Fluoride - Demand AARP Take Action

[CarryAnne]

“The evidence that fluoride is more harmful than beneficial is now overwhelming… fluoride may be destroying our bones, our teeth, and our overall health.” - Dr. Hardy Limeback,  former President of Canadian ADA, Head of Preventive Dentistry at Univ of Toronto, 2006 National Research Council Scientist (2007)

The 2006 National Research Council on Fluoride in Drinking Water commented to the EPA that fluoridation at 1 ppm can be anticipated to be harmful for those with reduced renal function and the elderly. The NRC confirmed that fluoride not excreted by kidneys builds up in bones, resulting in arthritic pain and increased brittleness. However, there were no EPA studies on the whole health impacts of fluoridated water on susceptible population such as kidney patients, children, those with prolonged disease or the elderly. There still aren’t. 

However, there is mounting science from other sources that “optimally fluoridated” water, which is known to cause varying degrees of dental fluorosis in 58% of Black American adolescents and 36% of White American adolescents, is causing subtle deficits in ability to remember or focus. That same “optimal level” has also been proved in a 2014 study as being nephrotoxic in rats with chronic kidney disease. Chronic kidney disease (CKD) affects approximately 15% of Americans, although CKD is quadruple the rate in Black Americans, and predictably worse in older Americans. 

Perhaps the most horrifying part of the story of fluoridation is that not only is at least 50% of every drop of fluoride that has passed the lips of a Baby Boomer permanently stored in bones, fluoride isn't the only poison in packages of fluoride that originate as the waste product of aluminum an phosphate industry. 100% of the fluoride sampled in a 2014 study was contaminated with aluminum; arsenic and lead were other common contaminants. In other words, fluoridated water serves as a delivery system for aluminum and lead into our bones and our brains. As we all know, aluminum is associated with Alzheimers in adults, and lead is associated with learning disabilities in children. Approximately 15% of the population who is sensitive to chemicals cite inability to think clearly and overwhelming fatigue as symptoms of exposure to fluoridated water. 

Our generation was part of a great human experiment. It may have had noble intentions based on the faulty hypothesis that  drinking fluoridated water prevented cavities. It is now known that any perceived benefits of fluoride are from tooth brushing.  Our grandchildren are the third generation in this travesty. I suggest we all DEMAND the AARP stand up for us and our grandchildren by issuing a strong position paper calling for the cessation of water fluoridation. 

SCIENCE REFERENCES

1. 2014 in Toxicology. Effect of water fluoridation on the development of medial vascular calcification in uremic rats. (“Optimal levels” worsen kidney function😞 http://www.ncbi.nlm.nih.gov/pubmed/24561004
    
2. 2015  in Neurotoxicology and Teratology. Association of lifetime exposure to fluoride and cognitive functions in Chinese children: A pilot study.  (Children with visible dental fluorosis perform less well on memory tasks, correlating with the degree of severity of their fluorosis. One of a series of human and animal studies with the same consistent findings.😞 
1. http://www.ncbi.nlm.nih.gov/pubmed/25446012  
2. http://braindrain.dk/2014/12/mottled-fluoride-debate/ 
   
   
3. 2014 in Physiology and Behavior. Fluoride exposure during development affects both cognition and emotion in mice. (Measurable behavioral changes😞 http://www.ncbi.nlm.nih.gov/pubmed/24184405
   
   
4. 2014 in International Journal of Occupational and Environmental Health. A new perspective on metals and other contaminants in fluoridation chemicals. (All samples of fluoride are contaminated with aluminum, plus other contaminants like arsenic, lead and barium); 
1. http://www.ncbi.nlm.nih.gov/pubmed/24999851
2. http://momsagainstfluoridation.org/sites/default/files/Mullenix%202014-2-2.pdf
   
   
5. 2014 in Scientific World Journal. Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention. (Health risks and cost don't justify minimal and questionable dental benefit.):  http://www.hindawi.com/journals/tswj/2014/293019/

RACIAL INEQUITY (FOIA)

Here are three Oct 2014 news articles on the content of the Freedom of Information Act documents. Rev. Andrew Young, former UN ambassador has pursued them with the CDC, but to little effect. Civil Rights leaders have been calling for an end to community water fluoridation (CWF) since 2011. 

• 1. Black Americans disproportionately harmed: http://www.thenewamerican.com/usnews/health-care/item/19317-feds-blacks-suffer-most-from-fluoride-fl...
• 2. CDC, ADA and Pew inappropriate relationships: http://benswann.com/do-newly-released-emails-reveal-conflict-of-interest-between-the-cdc-and-the-ada...
• 3. Kidneys, Civil Rights & Ralph Nader: http://portland.indymedia.org/en/2014/10/428383.shtml

2015 LEGAL ARGUMENT (GROSS DISPROPORTIONALITY) 

There is a legal initiative in Peel, Ontario (pop 1.3m) to remove fluoride from the water supply based on the principle of gross disproportionality, i.e. marginal benefit does not justify great risk of harm. There is also a political effort afoot in Canadian govt to mandate fluoridation and thereby make the legal argument moot. I suggest this document is well-worth printing.  http://fluoridealert.org/wp-content/uploads/peel.june2014.pdf

• a. The first 19 pages of this document is about the legal strategy. It includes summary of US legal cases that found water fluoridation harmful to the public, but legal under US "police power" mandate.
• b. Starting on page 20 is a devastating affidavit by Dr. Kathleen Thiessen, NAS/NRC scientist and international expert in risk assessment. Very readable summary of science indicating harm to populations in “optimally” fluoridated communities. 

POPULATION WITH LOW CHEMICAL THRESHOLD

1. In excess of 25% of previously healthy Gulf War Veterans have Multiple Chemical Sensitivities, which includes sensitivity to fluoride. See: http://www.va.gov/rac-gwvi/docs/committee_documents/gwiandhealthofgwveterans_rac-gwvireport_2008.pdf 
1. EXCERPT: “It is well established that some people are more vulnerable to adverse effects of certain  chemicals than others, due to variability in biological processes that neutralize those chemicals, and clear them from the body.” - Research Advisory Committee on Gulf War Veterans’ Illnesses 2008 
2. Affidavit of Dr. Hans Moolenburgh: https://fluorideinformationaustralia.files.wordpress.com/2013/01/affidavit-moolenburgh.pdf
1. Except: “As a summary of our research, we are now convinced that fluoridation of the water supplies causes a low grade intoxication of the whole population, with only the approximately 5% most sensitive persons showing acute symptoms.The whole population being subjected to low grade poisoning means that their immune systems are constantly overtaxed. With all the other poisonous influences in our environment, this can hasten health calamities.” 
3. PubMed Listed Studies on immune system response: 
1. a. Fluoride makes allergies worse, rats (1990): http://www.ncbi.nlm.nih.gov/pubmed/1707853 
2. b. Fluoride makes allergies worse, in vitro (1999): http://www.ncbi.nlm.nih.gov/pubmed/9892783
3. c. Immune system of the gut (2010): http://www.hindawi.com/journals/iji/2010/823710/ 
4. d. ASIA Syndrome, adjuvant impact (2011): http://www.ncbi.nlm.nih.gov/pubmed/20708902
5. e. Gene predicts fluoride sensitivity (2015): http://www.ncbi.nlm.nih.gov/pubmed/25556215
6. f.  Brain has an immune system (2015): http://www.ncbi.nlm.nih.gov/pubmed/26030524

AARP - STAND UP on our behalf! 

[rs5526]

It is incorect to claim that the data discussed demonstrate that there is no effect of fluoride ingestion during development on IQ. The reduction reported for boys that is not seen for girls is not surprising and has so many possible explanations that it isn't even funny. First of all, boys are not girls and girls are not boys because boys alone have a Y chromosome. And boys only have one X chromosome while girls have two. The genetic differences are vast and there is no reason to exclude the possibility that systemic fluoride can differentially affect either Y chromosome haplotypes more than other chromosomes, or that women can withstand a fluoride perturbation by having two X chromosomes rather than only one. Fluoride is a normal hydrogen bond disruptor by forming abnormal hydrogen bond interactions, with significant adverse effects on large macromolecules like DNA. Fluoride even at only around 0.1 ppm inhibits DNA repair enzymes which are very susceptible to the ion. Fluoride is also a recognized mitogen.

Secondly, statistical covering is a significant problem in epidemiologic studies. For example, if you do not want World War II to have ever existed, you could convince yourself of that by simply lookng at world populations from 1930 to 1950. You will find that the progressive increase in population is smooth and regular to the naked eye. However, if you analyze only the population of Europe over the same time period you wll see a huge drop from the otherwise regularly increasing population occurred during the War years. And the reason we can prove that WWII existed is from other data (e.g. photographic proof, eyewitness testimony, personal involvement, etc.)

Likewise, if you don't want fluoride to affect IQ, ignore the well controlled Mullenix studies with mammals that proved fluoride ingestion does impair neurologic development and the Raady animal studies and the Varner animal studies, and the many other human studies correlating blood fluoride concentrations with IQ, and then claim that since girls did not experience any detectable effect in one study of xposure that caused onlyh a slight difference in F urine levels, that voila there is no effect of fluoride on IQ. The argument is baesless of couse but yet people love to do it.

[KenP315323]

Richard - you ignore Krutchen's point. There is a very significant effect of sex on IQ - once that is removed there is no effect of fluoride on IQ. And that is reflected in the mean IQ for all children - exactly the same in fluoridated and unfluoridated areas.

In fact, fluoridation has no effect on the mean IQ for boys (104.78 vs 106.31) or for girls (111.47 vs 109.68) which confirms what Krutchen says. There is no statistically significant reduction for boys or girls (if you claim there is could you please show me the workings).

Yes, of course, the effect of sex on IQ is important, maybe a worry. But one can't help speculating on the fact the sample in this study was not really representative. Several critics have commented on this.

But I stress - there is no effect of fluoride on IQ and the Green et al results appear to have arisen from the frowned-on subsampling they used and possibly a non-representative sample. One also must remember there will be an effect due to non-normal data distribution and the reported effect explains only a very small part of the IQ variance.

Concentration on fluoride is perhaps obscuring what should be the real worry - at least for males.

The Mullenix study is irrelevant to community water fluoridation - high F diet and rats.

You seem now willing to discard the Green et al study (perhaps wise) but formerly thought it was the best thing since sliced bread.

[BillO538145]

Ken,

I have very little background in statistics, just my Masters program.  Dentistry did not have statistics.  So I need to consider those with more training and experience in statistics.  What is your statistical training?  MA?  PhD?  Have you had peer reviewed statistical publications?

Green et al 2019 has several interesting points.  One is the fluoride/IQ connection.  

Another is the urine fluoride concentraiton and fluoride intake per day. (See bottome of Table 1)

Non-fluoridated moms had 0.40 mg/L fluoride in their urine compared to fluoridated moms with 0.69 mg/L.(SD 0.4 mg/L)

Bashash et al 2017 also  reported lower IQ in children with mother's fluoride concentration above 0.4 mg/L and about the same 4 pt drop at 0.7 mg/L).

Ken, remember that there were no group of mother's without fluoride in their urine.   The question of interest would be whether urine fluoride levels even lower would result in even higher IQ for their children.   Is there a lower threshold where fluoride does not harm the infant, or like lead there is no known lower threshold, safe intake of lead.

Ken, what fluoride urine concentraiton is desireable for preventing dental caries and what concentration puts her child at risk?

Of course we want more research, but we do not need more research to stop adding fluoride to water.  Simply looking at dental fluorosis prevalence and we should stop adding fluoride to the water.

A crazy, crazy stupid public health myth to give everyone more fluoride when it probably hurts the unborn, infants should not have fluoridated water for making their formula, EPA agrees most children under 6 are ingesting too much for part of their life, and potential benefit from fluoride  is up to age 6.  

Fluoridation is an experiment on the public at large without their consent.

Bill Osmunson DDS MPH

[KenP315323]

Bill, I have a PhD. My research experience over many years has required statistical analysis because of the biological systems involved. But I have had the advantage of working closely with biometricians in this research. I have found their experience and sophisticated experience invaluable and believe that many academics who use statistical analysis but do not have that long background can produce naive results.

The institutes I worked in (except foir university) generally required the presence of statisticians on pre-publication review boards. They would always ask to look at the data used.

You say "Green et al 2019 has several interesting points.  One is the fluoride/IQ connection." And refer to Table 1. Well the data in this table is from Table 1

So, yes despite, as you say, Non-fluoridated moms had 0.40 mg/L fluoride in their urine compared to fluoridated moms with 0.69 mg/L.(SD 0.4 mg/L) this did not significantly influence the IQ of the offspring, all children, male or female.

Can you comment on that?

[BillO538145]

Ken,

You still have not responded to total fluoride exposure and dental fluorosis.  I'm waiting.  Too many are ingesting too much fluoride, but you refuse to respond because you like to data mine.

Now to your point on the Green et al study, 2019.

I agree the numbers in Table 1 show 1.53 IQ difference which is not significant.

However, the authors report 4.49 IQ difference which is significant.  

What are we missing?

We need to give the authors a chance to respond.    

Bill Osmunson DDS MPH

[BillO538145]

Ken,

Actually, the authors were clear in the study and we have failed to understand and carefully read their study.  My mistake and I hope I did not cause too much confusion.

The authors state:
“A 1-mg/L increase in MUFSG was associated with a 4.49-point lower IQ score (95% CI, −8.38 to −0.60) in boys, but there was no statistically significant association with IQ scores in girls (B = 2.40; 95% CI, −2.53 to 7.33). A 1-mg higher daily intake of fluoride among pregnant women was associated with a 3.66 lower IQ score (95% CI, −7.16 to −0.14) in boys and girls.”

A careful understanding of the study is important.  

As you know, one concern with a study of harm is we can NOT do prospective RCT’s to cause and thus prove harm. That would be unethical.  Studies of harm are complex.  

Another problem is a threshold below which a toxin/substance may not cause harm, or at least show the harm in the study due to limitations of the study at hand. 

Another problem is comparing a very small change in fluoride concentration may not be measurable in a study or perhaps even have an effect on some people, and others a significant effect due to host sensitivity, synergistic chemicals, etc. etc.

Although Table 1 does NOT show the 4.49 IQ loss, in contrast, when a 1-mg/L increase in urine fluoride was compared, a 4.49 IQ loss was found.

The authors are correct and their finding from a risk standpoint is significant.

The authors were very clear, We simply did not read the article carefully in the first run through.

I expect you to argue "data mining."  However, in the case of risk, you will need to be more persuasive.  

A study requires enough contrast to determine and understand any effect.  And although it does not appear to have a lower threshold, we don't know if there is a lower threshold where fluoride does not cause an IQ loss.  Thus, evaluating the difference in IQ with a 1 mg/L fluoride difference is valid and not data mining.

Bill Osmunson DDS MPH

[rs5526]

And the fetus and newborns have no teeth, so treating them with exogenous industrial fluoride is not only unethical but is flat out illegal. The FDA has not only never approved any fluoride compound for ingestion but also banned the sale of any Fcompund intended to be ingested by pregnant women in the U.S. The FDA based this ban on the requested studies proving that ingesting fluoride during pregnancy produces no dental benefit in offspring.

This is very old news, but does the CDC take the time to investigate and find the truth? Do fluoridationists even care? Of course not. They are far beyond that.

[sirpac271999]

FAN response to the unfounded criticism of the Green et al. (2019) study:

NEW YORK, Aug. 21, 2019 /PRNewswire/ -- A newly published carefully-researched and meticulously peer-reviewed US government-funded study published in JAMA Pediatrics reports maternal fluoride levels are linked to offspring's lower IQ. But the same day the study was released, many fluoridation proponents erroneously dismissed it, reports the Fluoride Action Network (FAN).

Critics claim: "It is only one study." The truth is that over 50 studies have found a lowering of IQ associated with fluoride exposure including another high-quality US-government funded study (Bashash et al., 2017) using similar methodology as the JAMA study. (Also, Thomas et al. 2018 Occupational & Environmental Medicine; Valdez Jiménez et al. Neurotoxicology  2017 and Li et al Fluoride 2008)

Critics claim: "It doesn't prove cause and effect." No epidemiological study can. However, over 400 animal and cell studies underline the JAMA study's biological plausibility.

Critics claim: "A loss of 3-4 IQ points is not enough to be concerned."  This is a predicted average drop for the whole population – such a shift could dramatically reduce the percentage of very bright children and increase the number of mentally handicapped. 

Critics claim: "Loss of IQ cannot be sex-related." This claim ignores what the authors state about these sex differences. Christine Till the lead author responds to this and other criticisms in an interview on Canadian TV Contradicting other claims, the mothers were not exposed to high fluoride levels and the study did control for lead, mercury, manganese, perfluoro-octanoic acid, and urinary arsenic.

Claims that thousands of studies show fluoridation is safe are not true. In fact, public health has been negligent about examining  the health of people living in fluoridated communities. Paul Connett, PhD, FAN Director says, "It is sickening to hear promoters tout the benefits of swallowing fluoride when confronted with such serious evidence of harm. You can repair a child's tooth but you can't repair a child's brain if it is harmed during fetal development." "It is fine to ask for more studies. But, the only reasonable course of action is to place a moratorium on fluoridation until the matter has been resolved. Meanwhile, pregnant women should be warned to avoid fluoride as much as they can," says Connett.         

Connett's video response to criticisms of the JAMA/IQ study https://www.youtube.com/watch?v=hjKUqf85E6Q&feature=youtu.be 

SOURCE Fluoride Action Network

Related Links

http://FluorideAction.Net

[CarryAnne]

“Industry has learned that debating the science is much easier and more effective than debating the policy. In field after field, year after year, conclusions that might support regulation are always disputed. Animal data are deemed not relevant, human data not representative, and exposure data not reliable.” - David Michaels, Assistant Secretary of Labor for Occupational Safety and Health, in “Doubt Is Their Product” (2008)

Given the ethical limitations of experimenting on human beings and the reluctance of organizations to reverse policy, there is unlikely to be a perfect single study that closes the book on fluoridation as harmful. However, the sum of the studies in multiple areas should do so. 

Chemists define fluoride as a poison and the EPA recognizes fluoride as a water contaminant. The in vitro, animal, bio-chemical, and other laboratory studies support the findings of epidemiological studies - fluoride even in low doses harms the health in a significant percentage of the population which includes vulnerable subpopulations that include pregnant women & their fetuses, bottle-fed infants & young children, the elderly and those with chronic health conditions like kidney, thyroid, autoimmune & inflammatory diseases.   

A scientist recently said to me that as a scientist, she'd hesitate to speak definitively about any epidemiological study at work, but when she goes home she'd be sure her pregnant daughter especially only drank fluoride-free water and used fluoride-free toothpaste. You just don't take that gamble when the stakes are so high. 

She went on to say, "but it is not just the epidemiological studies. There is no question that fluoride even in low doses is harmful to consumers, with some consumers being more vulnerable than others." 

UNSAFE: “Consequently, although the World Health Organization continues to support F schemes for caries prevention despite a lack of scientific proof, the F schemes are not able to improve the crystal quality but rather contribute adversely to affect tooth development and increases the risk of developing postmenopausal osteoporosis.” - Mitsuo Kakei, Masayoshi Yoshikawa and Hiroyuki Mishima. Fluoride Exposure May Accelerate the Osteoporotic Change in Postmenopausal Women: Animal Model of Fluoride-induced Osteoporosis. Adv Tech Biol Med 2016, 4:1 http://dx.doi.org/10.4172/2379-1764.1000170

UNSAFE: “These findings show that fluoride consistently increases BPb and calcified tissues Pb concentrations in animals exposed to low levels of lead and suggest that a biological effect not yet recognized may underlie the epidemiological association between increased BPb lead levels in children living in water-fluoridated communities." - Sawan RM, et al. in Fluoride increases lead concentrations in whole blood and in calcified tissues from lead-exposed rats. Toxicology. 2010 Apr 30;271(1-2):21-6. https://www.ncbi.nlm.nih.gov/pubmed/20188782

UNSAFE: "....the WHO's recommended concentrations in drinking water become nephrotoxic to CKD rats, thereby aggravating renal disease and making media vascular calcification significant."  - A. Martín-Pardillos et al. in Effect of water fluoridation on the development of medial vascular calcification in uremic rats. Toxicology. 2014 Apr 6;318:40-50 https://www.ncbi.nlm.nih.gov/pubmed/24561004 

OVERDOSED: “Fluoride is not an essential element for human growth and development. Prolonged exposure to fluoride in the prenatal and postnatal stages of development might have toxic effects on the development and metabolism of brain.… The United States Environmental Protection Agency (EPA) has done both a dose-response analysis and a relative source contribution analysis. This data show that at the 90th percentile a third of children between the ages of 6 months and 4 years are getting significantly more fluoride than is considered safe.” 
- A Strunecka et al. in Immunoexcitotoxicity as the central mechanism of etiopathology and treatment of autism spectrum disorders: A possible role of fluoride and aluminum. Surgical Neurology International. 2018 Apr 9;9:74. https://www.ncbi.nlm.nih.gov/pubmed/29721353

The biological plausibility of a poison causing harm in low concentrations, especially in vulnerable populations and when taken daily for decades is not scientifically controversial. The controversy over fluoridation is politicaly motivated but per David Michaels of OSHA quoted above, confused by biased players. 

[sirpac271999]

I am curious how KenP could have done the regression analysis here without the raw data? Based on just the figures that the authors have published in the Green et al. (2019) article?

I have acess to SPSS 25 (IBM, 2019) statistical software and would be happy to do the same, if there actually were the raw data that would be available. Yet, you cannot deduce what such raw data may be based on the results.

Reference:

Green, R., Lanphear, B., Hornung, R., Flora, D., Martinez-Mier, E.A., Nuefeld, R., Ayotte, P., Muckle, G., & Till, C. (2019). Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada. JAMA Pediatrics, doi:10.1001/jamapediatrics.2019.1729

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2748634#224604298

[KenP315323]

sirpac271999 - just extract the data from the figures using something like WebPlot digitizer.

[sirpac271999]

Science does not work that way. One cannot use some external software, such as a Webplot digitizer, and expect to complete a valid regression analysis. The researcher has to have the original raw data to complete a valid regression analysis. As for the Green et al. (2019) study, the authors explain the methods, results, and controls very clearly and the publisher had verified the results. That is all hard work that takes a lot of time and effort. Thus, there is no question as to the results.

Ken,

If you wish to do a replication study, then do one and do it properly. However, you cannot take someone else's study and use some external means to twist the data and the results in whatever way you would like. You can write a proper paper, using proper statistical methods to arrive at conclusions based on a valid analysis of the raw data, that was obtained by proper means. However, you cannot do what you just claimed you did. No-one has any idea what data you may have plucked in to get your conclusions. Thus, such claims are nothing but bogus. 

On the bright side, NPR has a good discussion regarding the Green et al. (2019) study. Here is the link:

https://www.npr.org/sections/health-shots/2019/08/19/752376080/can-maternal-fluoride-consumption-dur...

[KenP315323]

sirpac271999 - are you attempting to claim that the published figures do not accurately portray the data used?

Or have you somehow construed my comment the picture me using a graphical; extraction program to do a statistical analysis.

You are obviously attempting to ignore the facts I have presented.

[sirpac271999]

In the refutations to the empirical research study published in JAMA Pediatrics, which reports that maternal exposure to fluoride in pregnancy can lead to lower IQ scores in young children, Prof Thom Baguley, Professor of Experimental Psychology, at Nottingham Trent University, first said that: “The claim that maternal fluoride exposure is associated with a decrease in IQ of children is false, because the finding was non-significant”. Yet, the authors found significance. Then, the same professor says next that:..”the estimate of the decrease in IQ for male offspring is unfeasibility large – at 4-5 IQ points. This level of average deficit would be readily detectable in previous studies and is likely a reflection of bias or very noisy data (the interval estimate here is very wide). “ Thus, first the finding is “non-significant” and then “too significant” per this critique? So, which one is it? The study authors say the findings “are significant”, based on the significance, or p-value, which is a traditionally and commonly accepted method of determining significance in statistical analysis.

It appears that no matter what empirical research finds, if it is contrary to the non-science based public fluoridation policy, the fluoridation proponents will find fault with any such study. Yet, for almost 60 years, these proponents refused to do any valid studies themselves, and have no valid data to support their policy error. In addition, their furious defense of the erroneous fluoridation policy is evidence of express knowledge with egregious disregard for evidentiary harm that has now been proven by multiple empirical studies. Thus, the answer to the allegation that “other studies should have detected such IQ differences”, is that other studies have detected such differences (Bashash et al., 2018).

Reference:

Bashash, M., Marchand,  M., Hu, H.,  et al. (2018)  Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6-12 years of age in Mexico City.  Environ Int.,121(Pt 1):658-666. doi:10.1016/j.envint.2018.09.017

[KenP315323]

I have now done my own regression analysis of the data for males after log transformation (to overcome non-normal distribution of the data) and the relationship is not significant (p=0.20).

[BillO538145]

Ken,

If they way you twist the data is correct, send it to JAMA Pediatrics and the authors and I'm sure they will withdraw the study.

Do you realize how hard it was for the Journal to publish something so contrary to Public Health Policy and Ken P's belief, et al?   

They went through more than one peer review and this was done under guidelines of two governments.  

Sure, the study has limitations, as all safety studies do.  But this study has been a long time under review by many experts in various fields, some pro fluoride researchers.  Yet they agreed on the data, the statistics and the conclusion.

If they came to your conclusion, contrary to most fluoride/IQ studies, then I would question their data.  For example, testing a 3 year old's IQ seems a real stretch for me.  But the child experts say IQ testing can be done and reasonably reliable.

Ken, you have made at least one fatal flaw in playing with the numbers.    You may think the world is flat, but take a trip. . . When I was in NZ everyone was hanging upside down, so I know the world is round!!!!!

Bill Osmunson DDS MPH

[KenP315323]

Bill - you say "They went through more than one peer review and this was done under guidelines of two governments. "

Are you privy to information about the review process used?

I would be interested to know the details. Especially if, as you say, they had to use an extra review?

[BillO538145]

Ken,

Good questions.  

JAMA Pediatrics published the article and I have looked at three other items.

The JAMA Pediatrics Editor published a Note on the study.

The Editors also put a 12 minute podcast together regarding the study.

And Ballinger, well known toxicologist wrote a commentary.

I sent them to you in an email because I don't have time to link them here.

I can fix teeth, I can't fix brains.

The study of harm is much more difficult than benefit.  

No money in learning not to purchase or sell a product.

Causing harm can't be studdied.

Fluoride is an experiment with a highly toxic substance and little to no research.

I'm actually shocked at how clueless the MD's are on fluoride.  They endorse it but don't study it.

And then again, that was me a couple decades ago.  So much to learn, we must be humble because we certainly don't know everything.

Bill Osmunson DDS MPH

[KenP315323]

A US Biotastsitics PhD student has also extracted data from the paper's figures and produced a similar linear regression to mine. He is doing a more sophisticated analysis though.

https://twitter.com/AdamKruchten/status/1163852901124464640

He concludes that once the large and unexplained difference due to sex is considered there is no effect due to fluoride on IQ ("The answer is a resounding no in the digitized data.")

It is good to see others are on the case.

[sirpac271999]

If you look at the PhD student analysis, he had a smaller sample that was presumably derived from the Green et al. (2019) study, but he also found significance for Male children. See:

https://twitter.com/AdamKruchten/status/1163852901124464640

[KenP315323]

sirpac271999 - Yes, he extracted 407 points for fig 3A. I extracted 410. Quite a bit lower than the 512 claimed to be in the graph. As Krutchen says "either data was not plotted, or more likely over-plotting"

It's always difficult to ensure complete capture or avoid mistaken capture but I suspect the authors did not include all the data points in their graph. I enlarged the graphs to ensure as best I could that I captured all the points.

I think my capture was pretty representative though. For example, Green et al give mean values of IQ for MUF sample of 107.16 (I get 106.8) for total, for boys of 104.61 (I get 104.0) and girls 109.56 (I get 109.6).

For Fig 3B I extracted 319 points (Green reports an n of 400). But still, my mean IQ values were very close. For the nonfluoridated sample, they get a mean IQ of 108.07 (I get 108.3). For the fluoridated sample, they get a mean of 108.21 (I get 108.8).

So very close reproduction of values.

IMPORTANTLY - Green et al found no effect of fluoridation on IQ. (108.21 vs 108.07). They do not comment on this in their discussion.

Yes, Kruchten found a significant effect of sex and wonders why this should be commenting "which is of course strange. We shouldn't expect anything like that to happen. This difference is very significant. There's also some outlier extremely low IQ values among the male children."

He comments further "All of this is strange, we shouldn't expect a huge IQ difference by sex, and more importantly sex shouldn't likely be confounded by anything of interest in the study. E.g. expecting mothers are not likely have their fluoride consumption affected by the sex of their baby."

That is weird - yet my analysis showed that the mean MUF values  (during pregnancy before the child was born) were 0.50 mg/L for mothers who later had female children and 0.57 mg/L for mothers who later and male children.  I really do wonder if the sample, especially for male children, was unrepresentative or contaminated in some way because it is hard to think of a mechanism to explain this.

However, once the significant effect of sex on IQ is taken into account there appears to be no effect due to fluoride. Krutchen says:

"with such a significant effect of sex on IQ, does fluoride have any remaining relationship? The answer is a resounding no in the digitized data."

[BillO538145]

CarryAnne,

Yes, you are correct. 

Randy is probably very smart in some things, but fails to have a global view of problems and gets confused. 

Fluoridation has many streams of evidence to consider.   These streams of evidence appear to have become confusing to him. 

The latest fluoride lowering IQ study by Green et al 2019, is rather powerful, with dosages of fluoride similar from all sources except fluoridated water. 

In effect, this study does show harm from fluoridated water. 

I'm sure Randy and Ken are not intentionally trying to promote harm to the public, they simply get confused with so much information and fail to look at the big picture of all the evidence. . . such as desired dosage.

Bill Osmunson DDS MPH

[KenP315323]

Bill, you say "I'm sure Randy and Ken are not intentionally trying to promote harm to the public, they simply get confused with so much information and fail to look at the big picture of all the evidence. . . such as desired dosage."

Kind of you - but are you willing to show confidence in your claim of our "confusion?"

I will be writing a critique of this paper and post it in the next few days. I offer you equal space as a right of reply to critique my critique and justify your claim " this study does show harm from fluoridated water."

You could start by explaining how a nonsignificant difference in mean IQ of +0.5 (in favour of fluoridated water) between subjects from fluoridated and fluoridated areas shows harm!

I invite you to join a proper scientific exchange on the merits of this paper.

[BillO538145]

Hi Ken

So thoughtful of you to include me in the statistical evaluation of the Green et al 2019 study with measured urine fluoride concentrations and lower IQ.

I would invite you to discuss total fluoride exposure and recommended dosage.

How much fluoride do you want to prevent dental caries?

How much is each person ingesting?

How much is safe?

Of course one study does not prove most anything.  However, we now have over 50 human studies reporting harm. 

You and I want the highest quality of research.  But that does not exist for benefit of ingested fluoride.

And you will not find the highest quality of research evaluating harm.  That would be unethical and simply acceptable to University Research Ethics Committees. 

We cannot give enough fluoride to people and see when they start to be harmed.  Not ethical. 

So Ken, you want to pick the studies apart.  Good.  Design a study which you would accept that determines risk/safety of ingested fluoride.

The study of benefit is much easier than the study of harm.  We can intentionally cause benefit and measure it.  We cannot intentionally cause harm.

Bill Osmunson DDS MPH 

[KenP315323]

Bill, despite your attempted diversion I take from your reply that you are rejecting my offer of a proper scientific excxhange on this paper.

I also take from your reply ("Of course one study does not prove most anything.") that you are no longer willing to support your claim "this study does show harm from fluoridated water."

Not surprised. The study clearly shows no difference between individuals from fluoridated and unfluoridated areas.

[KenP315323]

sirpac -  Baguley actually wrote:

"the claim that maternal fluoride exposure is associated with a decrease in IQ of children is false. This finding was non-significant (but not reported in the abstract)."

He is referring to the data for all children (perhaps you only read the abstract). In fact, the p-value for that analysis (using maternal urinary F) is 0.12 (my own analysis) which is considered non-significant.

The abstract only gives an analysis for male children where a statistically significant relationship was found (they report a p-value for adjusted values of 0.02, I found a p-value of 0.10 for the values in the figure). However, that relationship explains only 1.3% of IQ variance so is quite meaningless. The expert comments also raise other issues involving the non-normal distribution of the data and subgroup analysis which makes their conclusion of statistical significance questionable.

There are many problems with reliance on p-value alone and the full results of statistical analysis should always be reported. In this case, the data is shown in the figures which enables one to do one's only analysis. As I have said, this shows the result is rather meaningless.

[CarryAnne]

"When you have the facts on your side, argue the facts. When you have the law on your side, argue the law. When you have neither, pound the table and holler like crazy." - Aphorism 

Dr. Osmunson @BillO538145 - 

It seems obvious that the NIH/NIEHS also drank the fluoridated Kool-Aid before they sponsored these epidiological studies, fully believing that they'd prove fluoridation safe. However, when faced with study after study that validate the findings of in vitro, animal, and other laboratory studies, i.e. that fluoride exposure even in low doses is harmful to biological systems including brain function, there are only two options left to fluoridationists. Either they admit the mistake and take action to remedy the situation or stick to the lie while doubling down on promotion per quote above. 

A friend recently sent me the following which illustrates his point of view. I suggest it is integrity more than intelligence that is lacking in fluoridationists and their organizations.

Goofy Science 

[CarryAnne]

“The effects of this study are comparable to the effects of lead… I would advise them (pregnant women) to drink bottled water or filtered water...” - Dimitri Christakis, MD, MPH and JAMA Pediatrics editor on “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada" (August 19, 2019)

The JAMA Pediatrics podcast on August 19, 2019 was ostensibly about the high-quality study published that day that added to the scientific evidence that prenatal exposure to even low doses of fluoride in 'optimally' fluoridated North American communities by educated white women living in urban settings results in a significant reduction in the IQ of their offspring. However, perhaps even more interesting is that these two medical doctors certified in public health medicine admitted that they struggled with the decision to publish this NIH sponsored science even after submitting it to an extended, repeated and scrupulous peer review and statistical analysis because they had been taught in medical school to ignore and disparage anyone or any science that claimed anything negative about fluoridation policy. 

Sadly, fluoridationist organizations wasted no time in following their script that both defends the policy and attacks the science, willfully blind to the evidence in front of them. Call it willful blindness, cognitive dissonance, agnotoloty or uncertainty bias, but whatever you call it recognize that the scientific evidence proves that fluoridation policy is a womb to tomb public harm policy.  

•  Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada. Rivka Green, Bruce Lanphear, Richard Hornung, et al. JAMA Pediatrics. August 19, 2019 [online ahead of print]. 
• CTV News Report with several videos attached including interviews with a study author. 

[BillO538145]

CarryAnne,

The Editor's note in the JAMA Pediatrics is well said:

"This decision to publish this article was not easy.1 Given the nature of the findings and their potential implications, we subjected it to additional scrutiny for its methods and the presentation of its findings. The mission of the journal is to ensure that child health is optimized by bringing the best available evidence to the fore .Publishing it serves as testament to the fact that JAMAPediatrics is committed to
disseminating the best science based entirely on the rigor of the methods and the soundness of the hypotheses tested, regardless of how contentious the results maybe. That said, scientific inquiry is an iterative process. It is rare that a single study provides definitive evidence. This study is neither the first, nor will it be the last, to test the association between prenatal fluoride exposure and cognitive development. We hope that purveyors and consumers of these findings are mindful of that as the implications of this study are debated in the public arena."

With over 50 human studies reporting harm to the developing brain, the Green et al 2019 study is certainly not the first, nor it will be the last. 

The question proponents must ponder is, "What are the chances more research will reverse the 50 studies reporting harm?"

We can fix teeth, but we can't fix brains.

Bill Osmunson DDS MPH

[KenP315323]

Bill, you do realise the publication of an editors note on the paper is extremely unusual. This indicates to me a huge dispute on publication - perhaps most or all referee's arguing against publication. The comment in the note from  Julian Poulkton-King from Monash health who says "this should not have been published without further exploration" supports this suggestion.

Unusually at this stage, the paper has been roundly condemned by independent experts contacted by the UK Science Media Centre - (see expert reaction to study looking at maternal exposure to fluoride and IQ in children). For example. Prof Thom Bradley comments:

"In summary, it is not correct to imply that the data here show evidence of a link between maternal fluoride exposure and IQ. The average change in IQ is not statistically significant.”

I will be writing my own analysis and critique of the paper. Fortunately, the authors include their data in the figures which enables an independent statistical analysis to overcome their deficiency in not presenting the full results of their own analysis. (Simple reporting of p-values can be very misleading).

My initial look shows absolutely no difference in IQ of offspring from fluoridated (mean IQ 108.8) and unfluoridated (mean IQ = 108.3) areas.

Prof Baguley also commented on the unorthodox statistical approach ("This is an example of subgroup analysis – which is frowned upon in these kinds of studies because it is nearly always possible to identify some subgroup which shows an effect if the data are noisy. Here the data are very noisy "). Others have criticised the statistical analysis because the data was not normally distributed and should have been transformed.

However, even with the analysis used the "apparently" significant relationship (low p-values which are often misleading) can explain only 1.3% (between IQ of male offspring and maternal urinary F) or 0.3% (child IQ with maternal fluoride uptake) of the variance in IQ. Considering this, and the faulty statistical methods use, I have no hesitation at this stage of concluding the results are meaningless. Which, of course, won't stop anti-fluoride campaigners from touting the study as "brilliant science" - simple confirmation bias.

I hope the journal editors will allow this study to be debated in the journal - it is disappointing that they refer only to debate "in the public arena." Proper scientific peer review should take place after publication - but I know from experience journal editors often prevent this and authors attempt to ignore scientific critiques.