Fluoride Action Network

Proposal to fluoridate Southampton based on scientifically flawed consultant reviews

Source: Fluoride Action Network | February 26th, 2009 | FAN Press Release

Six days prior to the decision on whether to fluoridate the drinking water in Southampton the South Central Strategic Health Authority (SHA) released key documents. They contain significant scientific misrepresentations and poor public health judgment.

The public are excluded from commenting on these critical flaws and the SHA’s decision is final. If the SHA votes for fluoridation, the only recourse the public will have is through the courts.

SHA and Bazian disregard FLUORIDE toxicology

The SHA hired Bazian Ltd. to review safety concerns raised in a 2006 report by the U.S. National Research Council (NRC) on the toxicology of fluoride, and 18 published studies that reported an association between fluoride exposure and lowered IQ in children.

Bazian’s work reveals a lack of understanding of risk assessment and toxicology. Bazian faulted the NRC review for not having focused on Randomized Controlled Trials (RCTs) when evaluating the effects of fluoride. But it is unethical to perform RCTs on humans with the goal of determining adverse health effects, so no RCTs exist. Instead, the NRC review used the standard toxicology approach and examined the available forms of evidence: studies of effects in cells, animals, and human populations.

The 500-page NRC report reviewed over 1,000 such studies. It concluded fluoride is likely to cause increases in bone fractures, arthritis-like symptoms, and severe dental fluorosis. It also concluded fluoride is a possible neurotoxin and endocrine disruptor. The report found that there are certain population groups that are most vulnerable to fluoride’s toxic effects: infants, children, diabetics, and those who consume larger amounts of water.

However, Bazian dismissed these concerns, claiming that the NRC report is not relevant to Southampton because it relied mostly on studies where the drinking water fluoride level was 2 mg/L or higher. The intended level in Southampton is 1 mg/L. This dismissal reveals a lack of understanding of principles of toxicology and public health policy. Instead of saying health problems from drinking 2 mg/L are irrelevant to Southampton the proper reaction should be great concern because there is no margin of safety. Toxicology and public health policy commonly seek a margin of safety of 100-fold, or at a minimum, 10-fold. Even using a minimum margin of safety, fluoridation at 1 mg/L is 5 times too great to assure safety for all people.

The reason for requiring a margin of safety when extrapolating from scientific studies to an actual real-world large population, such as the residents of Southampton, is because so much individual variation exists in water consumption and sensitivity to fluoride’s effects.

In February 2009, Dr. Arvid Carlsson, a 2000 Nobel Laureate, sent a letter to the SHA stating:

”Fluoridation is an obsolete practice. It goes against all principles
of modern pharmacology. The use of the public drinking water
supply to administer the same dose of fluoride to everyone, from
the infant to those who consume copious amounts of water (such
as diabetics), goes against all principles of science because
individuals respond very differently to one and the same dose and
there are huge variations in the consumption of this drug.”

The attached figure graphically shows the NRC report’s findings that some people in high water consumption groups are likely to ingest enough fluoride to cause adverse effects. [included in PDF version of press release]

Bazian dismissed the 18 IQ studies reporting an association of fluoride exposure to lowered IQ in children in part by stating “None of the studies explicitly dealt with artificial fluoridation of drinking water. Instead they dealt with cases in which drinking water was naturally high in fluoride, or high fluoride exposures came from use of high fluoride coal for heating and drying grain.” Again, the Bazian consultants ignored the necessity for a margin of safety. The lowest level at which fluoride was estimated to reduce IQ in children, 1.8 mg/L (according to Xiang et al., 2003) clearly offers no adequate margin of safety to protect all the children of Southampton. Whatever the weaknesses found by Bazian in the 18 studies on childhood IQ, they pale when compared to the evidence from the UK and other fluoridated countries on this matter – because the authorities in these countries have never done a single study!

Poor public health judgment

Mothers’ milk contains extremely low levels of fluoride The infant who is fed baby formula reconstituted with fluoridated water receives 250 times more fluoride than the breast fed infant. In 2006, the American Dental Association, the leading pro-fluoridation group in the US, stated that fluoridated water should NOT be used to make up baby formula. However, a February 19, 2009 report authored by Professor John Newton, Regional Director of Public Health, and a SHA Board Member, disagrees with that position, stating: “It is not a recommendation to avoid fluoridated water.”

While most people would argue that this is an issue where the Precautionary Principle should be invoked (when in doubt, leave it out), Newton’s report states: “… we do not believe the principle should be applied in the case of water fluoridation in Southampton… “

The Achilles’ heel of fluoridation proponents is that they cannot allow credence to be given to any report that finds evidence of harm from fluoride. By denying everything, they end up appearing as scientific illiterates. This situation pervades the “scientific evidence” upon which the SHA will base their decision.


• NRC 2006 review of fluoride: www.nap.edu/catalog.php?record_id=11571

• In addition to the scientifically flawed responses from Bazian Ltd., the SHA offered no responses to the majority of the 35 questions raised by Paul Connett, PhD, Director of the Fluoride Action Network, in his December 18, 2008, submission. Available: www.fluoridealert.org/sha.connett.dec08.pdf

• Links to statements from scientists urging the SHA to reject fluoridation at: www.fluoridealert.org/southhampton.html

• Links to SHA’s key documents at: www.fluoridealert.org/southampton.sha.htm