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 ---------- |