RESPONSE FROM FLUORIDE FREE NZ – ASA COMPLAINT 18/291

DESCRIPTION OF ADVERTISEMENT

RESPONSE

We have been asked to respond to this complaint under the following codes:

Code of Ethics – Basic Principle 4

Code of Ethics – Rule 2

Code of Ethics – Rule 6

Code of Ethics – Rule 11

 

Code of Ethics

Basic Principle 4: All advertisements should be prepared with a due sense of social responsibility to consumers and to society.

Rule 2: Truthful Presentation Advertisements should not contain any statement or visual presentation or create an overall impression which directly or by implication, omission, ambiguity or exaggerated claim is misleading or deceptive, is likely to deceive or mislead the consumer, makes false and misleading representation, abuses the trust of the consumer or exploits his/her lack of experience or knowledge. (Obvious hyperbole, identifiable as such, is not considered to be misleading).

Rule 6: Fear Advertisements should not exploit the superstitious, nor without justifiable reason, play on fear.

Rule 11: Advocacy Advertising Expression of opinion in advocacy advertising is an essential and desirable part of the functioning of a democratic society. Therefore, such opinions may be robust. However, opinion should be clearly distinguishable from factual information. The identity of an advertiser in matters of public interest or political issue should be clear.

Preamble
We note the complainants accept that fluoride is neurotoxic but make the unsubstantiated assertion that the amount ingested in fluoridated communities is insufficient to cause this. The scientific research presented at this talk demonstrates that it is. 

We note that it is not required that this be proven “Beyond reasonable doubt” or “with absolute scientific certainty”. The half-life of medical-scientific knowledge is currently about 5 years (That is, in 5 years half of everything doctors are taught today will be superseded). Science is never settled.

The Supreme Court (SC 141/2016 [2018] NZSC 59) cited with approval the position of the Canadian Supreme Court (emphasis added): 

[118] In terms of the standard of proof, … [i]n Atkinson, the Court of Appeal discussed the debate about the evidential requirements of the R v Oakes test used by the Supreme Court of Canada, citing an extract from an article by Professor Choudhry which acknowledges that public policy decisions are often based on approximations and extrapolations from the available evidence.112 The Court in Atkinson also referred to the Canadian Supreme Court decision in RJR-MacDonald Inc v Canada, citing a passage from McLachlin J’s reasons where she stated that “proof to the standard required by science is not required”, rather “the balance of probabilities may be established by the application of common sense to what is known, even though what is known may be deficient from a scientific point of view” 

As shown by the evidence presented by these scientists, discussed below, the weight of evidence that fluoride lowers IQ when consumed at the levels it is in fluoridated communities in NZ today is now well past the “balance of probabilities” test. Accordingly, we would be entitled to state it as fact under the Supreme Court’s ruling (although we do not consider we have done so in this case). 

We now wish to address the false claim by the complainants that “the majority” agree that fluoridation is safe and effective and our claims are those of a minority. On the global scale, the situation is the exact reverse. If the complainants were to proclaim in Germany, France, Sweden, or one of a countless number of other countries, that fluoridation was “safe and effective” they would be ignored as ill-informed. It is only in a handful of countries, such as NZ, Australia and the USA, that this view is the “consensus reality”.

We raise this to ensure the ASCB does not start from a predetermined position on whether fluoridated water is safe or not.

Basic Principle 4  – Due sense of social responsibility
Complaint relating to Basic Principle 4
Complainant Number 1: “The only point to an advertisement like this is to spread fear and distrust of our institutions”

Response from FFNZ
The point of our advertisement was to encourage people to attend the presentations given by world experts on fluoride and let people know that neurological harm from fluoride was the main topic of discussion. We also wanted members of the public who would not attend, to be alerted to the fact that fluoride has been found to be a neurotoxin, at the levels we are exposed to in fluoridated NZ communities, according to now-irrefutable scientific research.

The Bashash study from Mexico last year, and a study from Canada this year, confirm levels of fluoride able to affect neurological development are experienced in fluoridated areas.
We feel a social responsibility to let people know so they are aware and can take steps to avoid fluoride as much as possible. We are especially concerned about children being exposed in utero and the first years of life.Therefore, our advertisement does not breach Basic Principle 4 as we did prepare the advert with a sense of social responsibility.

 

Rule 2: Truthful Presentation

Complaints pertaining to Truthful presentation

Complainant Number 1: “Like all things poisonous, dosage is the most important factor in determining how poisonous a thing is. A thing which is beneficial at a low dosage may be poisonous at a large dosage.”

Complainant Number 2: “The add suggests that Fluroide is poisonous, and that that there is either uncertainty or concern in the medical community about the safety of Fluroide. Fluroide has been repeatedly been proven to have a positive impact on community health…”

Complainant Number 3:“The claim that “Fluoride is a Neurotoxin that Reduces Children’s IQ” is completely unsubstantiated and has no scientific backing in the credible academic literature”.

Complainant Number 4: “..as such claims are completely unsubstantiated..”

Complainant Number 5: “ .. the levels of flouride in NZ water do not pose serious concerns ..”

Complainant Number 6: “..misleads consumers by exaggerating the neurological effects of fluoride on children…”

 

Response from FFNZ

The 53 Human Studies

There are now 53 human studies out of 60 that have found that fluoride is a neurotoxin. There are also hundreds of animal studies.

In 2006 the US Government’s National Research Council produced a Report Fluorides in Drinking Water[1]. This was a 12-member, three-year review and is still the most comprehensive review of fluorides in water to date.

This panel concluded that “it is apparent that fluorides have the ability to interfere with the functions of the brain”. At this stage there were only five published studies.

By 2012 there were 27 studies. A team of researchers from Harvard then published a meta-analysis[2] of these in Environmental Health Perspectives. Twenty-five of the studies were from China and two from Iran. The Harvard team acknowledged that there were weaknesses in many of the studies. However, they stressed that the results were remarkably consistent. In 26 of the 27 studies average IQ in the “high fluoride” village was lower than the “low fluoride village “. The average loss was 7 IQ points.

 

New Zealand Report

In 2014, a review commissioned by the Prime Minister of NZ’s Chief Science Advisor Sir Peter Gluckman and the Royal Society of New Zealand’s president Sir David Skegg, Health Effects of Water Fluoridation: a Review of the Scientific Evidence[3], concluded:

“Recently there have been a number of reports from China and other areas …that have claimed an association between high water fluoride levels and minimally reduced intelligence (measured as IQ) in children.…the claimed shift of less than one IQ point suggests that this is likely to be a measurement or statistical artifact of no functional significance”

However, they had incorrectly interpreted the figure of 0.45 as less than one IQ point, whereas, it was less than one standard deviation. See Table 1 below. When this error was pointed out to the authors, they changed the premise but did not change the conclusion.

“Recently there have been a number of reports from China and other areas …that have claimed an association between high water fluoride levels and minimally reduced intelligence (measured as IQ) in children.…the claimed shift of less than one standard deviation suggests that this is likely to be a measurement or statistical artifact of no functional significance”.

This will no doubt have led many people in New Zealand to believe there was no reported drop in IQ, when in actual fact these studies did show an average drop of 7 IQ points. A drop of 5 IQ points across society will halve the number of geniuses and increase by 50% the number of mentally impaired. This is not a “minimal reduction” and it is definitely of “functional significance”.

 

Table 1

The Lancet
In 2014 a study Neurobehavioural effects of developmental toxicity[4]  identified fluoride as “an emerging developmental neurotoxin”. The authors say “In 2006, we did a systematic review and identified five industrial chemicals as developmental neurotoxicants: lead, methylmercury, polychlorinated biphenyls, arsenic, and toluene. Since 2006, epidemiological studies have documented six additional developmental neurotoxicants—manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene, and the polybrominated diphenyl ethers.”
 

Broadbent et al

By 2016 there were 55 human studies with 49 showing a lowering of IQ in high fluoride villages. One of the six studies that did not find an association was the Broadbent study[5] from Dunedin. However this study reported very few controls: 891 lived in fluoridated area, and only 99 in non-fluoridated. In an article for the Government’s National Fluoridation Information Service[6], Broadbent admitted that 46 of the children in the nonfluoridated area were taking fluoride supplements, bringing their control down to only 53 compared to over 900 (taking fluoride supplements results in the same level of fluoride as drinking fluoridated water). This study did not allow for maternal IQ, the biggest known predictor of IQ, nor maternal exposure to fluoride, as we will see may be the most important aspect. Note also that this study was conducted by dentists, not neuroscientists. Dr Broadbent was fluoridation spokesperson for the NZ Dental Association at the time.

 

Bashash 2017

In September 2017, a landmark IQ study, Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12 Years of Age in Mexico[7], was published in Environmental Health Perspectives, the world’s leading environmental health science journal.

The funding agencies for this study were U.S. National Institutes of Health (NIH), U.S. National Institute of Environmental Health Sciences (NIEHS), U.S. Environmental Protection Agency (EPA), National Institute of Public Health, and the Ministry of Health of Mexico.

This study was completed by a team of distinguished neurotoxicity researchers who have produced over 50 papers on the cognitive health of children as related to environmental exposure to other toxins like lead and mercury. The researchers were from highly respected Universities in North America such as Harvard, Toronto, McGill and Michigan and Public Health in Mexico.

The study reported that for every 0.5 mg/L increase of fluoride in the urine of the mothers there was a statistically significant decrease in average IQ of the children of about 3 IQ points.

Therefore, a fluoride level increase in urine of 1 mg/L could result in a loss of 5 – 6 IQ points. This is particularly relevant to the New Zealand situation where fluoride urine levels[8] have been found to be in exactly the same range as the Mexican women.

The lead investigator had this to say: “This is a very rigorous epidemiology study. You just can’t deny it. It’s directly related to whether fluoride is a risk for the neurodevelopment of children. So, to say it has no relevance to the folks in the U.S. seems disingenuous…” – Dr. Howard Hu, Dean of the Dalla Lana School of Public Health at the University of Toronto on Bashash et al. (Sept 2017).

 

Relating Bashash to NZ

The range of urinary fluoride levels in the Mexico City pregnant women are almost identical to the range found in Palmerston North by Brough et al, 2015

The exact median and quartile values for Bashash are 0.82 (0.64, 1.07) mg/L urine F.

Brough found a median concentration of 0.82 (0.62, 1.03) mg/L urine F.

Note the numbers in parenthesis are the 25th and 75th Inter-Quartile percentile values

The exposures in the Bashash study are about as similar to those in New Zealand as you could get.

 

Canadian study has confirmed Bashash

On the 28th of August 2018, a study was presented at the ISES – ISEE Joint Annual Meeting in Ottawa, Canada[9]. This study was carried out using data from pregnant women in Canadian towns and cities both fluoridated and not. They have found the same results as the Bashash study.

It is expected that this study will be published in the next few months.

 

Conclusion

Our statement that fluoride is a neurotoxin that reduces the IQ of children is true according to the current scientific research, certainly to the balance of probabilities as set by the NZ Supreme Court.  The latest science is finding that this effect is happening at the doses that we are exposed to in fluoridated communities. Therefore, our advert does not contravene Rule 2 Truthful Presentation, as it is indeed the truth.

To summarise the facts in relation to the specific claims by the complainants as noted above:

Complainant Number 1: “Like all things poisonous, dosage is the most important factor in determining how poisonous a thing is. A thing which is beneficial at a low dosage may be poisonous at a large dosage.” 

 

Response:

We agree. The science shows that fluoride is neurotoxic at the doses experienced in fluoridated NZ communities. (There is no reliable evidence that fluoride at any level of ingestion is beneficial – Cochrane Review 2015).

 

Complainant Number 2: “The add suggests that Fluroide is poisonous, and that that there is either uncertainty or concern in the medical community about the safety of Fluroide. Fluroide has been repeatedly been proven to have a positive impact on community health…”

 

Response:

There has been concern in the scientific community for decades (See for example the National Research Council Review, 2006). There has been similar concern throughout the medical world outside a handful of countries like NZ, where “consensus reality” has prevented any scientific debate. There is no reliable evidence that fluoride at any level of ingestion is beneficial – Cochrane Review 2015, York Review 2000.

 

Complainant Number 3:“The claim that “Fluoride is a Neurotoxin that Reduces Children’s IQ” is completely unsubstantiated and has no scientific backing in the credible academic literature”

Complainant Number 4: “..as such claims are completely unsubstantiated..” 

Response:

As demonstrated in this response the claim is fully substantiated by the scientific literature. Mr Lensen is merely showing he hasn’t read it and is promoting his personal beliefs as fact.

 

Complainant Number 5: “ .. the levels of flouride in NZ water do not pose serious concerns ..”

Response:

The science described in this response proves otherwise, to the balance of probabilities.

Complainant Number 6: “..misleads consumers by exaggerating the neurological effects of fluoride on children…”

Response:

The science described in this response confirms the neurological effect of fluoride on children. It is denial of this effect that misleads consumers.

 

Rule 6: Fear

Claims that the advertisement breaks Rule 6:

Complainant Number 1: ” is misleading and needless/dangerous fear-mongering…”

Complainant Number 5: “..The scaremongering claim at the top of the ad misleads consumers by exaggerating the neurological effects of fluoride on children..”

 

Response from FFNZ

The claim that fluoride reduces children’s IQ, even at the doses we are exposed to in New Zealand is a statement based on the latest science, establishing this effect to the balance of probabilities, as set by the NZ Supreme Court. Letting people know this cannot be considered to be “exploiting the superstitious”. Neither is it “playing on fear” when the purpose of the advertisement is to encourage people to attend a lecture to hear the latest science and make up their own minds based on that science. We are not exaggerating the harm that fluoride is likely to be doing. The latest science (Brough) indicates that around half of New Zealand women who are pregnant and living in a fluoridated area, are exceeding the level of fluoride found to cause a lowering of IQ in their children. The current scientific evidence shows that reasonable people should be very wary of fluoride, especially during pregnancy and early childhood years.

In this context we note that a bottle of fluoride tablets states “do not take during pregnancy”, and that one tablet has the same amount of fluoride as around three glasses of fluoridated water. As the Supreme Court has now ruled that water fluoridation is medical treatment, it necessarily follows that the same warning applies to consuming fluoridated water during pregnancy. Alerting the public to this risk can hardly be considered scaremongering unless the warning on fluoride tablet bottles is also scaremongering.

 

Rule 11: Advocacy Advertising

Response from FFNZ 

The name of our organisation was very clear to the reader. As we were advertising talks it is obvious that this is an advocacy position.

The complainants quote only the header to the advertisement, out of context.

The advertisement reads :
“Fluoride is a neurotoxin that reduces children’s IQ”

Below this is a picture of a child drinking water.

Directly below the picture, in a font of similar size to the heading, the advertisement then states:

“International experts share latest research linking fluoride to neurological damage and other harms.”

In all, the headings read:

“Fluoride is a neurotoxin that reduces children’s IQ

International experts share latest research linking fluoride to neurological damage and other harms.”

We think the reasonable out-take from this, in total, is that the first line is the advertiser’s advocacy position based on recent scientific research referenced in the second line. As such we do not think in this context the reasonable person would take the first line as an absolute statement of fact.

 

Conclusion

The 2014 New Zealand Report concluded with “It is recommended that a review such as this one is repeated or updated every 10 years – or earlier if a large well-designed study is published that appears likely to have shifted the balance of health benefit vs health risk.”

The Bashash study and the Canadian study, currently in the publication process, which confirms the Bashash study, meet the criteria for a review of fluoridation policy as set by the Prime Minister’s Chief Science Advisor’s office. This may well see an end to fluoridation in New Zealand. Therefore, it would be completely illogical and inconsistent that our group is censured for alerting people to a danger that is likely to become common knowledge in the short or medium-term future.

We also suggest that members of the Advertising Standards Board, and the complainants, watch the presentations given at Otago University to gain full understanding of how the title of the talks, provided on the advert, was appropriate.

Otago University Talks September 2018

Paul Connett https://www.youtube.com/watch?v=3uDvD5UcSwg&t=3s

Vyvyan Howard https://www.youtube.com/watch?v=e0o3kxZNXCw&t=6s

Declan Waugh https://www.youtube.com/watch?v=lx4_DlUGJZg&t=52s

Also accessed via https://fluoridefree.org.nz/international-experts-to-speak-in-dunedin-and-wellington-september-2018/

 

[1] https://www.nap.edu/catalog/11571/fluoride-in-drinking-water-a-scientific-review-of-epas-standards p 222

[2] https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70278-3/abstract

[3] www.pmcsa.org.nz

[4] https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70278-3/abstract

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265943/

[6] https://www.health.govt.nz/our-work/preventative-health-wellness/fluoride-and-oral-health/water-fluoridation/national-fluoridation-information-service

[7] https://www.ncbi.nlm.nih.gov/pubmed/28937959

[8] http://nutr2015.p.events4you.currinda.com/days/2015-12-02/abstract/307

[9] https://isesisee2018.org/wp-content/uploads/2018/08/Abstract-Book-V4-COMPLEET-20-08.pdf