Although I just play the role of a scientist on the internet, my father actually is one. As well as being a medical doctor, he is a retired professor of biophysics. I am telling you this because he has recently co-authored a book on a subject that might interest readers of ScienceBlogs: fluoridation of human water supplies. The book is entitled "The Case Against Fluoride: How Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep It There" and you can read a detailed review of that book here [PDF].
At my request, he has written up a guest post outlining the arguments he and his co-authors make in much greater detail in "The Case against Fluoride" and says he will be checking the comments in case there are questions. So, without further ado, take it away Dad!
Guest post by James S. Beck
Participants in this blog will be familiar with at least one struggle between science and science-deniers in the context of a man-made disaster, where material interests and greed and reluctance to face responsibility and fear of legal liability all lie in the background. That’s the drama of climate change. Well, here’s another one for us: fluoridation of public water supplies. The science is perhaps simpler and the solution certainly is easier but the parallels are nevertheless striking.
This drama got its start in North America in the 1940′s after a big effort on the part of industries that were faced with costly law suits over illness and death, things apparently caused by their industrial use of fluorine-containing chemicals. The government of the United States was also involved in fluorine use in its enrichment of uranium for fission bombs. The public became involved unknowingly in 1945 with the beginnings of trials of fluoride as a preventive of dental caries (cavities). These trials were imposed on large cities in Canada, the US and New Zealand without consent of their inhabitants. The goal of some of the actors was prevention of cavities. The goal of the pushers seems to have been to make fluoride look harmless and beneficial, thus making legal challenges hopeless of success. But these trials were imposed without prior tests for safety or effectiveness and fluoridation of public water supplies was approved and promoted by the US Public Health Service in 1950 – half-way through these ill-conceived and incompetently executed trials. After that other government agencies and some professional associations quickly got on the bandwagon. Currently about two-thirds of the population of the United States is using fluoridated water. In Canada usage varies with province but overall less than 40% of the population has it. In Europe the practice has been refused and stopped to the extent that over 90% of the people do not have it.
A brief review of three critical questions about fluoridation follows.
Is fluoridation effective in reducing the incidence of dental caries (cavities)?
Fluoridation of public water supplies has been in effect somewhere in the world for seven decades now. Over that time the prevalence of dental caries has fallen in industrialized countries. This has been taken by many to indicate efficacy. But research has consistently shown that the decrease has occurred in countries without fluoridation to the same or greater degree as in those with fluoridation. Furthermore it is observed that in jurisdictions where fluoridation has been discontinued the incidence of caries has not risen. And studies comparing caries experience of cities fluoridated with cities not fluoridated have shown no difference, except where the nonfluoridated cities do better.
The answer to this first question is clearly no.
Is fluoridation safe?
The most obvious toxic effect has been dental fluorosis. In mild cases it appears as mottling discoloration of tooth surfaces. In moderate and severe cases it involves discoloration, pitting and weakening of the enamel and has serious consequences. The treatment of this condition costs tens of thousands of dollars per patient. Even if this effect were only cosmetic, it would have serious negative effects on a child’s or teenager’s life. Aside from dental fluorosis, evidence uncovered over the last two decades has shown an association of fluoride in drinking water with lower IQ in children. There are over twenty published studies showing this association. In laboratory studies of animals and of aborted human fetuses an association with abnormalities of cells of the brain has been found. Also it has been shown that fluoridation is associated with high levels of lead, a known neurotoxin, in the blood of children.
And there’s more, including, but not limited to, the following:
- Fluoride intake is a cause of impaired thyroid function. Indeed fluoride was once used medically to suppress thyroid function.
- Deleterious effects on reproductive systems in humans have been found to be associated with fluoridation: in girls, early onset of menstruation; in men, low sperm counts.
- We now have strong evidence of the association of osteosarcoma in boys and young adult males with fluoridation. Osteosarcoma is a bone cancer which is often fatal.
- The possible incidence of bone fracture with fluoridation has been studied with mixed results. One of the strongest studies is presented in a paper by Li et al. published in 2001 which shows a rising prevalence of hip fracture correlated with a rising intake of fluoride starting with concentrations comparable with those used in fluoridation in North America. And this is just one example that suggests that hip fracture is caused by fluoridated water.
- Fluoride adversely affects kidneys.
- Two recent studies have shown adverse effects on the heart and the aorta.
Ironically, this multiplicity of demonstrated and possible toxicities has actually been cited by some proponents of fluoridation as discrediting the arguments of opponents. That tactic appears as an assertion that opponents are scaremongers, that nothing would cause so much trouble for so many body systems. But these effects of fluoride are not so surprising to anyone who recognizes that the element fluorine is the most reactive chemical element and that it reacts with many components of the human body. For example, fluoride has been used in thousands of laboratory investigations as an inhibitor of enzymes, the proteins that catalyze (facilitate) biochemical reactions. It is also well known that fluoride, in combination with other elements such as aluminum and with components of cell membranes, disrupts the normal signalling across the membanes of hormones and other messengers that activate or moderate cellular functions. Really, the multiple toxicities are to be expected rather than dismissed because there are so many.
All of this is backed up by scientific reports in peer-reviewed journals. I recognize that there are well educated proponents of fluoridation including scientists, physicians and dentists, but in my experience they have never offered evidence of safety or efficacy that stands up to careful scrutiny.
So the answer to the second question, "Is it safe?", is clearly no.
Is fluoridation ethical?
Given the evidence that fluoridation is ineffective and that it is unsafe, the question of ethicality is easily answered in the negative. But even if it were effective, it would not be acceptable for the following reasons.
It is unethical to administer a substance or procedure to a person without the consent of that person, consent informed by a qualified professional who must answer questions from that person and who must inform the recipient of the reasons for the administration and of possible side effects. Such consent has never been sought from, much less given by, those whose tap water is fluoridated.
It is unethical to administer a substance or procedure that has not been approved by a qualified body. Dosage and/or intensity must be monitored and controlled and the effects on individuals must be monitored by a qualified professional (control of concentration in water does not control amount per unit body weight consumed by an individual). The recipient must be able to stop the administration at will. These are simple precepts of medical ethics, precepts clearly not adhered to in the case of fluoridation.
In short the substances used to fluoridate drinking water (mostly hexafluorosilicic acid) have not been tested or approved for use in humans; the dosage is not controlled; individual consent has not been obtained; the effects on individuals are not monitored; individuals can not stop the administration.
Fluoridation of public water supplies fails on all these ethical requirements.
For more information on this issue, such as which city water supplies are fluoridated and how you can get involved can be found at the Fluoride Action Network.
[Update: references for this book can be found here: http://fluoridealert.org/caseagainstfluoride.refs.html, sorry this was not offered initially]