Questions arising from PHE’s ‘community water fluoridation toolkit for local authorities’

24 Mar

Is it authoritative? Hardly:

“This toolkit has no legal status and does not represent legal advice. A local authority involved with or considering water fluoridation should familiarise itself with the relevant legislation and secure its own legal advice on the interpretation and implementation of that legislation.

Who profits? American manufacturers?

In this report, published by Public Health England, local authorities were said to be the driving force behind the introduction of water fluoridation schemes in England in the 1960s. Were they? Or was it the manufacturers of sodium fluoride, used to fluoridate watersee 25 American companies.

A well accepted process? No only 10% of British people have artificially fluoridated drinking water (see blurred but readable map at the foot of the article)

Fluoridation has been banned by Germany, Finland, Japan, Netherlands, Sweden, Switzerland and Denmark.

“At 1 January 2016, 26 local authorities had Community Water Fluoridation (CWF) schemes covering the whole or parts of their area with some six million people in England receiving a fluoridated water supply, principally in the North-East and in the West and East Midlands”.

But there are 433 principal authorities in the UK: 27 county councils, 55 unitary authorities, 32 London boroughs, 36 Metropolitan boroughs, 201 districts, 32 Scottish unitary authorities, 22 Welsh unitary authorities, and 26 Northern Ireland districts (the City of London and the Isles of Scilly are non-party based).

There is no credible scientific evidence of harm to the health of people supplied with fluoridated water was found: accurate?

Here are a few of the examples recorded in our database:

  • The Irish Examiner ( 09 Jan 2002) reported that research carried out at Boston University of School of Public Health, using data from the Irish National Cancer Registry and its northern equivalent, found 40% more people suffer from the rare bone cancer osteosarcoma in the Republic than the North, where water is not fluoridated. The Washington Post reported in 2005 that federal investigators and Harvard University officials were exploring an allegation that Professor Chester Douglass had tried to suppress research suggesting a link between fluoridated tap water and bone cancer in adolescent American boys.
  • In the Journal of American Physicians and Surgeons, Volume 10 Number 2 Summer 2005, Page 42: “After 20 years, the ten fluoridated cities had 10% more cancer deaths than the non-fluoridated cities. The cancers were found in the tongue, mouth, pharynx, oesophagus, stomach, colon, rectum, pancreas, larynx, bronchi, and lungs”.
  • In 2006 a 500-page review of fluoride’s toxicology was undertaken by a distinguished panel appointed by the National Research Council of the National Academies (NRC, 2006). It concluded that the US Environmental Protection Agency’s (EPA) safe drinking water standard for fluoride (i.e. maximum contaminant level goal or MCLG) of 4 parts per million (ppm) is unsafe and should be lowered. The report listed many basic research questions that have not been addressed over 60 years of fluoridation. The panel reviewed a large body of literature in which fluoride has a statistically significant association with a wide range of adverse effects. These include an increased risk of bone fractures, decreased thyroid function, lowered IQ, arthritic-like conditions, dental fluorosis and, possibly, osteosarcoma.
  • Lead author of a report published in the British Medical Journal, Professor Stephen Peckham, from the Centre for Health Service Studies, said: “I think it is concerning for people living in those areas. The difference between the West Midlands, which fluoridates, and Manchester, which doesn’t was particularly striking. There were nearly double the number of (thyroid) cases in Manchester. Underactive thyroid is a particularly nasty thing to have and it can lead to other long-term health problems. I do think councils need to think again about putting fluoride in the water. There are far safer ways to improve dental health.”

A blank cheque? PHE will keep this arrangement under continuous review. One factor will be changes in unit cost of materials, particularly the fluoridation chemicals

“The secretary of state is required to meet the reasonable capital and operating costs incurred by water undertakers operating water fluoridation schemes in England. The secretary of state has the power to require local authorities whose populations are serves by those schemes to make payments to the secretary of state to meet these costs. At present PHE meets the capital cost of schemes and recovers the operating costs from local authorities. Local authorities also pay for the cost of feasibility studies . . . At present PHE meets the capital costs of schemes and recovers only the operating costs from local authorities . . .

A reversible decision? Only at a cost

A Page 35 link describes how requirements are imposed on how local authorities must exercise their powers to propose, vary or terminate fluoridation schemes: they must (c) consider—

(i) the capital and operating costs which are likely to be incurred in giving effect to such variation of the arrangements as is specified in a variation proposal, or

(ii) the decommissioning and associated costs which are likely to be incurred in giving effect to the termination of the arrangements specified in a termination proposal; and

(d) consider any other available scientific evidence in relation to the variation or termination proposal, including any evidence of benefit to the health and well-being of individuals who would be affected by the proposal.

Can a determined, well–informed public can stop the process? See Hampshire’s example:

  • Despite consultation showing the majority of people who responded did not want it to be implemented, plans to put fluoride into water in parts of Hampshire were approved in 2009 by the South Central Strategic Health Authority.
  • The Parliamentary and Health Service Ombudsman then ‘threw out’ a judicial challenge by New Forest East MP Julian Lewis and Hampshire county councillor David Harrison to stop fluoridation.

But a year later the plans to add fluoride to the public water supply in Southampton and parts of Hampshire were scrapped. Public Health England said it still endorsed water fluoridisation but would not proceed without backing from Southampton City Council.

fluoridation map

The government ‘toolkit’ may be read in full here.



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