Safe Water Information Service

The Water Bill's amendment to promote fluoridation

The Water Bill, now before Parliament, gets its second reading for the House of Commons on 8 September 2003. The Bill was introduced first into the House of Lords, and it has passed all its stages there.
An amendment to promote fluoridation was added only at the third reading in the House of Lords, where this abnormal procedure was roundly criticised.
The amendment provides that a water company would be compelled to accede to a request by a Strategic Health Authority to add fluoride to the water if the latter decides in favour of fluoridation after public consultation.

Under the proposed consultative procedure for England, Health Authorities themselves would be responsible for the assessment of public opinion. However, they are under the direction of the Department of Health (DoH), which grants more than three-quarters of the income of the British Fluoridation Society (a grant of £82,000 in the year to 31 March 2002). They are hardly impartial on this issue.

The Government plan for the consultative process is later to make Regulations, which will not be subject to amendment by Parliament. These unpublished Regulations ought, at the least, to include firm provisions for opponents of fluoridation to be given equal opportunity to state their case, and for the procedure to be in the hands of Local Authorities, which are more likely than Health Authorities to consult fairly.

Recent standard letters from the Department of Health say the York University and Medical Research Council reports, with DoH advice, "will help to ensure that local decisions are based on an authoritative, readily accessible summary of research into the safety and efficacy of fluoridation". We can guess how impartial the Department of Health's advice is likely to be, given its financial support only for those who promote fluoridation.

The efficacy of fluoridation is far less than the 50-60% reduction in tooth decay which has long been promised by its supporters. York's estimate was about 15% reduction, but even that is uncertain, owing to the inadequate quality of the evidence.
York showed that, when comparing different areas, studies concerning fluoridation's claimed efficacy failed to consider all relevant factors, such as potential examiner bias and comparative spending on dental health. Lord Hunt declared in the Lords debate that Birmingham enjoys a very strong public health dentistry service, yet the fluoride lobby disregards this when comparing tooth decay there and in other areas.

Nearly all European countries have rejected fluoridation, due to uncertainty over its safety and effectiveness, or because of its denial of the human right of choice in food and medicine. Almost the only exceptions are the UK (where about 10% of people get fluoridated water) and the Republic of Ireland (where the proportion is much higher, as the provisions of the legislation are mandatory).

Neither York nor the MRC was asked by the DoH to assess the long-term effect of adding to our environment, every year, thousands of tonnes of the toxic chemicals used in fluoridation. The fluoride usually used, hexafluorosilicic acid, is not pure as it is a crude industrial by-product of the manufacture of phosphate fertiliser. It is also far more soluble and thereby invasive than the occasionally found natural forms of fluoride.

The York University and MRC reports state that more research, of a better quality, is needed, and in particular regarding our increasing total exposure to fluoride from various modern sources.

The fluoridation lobby has far greater resources than those who oppose it, and in addition it is regularly given tens of thousands of pounds of taxpayers' money, while the other side is entirely dependent on voluntary support.

The fluoridation lobby's misleading claims (1)

A statement by Professor Trevor Sheldon, Head of the Department of Health Studies at the University of York, reveals how seriously the fluoridation lobby chose to misrepresent the findings of the York review.

Professor Sheldon's comments of 3.1.2001:

In my capacity of chair of the Advisory Group for the systematic review of the effects of water fluoridation recently conducted by the NHS Centre for Reviews and Dissemination the University of York and as its founding director, I am concerned that the results of the review have been widely misinterpreted. The review was exceptional in this field in that it was conducted by an independent group to the highest international scientific standards and a summary has been published in the British Medical Journal. It is particularly worrying then that statements which mislead the public about the review's findings have been made in press releases and briefings by the Britsh Dental Association, the British Medical Association, the National Alliance for Equity in Dental Health and the British Fluoridation Society. I should like to correct some of these errors.

1. While there is evidence that water fluoridation is effective at reducing caries, the quality of the studies was generally moderate and the size of the estimated benefit, only of the order of 15%, is far from "massive".
2. The review found water fluoridation to be significantly associated with high levels of dental fluorosis which was not characterised as "just a cosmetic issue".
3. The review did not show water fluoridation to be safe. The quality of the research was too poor to establish with confidence whether or not there are potentially important adverse effects in addition to the high levels of fluorosis. The report recommended that more research was needed.
4. There was little evidence to show that water fluoridation has reduced social inequalities in dental health.
5. The review could come to no conclusion as to the cost-effectiveness of water fluoridation or whether there are different effects between natural or artificial fluoridation.
6. Probably because of the rigour with which this review was conducted, these findings are more cautious and less conclusive than in most previous reviews. The review team was surprised that in a large number of studies carried out over several decades there is a dearth of reliable evidence with which to inform policy. Until high quality studies are undertaken providing more definite evidence, there will continue to be legitimate scientific controversy over the likely effects and costs of water fluoridation.

The fluoridation lobby's misleading claims (2)

With the fluoridation lobby continuing to issue false statements, the following letter, dated 11 December 2002, was sent from the NHS Centre for Reviews and Dissemination, at the University of York, to Hazel Blears, MP at the House of Commons:

Dear Minister,

We are scientists involved in the systematic review of evidence on the effects of water fluoridation, carried out by the NHS Centre for Reviews and Dissemination at the University of York. As far as we are aware, no other review of this topic is of comparable scientific standard, and we are concerned about some continuing misinterpretations of the evidence which could have implications for public policy. It is not for us to say whether the standard of evidence should be judged sufficient for a public health measure affecting whole populations, but we think it is important that decision makers are aware of what the review really found.

1. Effectiveness of fluoridation in reducing caries.

We could discover no reliable good-quality evidence in the fluoridation literature world-wide. What we found suggested that fluoridation was likely to have a beneficial effect, but in fact the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.

2. Effectiveness of fluoridation in reducing inequalities in dental health across social groups.

This evidence is weak, contradictory and unreliable.

3. Safety of fluoridation.

Apart from an increase in dental fluorosis (mottled teeth) we found no clear pattern among the possible negative effects we examined, and we felt that not enough was known because the quality of the evidence is poor.

We append relevant extracts from the report of the review from which the conclusions under 1 and 2 can be substantiated. 3 covers too broad an area to summarise easily.

Since the report was published in September 2000 there has been no other scientifically defensible review that would alter the findings of the York review. As emphasised in the report, only high-quality studies can fill in the gaps in knowledge about these and other aspects of fluoridation. Recourse to other evidence of a similar or lower level than that included in the York review, no matter how copious, cannot do this.

We think these matters are important enough to bring directly to your attention, as well as to the notice of others who have a stake in public health policy.

Yours sincerely,

Professor Jos Kleijnen, Director, NHS Centre for Reviews and Dissemination.
Professor Trevor Sheldon, Head of Department, Department of Health Sciences, University of York.
Sir Iain Chalmers, UK Cochrane Centre.
Professor George Davey-Smith, Department of Social Medicine, University of Bristol.

COPIES TO:
Rt Hon Alan Milburn, MP; Sir Liam Donaldson, Chief Medical Officer;
The Lord Hunt of Kings Heath; Sir Anthony Cleaver, Chairman, MRC.

Scientists in many countries have criticised fluoridation

For a list of some of the scientists who have criticised fluoridation, and a few quotations, see: Scientists.

Safe Water Information Service

The Safe Water Information Service (SWIS) was formed in early 1995 at the request, and with the support, of water consumers who are opposed to the deliberate pollution of the public water supplies, especially fluoridation, and who are concerned about the lack of unbiased information about the numerous pollutants discharged into our streams and rivers which are among the main sources for our public water supplies.

SWIS is a national voluntary organisation whose aims are:

• To promote factual scientific information about all forms of water pollution.
• To promote the protection of our public water supplies from the many forms of contamination.
• To assist local water consumers in any lawful actions deemed necessary to prevent deliberate pollution of their public water supplies and to improve its quality.

Currently the major issue of concern is a deliberate form of pollution: fluoridation. Our publications and activities are organised entirely by volunteers. We do not have any paid staff.

We depend on public support in the considerable task of promoting safer public water supplies. If you would like to help, please say.

Articles from SWIS News

Some of the articles which have appeared in back issues of SWIS News are available here, and are listed on the following page:
SWIS News.

Early Day Motions in the House of Commons

Early Day Motions in the House of Commons for and against fluoridation have been signed so far by some 149 and 89 MPs respectively. There is an overlap as a few MPs have, astonishingly, apparently signed both EDMs. This is a non-party issue, and there are MPs of various parties on both sides.
For the latest lists of MPs who have signed either (or even both!) of these Early Day Motions, see the official site and search for the word "fluoridation": Early Day Motions.
The list shown initially of MPs who have signed an EDM is not in alphabetical order, but there is an option to see an alphabetical list.

Links to sites with further information

More information on various aspects of fluoridation, including much scientific material, is available from other sites. Page of links to other sites.