Thursday, 27 February 2014

Inside the Mind of an anti-fluoridationist

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.


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  2. Well 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.

  3. Excellent article Gerry.
    I'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.

    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.

    1. Ronan,
      Well 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?

  4. Dear Gerry; really enjoyed this.

    I'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?


    Dave ( @drg1985 / )

  5. David,
    I'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.

    1. 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.

      I 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;

      Would love your feedback, and feel free to share...

    2. David,
      Read the piece and concur. Will share. Keep up the good work.

  6. Well done Gerry. Thorough.

    The 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 ( 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

  7. Andrew,
    Thank 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.

    1. 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.


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