The O’Brien Institute for Public Health at Calgary University has just released their report on fluoridation. This institute has, up to now, been staunchly in favour of fluoridation. However, yesterday, with regards to fluoride’s effect on the brain, they say “The new emerging studies in this domain need to be tracked very closely, and carefully evaluated as they appear. We expect that health agencies at local, national, and international levels will confer and compare notes as they iteratively review, and re-review, this evidence”.

It certainly sounds like alarm bells have been ringing at the O’Brien Institute and a far cry from “the science is settled”.

Their report covers the major research that has been undertaken in this area which is showing fluoride exposure linked to cognitive impairment. “Of great relevance to the evolving evidence in this domain, another MIREC [Maternal-Infant Research on Environmental Studies] study focusing on cognition also examined the association between fluoride exposure and childhood IQ”. This study was carried out in fluoridated Canada and links increased fluoride exposure during pregnancy to lowered IQ in their offspring.

In other words, the O’Brien Institute is telling us that there is a Canadian study in the works that has essentially reproduced the Bashash study findings from 2017: the more fluoride a pregnant woman is exposed to the lower the IQ of her baby. This must be the torpedo that sinks this battleship.

It is hard to imagine a parent that would willingly sacrifice some of their child’s IQ for the possibility of saving a filling or two over a lifetime. Brain function affects every part of our lives. Obviously, our work opportunities and income, but also our relationships and our ability to look after ourselves. The cost to society is also huge. A drop of 5 IQ points across the population, halves the number of geniuses and increases by 50% the number of mentally impaired.

Our health authorities have to accept that there is now science that tells us that fluoride is harming children’s brains and they have to put that above any possible reduction in dental decay and above the embarrassment of admitting they were wrong. They must act to protect the children.

Most of the world does not fluoridate their water supply, including Japan and 98% of Europe. Dental decay rates in these countries is just as good, if not better, than the rates in New Zealand. Countries such as Scotland, are implementing dental health programmes that primarily involve school tooth brushing schemes that have seen a huge reduction in dental decay rates, and a halving of the number of general anaesthetics for severe decay. Apart from the reduced suffering, this is saving millions of pounds every year. A school tooth brushing scheme in Kaitaia has found the same astonishing results. There is no need to force harmful fluoridation chemicals on the entire population.

Currently, 22 councils out of 67 have any fluoridation amounting to around 50% of the population. There is a Bill in Parliament awaiting Second Reading, that aims to shift decision making to the district health boards. This would effectively make fluoridation mandatory as the DHBs are required to carry out MoH policy and the councils would be required to do what the DHB dictates.

It is time to kick not only the Mandatory Fluoridation Bill down the road, but fluoridation itself. The science is clear – fluoride is neurotoxic and should not be added to our water.

*Original press release online at http://www.scoop.co.nz/stories/PO1907/S00227/time-to-listen-to-pro-flouridation-agencies-raising-alarms.htm

Below are excerpts from the July 2019 O’Brien Report on Fluoride:

• Our various discussions with individuals on both sides of this fractious issue highlight that both sides bring knowledge and thoughtful perspectives.
• New evidence has emerged on potential cognitive effects of fluoride, arising from fluoride ingestion by pregnant women +/- fluoride intake from water consumed by infants. Recent National Institutes of Health funding decisions in the U.S., and corresponding new research funding decisions in Australia highlight that funding agencies and leading researchers in these two peer countries acknowledge the need to actively study/invest in understanding any potential cognitive effects. (p.10)
• The O’Brien Institute team has learned that the areas of uncertainty just described are being actively reviewed by health agencies (including Alberta Health Services, which is carefully tracking and reviewing emerging cognition studies), and time will tell whether new evidence leads to a change in the official agency positions. (p.10)
• Yet, there is also a nuanced middle ground that must be considered, where risks and benefits must be carefully weighted, while also fully understanding and acknowledging that there are still very definitely areas of persisting uncertainty, as just discussed. More knowledge is needed in a few key areas (the cognitive domain in particular), and from our expert interviews regarding new research that is happening around the world, more research evidence will emerge as time passes. (p.11)
• This report therefore stops short of ending with a simplistic “yes” or “no” recommendation for community water fluoridation. Our overall report findings suggest that such a simplistic response is not appropriate in any case. We hope that the bottom-line information just outlined is more enlightening than it is confusing. (p.11)

• Does ingested fluoride affect cognition?

This is an important section of our report, because it highlights an area where the evidence is evolving quite rapidly. Recognizing this, we present descriptions of new studies from the past eight months that were not covered in the recent CADTH report published in February of 2019. These are presented alongside some older studies on fluoride and cognition.

•  During fetal life and early infancy, the blood-brain barrier only partially prevents entry of chemicals into the brain and the developing brain is known to be sensitive to injury from toxic chemicals.
•  Several Chinese studies reported lower IQ among children exposed to fluoride in drinking water at average concentrations of 2.5-4.1ppm (several times higher than recommended fluoridation levels); these were published in journals specifically interested in fluoride (— namely, the journal Fluoride).
•  A meta-analysis of 27 studies led by a team at Harvard University, summarizing primary studies mostly done in China and Iran, reported an association between high fluoride exposure (upper limit of exposure up to 11.5mg/L) and lower IQ scores. The relevance of this study to the context of North American water fluoridation has rightly been questioned on the basis that the levels of fluoride exposure were generally higher than those seen in fluoridated Canadian water systems. Furthermore, the primary studies reviewed were generally either cross-sectional studies or ecological studies – i.e., weaker study designs for inferring causation. However, it should still be noted that the systematic review itself was very well done in reviewing an existing body of primary literature, and it certainly appears to have contributed to convincing national peer reviewed agencies like the National Institutes of Health in the U.S. to fund major studies (expensive studies) exploring the link between fluoride ingestion and cognition.
•  A later prospective study of a birth cohort in Dunedin, New Zealand found no association between fluoride exposure and IQ measurements performed repeatedly during childhood and at age 38. The cohort study design of this study, published in 2015, is stronger than prior study designs. However, there were also some important limitations to this study, including the fact that there were only a small number of control subjects (one-tenth the number of subjects exposed to fluoridated water), and as a (p.19) result, a lack of statistical power to make definitive conclusions. Also, various forms of oral fluoride supplements were in use in New Zealand in the 1970s, and it is likely that controls received fluoride from non-water sources – a factor that could bias the study toward finding no association. (p.20)
• A high-quality cohort study (ELEMENT: Early Life Exposures in Mexico to Environmental Toxicants) studied urinary fluoride in mothers during pregnancy and then from their children at 6-12 years (299 mother-child pairs). An increase in the mother’s urinary fluoride by 0.5mg/L predicted a lowering of 2.5 IQ points. The mean urinary fluoride was 0.9mg/L which is in the general range of exposures reported for other populations of adults. Though this study is based on subjects and fluoride consumption patterns in Mexico, the research was funded by the U.S. National Institutes of Health, and the work was led by Canadian researchers (Dr. Howard Hu, the former Dean of the Dalla Lana School of Public Heath at the University of Toronto, and lead author Dr. Morteza Bashash, a public health researcher, also at the University of Toronto).
•  Another similar analysis from ELEMENT found that higher levels of fluoride exposure during pregnancy were associated with global measures of attention deficit hyperactivity disorder (ADHD) and more symptoms of poor attention in children. One widely-stated stated caveat/criticism for these two ELEMENT studies just described is that the levels of urinary fluoride measured in pregnant Mexican women may not be relevant to Canada.
• This criticism is, however, addressed by a recent Canadian study. The MIREC (Maternal-Infant Research on Environmental Chemicals) cohort found that community water fluoridation appears to be a major source of fluoride exposure for pregnant women living in Canada, with urinary fluoride reflecting this exposure well. Further, this study reveals that the maternal urinary fluoride levels for women in communities with water fluoridation is comparable to that of Mexican women in the ELEMENT cohort. The amount of black tea consumed may further increase the exposure to fluoride.
•  Of great relevance to the evolving evidence in this domain, another MIREC study focusing on cognition also examined the association between fluoride exposure and childhood IQ using similar methods to the Mexico study, but in a Canadian sample of 510 mother-child pairs; 38% received recommended levels of community fluoridated water in major Canadian cities. Women from fluoridated communities had higher urinary fluoride (average 0.69mg/L vs 0.40mg/L), and higher levels were associated with lower IQ scores in boys at age 3-4 years (each 1mg/L increase in urinary fluoride associated with 4.5 IQ points lower) but not in girls. The new Canadian cognition evidence is currently in the public domain as a published and approved thesis (Ms. Rivka Green, York University), and it is also officially ‘in press’ with a leading medical journal, due to appear in the late summer or early fall. Of note, the MIREC studies just described were, like the ELEMENT study, funded by the U.S. National Institutes of Health. The lead (p.20) investigator for this research is a Canadian colleague, Dr. Christine Till, Associate Professor of Psychology at York University.
• The O’Brien Institute team conducted interviews with both Dr. Morteza Bashash (ELEMENT study) and Dr. Christine Till (MIREC) to clarify points in both of their respective studies, and to hear their perspectives on the overall fluoride issue. Importantly, we note that both are very clearly taking an objective and neutral scientific perspective in the work they do, and they firmly assert that they are neither pro- nor anti-fluoride in their perspective. Both simply indicate that ‘we need to get this right’. In that vein, both are engaged in continuing research that may shed more light on the question of whether ingested fluoride affects cognition.
• These very recent fluoride-cognition studies are being noticed and tracked by public health agencies. In Alberta, public health experts in Alberta Health Services are actively evaluating these new studies, and any others that may appear. Public Health Ontario has also recently done a careful analysis of the ELEMENT study, acknowledging its strengths, and the need for close monitoring of this issue (Note: the Public Health Ontario analysis was released before the Canadian MIREC data became publicly available).
• In summary, there is some new emerging evidence that fluoride exposure during pregnancy may be harmful to the brain development of children, with important studies having been published subsequent to the review of this evidence by the National Research Council in the U.S. in 2006. Many uncertainties remain about the mechanisms by which fluoride may harm brain development. Several – but not all – studies indicating toxicity have been performed in places where the ground water contains high levels of fluoride (versus community water fluoridation) and it is difficult to fully account for all the factors that may contribute to observed differences in IQ.
• The new emerging studies in this domain need to be tracked very closely, and carefully evaluated as they appear. We expect that health agencies at local, national, and international levels will confer and compare notes as they iteratively review, and re-review, this evidence (p.21).

*See original press release online at http://www.scoop.co.nz/stories/PO1907/S00227/time-to-listen-to-pro-flouridation-agencies-raising-alarms.htm

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