Back in 2006 Hamilton held a referendum on the issue of whether or not the city’s water supply should continue to be fluoridated. (We even held a Cafe Scientifique about it.) At that time 38% of eligible voters returned voting papers, & 70% of those voters wanted fluoride retained in our water. So I had a feeling of deja vu when I saw in Friday night’s paper that there is a move afoot among some councillors to have fluoride removed.
There are several things that concern me here. One is that councillors should want to vote on this, rather than hold another referendum, given the fairly solid majority in the previous vote. Another is that the councillor who brought this issue up feels that if a ratepayer referendum should be held, it should be in the absence of any additional information from either side in the debate. (And this is very much presented as a black-&-white question.) How then are ratepayers to make an informed decision? Very few people will have kept any material provided last time, & with the city’s population growth there will certainly be people here now for whom this will all be new. It’s a bit specious to argue that because both sides provided so much information last time, there should be none this time round. Especially because (as you’ll see if you read on) the question is most definitely not black-&-white!
And it’s all very well to say that "even ‘blind Freddy’ recongised it was a matter of when, not if, and [Cr Macpherson] felt the time had come." Why? What made him come to this decision? What new data does he have, that weren’t presented to the population last time? One can only hope that we are not seeing the result of the old ‘arguments’ that the populace is drinking an industrial poison, or drinking acid… (though I won’t be surprised if these make it to the press again shortly).
Yes, there are some interesting & necessary discussions to be held around the fluoridation issue. One – a social & ethical question – is to do with mass medicalisation of the population – treating everyone to minimise harm to a vulnerable sector of that population. (Vaccination would be another example of this.) It’s for this reason that I feel the local council should not be deciding the issue – on way or the other – without first holding a public referendum. Another – the one I’m more interested in here – is to do with some of the scare tactics associated with the ‘debate’, the ones I mentioned above. And these seem to hinge on a misunderstanding of some basic scientific concepts. The fluoride that’s added to our city water supply does come from fluorosilicic acid, and this is a by-product of the fertiliser industry. But – & this is a big but – the quantities necessary to fluoridate water are miniscule: Hamiltonians are not drinking ‘an industrial poison’. And nor are they ‘drinking acid’ (another claim I heard last time round). As for the fluoride ions themselves – fluoride is fluoride, regardless of its source. There is no chemical distinction between fluoride from a ‘natural’ source (weathered from rocks, for example) and the ‘artificial’ source used in treating town supply water.
What is important is concentration – as our original Cafe handout says, any discussion about benefits or toxicity needs to specify the concentrations involved. Typically fluoride concentrations in domestic water supplies are around 1 part per million (1 ppm, or 1 mg per litre). One litre of drinking water will contain about 0.001 g of fluoride anion. And interestingly, analysis of Waikato River water before treatment shows around 0.95 ppm fluoride. During normal flocculaton treatment, fluoride concentrations are reduced to around 0.2 ppm, so lfuoride is added to drinking water to a target level of around 0.8 ppm, as recommended by WHO guidelines – this is slightly less than the original natural level!
But questions do remain about the relative benefits of fluoridating water over the use of, say, fluoride gels and toothpastes. And it would be good to see some solid discussion of this in the local press, before we get to the point of having another go at this decision. As a starting point I’d recommend the Cochrane Library, which has reviews of the effectiveness of fluoridated toothpastes (a ‘yes’) and other topical treatments have been proposed as alternatives to fluoridation of water supply. (One of the underlying reasons for fluoridation is that it offers protection from dental caries to those who, for whatever reason, can’t afford or don’t use these alternatives.) Just in passing, I see that they’re also initiating a review to examine the possibility of links between topical applications of fluoride & the condition known as dental fluorosis.
Anyway – if we are going to revisit this again – please can we manage an informed, and a reasonable, debate?