Barry Cowen (Laois-Offaly, Fianna Fail) | Oireachtas source

In September 2002, the then Minister for Health and Children, Deputy Martin, launched the final report of the Forum on Fluoridation. He had established the forum in May 2000 to independently review the fluoridation of public-piped water supplies, the programme of research being undertaken on behalf of health boards in the area and to make recommendations to the Minister. The forum set out to examine scientific evidence for and against water fluoridation, to look at the best available recognised scientific evidence. That scientific evidence - not anecdotal evidence - led to the primary conclusion of the forum, namely, there are no adverse health effects of water fluoridation at the maximum permitted legal level.

The safety and effectiveness of water fluoridation has also been endorsed by several international and reputable bodies such as the World Health Organisation, the US Centers for Disease Control and Prevention, the US Public Health Service and the United States Surgeon General.

The forum comprised persons with expert knowledge from a diverse range of backgrounds such as public health, dental health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. It took a participatory and evidence-based approach striving to ensure balance between participants from both sides of the debate on water fluoridation. It went out of its way to engage those opposed to water fluoridation.

On an issue that creates strong feelings, it is vital to have responsible and measured debate wholly based on fact and evidence. Thanks to this report, future debate on this issue can be based on data published in scientific literature and subjected to minute scrutiny for accuracy and validation. Accordingly, we can avoid the invalid currency of assumptions and hearsay. This forum demanded scientific proof for every opinion expressed to it. As a result, it produced a credible and valuable report.

The then Minister, Deputy Martin, subsequently established the expert body on fluorides and health in April 2004. It has broad representation from the areas of dentistry, public health medicine, toxicology, engineering, management, environment and the public, as identified within the report on fluoridation. It has a strong consumer input in terms of members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs. The expert body monitors new and emerging issues on fluoride and its effects on health and related matters. It is satisfied, having studied current peer-reviewed scientific evidence worldwide, that water fluoridation causes no ill effects to the health of adults or children. It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and is the safest and most cost-effective method of protecting the oral health of the population.

Water fluoridation is supported by reputable international authorities including, among others, the World Health Organisation. There are several authoritative international reviews of the evidence available, the most recent of which was carried out by the European Commission’s, Scientific Committee on Health and Environmental Risks. It concluded in 2011 that the available evidence did not support a clear link between fluoride and osteosarcoma and cancer in general. Since then, a major study from Harvard University, An Assessment of Bone Fluoride and Osteosarcoma, concluded there is no evidence of a link between fluoride and osteosarcoma.

The results of the study, Drinking Water Fluoridation and Osteosarcoma Incidence on the Island of Ireland, do not support the hypothesis that osteosarcoma incidence on the island of Ireland is related to public water fluoridation. The European Commission’s Scientific Committee on Health and Environmental Risks published its opinion on critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water in 2011. Its main conclusion is there are no known health implications from fluoridating water at levels used in the EU.

Under SI 42, Fluoridation of Water Supplies Regulations 2007, water services authorities are required to arrange for the daily testing of the fluoride content of water to which fluoride has been added. The water services authorities have regard to the code of practice on the fluoridation of drinking water to ensure effective and efficient implementation of the technical aspects of the fluoridation of drinking water. The Health Service Executive, HSE, undertakes monthly sampling of tap water and can access the daily records of the water services authorities if an issue arises regarding fluoridation levels.

The Environmental Protection Agency, EPA, also collects and analyses the monitoring results carried out by water services authorities on drinking water supplies. Its most recent report in 2010 on the provision and quality of drinking water in Ireland includes information on water supplies where fluoride parametric values are exceeded. Of the 3,398 samples from public water supplies which were analysed, 74 were above the Irish statutory requirements of 0.8 mg per litre. All but one of these elevated levels was below the EU standard of 1.5 mg per litre.

Water fluoridation is one of the most widely studied public health policy initiatives in the world. Studies indicate the health benefits of water fluoridation outweigh its costs. To date there has been a significant reduction in the proportion of decayed, missing and filled teeth of people living in areas supplied by fluoridated drinking water when compared to those in non-fluoridated areas. The cost of fluoridation was €3.86 million in 2011. While the Department of Health has not conducted a cost-benefit analysis on this policy, the expert body on fluorides and health, which monitors new and emerging issues on fluoride and its effects on health, advises that water fluoridation is the safest and most cost effective method of protecting the oral health of the population.

I reiterate that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause ill effects and continues to be safe and effective in terms of the oral health of all age groups. As the Minister of State said, other countries that have water fluoridation schemes include the United States, Canada, the United Kingdom, Spain, Australia and New Zealand. Water fluoridation is less common in Europe, but fluoridated salt is often available as an alternative, although some populations are supplied with naturally fluoridated public water. Despite the aforementioned, I welcome the Government's commitment to continuously review fluoridation policy and continue to acknowledge and scientifically analyse the reports and issues that arise regularly regarding those who believe this is not a healthy water treatment method.

I acknowledge the Minister of State's comments on the Department of Health's co-operation with UCC and their ongoing project on children's oral health. I acknowledge his commitment to continuously update and review all scientific reports and recommendations or submissions to the bodies that have responsibility for this issue. I am sure he will honour that commitment and make available to the House the results of any such monitoring to allay the fears of many people who are led by much of what has been produced by parties that do not have the scientific analysis required, expected and provided for by the State in the ongoing review of that policy.

I join the Minister of State in recommending that we do not support the Bill, despite its best intentions. It is a very short Bill which is outlandish in the manner in which it seeks to repeal the legislation of the 1960s and the recommendations made thereafter. It could not be supported by this House. I acknowledge the fears and worries people may have about this issue based on some analysis of the subject, but my party and I are more inclined to respect the authorities, expertise and scientific bodies represented on the State's boards which seek to allay the public's fears.

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