Tag Archives: Hamilton City Council

Are submissions on fluoridation worth it?

Like most people I struggle to find the energy when representative and government bodies call for submissions. But I did make the effort recently when Medsafe called for submissions on their proposed clarification of how fluoridating agents are defined in the medicine regulations. I am pleased to see the simple suggestion I made was accepted. But my purpose here is to illustrate how this consultation proceeded and how opponents of community water fluoridation (CWF) tried to swamp it with their submissions.

The background

Last November the Ministry of Health (MoH), through Medsafe, called for submission on a change to the Medicine Regulations 1984. This change had been recommended by the High Court and the Crown Law Office who specifically suggested that fluoride compounds used for CWF be exempt from definition as a “medicine.” This arose from the defeat of attempts by an anti-fluoride group, New Health NZ, to use the argument that fluoridation was medication in the High Court actions against CWF. Despite these defeats the High Court and Crown Law Office considered the regulations should be clarified to remove the argument from repeated litigation.

Simply, the proposal was to add a new regulation:

“Fluoride-containing substances, including the substances hydrofluorosilicic acid (HFA) and sodium silico fluoride (SSF) are not medicines for the purposes of the Act when they are manufactured and supplied or distributed for the purpose of fluoridating community water supplies.”

Medsafe asked for responses to the following questions:

  • Question 1: Do you support the proposed amendment? If not why not?
  • Question 2: Are there other fluoride-containing compounds used to treat community water supplies that should be specifically named in the regulation? If so, what are they?

Submissions – quantity or quality

The report from MoH on the process and their recommendations to cabinet give an idea of the submissions made and the final decision.

As we might expect from past experience the submissions were dominated, in numbers if not quality and relevance, by those from the anti-fluoride groups. They had organised a national and international campaign to swamp Medsafe. Paul Connett’s Fluoride Action Network, Fluoride Free NZ and New Health NZ even provided texts and templates to copy and paste into submissions.

Here is the description of the consultation outcome in the MoH report:

MOH-report-extract

So, the activist organisations can certainly mobilise their forces for submissions. But concentration on numbers and not content – and cynical provision of content to followers anyway – didn’t win them any credence. Did they really think blatant duplication of submissions would not stick out like a sore thumb?

It is also heartening to see that the MoH was not swayed by blanket repetition of arguments which do not have credible scientific support. (I guess we can also see why the anti-fluoride activists groups are putting so much effort into their campaign to attack and discredit the NZ Fluoridation Review which summarises the scientific evidence.)

Sometimes suggestions are accepted

I had made the simple suggestion tha sodium fluoride be added to the short list of examples of fluoride chemicals used for CWF. So this recommendation to cabinet pleased me

recommend-to-cabinet

Nice to know that the consultation was not a sham and that reasonable and credible suggestions were listened to and even accepted. It is worth making submissions even when one is aware they me in a minority. If something is worth saying it should be said despite attempts by others to confuse issues.

Also nice to know that some consultations are not simply swayed by quantity and not quality – as was the case for the Hamilton City Council fluoride consultation in 2013 (see When politicians and bureaucrats decide the science).

The Hamilton City Council consultation also showed an extreme naivety in the Council’s willingness to ignore the established science. I wonder what approach they would have taken if the NZ Fluoridation Review had been available at the time?

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Did business interests interfere with Hamilton’s fluoride tribunal process?

Oldfield-Poster-2015

 Source: Abuse of democratic process in Hamilton Tribunal?. (Click to enlarge).

Early results from a Waikato University research project show that around 2/3 of all the written submissions to the Hamilton City Council’s fluoride tribunal process were directly or indirectly provided by parties associated with the ‘natural health’ lobby.

This is interesting as it raises the question of links between this lobby and the anti-fluoride movement. I showed in When politicians and bureaucrats decide the science  how the submission process in this case was dominated by the anti-fluoride movement and how their misrepresentation of the science fooled the local body politicians and bureaucrats. In Who is funding anti-fluoridation High Court action? I showed how big money from the “natural” health industry was financing legal action against fluoridation.

This research is not yet complete so we look forward to further details on this relationship and on how such corporate interests and activists groups cooperate in submissions to local body councils.

The research project is “Public Integrity and Participatory Democracy: Hamilton City Council’s Water Fluoridation Decision“. Waikato University student Luke Oldfield is carrying out the work financed by the grant. He recently displayed a poster(above) to an audience of academic faculty sharing some preliminary results of his research.

Interestingly spokespeople for the anti-fluoride groups have opposed this research from the moment of the announcment of the grant (see Anti-fluoride activists unhappy about scientific research).

Something to hide, perhaps?

Thanks to Abuse of democratic process in Hamilton Tribunal? at the new Making Sense of Fluoride web page.

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Pandering to anti-fluoridation campaigners

Screenshot-2014-04-07-11.19

Twitter time-line from an anti-fluoride propagandist – Click to enlarge

Social media can be bloody frustrating at times.

I do find Twitter useful for identifying interesting newspaper reports, scientific articles and videos – often long before I would see them myself on other sources. But, boy, there is loads of rubbish – especially when following a search term rather than people you trust.

Take search terms like #fluoride and #fluoridation – most of the time these are a complete waste because they are dominated by crazies who are using Twitter as a political propaganda tool. Click on the image to the left to see just a small part of the timeline from one of these propagandists.

But there are exceptions. Over the weekend these search terms went crazy with links to a great article in the Guardian by David Robert Grimes –  Politicians should stop pandering to anti-fluoridation campaigners. I recommend you read this if you haven’t already.

Sound and fury of opposing ideology

Grimes

David Robert Grimes

Grimes is commenting on the irrational backlash against fluoridation in the Republic of Ireland – and expecting a similar backlash to last week’s report from Public Health England urging more councils to consider fluoridating their water supplies. He said “as with so many public health interventions, the sound and fury of opposing ideology often trumps rational analysis.”

“Fluoride has been added to water in Ireland since the 1960s and has substantially improved the nation’s dental health, even in the era of fluoridated toothpaste. Despite this, a small but highly vocal opposition repeatedly pops up to claim fluoridation is harmful to health. These claims have been debunked time and time again.

The current incarnation of the opposition relies heavily on a report by self-proclaimed “fluoridation scientist” Declan Waugh, who blames fluoride for a range of illnesses. The report has been roundly dismissed by the Irish Expert Board on Fluoridation and Health, its chairman Dr Seamus O’Hickey concluding that … in spite of its presentation, its content is decidedly unscientific … the allegations of ill-health effects are based on a misreading of laboratory experiments and human health studies, and also on an unfounded personal theory of the author’s.”

Despite this, clever use of social media and strong lobbying has gained fluoridation naysayers considerable political traction, prompting the Irish government to promise yet another full review of the practice.”

Appeasing politicians

And this is his concern –  appeasement by politicians:

“perhaps the ugliest facet of the Irish debate is how elected representatives have given such outlandish fringe assertions a sense of legitimacy. One Irish politician has claimed that fluoridation causes cancer and Down’s syndrome; others have demanded an end to the practice, parroting claims that would have taken all of three minutes on Wikipedia to expose as utter nonsense.

The Irish government’s response is appeasement, and a waste of time and public money. Not only is there already an Irish body that routinely reviews the safety of fluoridation, this is a Sisyphean task because anti-fluoride groups have already reached their conclusion, and will trust no expert body unless it agrees with their assertions. Almost certainly fluoride will get yet another clean bill of health, campaigners will reject the findings and the same tedious cycle will repeat again, in much the same way parents who oppose vaccination are impervious to the scientific literature undermining their position.

It is irresponsible for politicians to show such contempt for science that they’re willing to take the lead from pseudoscientists and conspiracy theorists rather than experts. Leadership should be about making the best decisions based on the data available, even on emotive issues such as fluoridation and vaccination.”

Hear, hear – that is exactly how I felt about the Hamilton City Council politicians who gave far more weight to “pseudoscientists and conspiracy theorists rather than experts” in their deliberations on fluoridation last year.

A quirk of human psychology?

Grimes makes an interesting observation that the sort of irrationality, conformation bias, motivated reasoning and conspiracy theories we see in the anti-fluoridation and similar movements is really just part of human nature.

“That such beliefs persist in the face of strong evidence may be a quirk of human psychology. Campaigners may see themselves as enlightened crusaders, so when their assertions are questioned or contradicted by the data, this is viewed not as a useful correction of error but rather an attack on their identity and narrative. Conspiratorial thinking is endemic in such groups with critics being regarded as agents of some ominous interest group – big pharma is a common bogeyman – that wants to conceal the truth. This becomes a defence mechanism to protect beliefs that are incompatible with the evidence.

If all else fails, attacking the messenger may be easier than accepting that your whole raison d’être is misguided.

Motivated rejection of evidence is often a symptom of cognitive dissonance, a psychological phenomenon that occurs when individuals are challenged by information inconsistent with their beliefs. They may reject unwelcome information, seek confirmation from those who already share their beleaguered viewpoint, and try to convince others of the veracity of their world view. This may explain why some people proselytise even more vigorously after their beliefs have been debunked.”

So, perhaps we can understand the psychological motivations of people promoting pseudoscience and conspiracy theories. But, as Grimes says,” this does note excuse the fact that “elected representatives have given such outlandish fringe assertions a sense of legitimacy.” That goes for Hamilton as well as Ireland.

Grimes finishes with a message to the politicians:

“what is crucial is that decisions are based on scientific research, not misinformation and fear. The cost of such folly is clear to anyone who remembers the human suffering in the wake of the misinformed panic over the MMR vaccine just a decade ago.”

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Getting a grip on the science behind claims about fluoridation

Here’s an interesting graphic on fluoridation and the scientific evidence for it. It is from Ethan Seigel’s blog Starts with a Bang (see Weekend Diversion: Fluoridated Water: Science, Scams and Society). The article itself is a good description of the issues involved in the current debate.

Handmade_Graph_ES-600x490

It conveys some of the points I was making in Is fluoride an essential dietary mineral? More clearly, I think.

It also provides a useful template for placing research findings, and the claims being made about them, into context. Most claims about the harmful effects of fluoride are represented by the red line. They have been found at, and are important at, higher concentration of F. Whereas the beneficial effects are displayed at lower concentration.

The CDC recommended for fluoridated water in the diagram is similar to that for New Zealand (0.7 – 1.0 ppm) (The US has a larger range to accommodate for different intakes of water in different climates)

Remember – this is purely diagrammatic – it shows the principles, not real data.

But next time yet get told by an anti-fluoridation activists how horrible fluoridation is and they make claims based on research, or refer to a scientific paper – think of this template. Ask about the concentrations involved.

See also:

Fluoridation
Is fluoride an essential dietary mineral?
Fluoridation – are we dumping toxic metals into our water supplies?
Tactics and common arguments of the anti-fluoridationists
Hamilton City Council reverses referendum fluoridation decision
Scientists, political activism and the scientific ethos

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Will Hamiltonians finally get a voice on fluoridation?

Well, I am not surprised this has happened but am surprised it’s happened so quickly.

Disaffection with the Hamilton City Council decision to stop fluoridation has resulted in an attempt by at least one councillor to get the decision reversed and submitted to a referendum. The Waikato Times is reporting:

The notice of motion from Mr Wilson being circulated today among city councillors today would force the council to debate when it meets in three weeks whether it should hold a referendum.

Mr Wilson said the controversial decision had been hijacked by the anti-fluoride lobby and was not what the majority of Hamiltonians wanted.

“The anti-fluoride position are mostly well-meaning individuals that have misinterpreted the science. And then there’s a group of nutters who are convinced this is mass-medication. There is considerable good science that shows fluoridation is a good base for public health. I believe the majority of people in Hamilton want fluoridation, and they should have the final say.”

Seems to me this would be the best outcome. Hamiltonians have shown in the previous referendum and recent polls they support fluoridation and there has been a lot of criticism of the Council’s recent decision.

Mind you, the anti-fluoridationists are not happy:

the co-ordinator of Fluoride Free Hamilton, Pat McNair, said a referendum was not necessary.

“A tribunal is a robust process where reasoned evidence from both sides can be given. A referendum is just peoples’ opinion in the street.

“The others [Councillors who voted against water Fluoridation] in their summary gave very good reasons why a referendum would not work.”

Ms McNair said she would only accept a referendum if lobbies from both sides of the argument had equal amount of money to campaign with, as education costs “hundreds of thousands of dollars.”

Ms McNair really seems to not like a democratic and full discussion. She preferred a almost behind-doors tribunal dominated by 90% anti-fluoridation submission when the city itself had voted 70% support for fluoridation. The real problem is not money to campaign with – but the presence of activist groups to do the campaigning. She had everything her own way with the tribunal, no wonder she doesn’t want a referendum and the associated public discussion

A referendum will give opportunities for supporters of fluoridation to organise and get their case across. Hopefully they will do so. If not they will only have themselves to blame.

See  Hamilton City Council | Referendum On Fluoride |… | Stuff.co.nz.

See also: Fluoridation

Tactics and common arguments of the anti-fluoridationists

Anti-fluoridation activists have celebrated their recent win in Hamilton (see Hamilton City Council reverses referendum fluoridation decision) and are moving on with their plans for similar victories in other New Zealand communities. While most of the newspaper and TV polls show a clear majority support for fluoridation these activists managed to achieve a victory in Hamilton by relying on a raft of arguments which misrepresent or distort the science. They used the facade of science to attack the reality of science.

In essence this is the same as the “sciency” sounding tactics of the climate change and evolution science denial movements. These tactics of the anti-fluoridationists were analysed by Jason M Armfield in his 2007 paper When public action undermines public health: a critical examination of  antifluoridationist literature. Tactics like:

  • Selective reporting of studies and results,
  • Downplaying or ignoring the evidence,
  • Ignoring ecological factors in comparing communities,
  • Fear mongering,
  • Misrepresentation of evidence,
  • Using half-truths and “The Big Lie,”
  • Innuendo,
  • Follow the leader arguments.

In short – bamboozling with science.

The paper provides a clear and well documented description of the anti-fluoridationist tactics. It does briefly give examples and citations to show how the science gets distorted, although detailed discussion of the science is not the main purpose of the paper. It’s a useful resource for anyone trying to come to grips with the “Gish galloping” claims made by these activists.

One of the tables in the paper provides a handy list of common arguments used together with brief rejoinders. It’s a handy summary and I have reproduced the content below – the fluoridationist claim, followed by the real situation:


Water fluoridation confers no oral health benefit:

Numerous systematic literature reviews from a number of countries have found water fluoridation to provide a significant caries preventive effect.

Water fluoridation causes hip fractures, cancers, Alzheimer’s, reduced intelligence in children, etc.:

Research finding associations between water fluoridation and various diseases offer no proof, as causality cannot be established in these studies. Water fluoridation opponents handpick studies and may misrepresent the results so as to support their views. Large-scale systematic reviews have not confirmed any associations between water fluoridation and the large list of diseases linked to it by opponents of water fluoridation.

Fluoride is a toxic poison:

Fluorine is a naturally occurring element that, like many other natural substances, can be toxic if consumed in excess. Water fluoridation ensures ingestion of fluoride well below any toxic level, both for adults and children. Fluoride is used in rat poison and other dangerous substances. It is dose that determines the level of toxicity. Many essential and commonly occurring elements form poisonous or toxic substances.

Numerous other countries have rejected water fluoridation:

Some other countries have elected not to introduce water fluoridation because they prefer, or already have, other approaches to improving dental health. Nonetheless, many countries do have water fluoridation and benefits are conferred to all people, including those at high risk who may not effectively use individual fluoride exposures.

Water fluoridation is supported only by ‘shoddy’ science:

Decades of research and hundreds of scientific articles published in peer-reviewed journals support water fluoridation. This research is so convincing that almost all major dental and health authorities support it.

There should be a public plebiscite. It is undemocratic to have water fluoridation forced upon us:

In almost all democratic systems representatives of a population are elected to make decisions on behalf of the population. Plebiscites or public referendums are not required to pass legislation that is compatible with the constitution or charter under which the country operates. Water fluoridation fits within a government’s duty of care to the country’s citizens.

Tooth decay has declined in countries with and those without water fluoridation. Water fluoridation makes no difference:

Declines in tooth decay have occurred as a result of changing exposures to fluoride and dietary changes. Regardless, water fluoridation reduces tooth decay above and beyond these other effects. Ecological comparisons of some countries with others offer no support for or against water fluoridation as many other factors may account for differences in disease experience from one country to the next. Water fluoridation does make a difference.

Most people do not want water fluoridation:

Independent research in most places where water fluoridation is being considered shows that people support water fluoridation. Generally, the more knowledge people have the more likely they are to support it.

Water fluoridation is costly and not economically viable:

Research has previously found water fluoridation to be cost-effective. Newer technologies have made water fluoridation cost-effective for increasingly smaller populations. In addition to being cost-effective, it is also necessary to keep in mind the reduction in dental disease and therefore the pain and suffering reduced as a result of water fluoridation.

Water fluoridation infringes freedom of choice and individual rights and is unconstitutional:

Adding fluoride to water is just one of many instances where a chemical or nutrient is added to a food or beverage for public health benefits. It already occurs in water with the addition of chlorine, which aids greatly in eliminating water borne disease, as well as in several foodstuffs. Water fluoridation sets no precedent.

Water fluoridation is being pushed on us as a result of ‘big business’ interests:

The scientists researching the effectiveness of water fluoridation as well as health officials and dentists do not receive money from sugar, aluminium or any other companies for their research or opinions.

There is more caries in fluoridated X than in non-fluoridated Y. This proves water fluoridation does not work:

Ecological comparisons involving the arbitrary selection of fluoridated and non-fluoridated communities or areas do not provide credible evidence of the effectiveness or otherwise of water fluoridation as any differences may be the result of other factors which are linked to tooth decay but differ across the areas. Scientific research has found water fluoridation to be effective.

We should wait until water fluoridation is proved to be safe:

Water fluoridation has been implemented in some places for more than half a century – long enough that any dangers would be apparent if they existed. The weight of evidence strongly indicates that water fluoridation is safe.


I think this list provides a good starting point for sensible discussion.

Thanks to Jason M Armfield (2007): When public action undermines public health: a critical examination of  antifluoridationist literature. Australia and New Zealand Health Policy 2007, 4:25

See also: Fluoridation

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