Submission on the Health (Fluoridation of Drinking Water) Amendment Bill

Introduction

The Soil & Health Association of New Zealand Inc. (“Soil & Health”) was incorporated under the Incorporated Societies Act 1908 on 4 December 1942. Soil & Health’s objectives broadly include soil health and the promotion of organic gardening and farming. Its membership is chiefly composed of home gardeners and consumers, organic farmers and growers, secondary producers, retailers and restaurateurs. Its age and membership make it the oldest and largest representative organic organisation in New Zealand.
Soil & Health is aware that currently in New Zealand around 60% of public water supplies have fluoride added as a treatment for dental decay. We are also aware that there is conflicting evidence on the benefits of water fluoridation to dental health and that there is growing medical concern about the cumulative negative wider health impacts of ingestion of fluoride and its adverse effects on the environment. The main chemicals used to fluoridate drinking water are known as silicofluorides. These fluorides are not pharmaceutical-grade fluoride products but unprocessed toxic industrial chemical by-products of the phosphate fertiliser industry.

As an organisation that advocates for organics we are opposed to the use of toxic chemicals in New Zealand. We are therefore opposed to the artificial fluoridation of public water supplies. We believe that adding fluoride to local body water supplies is a form of forced medication and therefore is a breach of section 10 of the Bill of Rights Act 1990. We strongly believe that individuals should have a right to choose whether they want to ingest fluoride or not. We believe that dental health is best achieved through a healthy diet and eating fresh, wholesome organic foods.

Detailed submissions

The role of the DHBs and local democracy

The Health (Fluoridation of Drinking Water) Amendment Bill (“the Bill”) was introduced to Parliament in order to enable District Health Boards (“DHBs”) rather than local councils to decide whether community water supplies are fluoridated “with the intention that the change would benefit over 1.4 million New Zealanders who live in areas where networked community water supplies are not currently fluoridated.”[1] This Bill therefore is fundamentally about facilitating the roll out of fluoridation of community water supplies across New Zealand. The Bill itself states in its Explanatory Note that: “Transferring decision-making to DHBs is expected to enable extended fluoridation coverage”.[2]
The Regulatory Impact Statement says: “The Ministry of Health has considered a range of options for managing fluoridation and increasing the proportion of the population having access to fluoridated water supplies.”[3] We argue that “having access” implies having a choice. Under the Bill however there will not be a choice and in fact the Bill is about removing the ability for local communities to have a say on fluoridation. The Bill is therefore dishonest.
It has been argued in the first reading of the Bill that democracy is upheld because the DHB’s have locally elected representatives, and are better placed to make decisions about the health benefits and risks of fluoridation. Part 1 Clause 8(2) of the Bill however sets out only two things the DHBs must consider when making a decision on, which are:

(a) the scientific evidence on the effectiveness on dental health; and

(b) whether the benefits outweigh the costs.

There is no provision for the DHBs to take on board community views, nor to assess health risks or environmental effects. Nor can the DHBs go against Ministry of Health objectives.

The process as it currently exists for considering fluoridation enables local decision making amongst the communities affected. All residents of local councils who want to participate in the process can voice their opinion and a council decision can be appealed in court – as has recently happened in the case of Health New Zealand Inc v South Taranaki District Council.[4] Transferring the decision making from councils to DHBs will effectively remove the ability of communities to be fully involved in the investigation and reporting of any health, community or ecological impacts.

We consider that the DHBs are also less representative of communities than councils because they are not independent. Under the New Zealand Health and Disability Act 2000 DHB’s “must pursue its objectives in accordance with any plan prepared under section 38, its statement of intent, and any directions or requirements given to it by the Minister”[5] and “The Minister may give a direction to all DHBs to comply with stated requirements for the purpose of supporting government policy on improving the effectiveness and efficiency of the public health and disability sector.”[6]

The toxicity of fluoride

The type of fluoride that is added to drinking water is not naturally occurring calcium fluoride, or even pharmaceutical grade sodium fluoride.[7] It is a contaminated chemical by-product of the phosphate fertilizer manufacturing process, known as hydrofluorosilicic acid (“HFA”).[8] It is concentrated, highly toxic and contains hazardous impurities. Due to it’s toxicity by law it cannot be dumped onto the land, into rivers or the sea and cannot be discharged to air. Uranium and radium are found in HFA, both of which are known carcinogens. Two decay products of uranium are even more carcinogenic: radon-222 and polonium-210. Polonium decays into stable lead 206, raising significant health risks, especially for children. Research has shown that drinking fluoridated water increases lead absorption.[9]

New Zealanders are already ingesting elevated levels of fluoride from plants and animals raised on land treated with phosphate which contains naturally occurring fluorides and many people already manifest dental symptoms of fluorosis – fluoride overdose. Further there is no antidote for fluoride toxicity and fluoride does not absorb to activated charcoal in filters.[10]

A further concern is that the Bill’s is sole focus is on dental health with no requirement for the DHBs to assess risk to other parts of the body such as kidneys, liver, brain and thyroid.

Fluoride in the environment

Fluoride ions are directly toxic to aquatic life, and accumulate in the tissues, at concentrations where absorption rates exceed excretion rates.[11] In a scientific journal article titled ‘Fluoride toxicity to aquatic animals’ Julio A. Camargo states how even at concentrations as low as 0.5 mg F⁻/l fluoride in soft water can adversely affect invertebrates and fishes. Camargo further states that “safe levels below this fluoride concentration are recommended in order to protect freshwater animals from fluoride pollution.”[12] There are other studies that indicate levels below water fluoridation level, 1.5ppm, have lethal and other adverse effects on fish. Delayed hatching of rainbow trout has occurred at 1.5ppm6, brown mussels have died at 1.4ppm7; an alga (Porphyria tenera) was killed by a four-hour fumigation with fluoride with a critical concentration of 0.9ppm 8, and levels below 0.1ppm were shown to be lethal to the water flea, Daphnia magna.[13]

Only 1% of water from community water supplies is ingested by humans, the remaining 99% is discharged into the environment via the wastewater systems. Fluoride is not filtered out by wastewater plants. In 2015 an investigation found that approximately half a tonne of HFA is discharged every year into Lake Taupo via the Hangarito stream from the township of Turangi alone.[14] The safety datasheet for HFA by Orica states it is an exotoxin and to avoid discharge to waterways. New Zealand waterways are already in a dire state with a staggering 62% of monitored waterways being unsafe for swimming. Increasing the amount of fluoridation in local body water supplies will only make this worse.

Of concern for the Bill is that transferring the decision making to the DHBs will mean that environmental effects of fluoride will no longer be taken into account. The DHBs role is to deliver public health services, not to take into account environmental effects. Whereas councils can assess environmental effects when considering fluoridation, DHBs cannot, because their statutory role is restricted to the delivery of health services.

The need for a precautionary approach

Principle 15 of the Rio Declaration mentions the precautionary approach as follows:

“In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation”

The precautionary approach has been considered a milestone in its ability to reduce environmental risk as it involves an anticipatory preventative action in response to uncertainty. In its use public authorities are not only required to anticipate possible adverse effects that could arise from activities but also to act to control the risks even when it is still uncertain whether adverse effects will occur.

A report compiled in 2013 for the Government of Ireland, the European Commission and the World Health Organisation titled ‘Public Health Investigation of Epidemiological Data on Disease and Mortality in Ireland related to Water Fluoridation and Fluoride Exposure’ found that public health authorities have pursued a policy of medicating the population with fluoridation chemicals for half a century without undertaking any clinical trials, medical, toxicological, scientific or epidemiological studies to examine how exposure to such chemicals may be impacting on the general health of the population. The report concludes that in the absence of any scientific data proponents of water fluoridation continue to believe that the policy is both safe and effective for all sectors of society regardless of the age, nutritional requirements, medical status or total dietary intake of fluoride of individuals.[15]

While studies have shown that a lifetime exposure to fluoride can lead to health risks, especially to those with challenged immune systems and the young and the elderly, [16] it is still unknown at what point HFA causes harm. Our health authorities in New Zealand have not yet found the real safe level to protect sensitive groups, particularly people with kidney disease, diabetes and bottle-fed babies. No safety studies have ever been conducted anywhere in the world.

Soil & Health strongly endorses a precautionary approach to fluoridation of local body water supplies at all levels of government and regulation. Due to the uncertainties of the safety of water fluoridation we consider that applying the precautionary approach should involve a moratorium on the fluoridation of local body water supplies until further research is undertaken.

Conclusion

As set out above Soil & Health opposes the introduction of the Bill. Under the Bill local decision making will be removed, making fluoridation of local body water supplies easier to implement. A number of independent scientific studies have raised serious concerns about the adverse effects that HFA has on human health and the environment.

We consider that to transfer decision making to the DHB’s the government is showing disregard for appropriate decision making, especially when any risk for those affected is not required to be assessed, nor can the DHBs assess environmental effects or go against Ministry of Health objectives.

We urge the select committee to apply the precautionary approach and implement a moratorium on the fluoridation of local body water supplies until an ‘independent’ review of its effects on human health and the environment is undertaken.

Soil & Health wish to be in heard in support of our submission.

Yours sincerely

Name: Mischa Davis

Position: Policy Advisor

The Soil & Health Association

PO Box 340002

Birkenhead

Auckland 0746

Phone: 0212667754

Email: advocacy@organicnz.org.nz

Website: www.organicnz.org.nz

[1] Background to Bill https://www.parliament.nz/en/pb/bills-and-laws/bills-digests/document/51PLLaw24221/health-fluoridation-of-drinking-water-amendment-bill

[2] Page 1 the Bill.

[3] Page 1 Regulatory Impact Statement.

[4] New Health New Zealand Inc v South Taranaki District Council – [2014] NZHC 395

[5] Section 22 (2).

[6] Section 33B (1).

[7] https://www.cdc.gov/niosh/ipcsneng/neng1233.html

[8]http://www.waternz.org.nz/Folder?Action=View%20File&Folder_id=315&File=140604_nzwwa_f_gpg_revision_final.pdf

[9] http://cof-cof.ca/wp-content/uploads/2012/08/Masters-Coplan-Water-Treatment-With-Silicofluorides-And-Lead-Toxicity-International-Journal-Of-Environmental-Studies-1999.pdf and https://www.ncbi.nlm.nih.gov/pubmed/17420053

[10] http://emedicine.medscape.com/article/814774-overview

[11] http://www.env.gov.bc.ca/wat/wq/BCguidelines/fluoride/fluoridetoo-04.html

[12] http://www.sciencedirect.com/science/article/pii/S0045653502004988

[13] Dave G. Effects of fluoride on growth reproduction and survival in Daphnia magna, Comparative Biochemistry and Physiology, 78c (2)