Health

As a general rule PPNZ policy should be based on evidence, where properly peer reviewed research is available, and not on ideological grounds. This is especially valid for health policy and Dr. Goodacre's work is a good basis for health policy foundation. All medical trial results should be made published and all research, paid for in full or in part by the public should be made free access.
Also the problem of harmful externalities, especially those that affect health, should be dealt with in ways that prevent or ameliorate damage at the cost of the product producer.

I did an Official Information Act request using FYI.org.nz about the chemicals used in water fluoridation, and who supplies them. What I learned really alarmed me:
http://www.webcitation.org/6Owyo6zcM

Most of the Councils which responded said they used HFA (hydrofluorosilicic acid) sourced from the NZ of Orica, an Ozzie mining chemicals company. It turns out it's true that their HFA is made from byproducts (they use the euphemism "co-products") of superphosphate fertilizer production:
http://www.orica.co.nz/files/Fluoride/HFA_safety_data_sheet_shess-en-cds-020-000000015539.pdf

Worse, the guy from the Palmerston North City Council also included an ingredients list, also from Orica, which seems to indicate that the HFA they use has measurable amounts of barium, cadmium, chromium, and arsenic (1.1g mg/kg!)
http://webcitation.org/6OEm5FMTD

Is adding industrial byproducts containing toxic heavy metals (which can bioaccumulate in cells and soils) really a legitimate health intervention?

It would seem that NaF Sodium Flouride would be a better choice, having a lower social cost for the same benefit.
http://www.sciencedirect.com/science/article/pii/S1462901113000087

Please let us keep the discussion away from fluoride @strypey as it is not a good look as a party to discuss conspiracy theories about health.

Just because a topic may be linked to conspiracy theories is no reason not to discuss it. People who believed that the government were spying on them were dismissed as conspiracy theorists; it turns out that they were right.

Here we are looking at the safety of the fluoride additive not the question of whether there is some sort of insidious plot.

If hydrofluorosilicic acid is being used instead of sodium fluoride as a cost cutting measure then there is a very good reason to talk about it.

I would very much like PPNZ to become a democracy where there are no taboo subjects and discussion is based on well supported argument.

@andrewreitemeyer when a recovered mental patient such as myself tells people that their "crazy radar" is going off about a certain topic being discussed, it is usually a good indicator that the topic is in fact a paranoid delusion strong enough to get someone sectioned under the mental health act 1993.

Frankly, the whole Fluoride in water topic is prone to advocacy of quackery from paid astroturfers in the states who would like to make all sorts of pseudo-scientific statements about toxicity and pineal gland calcification.

However, as the entire topic of biochemistry is simple enough to consult with a friendly pharmacist, then I would suggest that a reality based approach to science would be in order.
Incidentally, my neighbourhood pharmacist has confirmed last week that the entire Fluoride controversy is in fact a load of paranoid bollocks that won't stop him brushing his teeth with fluoridated water and fluoridated toothpaste.

@andrewmcpherson please read the research posted it is NOT about whether fluoride should be used but which chemical formulation is safe Which one do you have in your water and toothpaste?
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I agree with @andrewreitemeyer that no topic is taboo when we discuss evidence-based policy, and water fluoridation is the subject of a vigorous public debate at present. Even some dentists are now speaking out publicly against the practice:
https://www.youtube.com/watch?v=IhZXChLyk90

A parliamentary health committee has proposed shifting the power to make decisions about fluoridating water from local government to central government: http://www.nzherald.co.nz/bay-of-plenty-times/news/article.cfm?c_id=1503343&objectid=11165098

The Greens have a (fairly non-committal) policy on water fluoridation which recognises over-exposure is an issue:
https://www.greens.org.nz/policy/health-policy

The topic is also being discussed by prominent people in Mana:
http://thedailyblog.co.nz/2014/02/06/the-science-is-not-settled-on-the-benefits-of-fluoridation-of-water-supplies/

Getting accurate information about exactly what chemicals are being used, where they come from, and what is know about them, is essential to having an informed opinion on this subject. This is why I made the OIA request, and why I shared the results here.

I would say that it is irrelevant to deciding what the medical effects of fluoride are when they have already been determined to be safe (at the quantities used as standard) over 60 years ago.
Furthermore, if fluoride was really unsafe, then at the least I would have been advised to not use it by my Uncle Dr. Ian Munt, who has 2 medical degrees and over 30 years of practical experience in medicine.

My personal opinion is that it would be best decided by the ministry of health, and not councillors who have tried to ban dihydroxymonoxide from a complete lack of understanding of basic science.

The concept is simple, do we accept the advice from qualified scientists, doctors and dentists who we could expect to tell us if there is a problem, or do we take onboard the advice from those people who would have a problem with public health initiatives to the extent of paranoia ?

@andrewmcpherson My understanding is that @strypey s initiative is not so much about questioning fluoridation as such - but more so the implementation details of that practice.

He has evidence that some products that are used for fluoridation programmes in NZ are better than others. Better - in the meaning of: less toxic by-products used in the compound. The possible argument that toxic substances are a non-issue if being diluted to a high enough degree doesn't count for substances which can bioaccumulate in cells and soils. Those must be avoided where ever possible.

So this initiative is actually not about fluoride, but about barium, cadmium, chromium, and arsenic (1.1g mg/kg!) and other toxic substances.

Andrew your appeals to authority ( https://yourlogicalfallacyis.com/appeal-to-authority) can be easily countered with cases where the medical profession has ignored evidence that shows that established practice was dangerous. For example: the routine use of clinical x-rays for pregnant women went on for 25 years after clear evidence was found that it was causing childhood cancers.
http://www.columbia.edu/~ejh1/papers/teratol2.pdf

Semmelweis died before his hand-washing routine for doctors was accepted.

But you claim the ministry of health would warn us of any problems that turn up. It is a political body and just as vulnerable to lobbying as any other government department. With the same logic one can say that the cabinet has the best information regarding all aspects of the TPPA and we should trust them blindly to negotiate and sign it in total secrecy,.

It is the role of the populace, in a democracy, to continually question and hold to account those placed in authority. Any deviation from this is a step towards athoritarianism.

I accept that this is a democracy, but as Isaac Asimov said "There is a weird belief that your democratic opinions count for more than my scientific knowledge."
I should not have to remind you that I am not stopping you from getting a scientific education to be in a position to decide for yourself, however as I already have a scientific education, I am better qualified to state the facts than a BA or MBA graduate serving sandwiches and freaking out about the trace chemicals in their water, but not the carcinogenic chemicals in what they smoke.

But seriously, what kind of conspiracy is it ? The dentists want us all to have good teeth, less fillings and no root canals ? Sounds pretty lame for a true delusional conspiracy, if the paranoid and delusional people really came up with a conspiracy like that, wouldn't it really be spread through the aeroplane exhaust fumes so that it would poison everyone and make them sterile ? Oh, no... That's chemtrails, a completely fucked up level of derp by half-wits who don't even understand basic chemistry or physics.

Gosh, perhaps there are a whole lot of people who don't understand basic science and are basically scared of things they don't understand ?
Perhaps there is such a thing as fear of the unknown ?
Perhaps then there is a valid reason why we should ignore the entire anti-fluoride argument as it is essentially a fear of the unknown by the neo-luddite community who would rather we all had bad teeth, if any, or dentures.

It is the duty of everyone who can claim to think logically, to actually be able to understand both the argument and the scientific truth. As scientific truth is the only reality that we live, all authority can be only be validated from science.

@andrewreitemeyer The word 'conspiracy' has only be used by you and you alone, with the only exception of @andrewreitemeyer in direct response to your suspicion, explaining why this is NOT about actual or imagined conspiracies.

There appears to be at least two different products which are widely used around NZ for fluoridation programs. One of them appears to be composed explicitly for this purpose. The other one appears to be derived from by-products of an industrial process - basically reconditioned waste, refurbished to meet minimum criteria to be deemed acceptable.

The assumption has been raised that the latter might be cheaper and that this could explain the wide adoption of the product with the lesser quality. This assumption is pretty much the opposite of a conspiracy theory; it completely complies to http://en.wikipedia.org/wiki/Occam%27s_razor , so much to scientific correctness.

Lesser quality can be read as: containing highly toxic substances. These are applied to all citizens, be it newborns or otherwise sensitive people as well as animals, be it pets or farm animals and soil. Because some of them bio-accumulate, your implicit statement that they can be regarded as traces and therefore ignored (which is anyway only your assumption as you have not given any numbers) is invalid.

Your argument, that those complaining are happily and recklessly accepting higher risks in other contexts is firstly again only an unfounded assumption of yours and secondly irrelevant as (given you are right) consciously accepted risk can not compare to one you have no control over.

The question raised here is really: Are we maybe by using the cheaper product for our otherwise unquestioned fluoridation programs paying much, much more in the long run, not only if taken the long term health care costs but also the social and environmental costs into account?

Strictly speaking we would have already seen long term health care costs rise a few decades ago, if that was the case.
However, what we have seen is that the longevity of the population is rising to the point where the major parties are arguing about the pension age needing to be raised in 20 years time.

@strypey is currently in the process to gather information of the products currently used. Do you, @andrewmcpherson, have information about the products and their compounds that have been used some decades ago? I am sure @strypey would be interested in those statistics.

@andrew BTW, not that I would argue that this is an argument for anything; but as you where mentioning it:
http://www.wolframalpha.com/input/?i=annual+health+care+costs+new+zealand

"Scientific truth" is an oxymoron. The scientific method requires one to constantly question and test existing working hypotheses there cannot be any absolute truth in science. Also Andrew, your claims would be more acceptable if you could point us to peer reviewed research rather than relatives and anecdotes - these cannot and do not deserve to be answered.

$2508 per person per year. Yet the health system has noticeably improved over time, even in the last 30 years (which is not the same as what I said would be the case).

1. It is not my field of study, nor is it a good use of my time to restudy the previous products. I have a different element to study.

@andrewreitemeyer It is neither my field nor yours, and I have little time to find peer reviewed research in this field. I have more significant research to conduct with my limited time in the specialities I concentrate on.
I have six major projects which require more attention than a diversion into a doctorate of medicine will provide, furthermore it is not going to be a useful use of my time to do so, as I have already used all my available student loan years in 9 years of tertiary study.
As I can neither afford to put my life on hold for 6 years, nor will I be able to pay the fees required, then this $100k question you want me to burrow to answer is unreasonable in the extreme.

Finding research on the net is relatively easy using google scholar or any of the opens science journals found at http://en.wikipedia.org/wiki/List_of_open-access_journals.
When Strypey revealed his FOI I was also sceptical but there was adequate research to show that the fluoride formulation, that New Zealand uses, is questionable at best and contrary to expert opinion. In my opinion the matter deserves further investigation. You have not produced any solid evidence to the contrary.

I am not asking that you do the research yourself - merely take the time to a little surfing.

OK, let's summarise: @andrewmcpherson is in favour of fluoridationprograms as he is looking at the beneficial aspects of fluoride and fluoride alone.

Nobody has so far been arguing against that.

Everyone else is worried about barium, cadmium, chromium, and arsenic being deliberately added to the water supply.

Nobody has so far been arguing in favour of barium, cadmium, chromium, and arsenic being added to the water supply.

The open question is: are there really toxic substances in one or more products used? And if so: are there non-toxic alternatives? And if so: should we take the stance to advocate for using the better product and ruling the problematic product out?

It would be great if we could start two decisions at once, one per each of the first two aspects. But we can't. So I suggest that we first decide on barium, cadmium, chromium, and arsenic; and then decide on fluoride.

We can then proceed discussing the matter productively with everyone knowing where we stand and talk about.

OK, sorry for the confusion. But second thoughts suggest that we should go from the broader to the more detailed decision. Hence the Fluoride aspect should be the first to agree upon, only if we agree on supporting Fluoride programmes in principle do we have to bother about the actual products to support or dismiss.

I think different fluoridation products are used due to solubility, some like the calcium fluoride are very insoluble so will never be used. There is probably research on contaminants available. Do we have a contamination problem? IE in areas where the 'contaminated' fluoride is used are people showing signs of contamination?

Delivering either medicines or supplements (eg fluorides) through food or drinking water is a health intervention. People can't give informed consent to a supplement delivered by stealth through the public water supply, and large numbers of people have explicitly said they don't consent. Forcing health interventions on people who do not consent "for their own good" is unethical, and frankly, authoritarian.

Also, I challenge @andrewmcpherson or anyone to supply reliable, peer-reviewed evidence that swallowing fluorides improves dental health. You won't find it. Don't take my word for it, Dr Ben Goldacre (currently a Research Fellow in Epidemiology at London School of Hygiene and Tropical Medicine) wrote in 2008:

"In 1999 the Department of Health commissioned the centre for reviews and dissemination at York University to do a systematic review of fluoridation and its effects on dental health. Little new work has been done since. In the review, 3,200 research papers, mostly of very poor quality, were unearthed. The ones that met the minimum quality threshold suggested there was vaguely, possibly, around a 15% increase in the number of children without dental caries in areas with fluoridated water, but the studies generally couldn't exclude other explanations for the variance. Of course, the big idea with fluoride in water is that it can reduce social inequalities in dental health since everyone drinks it. But there isn't much evidence on that either."
http://www.theguardian.com/science/2008/feb/09/medicalresearch.health

On the other hand, there is overwhelming evidence that fluorides are poisons which should not be swallowed. Fluoridation advocates keep hand-waving at the low concentrations of fluorides (<0.5ppm) in drinking water, ignoring the copious evidence that fluorides bioaccumulate, especially in the bones and cartilage, leading to conditions like skeletal fluorosis. This happens in both humans and non-human animals, so by pouring fluorides through the drinking water supply, into stormwater and sewage treatment, and then into waterways and the ocean, we are poisoning aquatic wildlife.

I believe there is some evidence that topical application of fluoride to the surface of the teeth has dental benefits. If this is true, redirecting the money spent on water fluoridation into handing out free toothpaste at schools would be both more ethical and more effective in improving dental health.

Other policies which could improve dental health without mass medication include:
* free dental check-ups for all under the public health service
* bringing back school dental nurses

I would also like to note that it is completely unethical to blindly quote @andrewreitemeyer "surf a few research papers on google scholar in a field unrelated to your study and then pass judgement like an expert."

All I see is a critical lack of credibility from the pet experts quoted.

@andrewreitemeyer can you provide a link or something, please?

Perhaps @andrewmcpherson is thinking of Professor Paul Connett when he refers to "a world renowned shrill against fluoridation"?
http://www.psr.org/chapters/oregon/paul-connett.html

AFAIK the only time Dr Ben Goldacre has commented publicly on the subject of fluoride is in that blog post I linked. He has done a couple of excellent TED talks on the way bad science is used to justify dodgy health interventions:
http://www.ted.com/talks/ben_goldacre_battling_bad_science
http://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe

@hubatmcjuhes The link is in my first post on this page. There were a few others that approached the subject but they are behind paywalls.

Remembering that the desired chemical is already diluted way down from kg's of concentrated solution to a small number of ppm, contaminants that exist in the ratio of milligrams/micrograms per kg will be diluted down even further to mere parts per trillion? My gut feeling is that this is a non-issue.

@robueberfeldt the current decision is not about weighing the risks. It is only about the question if water quality is an issue that the Pirate Party would like to stand tall for if we later on would decide to be staunch.
If we don't care about water quality at all, we don't even need to bother about the facts. I have chosen this sequence of decisions to be made to avoid putting lots of effort into providing evidence for something we wouldn't make a party position from anyway. Hence you cannot expect any evidence provided at this point in time.

So can I kindly ask you to revise your vote for this decision and spare the valuable argument for the next round, please?

Accepting for the sake of argument that "correcting" the level of fluoride in drinking water is desirable (as already mentioned, epidemiologist Dr Ben Goldacre says the evidence doesn't support the claimed benefits), this should be done by using material from the same parent rocks that supply the naturally-occurring fluorides. Not by using industrial by-products which are known to be contaminated.

I have shown evidence from my OIA request through FYI.org.nz that a number of toxic substances are being added to drinking water, as contaminants of the industrial by-products (or "co-products") used in water fluoridation. It doesn't matter how much these substances are watered down, as they are known to be bio-accumulative, even the tiniest amounts per day accumulate in organs and tissues over a lifetime, leading to avoidable illness. This is why mercury is being phased out of use, why lead has been removed from paint and petrol, why cadmium turning up in dairy pasture is a concern etc etc.

As I have already mentioned, it is not worth asking an expert from an irrelevant field their opinion on a simple medical matter, unless they are a psychiatrist, a biomedical chemist, a urologist, etc.
An epidemiologist is merely a medically trained statistician, and can not be relied upon to give anything other than advocacy for statistically derived positions.
As a mathematician I know all too well why the famous quotation about "Lies, politics and statistics" implies about trusting statistical observations, particularly when used to advocate a particular position that has had numerous countering surveys over the last 60 years.

The current era would only realistically see problems with industrial waste fluoride in mainland china water supplies.
In NZ, fluoride is added in some local water supplies to counter problems with extremely low levels of fluoride in our rivers. This is important because humans evolved in areas where natural fluoride levels are higher, which makes this trace element vital to our teeth.

It is hardly a conspiracy worthy of a "Dr. Strangelove" argument that adding fluoride to the water supply is a soviet plot to sterilise the youth of the country.
It is merely a public dental health initiative to ensure people who can't afford toothpaste every week can keep their teeth in good condition by drinking water.

I apologise if I sound cranky in this reply, but as someone who has formerly suffered from a paranoia based mental illness, I have no desire to entertain conspiracy theories that do not stand up to reasonable investigation.