Statement on the fluoridation of public drinking supplies by
Professor C V Howard. MB. ChB. PhD. FSB. FRMS. FRCPath. 14/2/2013
1) I am a medically qualified toxico-pathologist and expert
on effects of toxic substances on the fetus and infant during the developmental
period of life. I am a Past President of the International Society of Doctors
for the Environment, which is a World Health Organisation and United Nations
recognised NGO representing some 30,000 medical doctors around the world. I
have served on UK Government regulatory committees and am currently Professor
of Bioimaging at the University of Ulster. I served as an Expert Witness on fetal
toxicology causation in the case of Castillo vs Dupont in Miami,
Florida.
2) Pre-industrial levels of fluoride in the environment were
very low. There are now many different sources of both therapeutic and
pollutant sources of fluoride. The former can be taken, under informed consent,
for dental health purposes.
3) It is generally accepted that the predominant action of
fluoride on dental enamel is a topical one and that there is little additional
benefit from systemic administration (CDC, 1999).
4) The ‘one dose fits all’ method of administration to whole
populations via the public drinking water supply is known to be deeply flawed.
This particularly applies to the neonatal infant being fed formula milk, which
is reconstituted using fluoridated tap water. In the latter case it is
acknowledged overdosing is occurring. A baby drinking formula made up with fluoridated
tap water at 1 ppm will get 250 times more fluoride than a breast-fed baby.
5) Breast milk contains very low levels of fluoride (0.004
ppm, NRC, 2006, p.40), even when the lactating mother has been administered
fluoride. Though the serum level of fluoride increased, the breast milk level
remained very low (Ekstrand, 1981, 1984)). It is my opinion that this is the
result of a specific exclusion process that has evolved to protect the neonate
from exposure to anything other than very low levels of fluoride during
critical windows of development of a number of organs.
6) There is evidence of developmental neurotoxicity from
exposure to fluoride, expressed as reduced IQ distributions in populations,
when compared epidemiologically with populations with lower exposures. There
now have been 36 studies (see the complete listing at
www.FluorideAlert.org/health/brain) that have found a lowered IQ associated
with even modest exposure to fluoride. For example Xiang et al. (2003) found a
threshold for IQ lowering at 1.9 ppm. Ding et al. (2010) have found a lowering
of IQ in the range of 0.3 to 3 ppm. Moreover, they and other researchers, have
reported a correlation between the extent of the IQ lowered and the level of
fluoride exposure as measured in the urine.
7) Recently a team from Harvard University (Choi et al, 2012) reviewed 27 of these IQ studies using a
meta-analysis. They found a remarkable consistency in the results even though
they were derived from four different countries (China, India, Iran and Mexico). Of the 27 studies comparing villages with low levels of
fluoride and with villages with modest to high levels of fluoride (0.88- 11.5
ppm), 26 revealed a lower IQ in the children from the “high” fluoride village.
The mean difference was 7 IQ points, which from a population perspective is
highly significant. Such a shift would reduce the number of geniuses in a large
population by at least 50%, and approximately double the number of mentally
handicapped.
8) The mechanism by which this
IQ lowering could occur is not fully understood. However, direct toxicological
action by fluoride on the developing nervous system is a biologically feasible
likelihood. There have now been well over one hundred animal studies indicating
that fluoride can cross the blood brain barrier and cause changes in the brain
(see appendix 1 in the book “The Case Against Fluoride” by Connett, Beck and
Micklem). Another mechanism is an indirect one, via disturbance of thyroid
hormone metabolism, which should be considered (See chapter 8 of the National
Research Council report Fluoride in
Drinking Water: A Review of EPA’s standards, NRC, 2006, for a comprehensive
review of fluoride’s interactions with the endocrine system). The finding that
even variations in thyroxin levels within the maternal euthyroid (normal) range
can subtly affect the IQ of offspring (Pop et al 1995, 1999) highlights the
very critical role of the hormone in controlling normal neural development. The
prior therapeutic use of F to reduce thyroid hormone levels in cases of
thyrotoxicosis is well documented (Goldemberg, (1926, 1930, 1932); May (1935, 1937);
Orlowski (1932) and Galletti and G. Joyet, (1958)).
9) There is evidence that the incidence of osteosarcoma, a
frequently lethal bone cancer, increased in teenage boys in fluoridated versus
non-fluoridated areas (Hoover et al., 1991); Cohn, 1992). These findings were
greatly strengthened by a case-control study conducted at Harvard by Elise
Bassin (Bassin et al., 2006). Bassin
found that young boys exposed to fluoridated water in their 6th,
7th and 8th years had a 5-7 fold risk of succumbing to
osteosarcoma by the age of 20. At the time that this study was published
Bassin’s thesis adviser, Chester Douglass promised in a letter (Douglass and
Joshipura, 2006) that his larger study would refute her findings. However,
Douglass’s study was finally published (Kim et al., 2011) failed to refute
Bassin’s thesis. In other words we have a high quality – unrefuted - study,
which indicates that fluoridation may actually be killing a few young men each
year.
10) Given the above uncertainties concerning the causation
of harm to human health through mandatory fluoridation of the public drinking
water of whole populations, allied to the very dubious advantage for dental
health of the practice, it is my considered opinion that on the balance of
medical probabilities that there is a strong case for not considering the
fluoridation of public drinking water.
This statement is made also in the light of ethical issues concerning a)
the incidence of avoidable dental fluorosis in young people and b) the mass
medication of a whole population without prior informed consent.
11) Statement on
conflicts of interest. I have no commercial interests or research grants,
current or past, concerning the fluoridation of drinking water. I hold no
shares in any companies involved in water fluoridation. I have never received a
fee for speaking on the topic of fluoridation.
References
Bassin,
EB, Wypij, D, Davis, DB, and Mittleman, MA. (2006). “Age-specific
Fluoride
Exposure in Drinking Water and Osteosarcoma (United States),” Cancer Causes
and
Control 17, no. 4 (May): 421–28.
CDC (1999). Centers for Disease
Control and Prevention, “Achievements in Public Health,
1900–1999: Fluoridation of Drinking Water to
Prevent Dental Caries,” Mortality and
Morbidity Weekly Review 48, no. 41 (October 22,
1999): 933–40, http://www.cdc.gov/
mmwr/preview/mmwrhtml/mm4841a1.htm.
CDC (2010). Beltrán-Aguilar ED,
Barker L and Dye BA. Nov 2010, Prevalence and Severity of Dental Fluorosis in
the United States, 199–2004 National
Center for Health Satistics. http://www.cdc.gov/nchs/data/databriefs/db53.pdf
Choi, A.L., et al., Developmental
Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis. Environ
Health Perspect, 2012
Cohn, PD (1992). An Epidemiologic Report on
Drinking Water and Fluoridation, New Jersey Department of Health, Environmental
Health Service, November 8, 1992. Note:
The original title of this report was A Brief
Report on the Association of Drinking Water
Fluoridation and the Incidence of Osteosarcoma
Among Young Males. The word “osteosar-
coma” was deleted from the title soon after the report
was released; http://fluoridealert
.org/cohn-1992.pdf.
Connett,
P., Beck, J. Micklem, H.S. The Case Against Fluoride. Chelsea
Green, Vermont, 2006.
Douglass, CW and Joshipura, K (2006). “Caution
Needed in Fluoride and Osteosarcoma Study” (letter), Cancer Causes &
Control 17, no. 4 (May 2006): 481–82.
Ekstrand,
J., Boreus, LO and P. de Chateau, P. (1981). No Evidence of Transfer of
Fluoride from
Plasma to Breast Milk. British
Medical Journal 283, no. 6294: 761–62.
Ekstrand,
J., Spak,CJ, Falch, J. et al. (1984). Distribution of Fluoride to Human
Breast
Milk Following Intake of High Doses of Fluoride. Caries Research 18 (1):
93–95.
Galletti P, and Joyet, G. (1958). Effect of
Fluorine on Thyroidal Iodine Metabolism in
Hyperthyroidism. Journal of Clinical Endocrinology 18, no. 10: 1102–10.
Goldemberg,
L. (1930). Traitement de la Maladie de Basedow et de l’Hyperthyroidisme par le
Fluor. La Presse Médicale 102: 1751.
Goldemberg, L. (1932). Comment Agiraient-ils Therapeutiquement les
Fluoers dans le Goitre Exopthalmique et dans L’Hyperthyroidisme. La Semana Médica 39: 1659.
Hoover, et al. (1991). U.S. Department of
Health and Human Services, Review of Fluoride: Benefits and Risks,
Public Health Service, Washington, DC, February 1991,
http://health.gov/environment/
ReviewofFluoride/ appendix E.
Kim FM, Hayes C,
Williams PL, et al. (2011). An assessment of bone fluoride and osteosarcoma. J Dent Res. 2011. doi:
10.1177/002203451141882
May, W. (1935). Antagonismus
Zwischen Jod und Fluor im Organismus. Klinische
Wochenschrift 14:
790–92.
May, W. (1937). Behandlung the
Hyperthyreosen Einschliesslich des Schweren Genuinen
Morbus Basedow mit Fluor. Klinische
Wochenschrift 16: 562–64.
NRC (2006). National Research
Council of the National Academies, Fluoride in Drinking Water: A Scientific
Review of EPA’s Standards (Washington, DC: National Academies
Press, 2006),
Orlowski, W. (1932). Sur la
Valeur Therapeutique du Sang Animal du Bore et du Fluor dans la Maladie de
Basedow. La Presse Medicale 42: 836–37.
Pop
VJ, Kuijpens JL, van Baar AL, Verkerk G, van Son MM, de Vijlder JJ, et al. Low
maternal free thyroxine concentrations during early pregnancy are associated
with impaired psychomotor development in infancy. Clinical Endocrinology
1999;50:149-55.
Pop V.J., de Vries E., van Baar A., Waelkens J.J., de Rooy
H.A., Horsten M., et al. Maternal Thyroid Peroxidase Antibodies during
Pregnancy: A marker of impaired Child development? Journal of Clinical
Endocrinology and
References to the 25 IQ studies:
(links to the references cited here can be accessed
at http://fluoridealert.org/caseagainstfluoride.refs.html. )
Y. Chen, F. Han, Z. Zhou, et al., “Research on the
Intellectual Development of Children in
High Fluoride Areas,” Fluoride 41, no. 2 (2008):
120–24, (originally published in 1991 in
Chinese Journal of Control of Endemic Diseases),
http://www.fluorideresearch.org/412/files/
FJ2008_v41_n2_p120-124.pdf.
Ding Y, Gao Y, Sun H, Han H, Wang W, Ji X, Liu X, Sun D.
(2010). The relationships between low levels of urine fluoride on children's
intelligence, dental fluorosis in endemic fluorosis areas in Hulunbuir, Inner
Mongolia, China.
Journal of Hazardous Materials doi:10.1016/j.jhazmat.2010.12.097.
X. Guo, R. Wang, C. Cheng, et al., “A Preliminary
Investigation of the IQs of 7–13 Year Old
Children from an Area with Coal Burning-Related
Fluoride Poisoning,” Fluoride 41, no. 2
(2008): 125–28 (originally published in 1991 in Chinese
Journal of Endemiology), http://www.
fluorideresearch.org/412/files/FJ2008_v41_n2_p125-128.pdf.
F. Hong, Y. Cao, D. Yang, and H. Wang, “Research on
the Effects of Fluoride on Child
Intellectual Development Under Different
Environmental Conditions,” Fluoride 41, no. 2
(2008): 156–60 (originally published in 2001 in
Chinese Primary Health Care), http://www
.fluorideresearch.org/412/files/FJ2008_v41_n2_p156-160.pdf.
X. S. Li, J. L. Zhi, and R.O. Gao, “Effect of
Fluoride Exposure on Intelligence in Children,”
Fluoride 28, no. 4 (1995):
189–92, http://fluoridealert.org/scher/li-1995.pdf.
Y. Li, X. Jing, D. Chen, L. Lin, and Z. Wang,
“Effects of Endemic Fluoride Poisoning on the
Intellectual Development of Children in Baotou,” Fluoride 41, no.
2 (2008): 161–64 (origi-
nally published in 2003 in Chinese Journal of
Public Health Management), http://www
.fluorideresearch.org/412/files/FJ2008_v41_n2_p161-164.pdf.
F. F. Lin, Aihaiti, H. X. Zhao, et al., “The
Relationship of a Low-Iodine and High-Fluoride
Environment to Subclinical Cretinism in Xinjiang,”
Xinjiang Institute for Endemic
Disease Control and Research; Office of Leading
Group for Endemic Disease Control
of Hetian Prefectural Committee of the Communist
Party of China; and County Health
and Epidemic Prevention Station, Yutian, Xinjiang,
Iodine Deficiency Disorder Newsletter 7,
(1991): 3,
http://fluoridealert.org/scher/lin-1991.pdf; also see
http://www.fluoridealert.org/
IDD.htm.
S. Liu, Y. Lu, Z. Sun, et
al., “Report on the Intellectual Ability of Children Living in High-
Fluoride Water Areas,” Fluoride 41, no. 2 (2008):
144–47 (originally published in 2000 in
Chinese Journal of Control of Endemic Diseases),
http://www.fluorideresearch.org/412/files/
FJ2008_v41_n2_p144-147.pdf.
Y. Lu, Z. R. Sun, L. N. Wu, et al., “Effect of
High-Fluoride Water on Intelligence in
Children,” Fluoride 33, no. 2 (2000): 74–78,
http://www.fluorideresearch.org/332/files/
FJ2000_v33_n2_p74-78.pdf.
Poureslami HR, et al. (2011). International Journal of
Paediatric Dentistry 21(Suppl s1):47.
L. Qin, S. Huo, R. Chen, et al., “Using the Raven’s
Standard Progressive Matrices to
Determine the Effects of the Level of Fluoride in
Drinking Water on the Intellectual
Ability of School-Age Children,” Fluoride 41, no. 2
(2008): 115–19 (originally published in
1990 in Chinese Journal of the Control of Endemic
Disease), http://www.fluorideresearch
.org/412/files/FJ2008_v41_n2_p115-119.pdf.
D. Ren, K. Li, and D. Liu, “A Study of the
Intellectual Ability of 8–14 Year-Old Children in
High Fluoride, Low Iodine Areas,” Fluoride 41, no.
4 (2008): 319–20 (originally published
in 1989 in Chinese Journal of Control of Endemic
Diseases), http://www.fluorideresearch
.org/414/files/FJ2008_v41_n4_p319-320.pdf.
D. Rocha-Amador, M. E. Navarro, L. Carrizales, et
al., “Decreased Intelligence in Children
and Exposure to Fluoride and Arsenic in Drinking
Water,” Cadernos de Saúde Pública 23,
suppl. 4 (2007): S579–87.
B. Seraj, M. Shahrabi, M. Falahzade, et al.,
“Effect of High Fluoride Concentration in
Drinking Water on Children’s Intelligence,” Journal
of Dental Medicine 19, no. 2 (2007):
80–86. Note: English translation forwarded by lead
author (B. Seraj, department of pediatric
dentistry, faculty of dentistry, Tehran University
of Medical Sciences), http://fluoridealert
.org/scher/seraj-2007.trans.pdf.
M. H. Trivedi, R. J. Verma, N. J. Chinoy, et al.,
“Effect of High Fluoride Water on Intelligence
of School Children in India,” Fluoride 40, no.
3 (2007): 178–83, http://www.fluoride
research.org/403/files/FJ2007_v40_n3_p178-183.pdf.
G. Wang, D. Yang, F. Jia, and H. Wang, “A Study of
the IQ Levels of Four- to Seven-Year-Old
Children in High Fluoride Areas,” Fluoride 41, no.
4 (2008): 340–43 (originally published
in 1996 in Endemic Diseases Bulletin [China]),
http://www.fluorideresearch.org/414/files/
FJ2008_v41_n4_p340-343.pdf.
S. Wang, H. Zhang, W. Fan, et al., “The Effects of
Endemic Fluoride Poisoning Caused by
Coal Burning on the Physical Development and
Intelligence of Children,” Fluoride 41,
no. 4 (2008): 344–48 (originally published in 2005
in Journal of Applied Clinical Pediatrics
[China]), http://www.fluorideresearch.org/414/files/FJ2008_v41_n4_p344-348.pdf.
S. X. Wang, Z. H. Wang, X. T. Cheng, et al.,
“Arsenic and Fluoride Exposure in Drinking
Water: Children’s IQ and Growth in Shanyin County, Shanxi Province, China,”
Environmental Health Perspectives 115, no. 4
(2007): 643–47, http://www.ncbi.nlm.nih.gov/
pmc/articles/PMC1852689/.
Q. Xiang, Y. Liang, L. Chen, et al., “Effect of
Fluoride in Drinking Water on Children’s
Intelligence,” Fluoride 36,
no. 2 (2003): 84–94, http://www.fluorideresearch.org/362/files/
FJ2003_v36_n2_p84-94.pdf. Also see Q. Xiang, Y.
Liang, M. Zhou, and H. Zang, “Blood
Lead of Children in Wamiao-Xinhuai Intelligence
Study” (letter), Fluoride 36, no. 3 (2003):
198–99, http://www.fluorideresearch.org/363/files/FJ2003_v36_n3_p198-199.pdf.
L. B. Zhao, G. H. Liang, D. N. Zhang, and X. R. Wu,
“Effect of High-Fluoride Water Supply
on Children’s Intelligence,” Fluoride 29, no. 4
(1996): 190–92, http://fluoridealert.org/scher/
zhao-1996.pdf.
The following five
Chinese I.Q. studies have not yet been translated:
J. A. An, S. Z. Mei, A. P. Liu, et al., “Effect of
High Level of Fluoride on Children’s Intelligence”
(article in Chinese), Zhong Guo Di Fang Bing Fang
Zhi Za Zhi 7, no. 2 (1992): 93–94.
Z. X. Fan, H. X. Dai, A. M. Bai, et al., “Effect of
High Fluoride Exposure on Children’s
In Intelligence” (article in Chinese), Huan Jing Yu
Jian Kang Za Zhi 24, no. 10 (2007): 802–3.
Y. L. Xu, C. S. Lu, and X. N. Zhang, “Effect of
Fluoride on Children’s Intelligence” (article in
Chinese), Di Fang Bing Tong Bao 9 (1994): 83–84.
L. M. Yao, Y. Deng, S. Y. Yang, et al., “Comparison
of Children’s Health and Intelligence
Between the Fluorosis Area with Altering Water
Source and Those without Altering Water
Source” (article in Chinese), Yu Fang Yi Xue Wen
Xian Xin Xi 3, no. 1 (1997): 42–43.
J. W. Zhang, H. Yao, and Y. Chen, “Effect of High
Level of Fluoride and Arsenium on
Children’s Intelligence” (article in Chinese),
Zhong Guo Gong Gong Wei Sheng Xue Bao 17,
no. 2 (1998): 119.
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