Water Fluoridation: Many unneccesary risks versus a questionable benefit :

1. Water Fluoridation:Many unneccesary risks versus a questionable benefit: Paul Connett, PhD Senior Adviser, Fluoride Action Network Cortland, NY, Sept 8, 2016 www.FluorideACTION.net

2. Book published by Chelsea Green October, 2010 Can be ordered on Amazon.com Contains 80 pages of references to the Scientific literature

3. The many risks

4. The risks of water fluoridation are unnecessary • Fluoride is not a nutrient. There is no need to swallow it. • Even promoters recognize that the predominant benefit of fluoride is TOPICAL not SYSTEMIC (CDC, 1999). • There is no need to force it on people who don’t want it. • It is well established that fluoride interferes with many biological processes – for a review see Barbier et al, (2010). Molecular mechanisms of fluoride toxicity. Chem. Biol. Interact. 188(2):319-333.

5. Fluoride’s effects on human cells Barbier O, Arreola-Mendoza L, Del Razo LM. Molecular mechanisms of fluoride toxicity. Chem Biol Interact. 2010 Nov 5: 188(2):319-33

6. NRC (2006)

7. Based on the NRC (2006) review, there is no question that fluoride at certain levels can cause harm but what about the “low” levels used in water fluoridation?

8. Putting 0.7 ppm into perspective

9. Mothers’ milk protects our babies from early exposure to fluoride F = 0.004 ppm

10. This protection is removed when babies are bottle-fed with fluoridated water F = 0.70 ppm 175 x level in mothers’ milk

11. NRC (2006)

12. On page 85 the NRC (panel) showed that a bottle-fed baby where the formula is made-up with fluoridated tap water (at 1 ppm)exceeds the EPA’s safe reference dose for fluoride (NRC, 2006) (0.06 mg F per kilogram bodyweight per day)

13. Studies where fluoride shown to cause harm at or near 1 ppm 1. Fluoride damages teeth (dental fluorosis) at levels lower than 0.7 ppm. Dr. Osmunson will review this issue.

14. Studies where fluoride shown to cause harm at or near 1 ppm 2. Fluoride damages bone (skeletal fluorosis). About 50% of daily intake of fluoride is excreted through kidney. Most of the rest concentrates in the bone over a lifetime.

15. Studies where fluoride shown to cause harm at or near 1 ppm 2. Fluoride damages bone (skeletal fluorosis). About 50% of daily intake of fluoride is excreted through kidney. Most of the rest accumalates in the bone over a lifetime. 3. The first symptoms of skeletal fluorosis are identical to arthritis. US Health authorities have never investigated the sky rocketing prevalence of arthritis in US to see if it relates to daily exposure to fluoride. .

16. Studies where fluoride shown to cause harm at or near 1 ppm 2. Fluoride damages bone (skeletal fluorosis). About 50% of daily intake of fluoride is excreted through kidney. Most of the rest concentrates in the bone over a lifetime. 3. The first symptoms of skeletal fluorosis are identical to arthritis. Health authorities in US have never investigated the sky rocketing prevalence of arthritis in US to see if it relates to daily exposure to fluoride. If you don’t look you don’t find. The absence of study is not the same as absence of harm.

17. Alarcon-Herrera et al. 2001 A Mexican study in an area where natural fluoride ranged from 1.5 to 5.7 ppm, found as the severity of dental fluorosis increased in local clinics, the occurrence of bone fractures in local clinics in both children and adults also increased. Children Adults Severity of dental fluorosis Very mild

18. Studies where fluoride shown to cause harm at or near 1 ppm 5. An unrefuted study from Harvard (Bassin et al., 2006) shows that young boys exposed to fluoridated water in their 6th to 8th years (which corresponds to a period of rapid bone growth) had a 5-7 fold increased risk of succumbing to osteosarcoma by the age of 20 (ostesarcoma is a rare but frequently fatal bone cancer). No subsequent study (including Kim et al. 2011) has examined this critical window of vulnerability. If you don’t look you don’t find.

19. Peckham et al, 2015 6. Peckham et al. in a survey of the incidence of lowered thyroid function in the UK found a higher incidence in fluoridated versus non-fluoridated communities. US Health authorities have never investigated the sky rocketing prevalence of hypothyroidism in US to see if it relates to daily exposure to fluoride.

20. Malin and Till (2015) 7. Malin and Till found a correlation between the prevalence of ADHDfor each US State in 2003, 2007 and 2011 (CDC data) with the percentage of the population in each state drinking fluoridated water in 1992 (CDC data).

21. Percent of children with ADHD (by state) for 2003, 2007 and 2011 plotted against the % of population in each state fluoridated in 1992 ADHD Prevalence Artificial Water Fluoridation Prevalence in 1992

22. In 1978 Arvid Carlsson, who led the successful fight against fluoridation in Sweden, said this

23. Arvid Carlsson Nobel Prize for Medicine, 2000 “One wonders what …an increase in the exposure to fluoride, such as occurs in bottle-fed infants …may mean for the development of the brain …” 1978

24. In 2006 the NRC had this to say:

25. National Research Council (2006): Fluoride & the Brain “it is apparent that fluorides have the ability to interfere with the functions of the brain.”

26. Since 2006, many more studies of fluoride and the brain have been published.

27. Today, over 300 animal and human studies indicate that fluoride has the potential to damage the brain FluorideACTION.net/issues/health/brain

28. Over 100 animal studies show that fluoride can cause biochemical and physical changes to the brain 34 out of 36 animal studies show rodents exposed to fluoride have a decreased ability to learn 50 out of 57 human studies link fluoride exposure to lowered IQ 12 studies (7 human, 5 animal) link fluoride with other brain function deficits 3 human studies show fluoride impacts fetal brain

29. Opponents of fluoridation can cite over 300 red flags warning of fluoride’s potential to damage the brain 300 +

30. Opponents of fluoridation can cite over 300 red flags warning of fluoride’s potential to damage the brain 300 + How many green flags can proponents cite that suggest we can confidently ignore this very serious concern? ?

31. Proponents usually cite just TWO studies:1) A short-term high-dose animal study by Whitford2) An IQ study from New Zealand by Broadbent et al., 2014. This study is very poor as it had very few controls, with 900 drinking F-water and only 90 drinking non–F water, with about half of those getting fluoride supplements. There is little power to detect any difference in IQ. See critique by Osmunson, Limeback and Neurath, letter to JAPHA and Spittle editorial.Can either Dr. Johnson or Dr. Slott cite any more studies?

32. Here are some examples of specific studies finding brain effects

33. Varner et al. (1998) • Gave rats 1 ppm fluoride in their water for one year. • The exposed rats had kidney damage, brain damage, greater uptake of aluminum into the brain and beta amyloid deposits characteristic of Alzheimer’s disease.

34. Xiang et al, (2003 a.b) • One of the fifty studies that have found an association between lowered IQ in children and exposure to low levels of fluoride

35. Xiang et al. (2003 a,b) • Compared IQ of children in two villages: • Low Fluoride Village Average F in well water = 0.36 ppm (Range = 0.18 -0.76 ppm) • High Fluoride Village Average F in well water = 2.5 ppm (Range 0.57 – 4.5 ppm) • Controlled for lead exposure and iodine intake, and retrospectively for arsenic • Found a drop of 5-10 IQ points across the whole age range between the two villages

38. This data would suggest that IQ is lowered somewhere between 0.75 and 1.5 ppm

40. NOAEL LOAEL

41. Dr. William Hirzy, a former risk assessment specialist at US EPA, has used standard risk assessment procedures to calculate a safe level of fluoride that would protect all children against lowered IQ and this is so low it would make fluoridation unthinkable

42. Calculating dose at NOAEL For 0.75 ppm (NOAEL) in Xiang study Daily Dose from Water = 0.75 mg F/L x 1.24 L/day = 0.93 mg F/day   Daily Dose from Food = 0.50 mg F/day Total daily dose = 1.43 mg F/day

43. To calculate Safe dose to protect all US children from lowered IQ In risk assessment we divide the NOAEL by a safety factor to protect for the full range of sensitivity expected in a human population (genetics, diet, lifestyle etc) when extrapolating from a small study group: Default value = 10. 1.43 mg/day divided by 10 = 0.14 mg F/day A pea-sized amount of F-toothpaste = 0.25 mg

44. Harvard Meta-analysis of IQ studies Environmental Health Perspectives, 2012 Oct;120(10):1362-8.

45. Dr. Philippe Grandjean “Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain.”(Harvard Press Release)

46. The NIEHS/NTP review In Dec 2015 the National Institute of Environmental Health Sciences (NIEHS) requested that the National Toxicology Program (NTP) review the literature on fluoride and neurotoxicity. In July 2016 they reported that the animal studies showed low to moderate evidence of neurotoxicity. In part 2 of their review they will report on the human studies. In part 3 of their review they will report on their own animal study.

47. The very last children who need to have their IQ lowered are children from low-income families, precisely the ones being targeted for fluoridation!

48. Based on Xiang‘s (Xiang et al., 2003a,b) study 1) Water fluoridation should be ended. 2) For children, fluoridated toothpaste should be used only under prescription 3) Safer methods be investigated for reducing tooth decay in children from low income families which pursue better dental hygiene and better diet, e.g Childsmile (Scotland) and Nexo program (Denmark).

49. Better Alternatives to Fluoridation The Nexø program in Denmark.

50. Nexø program in Denmark 1. Denmark has lowest caries rates in the world and has never fluoridated its water, salt or milk (WHO, 2015) . 2. The  Nexø  Method – see Ekstrand and Christiansen, Outcomes of a non-operative caries treatment program for children and adolescents Caries Research, 2005, 39(6):455-67. 3. Nexo is the community where the program began 4. The results were so dramatic in lowering caries rates that it has spread to other Danish cities 5. The program began in 1980. The following graphs show results.