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Wednesday, April 25, 2012

Fluoride gets passing grade

Councillor Steve Orser came into the Civic Works Committee on Monday afternoon pumped and loaded for bear. Armed with a petition signed by 1442 London residents requesting the immediate cessation of water fluoridation, he headed straight for the media table to show his ammunition. They opted to wait until he had presented it to the committee.

As soon as chair Harold Usher had completed the preliminaries to open the meeting, Orser broke in with a motion. He wanted to move the staff recommendation, remove the fluoride, and hold a plebiscite on the issue.

The chair was nonplussed. The motion didn’t make sense, as far as he was concerned, since the staff recommendation was to continue fluoridation of the water. How did immediate cessation fit with that? Usher ruled his motion out of order as it was contrary to the staff recommendation which he had put on the floor.

Orser was upset. He was being blocked and he didn’t understand why. “You’re throwing grenades all over here,” he complained to Usher. He just wanted to get things going so that he could “give the information to all the committee.”

It took a while for him to grasp the problem with what he had set forth. He had been pretty revved up, he acknowledged, but now “I’ve got clarity of mind.”

Since no one challenged this statement, he continued that he wanted to set aside the staff recommendation and to recommend discontinuing fluoridation, thereby saving money, realizing environmental benefits and demonstrating confidence in tap water.

In the pause that followed, Usher recognized Councillor Joni Baechler. She wanted something more. 

They needed a strategy involving the Middlesex London Health Unit (MLHU) to provide an alternative to fluoridation. Orser was happy to accept this as a “friendly amendment”, but Baechler suggested that what she was talking about was “much more than a friendly amendment.”

For Baechler, arriving at the position she was about to take had been a “circuitous journey”. She considers herself to be health conscious, she likes to understand what she puts into her body. The loss of family members had made her more aware of the fragility of life and to contemplate her own mortality.

She had spent a lot of time over the past few weeks trying to get some answers on the issue of fluoridation and its health impacts and the certification process. She takes her position on the joint water boards seriously.

She had tried to contact a lot of the organizations that staff had identified in its reports as experts whose opinion could be relied upon. It had not been an easy process. She had been bandied about, referred from agency to agency and not getting any straight answers along the way. She had been in touch with the National Sanitation Foundation (NSF), the Ministry of the Environment (MOE), Health Canada. None could point to any toxicology studies that had been done. All were pointing their fingers at the municipality. The safety of the water, the testing, it was the municipality’s responsibility.

“We are responsible for it” she concluded. “We’ve been relying on the NSF certification, but NSF does only one testing per year. Are we evaluating that product when we receive it?”

She had noted that, when she had made her call, NSF had assumed she was asking about a pharmaceutical grade of fluoride. But the stuff London puts in its drinking water is a by-product of the fertilizer industry, and is shipped in concentrated form from Florida by tanker truck.

Water Quality Manager Dan Huggins was called on to respond. He explained that the MOE regulates fluoridation and NSF looks after all the products that end up in the water. None of the elements—lead, copper, arsenic, etc.—are allowed to reach more than 10% of their maximum allowable to ensure purity of the product. Those standards are based on Health Canada studies and the US Environmental Protection Act (USEPA). Truckload operators have to check the certification but they don’t have to do additional testing.

Baechler wasn’t satisfied. She had requested that the NSF Standard 60 send her the studies but was still waiting for someone to get back to her.  She had received a 2011 report containing fact sheets and procedures but no toxicology studies. It did include two pages of disclaimers and a request that the report not be shared. What she wanted to know was, is the product used by the city a toxic substance?

Acting city engineer, John Braam responded that any chemical in concentrated form is toxic. Huggins pointed out that when the product is diluted 450K to 1, the atoms hydrolyze, separate and become free floating; hydrofluorosilicic acid (HSFA) ceases to exist. NSF looks at all the elements to standards of maximum acceptable concentration set by Health Canada.

But Health Canada doesn’t do independent studies, Baechler noted, just literature reviews of studies done by others, many of which are by the industries which produce the fluoride. And standards have been changed over time; there is more awareness of chemical interactions and there have been reductions in the maximum allowable daily dose.  “NSF doesn’t absolve me of due diligence,” she argued. “We should be testing to see we get what we think we’re getting.”

She wanted to include the need for a strategy for removing fluoride involving MLHU in the motion. She suggested provision of topical applications of fluoride through the Healthy Smiles program.
Orser had unwittingly lost the floor. He used the addition to the motion to reclaim it. The savings from fluoride could be directed oral health, just like what Windsor was proposing, he suggested.

Councillor Sandy White was on the fence. She was being lobbied by poverty groups wanting to keep fluoride in. She didn’t want to make a decision and would rather go to a plebiscite. She was concerned about legal aspects, about liability.

Although he is not on the committee, Councillor Dale Henderson wanted his say. He had made up his mind and he wanted to give his reasons. It was difficult to make out what they were, as he listed a series of issues he had received via emails. He identified chlorine and fluoride, toxic waste, environmental wanting to shut this thing down, can’t control how much people drink, topical application, fluorosis in 1 out of 8 children, kids still suffer from tooth decay, a student’s paper findings were suppressed. “We’re poisoning our water system!” he proclaimed.

Apart from this last statement, it was all pretty incoherent, but he spoke passionately and the anti-fluoride lobby in attendance appreciated it. They gave him a loud round of applause.
Councillor Denise Brown concurred. She had been reading a lot of journals. She had done a lot of work. She wanted fluoride out.

Then it was Councillor Paul Hubert’s turn. “This issue has dogged me for last four or five years,” he acknowledged, but he hadn’t been won over by the lobbyists. What other municipalities had done didn’t matter. What he objected to was the tenor of conversation, talk of conspiracies and poisoning Londoners. The research was difficult but he had actually read the stuff. He gave kudos to Baechler for the hard work she had done, but Henderson and Brown and their reading, where was it coming from? 

“Sort the fiction from the fact,” he urged. None of the members of council had technical expertise to assess the studies; he appreciated Health Canada’s meta-analysis. He wouldn’t support the discontinuation of fluoridation at council where he would have a vote. His decision would be evidence-based.

Seeing no other speakers, Usher took his turn. He had read all the emails and the comprehensive staff report, he assured the committee. He was supportive of the staff recommendation. He was convinced that “If you don’t have fluoride in the water, you’re going to have problems with cavities.”

Medical Officer of Health Dr Graham Pollett was asked to respond to the alternatives to fluoridation being proposed. A proponent of fluoridation, he pointed out that existing dental health programs are not universal and have strict income thresholds. He stressed that cost savings shouldn’t be the turning point for this discussion.

It was time to vote. The motion to discontinue fluoridation lost on a vote of 2-3, with Usher, White and Paul VanMeerbergen in opposition.

VanMeerbergen, who had remained silent to this point, moved the staff recommendation. He pointed out what was already contained therein, that 90 national and international agencies had loaned their support. Who were councillors to question their assessments?

White wanted to add the provision of a plebiscite, but VanMeerbergen pointed out that the public is in no better position to question the experts who “are saying unanimously to continue.”

This statement resulted in an uproar in the audience. Most of them could point to dissenting viewpoints from legitimate authorities.

Orser wanted everyone to know that he had talked to a lot of people about this, not just “wingnuts”. 

He appealed to the committee, and if truth be told, to the audience he was courting, on behalf of his daughter, his little girl. He wants to be able to tell her that the city is no longer trying to poison her. He gave her name. More applause.

The motion to approve the staff report and its recommendation to continue fluoridation passed with White and Usher supporting VanMeerbergen’s motion. White’s suggestion for a plebiscite failed as only she and Orser supported it.

So it seems that the push to eliminate fluoride from the water supply will not be realized although it is still another week before council makes its final decision.

In the meantime, I was interested to read the following statement from Sheldon Thomas, retired Manager of Water Distribution for the City of Hamilton at a recent Board of Health meeting. 

You may find it interesting too.


Why's woman said...

Hi Gina,
As always, thanks for the notes-not-formal-minutes reporting on this.

This is a topic I've never delved into ... but I've just read the first section of Sheldon Thomas' submission to Hamilton Council... and I'm shooken (as my Mum used to say).

This morning I have an appointment at the Western (Schulich) Dental Clinic. After the session I'm going to ask my student some questions about the information they receive in school. It'll be my research contribution.

Best regards,

Why's Woman

Anonymous said...

and to confuse the situation even more...Americans and Canadians use a different system of calculating parts per measure.
A cup=8oz.
Maybe we've been supersized.

Barry Wells said...

50 Reasons to Oppose Water Fluoridation: http://www.altlondon.org/article.php?story=20120424161615594

Anonymous said...

probably the best article on the issue from both sides is:


Kathy Clee said...

If council approves Joni's suggestion of vending machines such that the gallery can obtain refreshment during long meetings, it would be most appropriate, I suspect, if they start with a popcorn machine.

Tony Huys said...

I much appreciate your blog and recommend it to any who wish to have a sense of what goes on at city hall. I have tried, but apparently without success, to register so that I can respond when the spirit moves me, but I appear to lack the requisite e-skill.

On the subject of fluoridation, allow me this. I started teaching in London elementary schools about the same time fluoridation was introduced and probably some years before a good number of its current critics can recall. At the time the public health department was providing a much more extensive dental health service for children. Within a very few years the consistent comment from health care workers in the schools noted a dramatic improvement in dental health among young children. I have had much occasion to summer in a rural east-coast community the past number of years and continue to be struck by the terrible dentition so very much in evidence. I cannot help but wonder how fluoridation might have helped there - anecdotal cause to pause.

In addition, I have heard no plausible response to three concerns.
In the years since the introduction of fluoride in London water, the cost of dental care has grown so dramatically that a return to the kind of public dental health program then in place would today be judged prohibitive.
This same cost factor would be prohibitive for a great many London families and there is no doubt that the children of the poorest, and of families without the security of a full and dependable benefit package would suffer disproportionately.
We have no proven realistic and cost-effective alternative to put in place. Fluoridation may not be perfect, but I dare say that until we have a proven improvement, changing the status quo would be to put the horse before the cart.

It is somewhat reassuring to note that current criticism by and large avoids the most absurd hyperbole and claims of communist plots to poison us all. However, I cannot help but feel that it lacks historical perspective and is propelled to a significant degree by the first generation to view dental health as somewhat of a given. It wasn't always so. A good many of my parents' generation were reconciled, often to their great relief, to dentures by middle age. It seems reckless to shake what is a most likely pillar of the very significant progress in such a relatively few years.