their claims that community water fluoridation is ineffective.

Summary

The Calgary/Edmonton study does not have the limitations of most fluoridation cessation studies – in particular, a comparison community was used and the more sensitive and appropriate tooth surface-level data was used rather than tooth-level data. The period between the first assessment and cessation is an admitted limitation but certainly does not indicate the omission of data or hiding data as anti-fluoridationists are claiming. There was just no intermediate data available.

The resort to speculative extrapolation of tooth-level data for only Calgary is disingenuous as it ignores the low sensitivity of that data and the influence of other factors compensated for by the use of Edmonton as a comparison community.

Anti-fluoridation campaigners often make ready use of older cessation studies which showed no effect – despite the obvious limitation. In particular, they often use studies where no comparison community was included and ignore completely the other factors involved such as changes in dental health provisions or social health policies such as replacing fluoridation with mouth rinse campaigns.

It is, therefore, ironic for them to come out fighting in an attempt to discredit a study which has fewer limitations than the ones they rely on. Worse, to accuse researchers of purposely omitting data – or even of scientific fraud.

The real reason for these attacks on honest researchers is that the data just does not fit the anti-fluoridation agenda and therefore, in their eyes, must be discredited.

Oh, and beware of such activists using the word “independent’ to describe a researcher. It inevitably indicates someone with allegiances to their campaign. Someone who can be relied on to give the appropriate quote to be used in their press releases.

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Chemistry – “to dupe, to cheat?”

misinformation

OK – these are actors – but they could be portraying a certain PhD qualified chemist presenting a submission to a local body

I was reading a few articles about Dmitri Mendeleev recently – seeing we were celebrating his 182nd birthday (see What a pleasant surprise!). One I came across (Dmitri Mendeleev: Chemistry, the hot-air balloon and vodka) set me back a bit. Initially, it offended my feeling about the noble science of chemistry (have I mentioned I am a chemist) with this little titbit:

“Mendeleev himself did not consider himself to be a chemist. And rightly so. Back in those years the word “chemist” was synonymous to conman and the expression “to do chemistry” (khimichit in Russian) meant to dupe, to cheat.”

OK, I can understand how that attitude came about in  the early days – scientists often had unsavoury links with the spiritual and industrial or economic spheres. But surely not today?

Unfortunately, it does happen today. We can all think of a few names of qualified chemists (and other scientists) who are effectively snake-oil sales persons. Or something worse – in my mind – people who use science and cherry-picking of the scientific literature to misinform the public for ideological reasons. Paul Connett, from the US anti-fluoridation activist group the Fluoride Action Network, is an obvious example.

When you think about it these sort of people – with academic degrees – are all over the place. From “creationist science,” to “intelligent design” to climate change denial, anti-vaccination and anti-GMO groups, and so on. Their presence  seems particularly strong in the alternative and “natural” health movement. And this is an area where the use of honorifics like Doctor, Professor, etc., is milked quite irrationally.

We are all consumers of scientific information so should be wary of such charlatans. We owe it to ourselves not to be swayed by such honorifics so that we don’t properly assess their claims. If we do not have the scientific skills to do our own critical analysis of the claims then we should take the advice of experts whose background rest on more than a degree. Their occupation, employment and publication history.

This is particularly true for public officials when they make decisions which can affect the health of citizens. And, yes, I must admit I have in mind the Whakatane District Council who tomorrow are to reconsider their decision a few weeks back to discontinue community water fluoridation.  On this – have a read of this open letter from one of the councillors criticising the way that decision was made (Open letter to Councillors).

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“Do your own research!”

How many times have I had discussion partners on the internet say to me “Do your own research?”

Inevitably they are pushing some pseudoscientific or anti-scientific conspiracy theory – yet claiming science is their friend!

Here, one of the members of Paul Connett’s Fluoride Action Network team ( Carol Kopf, Media Director who uses the Twitter name @nyscof) tells critics to do their own research – internet research:

And if you type in fluoride adverse effects, you get 270 results

Well, I followed her advice and got this:

Fluoride adverse effects – PubMedScreenshot-fluoride

But unlike Carol Kopf I naturally didn’t stop there – I also typed in “water adverse effects” and got this:

Water adverse effects -PubMed
Screenshot-water

She has a really funny understanding of what the word research means.

Imagine if she followed her implied advice and refused to consume water because of all its adverse effects!

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Poisoning the well with a caricature of science

Spoiler alert – if you haven’t seen this video before have a look at it before reading on.

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