1.Presentation onon Water Fluoridation By Declan Waugh Chartered Environmental Scientist Chartered Waste Manager Chartered Water and Environmental ManagerTo download full report onHuman Toxicity, Environmental Impact and Legal Implications of Water Fluoridationgotohttp://www.enviro.ie/risk.htlm

2. Lets begin by examining why other European Countries stopped fluoridationtheir drinking water suppliesDenmark banned fluoridation when itsNational Agency for EnvironmentalProtection, after consulting the widestpossible range of scientific sources, pointedout that the long-term effects of low fluorideintakes on certain groups in the population(for example, persons with reduced kidneyfunction), were insufficiently known.Source: National Agency of EnvironmentalProtection, Denmark. February, 1977. 3. Sweden also rejected fluoridation onthe recommendation of a specialFluoride Commission, which includedamong its reasons that: "The combinedand long-term environmental effects offluoride are insufficiently known."Source: Report of Swedish FluorideCommission. Stockholm 1981. 4. How Sweden changed its policy to end waterfluoridationThe research group around Dr. Anders Thylstrup, PhD,Professor of Cariology at the University of Copenhagenincluding Dr. Gillberg, Dr. Jan Sallstrom- Associate Professorof Experimental Pathology and Dr Agnetha Sallstrom revealedthat the Government experts of the National Board ofHealth and Welfare who were advocating fluoridation ofboth ignorant concerning basicwater werephysiological knowledge and werebluffing with statistics on cariesreduction and fluorosis, the decision processturned against water fluoridation in Sweden. 5. Germanys stance on Water Fluoridation canbe defined in this quote."The argumentation of theFederal Ministry of Healthagainst a general permission offluoridation of drinking water isthe problematic nature ofcompulsion medication." 6. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993To prevent dental decay (caries), fluorides aresometimes added to drinking water to achieve levels ofabout 1 ppm.If you swallow the treated water, or these products, youwill be exposed to fluoride. 7. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Drinking or eating fluoride during the timeteeth are being formed can cause visiblechanges in teeth. These changes increase inseverity with increasing levels of fluoride.The condition is called dental fluorosis. 8. Fluoride accumulates in the bones, kidneys, brain-pinealgland, thyroid and reproductive systems.Ingested fluoride generally first acts on the stomachmucosa, and creates hydrofluoric acid, it becomescorrosive and leads to gastrointestinal problems, largeraccumulations have also been attributed to irregularheartbeats and cardiac arrest.When fluoride gets into blood plasma it inhibitsmetabolic processes in the body as well as physicallychanging the structure of bone and teeth.Dental Fluorosis is the most obvious sign of chronicoverexposure to fluoride as it is the only clear visibleexternal mark of the toxin effects on the human body. 9. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Exposure to certain levels of fluoride canharm your health. The health effects dependon the type of fluoride you are exposed to, howlong you are exposed, and how much gets into the more soluble theyour body. In general,fluoride-containing substance is, themore toxic it is. 10. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE,AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Neurological EffectsFluoride has been shown to interfere with glycolysis.Because the central nervous system relies heavily on this energysource, hypotheses have been advanced as to a mechanism forfluoride effects on the central nervoussystem. Studies tend to indicate that hypocalcemiacaused by fluoride binding of calcium causesthese symptoms of fluoride poisoning. 11. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGEN FLUORIDE,AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Developmental EffectsFluoride crosses the placenta in limited amounts and is found infetal and placental tissue.No developmental studies for humans were available to examine theimpact on developing fetuses.Wild and domestic animals may be more sensitive than arelaboratory animals to developmental effects of fluoride. The onlyclinical signsgeneral in the adult mink wereunhealthiness, hyperexcitability, and lethargy. 12. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE, AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Genotoxicity.with cardiovascularSome peopleproblems may be at increased riskof fluoride toxicity. Fluoride inhibits glycolysisby inhibiting enolase. It also inhibits energymetabolismthrough the tricarboxylic acid cycle byblocking the entry of pyruvate and fatty acids and byinhibiting succinic dehydrogenase. 13. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE, AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Immunological Effects.Very limited human and animal data were located to Theevaluate the immunological effects of fluoride.existing database does not permit acomplete assessment of theimmunotoxic potential of fluoride. 14. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE, AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Neurological Effects.There are few data on the neurological effects of fluorine,hydrogen fluoride, or fluoride exposure in humans oranimals.Animal data that showed that rats continuously exposedfor an intermediate duration to a low concentrationexhibit histological changes in the synapses of nervecells. There are some data suggesting that nonspecificneurological effects (headaches, paresthesia,vertigo) occasionally occur in cases of fluorosis. 15. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Fluorides in drinking water may increasethe risk of old women and men breaking abone. 16. FLUORIDES, HYDROGEN FLUORIDE, AND FLUORINE, RELEVANCE TO PUBLIC HEALTH, U.S Agency for toxic Disease ATSDRFluoride.The main health concern regarding fluoride is likely to befrom excessive chronic oral exposure in drinking water.Due to the deposition of significant amounts of fluoride inbone, the primary target system for intermediate andchronic exposures of both humans and several laboratoryanimal species is the skeletal system (including teeth). 17. As far back as 2006 the U.S. Centresfor Disease Control and Prevention(CDC) and the American DentalAssociation (ADA) advised that usingfluoridated water to mix formulacould cause infants to developfluorosis. 18. Children under three shouldnever use fluoridated toothpasteor drink fluoridated water. Andbaby formula must never be madeup using fluoridated tap water.Professor Hardy Limeback, B.Sc., Ph.D., D.D.S., headof the Department of Preventive Dentistry for thePresident of theUniversity of Toronto andCanadian Association for DentalResearch. 19. The American Dental Association (ADA)stated that infants could receive a greaterthan optimal amount of fluoride throughliquid concentrate or powdered baby formulathat has been mixed with water containingfluoride during a time that their developingteeth may be susceptible to enamelfluorosis." 20. The American Dental Associationwarned that, in order to preventtooth damage, fluoridated watershould not be mixed into formula orfoods intended for babies aged oneand younger.No such warning has ever beenissued in Ireland. 21. Since 2006 of theAmerican Dental Association,the American Academy of Pediatric Dentistry, andthe American Academy of Pediatricshave all advised that fluoride should not be given toinfants under 6 months and that the limit for childrenfrom 6 months up to 3 years of age should be 6 months to 3 years0.25 mg/dayNone >3 to 6 years 0.5 mg/day None >6 years1.00 mg/dayNoneJournal of Paediatric Child Health2002; 7(8):569-72, Reference No. N02-01 23. The amount of fluoride in toothpaste varies between 500ppm and 1,500 ppm.Table 12.1 below lists the corresponding amounts offluoride in milligrams for each toothpaste concentrationassuming the recommended small pea size amount(0.25mg) is used.ppm F ToothpasteAmount of F in pea sized (0.25 g) amount of toothpaste500ppm 0.25 x 0.5 = 0.125 mg F1,000ppm 0.25 mg F1,450ppm 0.25 x 1.4 = 0.36 mg F1,500ppm 0.25 x 1.5 = 0.375 mg FSource: Irish Forum for Fluoridation Report 2002 24. Dental Fluorosis in Primary Teeth of 5-year-olds in IrelandD.M.OMULLANE1, M. HARDING1, H.P. WHELTON1, M.S. CRONIN1, andJ.J. WARREN2, 1 University College Cork, Ireland, 2 University ofIowa, USAThe aim of this study was to measure the prevalence of dentalfluorosis amongst 5-year-old children resident in fluoridated andnon-fluoridated communities in Cork.No fluorosis Definite Fluorosis ModerateSevere FluorosisFluorosisfluoridated 67.8%, 29.3%, 2.4%0.5%.childrennon-98.8%, 1.2%.ZEROZEROfluoridatedchildren 25. Animal studies in the 90sfound that when evensmall amounts of fluoride,was given to rats theydeveloped dementia andAlzheimers like symptoms. 26. Human studies in China, Indiaand Mexico have found thatthe more fluoride a child isexposed to the lower their IQ. 27. Toxicological MechanismSeveral toxicological mechanisms occur including1. Fluoride binds to metal-containing enzymes, thereby inactivating them.2. Fluoride binds to calcium inhibiting its metabolism in the human body3. Fluoride binds to potassium and magnesium ions leading to myocardial irritability and arrhythmia.4. Fluoride may be directly toxic to the central nervous system.Environment, Health and Safety ,Hydrofluoric Acid Chemical Safety Information 28. Consumption of fluoride treated water for twoor more years leads to substantialprecipitation of fluoride into bone atthousands of times the level in the water andalso into tendons and ligaments.Chemical Analysis of Poisoning from Fluoridated Public WaterRichard D. Sauerheber, Ph.D. University of CA 29. European Food Safety Authority, 7th June 2006.Fluoride content of the body is not under physiologicalcontrol. Absorbed fluoride is partly retained in bone andInpartly excreted, predominantly via the kidney.infants retention in bone can be as highas 90% of the absorbed amount,whereas in adults retention is 50% orless. 30. UK EXPERT GROUP ON VITAMINS AND MINERALS, 2000Found that the most vulnerable groupsto the toxin effects of fluoride werebabies and young children 31. UK EXPERT GROUP ON VITAMINS AND MINERALSThe most commonly observed clinicalsign of chronic over-exposure to fluorideis fluorosis of the teeth, which has beenobserved in almost 50%of childrenreceiving the suggested optimal levelof fluoride in their drinking water 32. UK EXPERT GROUP ON VITAMINS AND MINERALSFound thatThe total human intake is of interest,since multiple sources, all of which aregenerally considered safe by themselves,could, under some circumstances,provide total intake that is considered tobe above the "safe" level. 33. No study has ever been undertakenin Ireland to accurately determinethe total fluoride intake ofconsumers and sensitive subgroupsof the population. 34. So how do you know ifexposure to fluoridatedwater will cause you harmor benefit? 35. European Food Safety Authority7th June 2006.Excessive intake of fluoride duringenamel maturation before tootheruption from birth to eight years ofage, when enamel formation iscomplete, can lead to reduced mineralcontent of enamel and to dental fluorosisof deciduous but predominantly ofpermanent teeth. 36. European Food Safety Authority7th June 2006.Fluoride accretion in bone increases bonedensity but excessive long term intake increases riskreduces bone strength andof fracture and skeletal fluorosis(stiffness of joints, skeletaldeformities). 37. BRITISH MEDICAL RESEARCH COUNCIL: Waterfluoridation and health. 2002There is a need to address the aggregate rate ofaccumulation of fluoride in target tissuesand assess whether this is fast enough to incur the riskof pathology within a reasonable life span in more than asmall (and defined) minority of those exposed.In children, there have been too few studies of totalfluoride intake and the contribution of various sources tothat intake. 38. BRITISH MEDICAL RESEARCH COUNCIL:Water fluoridation and health. 2002A major area of uncertainty concerns thebioavailability of fluoride. This isparticularly important with respect to thepossible differential absorption of fluoridefrom naturally and artificially fluoridatedwater and the role of water hardness(calcium levels). 39. An array of scientific findings indicate that the decisionmade by many cities since World War II to injectartificial fluorides into municipal drinking water, as longas the dose is below a certain level (usually 1-4 part permillion, 0.05-0.20 mM), to decrease the incidence oftooth decay, has caused significant unwantedbiological effects, the extent determined by the acidityand the calcium and magnesium levels in the water andthe duration of exposure.[1] Gessner, B., New England Journal of Medicine 330 p. 95, 1994[1] National Research Council, Report on Fluoride in Drinking Water, National Academy ofSciences, Washington, D.C., 2006[1] U.S.P.H.S. Congressional Record, Mar 24, 1952 reporting 1,059 heart disease deathsin 1948 in Grand Rapids, Michigan per year after 3 years of fluoridation but 585 per yearbefore fluoridation; N.Y. News Jan 27, 1954 reported after 9 years fluoridation inNewburgh, 882 heart deaths per 100,000, 74% above national rate for un-fluoridatedcities.[1] Fluoride 30, pp. 16-18, 1997, no. 1, where EKG analyses of patients with fluorosis isreported, and Lancet, Jan 28, 1961, p. 197 and Tokushima, J. Exper. Med. 3-50-53, 156where mottling of teeth caused by fluoridation was associated with increased incidence ofEKG detected heart abnormalities. 40. It is accepted and acknowledged by theEU Commission and the United StatesNational Academy of Sciences, that thechemicals used for fluoridation of water inIreland have never been tested for humantoxicity or environmental safety, withoutwhich their is inadequate informationavailable to demonstrate that they areindeed safe. 41. The most recent international reviews of waterfluoridation by the NHS in England (2000), the NationalResearch Council in the United States (2006) and the EUScientific Committees for Food Safety and ConsumerProtection (2011) have all agreed that there isinsufficient scientific evidence to demonstratethat water fluoridation is safe and have identifiedthat there is a complete lack of toxicological data on thehuman or environmental toxicity of silicofluoridechemicals used for fluoridation of water.This is one of the reasons why every other EuropeanState has taken the precautionary approachto water management, this approach is legally enshrinedin the EU Constitution. 42. The Department of Health State thatthere is no need to undertakeToxicological studies on the waterfluoridation chemicals used forfluoridating our drinking water suppliesbecause they claim thathexafluorosilicic acid dissociates 100%in drinking water and therefore the publicdo not come in contact with thechemical. 43. This assertion is entirelyfalse and unscientific. 44. There is not one PEER reviewed studyanywhere in the world that shows 100%dissociation of HSFA under conditions ofnormal use because it doesnt happen.You are always ingesting somefluorosilicates, usually SIF4 because itsthe most stable configuration. 45. Peer Reviewed Research undertaken by Dr. Johannes Westendorf, (Toxicology Department, Eppendorf-Hamburg University Hospital) found that under physiological conditions, dissociation of silicafluorides was no more than 66% in the concentration range considered optimum for fluoridated water. This was based on actual laboratory experimental evidence not theoretical modeling. This work has never been disputed in peer reviewed scientific journals.Source: Westendorf J. Die Kinetik der Acetylcholinesterasehemmung und dieBeeinflussung der Permeabilitat von Erythrozxytenmembranen durch Fluroidund Fluorokomplex-Jonen. Doctoral Dissertation, Hamburg UniversityHamburg Fachbereich Chemie, 1975. 46. At normal stomach pH range additional peer reviewed studies have foundsilicon tetrafluoride, (SiF4) acid molecules. Gabovich RD; "Fluorine in Stomatology and Hygiene"; translated from the original Russian and published in Kazan (USSR); printed by the US Govt Printing Office on behalf of the Dept of Health Education and Welfare. US Public Health Service, National Institute of Dental Health; DHEW pub no (NIH) 78-785, 1977 Roholm K; "Fluorine Intoxication; A Clinical-Hygiene Study"; H. K. Lewis & Co. Ltd, London; 1937 Lewis RJ, jr.; "Hazardous Chemicals Desk Reference": Van Nostrand Reinhold; Fourth Edition. Matheson Gas Products; 30 Seaview Drive, Secaucus, NJ; "Effects of Exposure to Toxic Gases" and MSDS for CAS # 7783-61-1; created 1/24/89. Voltaix, Inc.; Material Safety Data Sheet for Silicon Tetrafluoride (SiF4). Rumyantseva GI et al; "Experimental Investigation of The Toxic Properties of Silicon Tetrafluoride"; Gig Sanit ;(5):31-33, 1991 47. At the acidity of the human stomach - pH2 to 3 - theproportion of fluorine atoms that are present as fluorideions changes dramatically and effectively no fluorineatoms are present in the ionic state.The bioavailability of fluoride ions will also varyaccording to the drinking water hardness and its uniquechemical properties.Toxicological Studies should be based on environmentalconditions experienced by the consumer not using de-ionized laboratory water. 48. The incomplete dissociation of hexafluorosilicate wasalso confirmed in a peer reviewed study by Finney etal. who also proved the existence of fluorosilicateintermediates outside of H2SiF6.Source: Finney WF, Wilson E, Callender A, Morris MD, Beck LW.Reexamination of hexafluorosilicate hydrolysis by 19F NMR and pH measurement.Enviromental Science Technology. 2006 Apr 15;40(8):2572-7. 49. The World Health Organization has stated explicitlythat "in the assessment of the safety of a watersupply with respect to the fluoride concentration,the total daily fluoride intake by the individual mustbe considered."Source: WHO Water Quality Guidelines 1970-2004The Department of Health or the Food SafetyAuthority have yet to develop a national databaseof fluoride in beverages and foods or to commenceat a most basic level an assessment of the dietaryfluoride exposure of the general population. In theabsence of this basic information, fluoridation ofdrinking water is not recommended and must bediscontinued immediately. 50. Both the EU and U.S National Academy of Sciencesscientific reviews of fluoridation identified in excess offifty epidemiology, toxicology, clinical medicineand environmental exposure assessments thatrequire to be undertaken, in order to fill data gaps inthe hazard profile, the health effects and the exposureassessment of silicafluoride compounds.Not oneof these studies has been conducted bythe Health Authorities in Ireland. 51. The public health risks associated with fluoridation ofwater supplies have been highlighted by no less thanFourteen Nobel Prize winners in Chemistry and Medicinewho have publicly denounced the policy of fluoridation ofwater.These concerns have been entirely ignored by manyDentists who have somehow managed, unlike in otherEuropean Countries, to dictate public health policy onfluoridation of water for the past forty years in Ireland. 52. A newNeurological study by researchers Valdez-Jimenez, et al. published in a peer reviewedinternational journal in 2011 revealed that theprolonged ingestion of fluoride may causesignificant damage to health and particularly tothe nervous system,"The study examined how fluoride induces changes inthe brains physical structure and biochemistry whichaffects the neurological and mental development ofindividuals including cognitive processes, such aslearning and memory.Source: Valdez-Jimnez L, Soria Fregozo C, Miranda Beltrn ML, GutirrezCoronado O, Prez Vega MI. Neurologia 2011 Jun;26(5):297-300. Epub 2011Jan 20.Effects of the fluoride on the central nervous system, 53. The United States National Academy of SciencesNational Research Council on Fluoride in Drinking Water 2006Its apparent that fluorides have theability to interfere with the functions ofthe brain, says the US NationalResearch Councils (NRC) expert fluoridepanel. Fluorides also increase theproduction of free radicals in the brainthrough several different biologicalpathways. These changes have a bearingon the possibility that fluorides act toincrease the risk of developingAlzheimers disease. 54. Segments of the population areunusually susceptible to the toxiceffects of fluoride. They include"postmenopausal women and elderlymen, pregnant woman and theirfetuses, people with deficiencies ofcalcium, magnesium and/or vitaminC, and people with cardiovascularand kidney problems."United States Public Health Service Report (ATSDRTP-91/17, pg. 112, Sec.2.7, April 1993) 55. "Ingested fluoride is transformed inthe stomach to hydrofluoricacid, which has a corrosive effecton the epithelial lining of thegastrointestinal tract.SOURCE: US.A. EnvironmentalProtection Agency. (1999).Recognition and Management ofPesticide Poisonings. 5th Edition. 56. "Estimating the incidence of toxic fluorideexposures nationwide also is complicated by theexistence of biases. Parents or caregivers may notnotice the symptoms associated with mild fluoridetoxicity or may attribute them to colic orgastroenteritis.Journal of Public Health Dentistry 57: 150-8.In Ireland up to 25% of babies experience colic, yetthe exposure of infants to fluoride has never beenexamined as a likely source of this illness. 57. Nobel laureate scientist Professor Carlsson,world expert in neurological science,psychiatric disorders and pharmacology,has stated publicly that water fluoridationwill harm some people who will exhibitside effectsfrom exposure tofluorides and it should not be considered asa public health policy.Professor Carlson noted that fluoridation ofwater supplies would also treat people whomay not benefit from the treatment. Side-effects cannot be excluded and, thus, somepeople might only have negative effectswithout any benefit." 58. Fluoride toxicity to aquatic organisms: Camargo JA.International Scientific Journal Chemosphere. 2003 Jan;50(3):251-64.Persistent Organic Pollutants and DioxinsEnvironmental ChemistryEnvironmental Toxicology and Risk AssessmentScience for Environmental TechnologyAbstractPublished data on the toxicity of fluoride (F-) to algae, aquaticplants, invertebrates and fishes are reviewed. Aquaticorganisms living in soft waters may be moreadversely affected by fluoride pollution than those living inhard or seawaters because the bioavailability of fluoride ions isreduced with increasing water hardness.Fluoride can either inhibit orenhance the populationgrowth ofalgae,dependingupon fluoride concentration,exposure time and algal species. Aquatic plants seem to beeffective in removing fluoride from contaminated water underlaboratory and field conditions. 59. Fluoride toxicity to aquatic organisms: Camargo JA.International Scientific Journal Chemosphere.2003Jan;50(3):251-64.In aquatic animals, fluoride tends to be accumulated inthe exoskeleton of invertebrates and in the bone tissueThe toxic action of fluoride residesof fishes.in the fact that fluoride ions act asenzymatic poisons, inhibiting enzymeactivity and, ultimately, interruptingmetabolic processes such as glycolysisand synthesis of proteins.Fluoride toxicity toaquatic invertebrates and fishes increases withincreasing fluoride concentration, exposure time andwater temperature, and decreases with increasingintraspecific body size and water content of calcium andchloride. 60. Fluoride toxicity to aquatic organisms: Camargo JA.International Scientific Journal Chemosphere. 2003Jan;50(3):251-64.Freshwater invertebrates and fishes, especially net-spinningcaddisflylarvaeand upstream-migrating adult salmons, appear to be moresensitive to fluoride toxicity than estuarineand marine animals. Because, in soft waters with lowionic content, a fluoride concentration as low as 0.5mg F-/l can adversely affect invertebrates andfishes, safe levels below this fluoride/lconcentration are recommended in order toprotect freshwater animals from fluoridepollution. 61. UNITED STATES EPASewage sludge concentrations for Fluoride were411mg/kgdry weight.Background concentration of pollutants in soil werecalculated at 220mg/kg demonstrating thattheconcentration of fluoride in sewage sludge wastwice that found in uncomtaminatedsoil.The Irish EPA have never examined sewage sludge forfluoride content. Yet we dispose of over 120,000 tonnes ofsewage of land each year. 62. TOXICOLOGICAL PROFILE FOR FLUORIDES, HYDROGENFLUORIDE, AND FLUORINEAgency for Toxic Substances and Disease RegistryU.S. Public Health ServiceApril 1993Food grown in areas where soils have high amounts offluorides may have high levels of fluorides.Food cooked in water with added fluorides may also haveincreased fluoride levels. 63. The Irish EPA have found that fluorideis a persistent toxin in freshwaterecosystems, fluoride is also known tobe harmful to juvenile salmon andtrout at concentrations significantlybelow those currently discharged fromwastewater treatment facilities as aconsequence of fluoridation of water. 64. 99.5% of fluoridated water isnot used for the purpose if wasintended and is dischargedinto the environment as anenvironmental toxin. 65. No environmental study has beenundertaken since thecommencement of waterfluoridation examining theenvironmental impact ofdischarging over 75,000 tonnes offluoride into 120 salmonid rivers inIreland. 66. BRITISH MEDICAL JOURNAL 2007Adding fluoride to water suppliesBMJ 2007; 335 doi: 10.1136/bmj.39318.562951.BE (Published 4 October 2007)Cite this as:BMJ 2007;335:699 To suggest that the Medicines Act does not apply to fluoridation because it is covered by the Water Act 2003 is nave.[1] The assumption that the fluoridation clauses in the Water Act 2003 allow the British Government to circumvent the provisions of the legal constraints on medicines and food in both the European and English legislationisentirely wrong.Fluoridated water is, and will remain, legally a medicinal product, irrespective of the Medicines and Healthcare Products Regulatory Authoritys (MHRA) refusal to grant it a medicinal licence. 67. BRITISH MEDICAL JOURNAL 2007Adding fluoride to water suppliesBMJ 2007; 335 doi: 10.1136/bmj.39318.562951.BE (Published 4 October 2007)Cite this as:BMJ 2007;335:699In fact, the Offences Against the Person Act 1861prohibits the administration of any noxious orpoisonous substance, including any materialcontaining such substances, to any person.Sodium fluorosilicate is specifically listed as apoison in Part II of the UK Poisons List Order1982. Fluorosilicicacid,the fluoridationsubstance of choice and somewhat more toxicthan the sodium salt, contains another Part IIlisted poison, hydrogen fluoride. Adding either tothe public drinking water supply could beinterpreted as a violation of the 1861 Act. 68. BRITISH MEDICAL JOURNAL 2007 Adding fluoride to water supplies BMJ 2007; 335 doi: 10.1136/bmj.39318.562951.BE (Published 4 October 2007) Cite this as:BMJ 2007;335:699TheDepartment ofHealthsobjectivity isquestionableit funded the British FluoridationSociety and, along with many other supporters offluoridation, it used the York reviews findingsselectively to give an overoptimistic assessment ofthe evidence in favour of fluoridation.Against this backdrop of one sided handling of theevidence, the public distrust in the information itreceives is understandable. 69. MEDICAL LAW INTERNATIONAL MARCH 2012The legal fiction of water fluoridation.David Shaw, School of Medicine, University of Glasgow,Medical Law International March 2012 vol. 12 no. 1 11-27This paper provides an analysis of the jurisprudenceand legislation concerning the fluoridation of water inthe United Kingdom. Water fluoridation is currentlypermitted by the Water Act 2003, but this appearsto contradict legislation and regulationsgoverning food and healthcare in the UK andthe EU. It is concluded that the status quo rests on thelegal fictionthat fluoridated water does notconstitute a medication. 70. In summary, evidence of several types indicates thatfluoride affects normal endocrine function or response; theeffects of the fluoride-induced changes vary in degree andkind in different individuals. Fluoride is therefore anendocrine disruptor in the broad sense of alteringnormal endocrine function or response, althoughprobably not in the sense of mimicking a normal hormone.The mechanisms of action remain to be worked out andappear to include both direct and indirect mechanisms, forexample, direct stimulation or inhibition of hormonesecretion by interference with second messenger function,indirect stimulation or inhibition of hormone secretion byeffects on things such as calcium balance, and inhibitionof peripheral enzymes that are necessary for activation ofthe normal hormone.(SOURCE: National Research Council. (2006).Fluoride inDrinking Water: A Scientific Review of EPAs Standards.National Academies Press, Washington D.C. p 223.) 71. Pregnant women with subclinicalhypothyroidism have abnormal thyroid hormonelevels but no symptoms.They are at a increased risk of miscarriage, pre-eclampsia and preterm birth with impairedneuropsychological development in the child.The Children of mothers with hypothyroidismhave lower IQ and suffer a greater incidence ofneurological disease including symptoms suchas attention deficit disorder. 72. This paper explores in detail the legal position of, and legal justificationsfor, water fluoridation in theUK. First, it examines the UK jurisprudence, which very much sets thestage for the subsequent legislative analysis. It then goes on to consider thewider European Union (EU) context and how that might (or should) impacton the UKs position.It concludes that an accurate and honest interpretation ofthe law would result in the conclusion that water fluoridationdoes indeed constitute medication, as it seeks to improvehealth by the addition of a chemical, with the result that thecurrent manner of doing so (where it is done) is notcompliant with the law. 73. The annual budget for secretarialservices for the Forum forFluoridation (400,000) combinedwith the cost of silicofluoridechemicals(4,700,000), supervision, trainingand auditing costs (estimated at10,000,000), combined withequipmentmaintenance, overheads, insuranceand pollution prevention costs 74. SOME OF THE LEADING INTERNATIONAL ACADEMICS CALL FOR WATER FLUORIDATION BANDr.James Beck, MD, PhD, Professor Emeritus of Medical Biophysics, University of Calgary, Alberta, CanadaDr. Dominique Belpomme, Professor in Medical Oncology, ARTACs Cancer Research Center, Paris,FranceDr.Albert W. Burgstahler, PhD, Professor of Chemistry Emeritus, The University of Kansas, Lawrence, Kansas.Dr. Noel Campbell, BDSc, LDS, FACNEM, FASID, Hope Research Institute, Melbourne, AustraliaDr.Paul Connett, PhD, Professor of Chemistry Emeritus, St. Lawrence University.Dr. Joe Cummins, PhD, Professor of Genetics Emeritus, University of Western Ontario, London, Ontario,CanadaDr. Samuel S. Epstein, MD, Professor Environmental & Occupational Medicine Emeritus, University of Illinois,Chicago School of Public Health, Chairman, Cancer Prevention Coalition, ChicagoDr. Frank W. George, DO, MD(H), Adjunct Associate Professor, Midwestern University,Neuromusculoskeletal specialist, AZ College of Osteopathic Medicine, Phoenix, AZDr. Boyd Haley, PhD, Professor of Chemistry and Biochemistry, University of Kentucky, Lexington, KYDavid R. Hill, P.Eng., Professor Emeritus, University of CalgaryDr. Luc Hens, Vakgroep Menselijke Ecologie (Human Ecology Department), Vrije Universiteit Brussel (VUB),Brussels, Belgium.Dr. Donald Hillman, PhD, Professor Emeritus, Department of Animal Science, Michigan State University.Dr. C. Vyvyan Howard, MB, ChB, PhD, FRCPath, Professor of Bioimaging Molecular Biosciences, Universityof Ulster, Coleraine, Northern Ireland and newly elected President of the International Society of Doctorsfor the Environment (ISDE)Dr. William A. Ingram, MD, Assistant Professor, Dept. Otolaryngology/Head & Neck Surgery, University ofNebraska Medical Center. 75. Dr. Robert L. Isaacson, PhD, Distinguished Professor, Center for Developmental and BehavioralNeuroscience, Binghamton University, Binghamton, NY. Member of the 2006 National Research Councilpanel which reviewed the toxicology of fluoride, Binghamton, NYDr. Antone G. Jacobson, PhD, Professor of Molecular, Cell and Developmental Biology Emeritus, TheUniversity of Texas.Dr. Joel M. Kauffman, PhD, Professor of Chemistry Emeritus, University of the Sciences in Philadelphia,Dr. Leonardo Leonidas, MD, FAAP, Assistant Clinical Professor in Pediatrics, Tufts University School ofMedicine.Dr. Hardy Limeback, PhD, DDS, Professor and Head of Preventive Dentistry, University of Toronto, pastpresident of the Canadian Association for Dental Research, and Member of the 2006 National ResearchCouncil panel which reviewed the toxicology of fluoride, Mississauga, Canada.Dr. Lynn Margulis, PhD, Distinguished University Professor in Evolutionary Biology, Department ofGeosciences, member of the National Academy of Sciences, and a 1999 recipient of the NationalMedal of Science. Amherst, USA.Dr. Larry F. Mehne, PhD, Professor of Chemistry, Covenant College, Georgia, USA.Dr. Henry Micklem, PhD, Professor of Immunobiology Emeritus, University of Edinburgh, ScotlandDr. J. B. Neilands, PhD, Professor of Biochemistry Emeritus, University of California, Berkeley, USA.Dr. Perry O. Roehl, PhD, Distinguished Professor of Geology, Emeritus, Trinity University, Texas.Dr. Lisa R. Rogers, DO, Professor in Neuro-oncology, Department of Neurology, Taubman Center, USA.Dr. Caroline Snyder, PhD, Professor Emeritus, Rochester Institute of Technology, Rochester New York.Prof. Joerg Spitz, Managing Director of the Society for Medical Information and Prevention in Germany,Wiesbaden, GermanyDr. W. Gary Sprules, MA, PhD, Professor of Ecology and Evolutionary Biology, University of Toronto,Toronto, Canada.Dr. Anna Strunecka, DSc, Professor of Physiology Emeritus, Faculty of Sciences Charles University,Prague, Czech Republic. 76. Dick Thom, DDS, ND, Professor of Naturopathic Medicine, National College of NaturalMedicine, Portland, USA.Dr. Lennart Kroot PhD, Professor of Pathology Emeritus, Department of Biomedical Sciences, CornellUniversity, USA.Dr. Arvid Carlsson of Sweden, Professor in Neuropharmacology University of Gothenburg. Awarded theNobel prize for Medicine in 2000.Dr. Olof Lindahl, PhD Professor of Orthopaedics, University of Linkoping,Dr. Gunnar Gustafsson, Professor of Oral Pathology, University of Umea, Dr.Peter Soderbaum, Professoremeritus at Mlardalen University, School of Sustainable Development of Society and Technology.Dr. Anders Thylstrup, PhD, Professor of Cariology at the University of CopenhagenDr. Karl Arfors, PhD, Professor Biological Sciences (microcirculation and cellular inflammation), UppsalaDr. Jan Sallstrom, PhD, Associate Professor of Experimental Pathology University Hospital, Uppsala,SwedenDr. Richard J. Perry, PhD, Professor of Anthropology Emeritus, St. Lawrence University, Harvard CollegeDr. Qin Gao, PhD, Associate Professor in Pathology, Guiyang Medical University, Guiyang, ChinaDr. Zhi-Zhong Guan, MD, PhD, Professor in Pathology, Guiyang Medical University, Guiyang, ChinaDr. Kunli Luo, PhD, Professor, Institute of Geographic Sciences & Natural Resource Research, ChinaDr. Jifang Ren, MD, Professor in Public Health Medical University of Shamxi, Shamxi, ChinaDr. Quanjong Xiang, PhD, Associate Professor in Public Health, Nanjing, ChinaDr. Maria Rosario Garcia, Professor of Chemistry, University of Santo Tomas,Dr. Moises Norman Garcia, Professor of Environmental Science, University of Santo Tomas.Dr. Junie A. Quilatan, Professor of Ethics and Theology, University of Santo Tomas. 77. Dr. Dariusz Chlubek, MD, PhD, Professor of Biochemistry, Pomeranian MedicalUniversity, Szczecin, Poland.Dr. Anna Machoy-Mokrzynska, PhD, Assistant Professor, Pomeranian Medical University, Szczecin,Poland.Dr. Katarzyna Pawlowska-Goral, PhD, Assistant Professor, Medical University of Silesia, Poland.Dr. Olvaldo Rosario, PhD, Professor of Environmental Chemistry, University of Puerto Rico.Dr. Paul Coetzee, PhD (Nuclear Chemistry), Professor of Chemistry and Head of Department, Dept ofChemistry, University of Johannesburg.Dr. Bo H. Jonsson, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.Dr. Jan Rennerfelt, PhD, Professor in Biochemical Technology Emeritus, Stockholm.Dr. Richard Johns, PhD, LDS RCS (Eng.), Professor of Restorative Dentistry Emeritus, University of Sheffield,Winchester, Hampshire, England.Dr. Henry Micklem, PhD, Professor of Immunobiology Emeritus, University of Edinburgh, Scotland.Dr. Dominique Belpomme, PhD, Professor in Medical Oncology, ARTACs Cancer Research Center, Paris,France.Dr, Murray J. Vimy, DMD, practicing dentist and Clinical Associate Professor of Medicine, Dept. ofEndocrinology and Metabolism, University of Calgary, Alberta, Canada.Dr, Louis Ricci, PhD, Professor Clinical Psychology at the Universidade Federal de MInas Gerais, BeloHorizonte,Dr. Marc Boogaerts, MD, PhD, Professor of Medicine-Hematology, and Cancer Research University ofLeuven, Belgium.