I move: "That the Bill be now read a Second Time."
I will set the Bill in context. Next January it will have been 50 years since a woman named Gladys Ryan took a case regarding fluoridation to the High Court on the basis that citizens had no choice other than to drink medicated water. As the coming year will see another woman take a case to the High Court for the same reason, it would be a fitting tribute to Gladys if the Government supported the Bill before the House and ceased the mass fluoridation of the public water supply. After 50 years it is surely time to stop the fluoridation of public drinking water.
I have no doubt that when the Government of the day first introduced fluoridation in the 1960s, it may have believed it was acting for the correct reasons. According to a 2002 report for the forum on fluoridation, the fluoridation process was introduced as it was considered to be "a much cheaper" way of improving the quality of children's teeth than employing more dentists. Ethical approval was given by no less than the Guild of Saint Luke, Saint Cosmas and Saint Damian which had been established by the Catholic Archbishop of Dublin, John Charles McQuaid. This led to the Health (Fluoridation of Water Supplies) Act 1960 which mandated compulsory fluoridation by local authorities. In 1965 the legacy of mass medication of the population began.
Fluoridation was introduced at a time when tooth decay was a significant health issue, representing a cheap way to deal with a widespread problem, especially among poor and marginalised people. The Department of Health has never conducted any research on the health effects on the population of mass fluoridation in the intervening period, despite the fact that this was stipulated in the 1960s legislation.
The argument today is that there is no longer a requirement within the scope of public health for continued water fluoridation. The need for fluoridation - if there ever was a need - has been entirely negated by modern use of fluoride toothpaste which ensures a more than adequate supply of fluoride for the purpose of improving dental health. We also have improved dental services. In my constituency of Laoighis-Offaly, particularly County Laois, children do not see a dentist until they are 12 years old, which is scandalous. The matter must be addressed by the Department. It is a number of years since I was at school, but I recall seeing a dentist in primary school when we were eight years old. We could redirect the money used on fluoridation in the provision of proper dental health care for children.
A 2001 report in the United States detailing recommendations on using fluoride to prevent and control dental caries claimed that earlier studies from the 1950s indicated that water fluoridation had led to a reduction of 50% to 60% in childhood cavities. More recent studies, however, indicate a much lower rate of 18%. There is no need to swallow fluoride in order to protect teeth and dentures. The purported benefits of fluoride are topical - they are on the surface - but the risks are systemic. Therefore, it makes more sense to deliver fluoride directly to the tooth in the form of toothpaste. Swallowing fluoride is unnecessary and potentially dangerous; therefore, there is no justification for forcing people to consume fluoride through the water supply. Fluoride toothpaste is the most widely used and rigorously evaluated fluoride treatment and a report entitled, Oral Health in the United States: The Post-Fluoride Generation, states the introduction of fluoride in the early 1970s is considered to be the main reason for the decline in tooth decay in industrialised countries and toothpaste appears to be the single common factor in countries where tooth decay rates have declined.
I will move to the side effects of fluoride. Fluoridation of the water supply leads to fluoride accumulating in the body. Healthy adult kidneys - many people's kidneys are not healthy - only excrete 50% to 60% of the fluoride ingested each day, with the remainder accumulating in the body, largely in calcifying tissue such as bones and the pineal gland. Infants and children excrete less from their kidneys and retain up to 80% of ingested fluoride in bones. The fluoride concentration in bones steadily increases over a lifetime. The World Health Organization stated in 2006 that "excessive exposure to fluoride in drinking water can give rise to a number of adverse effects". These range from mild dental fluorosis to crippling skeletal fluorosis as the exposure increases. Dr. Robert Bolan claims that "recent studies show that brain adult exposure to fluoride induces central nervous system disturbance." He has also linked exposure to fluoride with the risk of developing Alzheimer's disease and osteoarthritis. Meanwhile, the Russian Academy of Sciences, the British Medical Research Council, the NHS York review, the USA Academy of Sciences and the European Commission have all detailed concerns.
Right across Europe countries have ceased the practise of the fluoridation of water such that 98% of Europe's population no longer drink fluoridated water. This is the only country with a state-wide policy of mandatory fluoridation and local authorities cannot make the decision to stop the process. Many local authorities have approved motions to seek to stop the process, but they have been told it is not possible for them to do so. Most countries in Europe have experienced substantial declines in cavities without the use of water fluoridation. For example, in Finland and Germany tooth decay rates remain stable or continued to decline after water fluoridation stopped. A pan-European report entitled, Community Water Fluoridation and Caries Prevention: A Critical Review", indicates:
The caries reduction directly attributable to water fluoridation has declined in the last decades as the use of topical fluoride has become more widespread, whereas enamel fluorosis has been reported as an emerging problem in fluoridated areas. Several studies conducted in fluoridated and non-fluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has become low.
Report after report has confirmed that where fluoridation has been discontinued in communities in Canada, the former East Germany, Cuba and Finland, dental decay has not increased but has generally continued to decrease. In 2001 the World Health Organization stated fluoridation was an effective way to prevent tooth decay in poor communities. It stated:
In some developed countries, the health and economic benefits of fluoridation may be small, but particularly important in deprived areas, where water fluoridation may be a key factor in reducing inequalities in dental health.
The Minister of State might use that line to make a different point, but what the WHO is really talking about is communities where fluoridated toothpaste is not available or not used to a great extent. That is similar to the situation in Ireland 50 to 60 years ago when fluoridated water was being considered and fluoridated toothpaste was not widely available or used. Ireland has moved on, yet the Government has not. It is sticking to its policy of fluoridation from a bygone era. Sweden had an official commission which published its final report in 1981 and recommended other ways to reduce tooth decay by improving dietary and oral hygiene habits instead of fluoridating tap water. Arvid Carlsson, winner of the 2000 Nobel prize for medicine, took part in the debate in Sweden, where he helped to convince parliament that fluoridation should be illegal for ethical reasons. He believed that it violated modern pharmacological principles, which indicate that medications should be tailored to individuals. The key point is that the effectiveness of water fluoridation declines where a country improves its dental care, increases the use of fluoride toothpaste and when the population improves its dietary intake.
The Commission for Health and Consumers in the European Union stated, "People do not need fluoride for normal growth and development". The European Court of Justice has defined fluoridation as a medication and refused to sanction its implementation. Mass fluoridation violates Article 35 of the European Charter of Fundamental Rights, under which article the right to health care includes the right to refuse health care, for whatever reason. It establishes the individual's right to receive particular drugs or treatments or to prevent him or her from having such treatment administered against his or her wishes. The use of fluoridation chemicals to medicate the public indiscriminately violates the code of medical ethics set out in the Council of Europe's Convention on Human Rights and Biomedicine. The convention establishes a valid code of medical ethics and is widely accepted throughout Europe. The failure of the Government to subscribe to it does not render its provisions invalid, as all such national codes should comply with the principles set out in it. States may not medicate any individual, except under exceptional conditions of recognised public health emergencies. All medical interventions must be carried out under proper medical supervision and in accordance with the patient's needs and fully informed wishes.
There has been a lack of debate in the State on the matter. It appears that the State is incapable of having a healthy debate on this matter, if Members will pardon the pun. In 2000 the forum on fluoridation was established by the then Fianna Fáil Minister for Health, Deputy Micheál Martin. The Food Safety Authority of Ireland, FSAI, drafted a risk assessment on the presence of fluoride in tap water used in infant formulae. The document, according to the chairperson of the FSAI's scientific committee, Mr. Wayne Anderson, was submitted on 18 October 2001. He wrote on 26 October 2001:
Since the document was tabled and members of both committees have had a chance to see the final document, two issues have been raised. One concerns the toxicology and the appropriateness of the NOAEL [a test] and other concerns the risk characterisation and the issue of repeated exposure over time.
Because of time restraints the risk assessment had to be withdrawn. Therefore, there was no mention of a risk assessment in the final report of the forum on fluoridation to the Minister. The final report noted that all of the benefits of fluoride were topical and that all of the risks were from swallowing it. It stated: "Although the predominant beneficial effect of fluoride occurs locally in the mouth, the adverse effect, dental fluorosis, occurs by the systemic route". In other words, a problem arises when fluoride is ingested.
While still in opposition the then Green Party Deputy John Gormley compiled a report on fluoridation in 2007. He now claims that the report was buried by the Joint Committee on Health and Children which had commissioned it. Had its recommendations been acted upon, we might not be having this debate today. The Government's own expert panel has no toxicologist on it. The chairperson of the panel has been a long-time vocal advocate of mass fluoridation. Therefore, it is by no means independent and its expertise does not include a toxicologist, which gives rise to questions. Despite the lack of a credible Government review and quashed reports and in the face of overwhelming evidence to the contrary, the Government continues to impose fluoride on 4.6 million people at a cost of €4.8 million to purchase the product, an unknown amount to administer it and in operational costs to local authorities in monitoring it and ensuring it is correctly added to the water supply.
This is not a party political issue. Sinn Féin has tabled the Bill, but Members of all parties to whom I have spoken privately have expressed concern. I also spoke to councillors from a Government party last night who were opposed to fluoridation. We are all being slowly poisoned by the use of fluoride in the water supply. It is an issue that affects the vast majority of households in the State and I urge the Minister to revisit the matter. Fifty years of fluoridation is sufficient. I wish to focus on what the scientific committee stated at the time of the 2001 report. It agreed that the precautionary principle should apply and, in the case of infant formulae, recommended that it not be reconstituted with fluoridated tap water. The evidence is stacking up and the case against mass fluoridation is overwhelming. The pro-fluoridation lobby has not been able to justify its continuation. I appeal to the Government to at least commence a debate on the issue, examine it and allow the Bill to go through to the next Stage. I hope we can re-examine the matter and take a more sensible approach.
