THE Second DAY.
By Paul Connett, PhD, Director of FAN
Day 2 certainly lived up to expectations and more. It featured just one witness: Philippe Grandjean MD, ScD. He testified from his home in Denmark. Dr Grandjean is both a medical doctor and scientist and an internationally known expert in environmental epidemiology, with ties to both Harvard School of Public Health and the University of Southern Denmark.
Dr Grandjean was the second expert witness to “take the stand” pitting Fluoride Action Network, Moms Against Fluoridation, and Food and Water Watch, and several other plaintiffs against the U.S. Environmental Protection Agency in U.S. District Court in San Francisco.
He has held grants and/or consulted with the EPA itself, the National Institutes of Health, the U.S. Food and Drug Administration, the World Health Organization, and numerous other bodies over 25 years. He is the author or co-author of some 500 scientific papers.
Grandjean is also the author of the book, Only One Chance, in which he warns of the dangers of exposing children to neurotoxicants during early development, especially during the fetal stage. Subtle changes here can last a lifetime. As a society we have literally “only once chance” to prevent this early exposure- and if we don’t do it the consequences last a lifetime, with serious consequences for the individual and the population as a whole.
As a witness Grandjean was knowledgeable, credible and was clearly concerned about public health, especially the mental development of children.
Grandjean is perhaps best known worldwide for his work in the Faroes Islands where his research on the neurotoxicity of mercury involved studying the IQ of children born to mothers whose diet was high in fish consumption (and thence high in mercury). This work led to defining the EPA’s safe regulatory levels for mercury in the diet. In fact, Grandjean is the EPA’s go-to-person when it comes to anything pertaining to the neurotoxicity of mercury. Thus, the Department of Justice of lawyer representing the US EPA, Debra Carfora, had a formidable job trying to undermine his credibility since they have relied on him for his expert advice on mercury and other neurotoxicants. Why we would they disregard his advice on fluoride?
Grandjean, like all the expert witnesses, had presented to the court his testimony in a prefiled Declaratory statement. Michael Connett, lawyer for the plaintiffs took him through this statement and his research on fluoride.
Grandjean has worked on fluoride since the 1980s when at the suggestion of Irving Selikoff (Selikoff was the founder in 1966, of the Environmental and Occupational Health Division of Mount Sinai Hospital in New York, and is known as the “father” of asbestos research) he looked into the health effects of cryolite workers (cryolite is a mineral containing fluoride and used in the manufacture of aluminium. It is also approved for use today as a pesticide on vegetables and fruits). Not only did the workers (exposed to the dust) have the expected symptoms of skeletal fluorosis, but they exhibited other health problems including neurological symptoms.
But as far as “our” fluoridation world was concerned Grandjean’s name came into prominence when he published a meta-analysis of 27 fluoride-IQ (all but two from China) which found – even though they were conducted in many different geographical areas, by different research teams over a period of about 20 years – a remarkably consistent result (Choi et al., 2012). Of these 27 studies, 26 found a lowering of IQ in the children with higher fluoride exposure. Under questioning from Michael Connett, lawyer for the plaintiffs, Grandjean explained that for this review he had help from two prominent researchers from China who were able to read the Chinese versions of many of these papers and were able to provide useful background information about the communities involved. These communities were nearly all rural and with highly stable populations – so that any levels of fluoride measured were likely to give an indication of exposure throughout the children’s lives including the fetal stage. So despite the weaknesses of many of these ecological studies (comparing two different communities with different fluoride exposure, but without individual measurements) the overall take-home message was that they were highly consistent and important findings.
During this testimony Grandjean gave a little bit of interesting history which revealed a lot about the way that pro-fluoridation forces have set out to discredit any study or any researcher who has the temerity to publish a study indicating any harm from fluoride. DOJ lawyer Carfora asked Grandjean about a statement he made about his paper for the Harvard University press department, which said that his work had no relevance to the USA fluoridation program. He said, ‘okay, you really want to know?’ He said that a member of the Harvard Dental department was enraged by the paper and had worked with the press department to obtain this statement as well as getting the Deans of the Medical School and Dental school and one other to put out a statement endorsing the “safety and effectiveness” of water fluoridation. Grandjean also related earlier efforts by the fluoridation lobby to infiltrate a World Health Organization committee on which he sat, in an effort to exclude any mention of fluoride’s harmful effects. When Grandjean saw this happening he resigned from the committee.
Back to the TSCA trial. Plaintiffs had asked Grandjean to do a review of the literature since his famous 2012 meta-analysis, to include the most recent US government-funded studies. Not only did Grandjean do this review but he also quantified the risk of IQ loss from fluoride to children based upon the Bashash 2017 and the Green 2019 (Canadian study) mother-offspring studies.
For this analysis, Grandjean did what is called a Benchmark Dose (BMD) study (using methods that he and his colleagues have pioneered) and used by the EPA. He concluded that a safe reference dose (RfD) be no higher than 0.15 mg per day to protect against a loss of one IQ point (this was referred to as the BMDL, with L standing for the level at which the benchmark response -a loss of one IQ point- would be expected based upon linear regression). This was well below the exposure levels experienced by the pregnant women (and passed to the fetus) in the Bashash and Green studies.
A dose of 0.15 mg of fluoride day would be reached by a pregnant mother drinking just one glass of fluoridated tap water a day. No parent would agree that a loss or one IQ point or more is a reasonable risk to take in order to achieve a very small benefit to teeth later in their lives. There are few scientists who now believe that any benefit accrues to the teeth during the fetal stage or early infancy when the greatest risks to the developing brain occur.
On cross-examination lawyers for the DOJ did their best to challenge Grandjean’s credentials which was both silly and a little insulting (Do you actually teach classes at Harvard? Do you have a PhD? Do you have a PhD in Toxicokinetics, Biometrics etc).
Then they asked him if he did a “systematic review” before he drew his conclusions about fluoride being a neurotoxic hazard. Grandjean answered that he did a thorough review of the literature which would have satisfied the EPA up to about two years ago, and moreover he read the systematic review provide by experts from Exponent and found no studies that would have reversed his position that fluoride was a neurotoxic “Hazard.” Thus he felt comfortable proceeding to use the findings of the best studies in the field to do his quantitative analysis (BMD analysis). In other words, he used the linear dose response relationships found in both the Bashash and Green studies to determine a safe reference to protect against loss of one IQ point in children.
In short, adding fluoride to the public drinking water presents a serious risk to the mental development of future generations of children and should end.
Grandjean found “no reasonable doubt that developmental neurotoxicity” was “a serious human health risk associated with elevated fluoride exposure.” That exposure, he said, is “occurring at the levels added to drinking water in fluoridated areas.”
Dr Grandjean was questioned for approximately 5 hours via Zoom by lawyers for both sides.
Debra Carfora, a DOJ lawyer for the defense team, attempted to disqualify Grandjean’s testimony in a lengthy cross-examination, but her motion to do so was denied by the court.