by Gerry Byrne
Perhaps unfairly, I have
always bracketed anti-fluoridation campaigners alongside folks who
say they were once kidnapped by aliens, and those from the whackier
cohorts of alternative medicine. But then my attention was drawn to
an Irish anti-fluoridation report which claims the backing of a
highly eminent body of US scientists for its premise that
fluoridation causes, or exacerbates, dozens of serious illnesses and
conditions in Ireland, including two that directly affect me.
Definitely worth a look, I
thought.
Yet what I found there not
only failed to change my mind about fluoridation. It also alerted me
to the cynical manner in which scientific facts are bent completely
out of shape by campaigners playing on the health fears of a
population which is, by and large, scientifically illiterate.
Fluoridation, for those
recently arrived from Mars, is the addition of a commonly occurring
natural chemical, fluoride, to our drinking water to improve the
nation's dental health. Here's the science bit: in the first
half of the last century US researchers pondering the ability of
groups of people in Colorado to resist the dental decay epidemic that
plagued the rest of the nation, discovered that high fluoride
concentrations occurred naturally in their ground water supplies.
When fluoride was experimentally added to a water supply in Grand
Rapids, Michigan, dental decay there fell 60%. In 1999, after
fluoridation had been extended to cover more than 70% of the US
population, the US National Institutes of Health hailed it alongside
vaccination as one of the top 10 public health breakthroughs of the
20th Century.
Like chlorine, which is
added to Irish drinking water to kill germs, fluoride can be harmful
if taken to excess but the quantities in the average water supply are
negligible. That didn't stop some far-out environmental scaremongers
parlaying the minuscule (and, so far, beneficial) amounts of fluoride
in water into a devious attempt at mass-poisoning, or, in one account
I've read, as a Communist way of controlling the minds of a servile
population. Long lists of the diseases it is said to cause are often
appended to these fruity claims but the science behind them is
usually so preposterous as to be easily dismissed. And while it is
true that a number of European countries no longer fluoridate their
water, they often ensure the population still gets fluoride, usually
through an additive to salt. “You cannot mass-medicate an entire
population”, one of the arguments often used against fluoridation,
and which was advocated recently by Labour TD Emmett Stagg, is
perhaps, a more reasonable starting point for discussing
fluoridation.
But when I was told the
hugely prestigious National Research Council (NRC) of the US Academy
of Sciences had produced evidence to support a claim that
Fluoridation is causing more cases than might otherwise be expected
in Ireland of Sudden Infant Death Syndrome, rheumatoid arthritis,
heart disease, thyroid and parathyroid difficulties (from both of
which I suffer) plus dozens of other ailments, I parked my usual
highly acute cynicism (a.k.a. bullshit meter) and took a look.
The
claims are contained in Public
Health Investigation of Epidemiological data on Disease and Mortality
in Ireland related to Water Fluoridation and Fluoride Exposure by
Declan Waugh. Unlike most scientific research, Waugh's 166 page
treatise is not published in a recognised peer-reviewed science
journal, or produced by an august body, like the Department of
Health, or a major university or hospital. He says it leans heavily
on a 2006 NRC report reviewing fluoridation in the US on behalf of
the US Environmental Protection Agency. If true, that's theoretically
good enough for me.
It's also good enough for
Hot Press Magazine which appears to have based much of its current
anti-fluoridation campaign on Waugh's "whistle-blower" (Hot
Press's words, not mine) testimony. Yet he's possibly a cut above the
average fluoridation naysayer because he has an environmental science
degree from Sligo Institute of Technology. However, much of his
working life before setting up Enviro, his consultancy firm, appears
to have been spent, not in disease research, but dealing with mining
wastewater, and the erection of wind farms. He has also described
himself as a director of the Sustainable Energy Authority of Ireland
(although that body tells me it doesn't have directors, just board
members, which include Mr Waugh). He also has a long list of letters
after his name but, apart from the Sligo B.Sc., none of them are
degrees or other academic qualifications.
In a nut-shell Waugh says
the 2006 NRC report's "key findings" (his phrase - the NRC
does not use the term) provided a signpost to the many dreadful
things fluoridation can do to us, and, armed with this knowledge he
then combed through appropriate disease statistics for the Republic
of Ireland (where water is fluoridated) and compared them to similar
statistics for Northern Ireland (where water is not fluoridated). A
higher incidence of a disease in the Republic is, according to
Waugh's thesis, "proof" that fluoridation is the cause and
he backs this up with what he says is NRC data.
Sadly for Waugh's thesis is
the fact that the NRC report's findings and recommendations fail to
correspond with his list. In fact the NRC pretty much gives
fluoridation a clean bill of health. The only area in which it
advises it advises caution in its use is in relation to fluorosis, a
well known side-effect of the over-fluoridation of water, where teeth
can display a mottled effect. There may also be a rare impact on bone
strength. Therefore it suggested reducing fluoride concentrations in
water to one quarter its previous maximum allowable US dose thus
bringing it down closer to the Irish level. Otherwise one searches
the US report in vain for any "key findings" listing any
proven harmful effects of fluoridation.
Take
Sudden Infant Death Syndrome (SIDS) as an example. According to
Waugh's paper there are 300% more cases per 1,000 live births in the
fluoridated Republic than in non-fluoridated Northern Ireland. And
sure enough, he mentions Sudden Infant Death Syndrome in a section of
his paper titled Pineal
Gland: Key Findings of the Scientific Committee [where
Scientific Committee refers to the NRC report]. This mention occurs
in a sentence which he prints in inverted commas suggesting that it
is a direct, unmodified quote from the NRC report: "Melatonin
seems to be involved in anxiety reactions and other physiological
effects including regulation of sleep, effects on calcium and
phosphorus metabolism, parathyroid activity, bone growth, development
of postmenopausal osteoporosis and anticarcinogenic effects,
antioxidant actions, effects on the central nervous system,
psychiatric disease and sudden infant death syndrome."
A problem for Mr Waugh's
thesis is that the above sentence, despite being in quotes, does not
occur anywhere in the official NRC report. Like some other "quotes"
by Waugh from the NRC report, it has been cobbled together using
phrases picked from a series of separate sentences, not all of which
are saying the same thing. Indeed the relevant paragraph of Waugh's
report which contains that sentence, and which is also presented as a
direct quote from the NRC report, does not exist as a complete
paragraph in the American study either. And, whereas the NRC report
does consider Sudden Infant Death Syndrome, it concludes that it
found no link whatever between the syndrome and Fluoridation.
Still, giving Mr Waugh the
benefit of the doubt, I contacted the Irish Sudden Infant Death
Association demanding to know why, according to Waugh, fluoridated
Ireland has one of the highest rates in the world of SIDS. Actually,
that's not true, replied Dr Cliona McGarvey, a medical researcher
into the syndrome at Temple Street Children's University Hospital,
and an advisor to the Association. She said that, according to the
latest figures, Ireland's death rate from SIDS is actually on a par
with the rest of the world. And far from being 300% higher in the
Republic than in Northern Ireland - as Waugh claims - there were
actually fewer cases per 1,000 in the Republic, according to the
latest statistics. The death rate from SIDS in the Republic is now
0.38 per 1,000 live births; it's 0.45 over the border, 18% higher
than in the Republic. Dr McGarvey also picked up an error in Mr
Waugh's calculations where he included unexplained deaths of children
older than 12 months in his figures while comparable international
statistics are based on unexplained child deaths aged one year or
younger.
Finally, Dr McGarvey stated
that studies have failed to find any link between SIDS and
fluoridation.
In a section of his paper
titled "Summary of the Main Findings of the NRC Report" Mr
Waugh writes "Cytogenetic effects of Fluoride may cause Downs
Syndrome." Later he writes "... the significantly increased
prevalence of Down's Syndrome in Ireland clearly suggests as indicated by the NRC
that fluoride exposure could be contributing to increased prevalence
of Down’s syndrome."
In fact the NRC paper,
cited by Waugh as "evidence" for his theories, actually
concluded that studies it examined attempting to link Fluoridation
and Downs syndrome were "of little value for risk evaluation."
Waugh's Down's Syndrome
theory is also rejected by Pat Clarke, the chief executive officer of
Down's Syndrome Ireland. Clarke said that the higher rates of Down's
Syndrome in this country was largely because Irish mothers tend to be
older mothers (the older a woman is giving birth, the higher the
chance of having a Down's Syndrome baby). In addition, he said that
elsewhere in Europe women are often pressured to have pre-natal scans
by doctors for legal reasons and this results in many terminations
where the syndrome is identified (research abstracts consulted by
this writer indicates abortion rates as high as 90% are common
following a pre-natal diagnosis of Down Syndrome). "There has
been no increase in the Irish rate apart from that which can be
explained by the age of the mother," says Clarke.
Elsewhere in his paper
Waugh writes that Down's Syndrome babies are bottle-fed (using
formula mixed with fluoridated water) more than the norm and that
this is "exposing them to the harmful effects of fluoride, which
in itself may clearly explain the much higher incidence of thyroid
disorders in children with Down's syndrome as well as other
ailments." This is also firmly rejected by Mr Clarke who pointed
out that Down's Syndrome children worldwide suffer from a
well-documented range of congenital thyroid ailments in addition to
coronary and intestinal problems.
"All these conditions
pre-exist fluoridation," Mr Clarke said.
And SIDS and Down's
Syndrome are not the only conditions that Mr Waugh seems to get very
wrong.
Although it is not dealt
with in any way by the NRC report, Waugh links fluoridation with the
little-known inflammatory lung and skin disease sarcoidosis on the
basis that there are more sufferers in the Republic than in
non-fluoridated Northern Ireland. However one doctor familiar with
the disease says that diagnosis in Northern Ireland was historically
poor due to the lack of sarcoidosis specialists there, whereas there
are several centres of excellence in the disease in the Republic.
Following the work of a patient advocacy group in Northern Ireland,
he added, more cases have been diagnosed and the percentage of the
population with the disease is now broadly similar, north and south.
"There is no evidence to blame sarcoidosis on fluoridation,"
he said.
Waugh also claims the
backing of the NRC report for his theories that fluoride may cause,
or be a factor in, various cancers, diabetes, Alzheimer's, arthritis,
rheumatism, thyroid diseases, osteoporosis, hypertension, anxiety,
psychiatric diseases, oral ulcers, urticaria, skin rashes, nasal
congestion and epigastric distress, among others. Not true, according
to my reading of the NRC report.
A rheumatologist commenting
on behalf of the Irish Society for Rheumatology, a group of
scientists and doctors working in the field, said that with respect
to sarcoidosis and rheumatoid arthritis, fluoride has not been proven
to be the causative agent.
Asked for a comment on
Waugh's claim implicating fluoridation with Alzheimer's disease, a
spokesperson for the Alzheimer Society of Ireland replied: "There
is no evidence in the epidemiological research that fluoride is a
risk factor for dementia." A similar reply was received from the
the Asthma Society of Ireland which stated that there was no known
asthma risk from Fluoridation. The Irish Heart Foundation also
disagrees with Waugh's theory that cardiovascular disease (CVD) can
be caused or exacerbated by fluoridation and stated that it was "not
aware of any strong evidence that tiny amounts of fluoride in water
increase prevalence of CVD."
Waugh lists dozens of what
he calls "Key Findings" of the NRC Report relating to
various endocrine diseases which could be caused, or aggravated by,
Fluoridation. In fact the NRC report drew no firm conclusions
whatever on the impact of Fluoridation on the human endocrine system
although it did produce a list of areas where further research might
usefully be undertaken.
One of Waugh's reported
"findings" from the NRC report was that studies
demonstrated that menarche, or time of first menstruation, in girls,
was earlier in some fluoridated areas of Hungary and the US, than in
non-fluoridated areas.
In reality the NRC
dismissed these studies as irrelevant. In one US study conducted more
than 50 years ago, the NRC made the point that the differences in age
at onset of puberty were statistically insignificant. Not all the
girls in the fluoridated district had been exposed to fluoridation
for the same amount of time making it even harder to draw conclusions
from the results. The second study compared the age of female puberty
between two Hungarian towns where one had a higher concentration of
Fluoridation than the other. Although some girls in the town with
greater Fluoridation achieved puberty slightly earlier, the median
age of menarche was the same in both towns.
By and large, the NRC study
leaned over backwards to be fair to the dozens of fluoridation
theories floating around and, where researchers claimed to have
spotted a link between a medical condition and the chemical, it
diligently tracked down the research and evaluated it. As I've
repeated here several times over, the NRC dismissed the vast majority
of the studies it considered. However, the fact that they even
bothered to look them up is, in Waugh's mindset, a "key finding"
in support of his theories.
Waugh is strong to the
point of being dogmatic about a link he says clearly exists between
fluoridation and diabetes, including a statement in which he says the
NRC report contains a warning to the United Kingdom about the
potential exposure risks for its citizens. When I asked in an email
for evidence of a diabetic "smoking gun" in the NRC report,
he cuttingly replied that I obviously hadn't read the report and
dispatched six email pages of extracts from it accompanied by a
comment accusing me of jumping to "unscientific and inaccurate
opinions." (Unbidden, a phrase linking the words pot, kettle and
black springs to mind).
Waugh's
extracts are presented in paragraphs which appear to be direct quotes
from the NRC paper and, at first glance, they appear to be very
convincing. One sentence, for example, reads: "Fluoride clearly
[Waugh's
emphasis] has the effect of decreasing
serum calcium and increasing the calcium requirement in some or many
exposed persons."
Ommitted by Waugh is the
preceding sentence in the NRC report which makes clear that the
"exposed persons" in this case are those already suffering
from hormonal and vitamin imbalances which affect their ability to
metabolise calcium. Such people (and I am one of them) must take
measures to improve their calcium and vitamin D intake (whether or
not their water is fluoridated). And what is effectively being
described in that sentence quoted above is the normal, everyday
influence of fluoride in the diet, taking additional calcium from the
bloodstream and diverting it to the bones, and more importantly, the
teeth. Also omitted by Waugh is the second sentence that follows in
the NRC report, and which clearly reads: "No information has
been reported in those studies on the clinical effects, if any, in
those persons."
Although it does recommend
further studies relating to diabetes and other issues, nowhere does
the NRC advocate the reduction, or elimination of fluoridation
because it causes, or exacerbates, diabetes. And that's a conclusion
echoed by Diabetes Ireland which tells me it knows of no evidence
linking diabetes and fluoridation. Furthermore, I have yet to
discover the "warning" for the UK Waugh says was given by
the NRC in its report.
Incidentally, I'm not the
first to question Declan Waugh's scientific method (or lack of one).
That honour fell to Dr Seamus O'Hickey, chairman of the Department of
Health appointed Irish Expert Body on Fluoridation and Health. In his
assessment (published on the Expert Body's website) of an earlier
February 2012 anti-fluoridation document produced by Waugh, he
commented: "... in spite of its presentation, its content is
decidedly unscientific."
He added: "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." Elsewhere he
states: "The author [Waugh] gives the impression that there is
an abundance of scientific material in existence, including
recommendations from respected international and national bodies that
condemn the practice of water fluoridation. This is not the case."
Having read Waugh's latest
report, I have to wholeheartedly second Dr O'Hickey's conclusions.
And I've rebooted my bullshit meter.
ENDS
This comment has been removed by a blog administrator.
ReplyDeleteWell done. I find it most interesting that most of the anti-fluorine noise is coming from west Cork. Is it by coincidence that this is an area where more people that elsewhere have decided to avoid infant inoculation? I have not really see an objection from the non-flakey side of humanity. As they say, let's give dental caries a fair crack of the whip.
ReplyDeleteExcellent article Gerry.
ReplyDeleteI'm a town councillor and have received many form letters from anti-fluoridation campaigners here. Despite responding to each and every one of them, initially anyway, the same people come back to me time and time again with exactly the same "evidence".
When first contacted I, like you, gave the claims of ineffectiveness and possible negative health effects some credence, as they appeared to be supported by some very prestigious scientific organisations.
After engaging for some time with the campaigns and after reviewing their information (including that from Declan Waugh) I had to revert back to my previous skepticism.
The claims they made were not supported by the scientific data they provided and when each one was addressed, another, just as unscientific, claim was thrown up. This continued until the original claim was made yet again (despite it having been addressed previously) and the whole horrible cycle continued.
I started a review of Waugh's report but abandoned it due to time pressures (and the knowledge that it wouldn't make a bit of difference).
Here is the only completed section which deals with SIDS, which I considered one of the more disgustingly manipulative sections.
https://drive.google.com/file/d/0B7IibyOvUf1Fc0VuSmYyQTJFNTg/edit?usp=sharing
All of that being said, I am not entirely comfortable with the ethics of the whole thing.
I do believe that we are better off with water fluoridation than without it but, as has been pointed out by many of the campaigners, other countries do manage very well without it, albeit with a lot more being spent on dental care or by providing fluoride in other ways.
Ronan,
DeleteWell done on the reference checking for SIDS. Your report is very revealing. I was personally appalled at the way Waugh employed inappropriate stats to suit his objectives. Imagine being a parent who lost a child and being convinced that the tap water did it?
Gerry
Dear Gerry; really enjoyed this.
ReplyDeleteI'm a physicist and also write on issues of science and health for the Irish Times and Guardian. I penned a bit on this in September 2013 with same tone as your piece, albeit under the inflexible 800 word limit of an Irish Times op-ed. What has struck me since is the almost religious fevour of those who have a stake in the issue. I've received reams of hatemail for it, and Mr Waugh himself has even penned aggressive letters to my employers demanding I be hauled out and and investigated. I did a radio bit on the subject last month and immediately TGAF and her followers posited that I was a stooge of big pharma. It's depressing that such ad homs and attacks are the response of these groups to their assertions being questioned, but it does indicate that they merely bend evidence to suit their conclusions, rather than the other way round as science insists.
As you point out, the medical literature is not on their side, and these campaigners are fundamentally misguided. If the MMR debacle has taught us anything, it should be that there are serious consequences when health policy is decided on emotive blind rhetoric rather than the balance of evidence.
Thanks for writing this piece - I don't want to give such people the publicity they sorely crave, but if it's alright with you I might link to this post in a future blogpost if needs be?
Yours,
Dave ( @drg1985 / www.davidrobertgrimes.com )
David,
ReplyDeleteI'm familiar with some of your work and enjoyed your take on fluoridation last year. I too am expecting an avalanche of hate mail but I think it's worth it. Did you come to this blog via the Sunday Times or otherwise? I had a shorter piece in today's Irish issue (p.15). But of course you are welcome to link to this. Anything that redresses the balance is welcome. I was aware of Waugh's feeble efforts to get you fired - he has a copy of his letter to the university on his website.
Gerry
Thanks Sir - RTE rang me today and I recommended you on the basis of this excellent blog. I also didn't want to pander to their assertion that there's few people supporting the policy. You were excellent and debunked Waugh completely.
DeleteI wrote the whole thing up, I hope you don't mind - My main annoyance is that science policy should be decided on the evidence base, not by scaremongering and I hold politicians catering to such crowds in more contempt than the sorely misguided groups themselves.
You'll find piece here;
http://3menmakeatiger.blogspot.co.uk/2014/03/health-policy-must-be-formed-basis-of.html
Would love your feedback, and feel free to share...
David,
DeleteRead the piece and concur. Will share. Keep up the good work.
Gerry
Well done Gerry. Thorough.
ReplyDeleteThe thing i find most frustrating is that one could quite happily (in a self-flagellating kind of way) spend every waking hour pulling apart just about everything Declan Waugh writes. Each and every piece on his blog (http://ffwireland.blogspot.ie/2013/01/fluoride-and-cardiovascular-disease_15.html) is full of basic errors in how to present a scientifically based argument that one would correct or mark down in student work:
"No attempt to compare or contrast results. Fails to identify consensus or debate."
"Results presented in a confused or inappropriate manner and incomplete or erroneous analysis. Discussion and interpretation of result severely limited, including some basic misapprehensions, and lacking any originality or critical evaluation."
"Basic references covered. Provides a general overview of main topics/authors. Some areas poorly covered with occasional omissions. "
"Manuscript contains clear sections, including an abstract, introduction and conclusion. Some key themes identified and explored, but maybe limited in scope or focussed on some areas to the exclusion of others. Structure/progression of ideas may be weak in places."
you would be looking at a solid 3rd class mark for most of it.
- andrew
Andrew,
ReplyDeleteThank you for your kind words and I agree with the self-flagellation bit. But at the same time I am appalled at how persuasive some of these arguments are. BTW did you see my bit in the Sunday Times yesterday (p.15) and how he "substituted" fluoridation for the flameproofing chemicals some authorities blame for the rise in thyroid cancers. Incredible.
Gerry
just tracked that Sunday Times article down now. Good article and good venue for it. I often think the anti-flouridation crowd are charlatans, knowingly selling us lies to further some circumspect business plan of theirs. In Declan's case, I think he is simply not a very good scientist, not sufficiently trained or experienced and well out of his depth. Oh, and also making some money off it too.
DeleteAndrew
@yodacomplex
http://www.tcd.ie/Zoology/research/research/theoretical/andrewjackson.php
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