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From: sbharris@ix.netcom.com (Steven B. Harris )
Subject: Re: Fluoridated water
Date: 31 Aug 1995
Newsgroups: misc.health.alternative,misc.consumers,misc.fitness,misc.kids,
alt.folklore.herbs
In <424s2f$ulo@cadvision.com> Elke Babiuk <fluoride@cadvision.com>
writes:
>>Dr. Harris, when you mention the hip fracture studies, you
seem to be confusing hydrogen fluoride with sodium fluoride (also,
instead of sodium silicofluoride, many cities which fluoridate use
hydrofluosilicic acid--a waste by-product of fertilizer manufacturing
which contains about 24% fluoride).<<
No, I'm not confusing anything. Some hip fracture studies have
used epidemiological methods to compare communities with natural
water fluoride, but most have looked at artificial fluoridation,
which is usually either sodium or hydrogen fluoride (there is no
difference once it hits both drinking water, then your stomach--
fluoride is a free anion in weak solution and cannot "tell" your
body what it was once attached to).
>>You are WRONG about the correlation between hip fractures and
fluoride. Of the many recent studies which have been performed
and published in peer-reviewed journals, MOST show a positive
correlation with increased hip fracture rates and fluoride levels in
drinking water. Others looking at fluoride therapy for osteoporosis
also report increased hip or other fracture rates from the drug.<<
No. Results are mixed with the large prospective osteoporosis
studies, which use very large levels of fluoride (one review I ran
across reports 2 of these studies that report more fractures, 2
that report fewer). As for the hip fracture studies in water
fluoridation (a very different question, with a very different
dose of mineral), we have a problem in how to evaluate epidemiologic
studies, which I always hit when trying to explain study results to
untrained people reading them.
Epidemiology shows correlation only. Correlation is not causation,
since the correlation can be one of "proxy" or "marker" variables.
Because there is more ice cream sold in the Summer, and more juvenile
delinquency in the Summer, for instance, does not mean that ice cream
causes delinquency. On the other hand, LACK of correlation is usually
pretty good evidence *against* causation, because it is very difficult
to have no correlation between variables which do in fact have a causal
relationship. The reason is, for this to happen, you have to have
TWO causal processes, acting in opposite directions, and by coincidence
canceling each other out-- and the odds of this are low. An example
(the only one I know of!) is un-irrigated corn growth rate and average
daily temperature during the year, which is statistically not well
correlated, but only because the actual large positive temperature
effect is being cancelled out by a positive rainfall effect which
correlates negatively with temperature, and cancels this effect during
the year almost entirely out (!) Again, this kind of thing doesn't
happen often.
The result of all this, though I know you hate to accept it, is
that studies showing no statistical correlation between fluoride
use and hip fracture, are more powerful than those that show one.
Studies which show an effect have many possible alternative
explanations, not least of which is that many of them end up
tacitly comparing different communities. Hip fracture rates are
different for metro and rural populations, for example,
for reasons still poorly understood, and they have been
since before fluoridation. If the rural/metro difference
is not taken into account when looking at fluoridation
epidemiology, results tend to get skewed due to the fact
that metropolitan areas historically fluoridate more often,
and fluoridate first.
>>In the latest French study (a large one), the increased
risk was 86% for seniors who lived in areas where water contained
between 0.11 and 1.83 parts per million (equivalent to milligrams
fluoride ion per liter of water) fluoride, compared to those in
areas with <0.11 ppm. The results were statistically significant
and were corrected for major individual risk factors (Jacqmin-Gadda,
H., et al., Fluorine Concentration in Drinking Water and Fractures
In the Elderly, Journal of the American Medical Association,
273:10 (letters-which, as I understand, are also peer-reviewed),
March, 8, 1995, pp 775-776).<<
This is exactly the kind of study I'm talking about; as is the
positive Utah study below, also published in JAMA. These kinds of
positive studies are intrinsically NOT as powerful as the negative
studies, nor are they as reliable in general as epidemiologic studies
comparing matched communities, or studies comparing single communities
with themselves through time as fluoridation is introduced (for reasons
which I hope will be obvious). Examples of both, finding NO effect of
fluoridation on hip fractures, are appended. One of them is a
Canadian study which you must surely be aware of. How come you
didn't mention it? In general, studies such as your JAMA letter,
which show an effect of fluoride, are of lesser intrinsic quality
than studies showing no effect.
>>Please also clue us to the literature you have read which leads
you to assume that the "good effects seem to outweigh any bad." Could
it be that perhaps your reading of the subject is a might limited?<<
Could it be that yours is? I'll include an abstract of an excellent
review. I recommend you read the review itself, of course, as I have.
Having access to all the study papers in the world will do you no good
if you have no idea how to evaluate a scientific study, and judge the
value of its findings. Talk to some people in public health, or take
an epidemiology class or two. It won't hurt, and may save you from much
embarrassment.
>> Should you be interested in coming up to speed on this issue,
please consider tuning into the locations in my signature file.
Regards, Elke Babiuk (Executive-Director). HANS, Alberta Chapter
"Fluoridation is the greatest case of scientific fraud of the
century." (Robert Carton, Ph.D., former U.S. EPA Scientist)<<
Really? I thought it was the HIV/AIDS hypothesis. Wait, no, I
thought it was public vaccination? Or mercury fillings? Or Darwinian
evolution taught in science classes... Gosh, you guys never get your
hierarchy of conspiracies straight. Again, it would be nice if you
would just divide up all the anxious, unhappy people amongst
yourselves, and give them all wallet cards, in order to save
everyone time on the question of who (which conspiracy) to blame.
It would certainly save me time in taking a history. Maybe
Medic-Alert bracelets could also be upgraded with social victimology
status: "Attention, physician: Longtime NutraSweet-induced chronic
fatigue sufferer. Call Searle for details."
Steve Harris, M.D.
Fluoride abstracts of interest:
AU - Jacobsen SJ ; Goldberg J ; Cooper C ; Lockwood SA
TI - The association between water fluoridation and hip fracture among
white women and men aged 65 years and older. A national ecologic
study.
AB - For the past 45 years, there has been a great deal of debate
regarding the health issues surrounding the fluoridation of
public water supplies. In order to assess the association between
fluoridation and hip fracture, we identified 129 counties across
the United States considered to be exposed to public water
fluoridation and 194 counties without exposure. Data from the
Health Care Financing Administration and the Department of
Veterans Affairs were used to calculate the incidence of hip
fracture among white persons, aged 65 years or older, in
fluoridated and nonfluoridated counties. There was a small
statistically significant positive association between fracture
rates and fluoridation. The relative risk (95% confidence
interval) of fracture in fluoridated counties compared to
nonfluoridated counties was 1.08 (1.06 to 1.10) for women and
1.17 (1.13 to 1.22) for men. As comparisons were made at the
grouped level, it may be inappropriate at this time to draw
inferences at the individual level. The relationship observed at
the county level needs to be duplicated at the individual level
with more precise measures of fluoride exposure.
SO - Ann Epidemiol 1992 Sep;2(5):617-26
AU - Danielson C ; Lyon JL ; Egger M ; Goodenough GK
TI - Hip fractures and fluoridation in Utah's elderly population [see
comments]
AB - OBJECTIVE--To test the effect of water fluoridated to 1 ppm on
the incidence of hip fractures in the elderly. DESIGN--Ecological
cohort. SETTING--The incidence of femoral neck fractures in
patients 65 years of age or older was compared in three
communities in Utah, one with and two without water fluoridated
to 1 ppm. PATIENTS--All patients with hip fractures who were 65
years of age and older over a 7-year period in the three
communities, excluding (1) those with revisions of hip fractures,
(2) those in whom the hip fracture was anything but a first
diagnosis, (3) those in whom metastatic disease was present, or
(4) those in whom the fracture was a second fracture (n = 246).
OUTCOME MEASURE--Rate of hospital discharge for hip fracture.
RESULTS--The relative risk for hip fracture for women in the
fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to
1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to
the nonfluoridated areas. CONCLUSIONS--We found a small but
significant increase in the risk of hip fracture in both men and
women exposed to artificial fluoridation at 1 ppm, suggesting
that low levels of fluoride may increase the risk of hip fracture
in the elderly.
CM - Comment in: JAMA 1992 Aug 12;268(6):781-2 ; Comment in: JAMA 1993
Apr 28;269(16):2087
SO - JAMA 1992 Aug 12;268(6):746-8
AU - Suarez-Almazor ME ; Flowerdew G ; Saunders LD ; Soskolne CL ;
Russell AS
TI - The fluoridation of drinking water and hip fracture
hospitalization rates in two Canadian communities.
AB - OBJECTIVES. The purpose of this study was to compare hip fracture
hospitalization rates between a fluoridated and a non-fluoridated
community in Alberta, Canada: Edmonton, which has had fluoridated
drinking water since 1967, and Calgary, which considered
fluoridation in 1991 but is currently revising this decision.
METHODS. Case subjects were all individuals aged 45 years or
older residing in Edmonton or Calgary who were admitted to
hospitals in Alberta between January 1, 1981, and December 31,
1987, and who had a discharge diagnosis of hip fracture. Edmonton
rates were compared with Calgary rates, with adjustment for age
and sex using the Edmonton population as a standard. RESULTS. The
hip fracture hospitalization rate for Edmonton from 1981 through
1987 was 2.77 per 1000 person-years. The age-sex standardized
rate for Calgary was 2.78 per 1000 person-years. No statistically
significant difference was observed in the overall rate, and only
minor differences were observed within age and sex subgroups,
with the Edmonton rates being higher in males. CONCLUSIONS. These
findings suggest that fluoridation of drinking water has no
impact, neither beneficial nor deleterious, on the risk of hip
fracture.
SO - Am J Public Health 1993 May;83(5):689-93
AU - Jacobsen SJ ; O'Fallon WM ; Melton LJ 3d
TI - Hip fracture incidence before and after the fluoridation of the
public water supply, Rochester, Minnesota.
AB - Recent ecological comparison studies have suggested a positive
association between fluoridation and hip fracture. Using data
from the Rochester Epidemiology Project, we found the incidence
of hip fracture for the 10 years before the fluoridation of the
Rochester, Minn, public water supply was 484 per 100,000,
compared with 450 per 100,000 in the following 10 years. When the
effects of calendar time and age were controlled for, the
relative risk associated with fluoridation was 0.63. These
ecologic trend data suggest that the fluoridation of public water
supplies is not associated with an immediate increase in rates of
hip fracture. Further studies of this association at the
individual level are clearly required before public policy
decisions can be made.
SO - Am J Public Health 1993 May;83(5):743-5
AU - Ripa LW
TI - A half-century of community water fluoridation in the United
States: review and commentary.
AB - The nearly 50-year history of community water fluoridation is
reviewed with the major emphasis on the benefits and safety of
fluoridation. Other aspects of water fluoridation also described
include the apparent reduction in measurable fluoridation
benefits because of the abundance of other fluoride sources, the
diffusion of fluoridation effects into fluoride-deficient
communities, preeruptive and posteruptive effects, technical and
cost aspects, sociopolitical and legal issues that affect the
successful fluoridation of communities, and alternatives to
community water fluoridation. The majority of studies have
evaluated the effectiveness of water fluoridation on the
permanent teeth of children, while there are fewer studies on
deciduous teeth and in adults; the relationship between fluoride
ingestion and bone health needs further clarification; the
sociopolitical issues of fluoridation need to be better
understood.
RF - REVIEW ARTICLE: 171 REFS.
SO - J Public Health Dent 1993 Winter;53(1):17-44
From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative,sci.med.dentistry,sci.med.nutrition,
misc.kids.health
Subject: Re: A Day In The Life/open Letter to Steve Harris
Date: 22 Sep 1998 12:55:35 GMT
In <6u7l31$2cf$1@nnrp1.dejanews.com> brou@istar.ca writes:
>>That's interesting, to say the least...Well, here is
Dr.Harris, who suggests a post on the list re:the MedLine
abstracts, then wants a clarification which also gets posted with
official NRC/NAS/Department of Health figures from 1993(!)
clearly stating that current (93) intake exceeds 6.5mg in
optimally fluoridated areas...<<
Comment:
The hardly means that the average exceeds 6.5 mg. Rather it
means that 6.5 is the highest they saw. Averages are
considerably lower,and if they were not, we would see mass dental
fluorosis (more kids would have it than not), something which happens
at F levels such that adults get around 6 mg/day, and which happens
long before toxicity from F is reached. Where is this dental fluorosis
in every child-- the fluorosis we use as a marker to tell us when we're
reaching the beginning of toxicity?
And you offer this nonsense as proof of your statement that average
intakes exceed 8 mg in some parts of the United States, due to
fluoridation and the nasty industry allowing more fluoride in baby
food. Sorry, we know better.
Actually, the only places where fluoride intake exceeds 8 mg
on average for adults are places drinking naturally high F water
supplies, like Bartlett, Texas (8 ppm = 8 mg/L = 20 mg/day for
adults). Where except for discolored (but hard and cavity-free)
teeth, the inhabitants are fine. They've been drinking that
stuff for a century, now. Say, when are all these bad things from
chronic F poisoning supposed to start happening to them?
Any time now, I'll bet.
>>Further he is invited to research links on the matter, again,
full of official Gov't-agency figures, some of them directly
leading to the document in question...You either have selective
reading skills or you do have a different agenda here...<<
Comment:
Excuse me? Let's talk about different agendas. On this
website of yours I'm offered a document, which you also post, in
which it states that 6 mg or more a day of F causes "fluorosis."
The symptoms of which are given as weak bones, weight loss,
anemia, and general ill health. This is utter nonsense, and
means possibly that somebody has confused dental fluorosis
(harmless discoloration of teeth, which starts at about 0.1
mg/kg/day, close to 6 mg/d for an adult) with osteofluorosis (F
induced bone disease) and fluoride poisoning. The only
justification given for this is a calculation that retention of 2
mg a day of fluoride for 40 years will result in enough skeletal
fluoride deposition for osteofluorosis. Alas, there are only a
few problems with this calculation. Chief among them is that the
author who made them (Spencer) must have revised his numbers,
since in 1981 he finds that people retain only 1 mg a day on a
dietary intake of 4.3 mg, figures which are born out by
metabolic ward studies. Wups. Might take you 80 years.
That is, if it weren't for the *other* problem. That being
that nobody has yet seen much osteofluorosis (or mass anemia and
weight loss, either) even in communities like Bartlett, with
naturally fluoridated water where intakes really do exceed 8
mg/day by a factor of 2 or 3. So there's something wrong with
the math, or the assumptions. A "day in the life" of somebody in
Bartlett should be a nightmare to make yours look like a day-
dream. Except it isn't. A beautiful theory killed off by a
nasty ugly fact! Which means you need to go back to the drawing
board. Obviously, lifetime intakes cause F balance changes which
don't look like those you see over months. People don't retain 2
mg a day for decades. Rather the skeleton hits an equilibrium at
some point at 5-10 years, after all bone has been turned over and
all old bone (the stuff being broken down) has been formed in the
presence of fluoride, and thus releases fluoride on breakdown.
It's new bone forming in the presence of fluoride, when the bone
being broken down has not, which causes net skeletal uptake of
fluoride. As soon as bone being broken down has as much fluoride
in it as does bone being formed, skeletal net uptake stops. At
that point, you must raise F concentration to get it to continue
upward.
BTW, that website also contains a breezy discussion of
fluoride metabolism which is only valid for dissolved fluoride.
Somebody forgot to mention that fluoride in solid foods is quite
a bit less bioavailable than fluoride in water and beverages, so
you cannot just add up all the fluoride in the diet to one big
number. Urinary fluoride levels (which track absorbed F pretty
well) need to be measured to see how equivalent of dissolved
fluoride ion people are really getting. You have presented NO
evidence of this sort.
And also, for some reason, your website seems to have glossed
over studies finding considerably lower F intakes for both adults
and children in the US, done years (1980's) after the ones you
cite in the 1970's. I'm sure you know them if you've done as
much research as you say. Must I quote? Is your idea of a
balanced and rational argument to simply ignore later data which
doesn't agree with you? The Dept of Health, BTW, isn't composed
of superscientists or Gods. The men and women there are subject
to the same scientific standards as the rest of us. Where are
their papers about US fluoride consumption in the 90's, published
in peer-reviewed journals? They seem to be missing.
>>Let me explain something to you. I have no interest in
having a war with anyone on this matter.<<
Please. Let me explain something to YOU. I really don't give
a flying banana what your interests are. If you show up here
with medical statements which are bunk, I'm going to ask for your
evidence. If the evidence you present does not back up your
claims, and if you're nasty about it, I'm going to embarrass you.
You can answer my posts or not-- I don't care. But when you post
nonsense, I'm going to point it out-- at least if it's obvious.
>> I have researched this issue for many 100's
of hours, maybe 1000's, and will continue to do so. (By the way,
so have many, many other people, at great expense. The ones you
might recognize have even been mentioned, such as Dr.Albert
Schatz and Dr.Phyllis Mullenix.)<<
Comment:
That's nice. Have somebody who knows something about fluoride
write your literature. There's a thought.
>>I have also no interest in responding to the same old
ignorant remarks over and over on this list. What I am offering
you is a gift, and you, as well as a few others here seem to
abuse it.<<
Comment:
What you're offering so far is deception (see above). That's
no gift, unless you like to count the kinds of gifts that Greeks
brought to Troy.
We'll see how much you resist the facts before we can finally
call it "lies." I can take ignorant people, because they can be
taught. I can take ignorant stupid people, because they too can
be taught, with patience. What I really cannot abide is
dishonest people.
Steve Harris, M.D.
Am J Clin Nutr 1980 Feb;33(2):328-332
Fluoride intakes of young male adults in the United States.
Singer L, Ophaug RH, Harland BF
The total daily fluoride intake for young male adults living in
four geographical areas of the United States has been estimated
by the analysis of "market basket collections" obtained in 1975
and 1977. The fluoride intake in 1975 vaired from 0.912 mg/day in
an unfluoridated city (Kansas City, Mo.) to 1.720 mg/day in a
fluoridated city (Atlanta, Ga.). The 1977 collection from San
Francisco, Calif. contained more fluoride (1.636 mg/day) than the
1975 collection (1.213 mg/day). The level of intake found in this
study is less than that reported by San Filippo and Battistone
(Clin. Chem. Acta 31: 453, 1971) who analyzed similar collections
from Baltimore, Md. in 1967 to 1968 (2.09 to 2.34 mg/day). This
study, as well as the earlier one, indicates that relatively
low levels of fluoride are being consumed in the United States by
the young adult male 16 to 19 years of age.
PMID: 7355803, UI: 80127267
Sci Total Environ 1981 Jan;17(1):1-12
Studies of fluoride metabolism in man. A review and report of
original data.
Spencer H, Osis D, Lender M
The dietary intake of fluoride and the fluoride excretions in
urine and stool were determined under controlled conditions in
man. Fluoride balance studies have shown that the urinary
fluoride corresponds to 50--60% of the intake, the fecal fluoride
was very low, corresponding to 6% of the intake, and
approximately 1 mg fluoride was retained per day during an
average fluoride intake of 4.3 mg/day. The fluoride intake
depended on the amount of fluoridated water consumed. The dietary
fluoride content ranged from 1.2 to 1.5 mg/day. During the intake
of supplemental fluoride the fluoride excretions increased
but the ratio of the urinary/fecal fluoride was similar. Added
fluoride is well retained. Following its discontinuation, very
small amounts of the retained fluoride are excreted for several
days. Inorganic elements, such as calcium, phosphorus, and
magnesium, which have been shown to decrease the intestinal
absorption of fluoride in animals were ineffective in man, while
aluminum, given as aluminum-containing antacids, markedly
decreased the intestinal absorption of fluoride and thereby
decreased the retention of fluoride.
Am J Clin Nutr 1981 Dec;34(12):2679-2684
Fluoride balance studies in ambulatory healthy men with and
without fluoride supplements.
Maheshwari UR, McDonald JT, Schneider VS, Brunetti AJ, Leybin L,
Newbrun E, Hodge HC
Fluoride balances were determined in healthy adult males under
metabolic ward conditions. This is the first fluoride study to
use the diffusion method in exploring the balances of subjects
ingesting basal (i.e., everyday) diets with deionized water for
cooking and drinking. Certain groups were given daily
supplements of 5 or 10 mg. fluoride as sodium fluoride in divided
doses with meals. Fluoride was measured in the diets, sodium
fluoride tablets, urine, feces, and serum. Approximately 90% of
the fluoride excreted was found in the urine and the remainder in
the feces in all groups. In the control subjects, fluoride
balances were uniformly negative (mean of -0.40 mg/day); in
contrast, balances were uniformly positive (mean of +1.38 and
+2.88 mg/day, respectively) in subjects receiving 5 or 10 mg F
supplements daily. Serum ionic fluoride concentration increased
proportionally to fluoride intake and averaged 0.016, 0.029, and
0.040 ppm in the control, 5-mg and 10-mg groups, respectively.
These fluoride supplements did not cause any clinical or
laboratory abnormality in any subjects.
PMID: 7315769, UI: 82088505
From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative,sci.med.dentistry,sci.med.nutrition,
misc.kids.health
Subject: Re: A Day In The Life/open Letter to Steve Harris
Date: 22 Sep 1998 16:34:00 GMT
In <Pine.GSO.3.95qL.980922112430.25210B-100000@aloha.cc.columbia.edu>
Aaron Andrew Fox <aaf19@columbia.edu> writes:
>Steve Harris is kicking ass and taking names. I've been to Bartltt (never
>heard anything about the fluoride, and all Texans have discolored teeth
>from chewing tobacco and cigs) and I can assure you that 8 ppm fluoride
>doesn't affect the redness of one's neck.
Well, to be sure, they did the last Bartlett study in 1954, then
mostly defluoridated it in 1955, to get rid of the discoloration. But
before that, their bones were fine, and had been for generations.
Steve
From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative,sci.med.nutrition,talk.politics.medicine,
sci.med.dentistry
Subject: Re: chronic fluoride poisoning
Date: 22 Sep 1998 16:40:56 GMT
In article <6u6eia$rbr@dfw-ixnews10.ix.netcom.com>,
sbharris@ix.netcom.com(Steven B. Harris) wrote:
> In <6u5u8l$6qt$1@nnrp1.dejanews.com> sherrell@cdsnet.netwrites:
>>Crippling skeletal fluorosis might occur in people who have ingested
>>10-20 mg of fluoride per day for >10-20 years." This statement appears
>>on page 59 of the National Academy of Sciences "Health Effects of
>>Ingested Fluoride," 1993. It is derived from the samedata base as the
>>statement they made in 1977: "a retention of 2 mg/day" would result in
>>crippling skeletal fluorosis after 40 years (for the average
>>individual). It's a matter of simple arithmetic,not scientific
>>controversy.
Comment:
One the contrary, simple arithmetic is 2 + 2 = 4. On the
other hand, the matter of just what it will take to get a human
to retain 2 mg fluoride a day for 40 years, contains considerably
more than arithmetic. Mathematical statements in biology are,
like statements of logic, only as true as their underlying
assumptions.
Humans on a metabolic ward getting 10 mg of fluoride a day
retain about 2.8 mg a day-- at least for the short term. And yet
people getting more than 20 mg of fluoride a day for a life time
(Bartlett, Texas) do not suffer mass osterofluorsis and
fractures. In fact, one of the best studies of fluoride toxicity
(in the early 1950's) looked at long-time residents of Bartlett,
where the water contains (or then contained) 8 mg/L F, and
compared them with long-time residents of Cameron, Tx just 30
miles away, drinking water at 0.4 mg/L. Full skeletal surveys of
more than 100 long time residents of each town were done and read
by experts. No differences could be found. Nor any other
obvious health differences except for tooth discoloration. There
was, if anything, slightly more heart disease in Cameron.
Obviously, there's something wrong with the idea that fluoride
accumulates at the same rate with the same dose for 40 years.
Since the skeleton turns over in 10 years or less, one would not
expect fluoride at any given dose to build up in the body for
longer than that. Nor can I find any evidence that it does.
>>Even the Surgeon General said fluorides accumulate in a
linear manner.<<
You'll have to provide the quote. If he said this without
qualifications, he blew it. There's plenty of evidence that it
does not, at least on a time scale longer than a decade.
>> With good kidney function, approximately half of the daily
intake is excreted in urine.<<
Half the dissolved intake (that in water and beverages). Not
half the total intake. Fluoride in solid foods is absorbed far
more poorly, on average.
>>The brackets were around a note regarding the arithmetic.
You have the references. If you choose not to read them, that is
not my fault.<<
What are they going to say? Insofar as they speculate, they
are uncertain. One cannot do fluoride balance studies on an 8
mg/day dose, measure retention at 2 mg a day for a few weeks or
months, and then expect that it will stay there for 40 more
years. This is on par to measuring an adolescent's growth at an
inch over a year, and then expecting on this basis that by the
time he's 55, he'll be 9 feet tall. It's simple arithmetic, to
be sure. Alas, however, biology just doesn't work that simply.
Experience (observation, i.e. primary data) must always trump
theory. That's an iron law in science. If the theory predicts
that the residents of Bartlett, taking in 20 mg a day in their
water and more, should have terrible skeletal problems, then
there's something wrong with the theory. Because they don't (or
didn't--- actually they defluoridated Bartlett in 1955, to get
rid of the tooth color problems). Anyway, if you don't like my
suggestions, come up with your own for what is wrong with the
theory. But know for certain that it's wrong.
Likewise, it's a fact of observation that dental fluorosis
begins to appear in populations at water fluoride levels above
about 2.5 ppm, corresponding to 0.1 mg/kg/day (this was true in
the days when there was no fluoride in the toothpaste and little
in the diet). If you have claims that the average intake in the
US is now at these levels, and yet we do not see the expected
mottling of teeth in many children, then there must be something
wrong with your claim. Perhaps you're counting fluoride which
isn't bioavailable. Or perhaps you're just plain wrong about the
levels. I don't know which, but it's surely one or the other.
Likewise, it's also a fact that mottling of teeth happens at
fluoride doses which have no discernable health effects on
populations, as seen with Bartlett and a number of other
communities. Therefore, if the US is supposed to have fluoride
levels which are toxic, and yet we see no bellwether tooth
mottling, again there must be something wrong with one of the
underlying assumptions.
>>Why don't you give me a reference indicating that I'm wrong
about increases in fluoride intake since the 1940s? <<
That's not the issue. Obviously we have increases since the
1940's-- we now have fluoridated water and fluoridated
toothpastes. The issue is whether or not this is too much.
>>If you don't agree with the National Academy of
Sciences, or the U.S. Public Health Service, or EPA, then take it
up with them.<<
None of them say the increase is too much. YOU take it up
with them.
>>I asked for the name of a specific type of study which the
fluoride pushers claim they can name by the hundreds. I'm
offering one hundred thousand dollars in cash to the first person
who can name just one. What are you waiting for?<<
There was once a similar reward, put up by certain German
groups, for the person who could PROVE that the Nazi holocaust,
with gas chambers and all, really happened (a court finally
forced them to pay the money to some guy, but my feeling is that
A man convinced against his will
Is of the same opinion still.
And Kary Mullis, NOBEL PRIZE WINNER, wants the paper that PROVES
the HIV virus causes AIDS. The tobacco companies say there's no
PROOF that cigarettes cause lung cancer, and they refuse to
believe it. All that shows me that you can't ever prove anything
to somebody who doesn't want to believe it. The best you can do
is answer them in public when they float their conspiracy
theories. Which they will surely begin to do when you come up
with studies which do not find what their theories demand.
There's no answer to that but to claim the studies themselves are
crooked. Which is where I'm sure we're headed.
Steve Harris, M.D.
Community Dent Health 1996 Sep;13 Suppl 2:63-68
Water fluoridation and osteoporotic fracture.
Hillier S, Inskip H, Coggon D, Cooper C
MRC Environmental Epidemiology Unit, University of Southampton,
Southampton
General Hospital, UK.
Osteoporotic fractures constitute a major public health problem.
These fractures typically occur at the hip, spine and distal
forearm. Their pathogenesis is heterogeneous, with contributions
from both bone strength and trauma. Water fluoridation has been
widely proposed for its dental health benefits, but concerns have
been raised about the balance of skeletal risks and benefits of
this measure. Fluoride has potent effects on bone cell function,
bone structure and bone strength. These effects are mediated by
the incorporation of fluoride ions in bone crystals to form
fluoroapatite, and through an increase in osteoblast activity. It
is believed that a minimum serum fluoride level of 100 ng/ml must
be achieved before osteoblasts will be stimulated. Serum levels
associated with drinking water fluoridated to 1 ppm are usually
several times lower than this value, but may reach this threshold
at concentrations of 4 ppm in the drinking water. Animal studies
suggest no effect of low-level (0-3 ppm) fluoride intake on bone
strength, but a possible decrease at higher levels. Sodium
fluoride has been used to treat established osteoporosis for
nearly 30 years. Recent trials of this agent, prescribed at
high doses, have suggested that despite a marked increase in bone
mineral density, there is no concomitant reduction in vertebral
fracture incidence. Furthermore, the increase in bone density at
the lumbar spine may be achieved at the expense of bone mineral
in the peripheral cortical skeleton. As a consequence, high dose
sodium fluoride (80 mg daily) is not currently used to treat
osteoporosis. At lower doses, recent trials have suggested a
beneficial effect on both bone density and fracture. The majority
of epidemiological evidence regarding the effect of fluoridated
drinking water on hip fracture incidence is based on ecological
comparisons. Although one Finnish study suggested that hip
fracture rates in a town with fluoridated water were lower
than those in a matching town without fluoride, a later study
failed to show differences. Ecological studies from the United
States and Great Britain have, if anything, revealed a weak
positive association between water fluoride concentration and hip
fracture incidence. Two studies examining hip fracture rates
before and after fluoridation yielded discordant results, and are
complicated by underlying time trends in hip fracture incidence.
Only two studies have attempted to examine the relation between
water fluoride concentration and fracture risk at an individual
level. In one of these, women in a high fluoride community had
double the fracture risk of women in a low fluoride community. In
the other, there was no relationship between years of fluoride
exposure and incidence of spine or non-spine fractures. In
conclusion, the epidemiological evidence relating water fluorida-
tion to hip fracture is based upon ecological comparisons and is
inconclusive. However, several studies suggest the possibility of
a weak adverse effect, which warrants further exploration. Data
on the relationship between fluoride intake and hip fracture
risk at the individual level, and data relating fluoridation to
bone mineral density are required. Until these become available,
the burden of evidence suggesting that fluoridation might be a
risk factor for hip fracture is weak and not sufficient to retard
the progress of the water fluoridation programme.
Publication Types:
Review
Review literature
PMID: 8897754, UI: 97053141
----------
J Dent Res 1985 Nov;64(11):1302-1305
Dietary fluoride intake of 15-19-year-old male adults residing in
the United States.
Singer L, Ophaug RH, Harland BF
The average daily dietary fluoride intakes of 15-to-19-year-old
males were estimated from the analysis of 24 FDA "market basket"
food collections made from 1975 to 1982. The data indicate that
15-to-19-year-old males residing in fluoridated (greater than 0.7
ppm) cities had an average daily dietary fluoride intake of 1.85
mg/day when the diet provided an estimated caloric intake of
11.72 megajoules (2800 calories). In non-fluoridated cities, with
less than 0.3 ppm in the drinking water, the average dietary
fluoride intake was 0.86 mg/day. The beverages and drinking water
contributed an average of 75 +/- 2% of the daily dietary fluoride
intake.
PMID: 3867689, UI: 86141151
----------
Am J Clin Nutr 1985 Oct;42(4):701-707
Dietary fluoride intake of 6-month and 2-year-old children in
four dietary regions of the United States.
Ophaug RH, Singer L, Harland BF
Based upon the analysis of 44 market basket food collections, the
average daily dietary fluoride intakes of 6-mo-old and 2-yr-old
children residing in cities with water fluoride levels of 0.05 to
1.04 ppm were determined. In cities with greater than 0.7 ppm
fluoride in the drinking water, a 6-mo-old child (infant)
and a 2-yr-old child (toddler) had mean dietary fluoride intakes
of 0.418 mg/day (0.052 mg/kg body weight) and 0.621 mg/day (0.050
mg/kg body weight) respectively. The data indicate that the
average dietary fluoride intake of infants and toddlers did not
exceed 0.08 mg/kg, and in all but three cases was within or below
the optimum range of 0.05-0.07 mg/kg. The ingestion of
fluoride-containing dentifrice or milk formula diluted with
fluoridated water may result in intake levels exceeding that
associated with the development of dental fluorosis (0.1 mg F/kg
body wt).
PMID: 4050730, UI: 86022734
----------
ASDC J Dent Child 1984 Sep;51(5):352-355
Urinary fluoride levels of children residing in communities with
naturally occurring fluorides in the drinking water.
Collins EM, Segreto VA
The studies by Dean and others in the 1930's established ex-
cessive fluorides as the causative agent in the mottling of
teeth. Although cultural and dietary patterns have changed during
the past half century, this study suggests that the fluoride
intake has remained relatively constant and generally
proportional to the community's water fluoride level.
PMID: 6592187, UI: 85007717
----------
Am J Clin Nutr 1980 Feb;33(2):324-327
Estimated fluoride intake of 6-month-old infants in four dietary
regions of the United States.
Ophaug RH, Singer L, Harland BF
Eleven composite food groups comprising the infant "market
basket" food collections for 1977 or 1978 from each of four
dietary regions of the United States were analyzed for their
fluoride content. Based upon the determined fluoride content of
each composite and Food and Drug Administration estimates
of food consumption the daily fluoride intake of an average
6-month-old infant residing in each of the dietary regions was
calculated. The daily fluoride intake varied from 0.207 mg/day in
Grand Rapids, Mich. (north central dietary region) to 0.541
mg/day in Orlando, Fla. (south dietary region). Flouride
intakes of 0.272 and 0.354 mg/day were calculated for Philadelph-
ia, Pa. (northeast dietary region) and Los Angeles, Calif. (west
dietary region), respectively. The fluoride content of the water
supplies ranged from 0.37 ppm (Los Angeles) to 1.04 ppm (Grand
Rapids). Drinking water, dairy products and substitutes (other
than milk), and grain and cereal products contributed 44 to
80% of the daily fluoride intake. In three of the four dietary
regions the daily fluoride intake was less than the optimum level
of 0.05 mg/kg body weight.
PMID: 7355802, UI: 80127266
----------
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