Forum Minutes of Meetings
Minutes of meeting of the Forum on Fluoridation of 9
Great Southern Hotel, Dublin Airport
Professor John Clarkson
Dr Carmel Parnell
As this was Professor Kelleher’s first meeting, she
introduced herself and gave brief background information.
Professor Fottrell informed the Forum that Dr Miriam
Owens is to draft the Forum’s report under his guidance and that of the
members. Dr Owens then introduced herself and gave brief background
The following documentation was circulated to the
members of the Forum:
(i) "A Systematic Review of Public Water
Fluoridation" , September 2000 (i.e. The York Review)+
(ii) "Water Fluoridation and Public
Health", October 1999 (Faculty of Public Health Medicine, Royal
College of Physicians of Ireland)+
(iii) "Community Water Fluoridation in America:
The Unprincipled Opposition" (Michael W Easley)*
+circulated by Secretariat
*circulated by Dr Owens.
The Minutes for meeting of 13/10/00 were read and
agreed. Professor Fottrell expressed his gratitude to Dr Shannon for
taking the minutes on that occasion.
Professor Fottrell thanked Professor O’Mullane for
hosting the meeting of 13/10/00 in UCC.
The following dates were agreed for coming meetings of
14 December 2000**
11 January 2001
8 February 2001
8 March 2001
5 April 2001
The meetings on these dates will be held in Dublin to
facilitate the majority of the Forum members; consideration will be given
to holding subsequent meetings outside Dublin.
Reminder that all members are welcome to give a
presentation at any meeting but are requested to submit a synopsis of
their presentation to the Secretariat for circulation beforehand.
Following on from the presentations given by the guest
speakers at the meeting of 13/10/00, Dr Connett forwarded further
documentation, as requested, and this has been circulated to the members;
however, nothing further has been received as yet from Professor Limeback
although he has received several reminders (by post and telephone).
Members of the Forum expressed disappointment at this as Professor
Limeback had made several unsubstantiated statements.
Professor Fottrell reminded the Forum members that the
Minister is very keen that the public (individuals and
organisations) be engaged in the consultation process in order that their
views be ascertained.
The Secretariat has been in contact with VOICE - the
organisation is to have a Board meeting on 14 November 2000 and the
Chairman, Fr McDonagh, will be in contact after that date to clarify if
they will be making a presentation to the Forum.
In relation to acquiring advice on dietary aspects,
Professor Kelleher may be able to suggest a suitable advisor and also
suggested that there is plenty of information available from surveys which
may be useful.
The wording of the draft advertisement for the national
newspapers was agreed and it is hoped to have it advertised on Sunday 19
November 2000 and Monday 20 November. A questionnaire to be sent to
respondents is to be drafted by Dr Flanagan - to be forwarded to
Secretariat. Importance of advertising on local radio as well as national
radio emphasised - advertisements to be short, catchy and informative.
Web site is now registered as fluoridationforum.ie but
a decision needs to be made regarding the following:
(a) what information is to be put on it?
(b) who will update it?
(c) what happens to it after the Forum issues its
Issues discussed and actions agreed:
(1) Dr Gavin gave details of a survey carried out by
Drury Research in conjunction with the Dental Health Foundation
(Ireland) on the subject of fluoridation. It was agreed that relevant
representatives would be asked to attend the Forum’s meeting at 10am
on 14 December 2000 to present their findings - Dr Gavin to arrange
this. Presentation to be followed by Q&A/ discussion.
(2) With reference to the individual who applied to
observe Forum meetings, the Secretariat has been in contact with him to
ask if he would be interested in giving a presentation to the Forum on
his research in the area of fluoridation.
(3) General Council of County Councils has monthly
meetings - next meeting to be held on 15 November 2000 - Secretariat to
liaise with the General Council to arrange date for meeting - Professor
O’Mullane and Dr Mullen willing to give presentation to them
concerning the Forum’s terms of reference, work to date, etc. - to be
done early in 2001. Important that one representative of public health
medicine be involved in this, too.
(4) Should there be a Principal Environmental Health
Officer on the Forum? Dr O’Connor to get name(s) of suitable
individual(s). To be discussed further at the next meeting of the Forum.
(5) If members identify any other areas from which it
would be useful to have representation (i.e., bio-statistician,
dietitian), it is important that this would be done asap so that any
additional members would be in place soon.
(6) Names of other speakers who could be invited to
give presentations: Dr Liz Treasure (or other author of the York Review)
and Dr Cyrus Cooper suggested. However, before any decision is made to
invite any further speakers (see enclosed list re future activities), it
is important that the Forum devise an action plan and timetable so that
the work will have structure. Stressed that claims made by speakers must
be substantiated by them by reference to peer-reviewed journals.
(7) SAAF video to be viewed at a future meeting.
(8) Dr Mullen gave details of his meeting with Dr
Caswell Evans, Director of Public Health in California. He agreed to
contact him for a submission which will then be circulated by the
(9) The Forum agreed to address Dr Paul Connett’s
Presentation made by Dr Flanagan
Recommended that the use of the term "ppm" be
replaced by micrograms - more precise. Suggested that the Forum recommend
that the distillation method be replaced by the specific ion meter as the
latter is more accurate; however, there is no need to specify which method
should be used - merely recommend that best practice be established.
Discussion followed the presentation. Recommendations
regarding engineering practices will be important in the Forum’s report.
Recommendation needed i.e. to specify who is accountable/responsible for
each fluoridation-related task/area. It is, apparently, rare for an
exceedence to occur in the Dublin area - it might be useful to examine
small plants (i.e. outside Dublin) in comparison with the larger ones in
(10) Agreed that the Forum should make recommendation
regarding distillation method, as detailed above - Dr Flanagan and Mr
Moyles to devise wording for the recommendation.
(11) Professor Clarkson to be asked for description
of work carried out on the epidemiology contract which was awarded by
the Department of Health and Children.
(12) Dr Owens and Forum Secretariat to liaise with
the following members to draft headings to be covered in the report,
with particular regard to the engineering recommendations required:
Headings then to be distributed to the members for
No decisions will be made on any of the aforementioned
recommendations until the Forum has completed its overall consideration on
(13) Mr Moyles stated that the Regional Analysts’
Laboratory would be willing to take on regular analysis of water to
detect levels of various elements including, specifically,
hydrofluosilicic acid; Mr Moyles to draw up wording for the
specifications for this.
Informal presentation made by Mr Fogarty
Information regarding training networks organised under
the auspices of the Department of the Environment and Local Government -
important to bring public health outlook to this training - co-operation
in this regard has commenced between the Department of Health and Children
and the trainers.
It was pointed out by a member of the Forum during the
subsequent discussion that while it is important to remember that the
Forum may recommend fluoridation of public water supplies be discontinued,
it is also important that, if the Forum recommends it continue, a number
of recommendations concerning safeguards, procedures and protocols be
made. This was agreed.
Informal presentation made by Ms Gallagher
Ms Gallagher reported that the Council of the Consumers’
Association of Ireland met recently and expressed concern about what they
perceived is the extent of the anti-fluoridation view on the Forum.
Members of the Forum, including the Chairman, assured Ms Gallagher that
they all have an open mind on the fluoridation issue. The Chairman also
assured Ms Gallagher that everything possible will be done to ensure a
balance is struck and, in his opinion, every effort has been made to date
to accommodate every opinion possible. The Minister for Health and
Children did not appoint the members for their views on the subject but on
their experience in related areas and he, himself, has stated that he is
open-minded on the issue. It was also pointed out that the Minister did
attempt to get representation from the anti-fluoridation perspective but
those invited declined the invitation. Ms Gallagher stated that she had
not intended to imply bias on anyone’s part but would still like to see
a recognised anti-fluoridationist as a member. It was agreed that the
inclusion of such an individual is important and additional efforts should
be made to encourage individuals with such views to participate in
discussions. Dr Elizabeth Cullen, Irish Doctors’ Environmental
Association, was mentioned in this regard.
Observations from other members:
- crucial also to engage members of the public to get their views
- need for the members to constantly monitor their work to ensure it
- all members agreed that if there is scientific evidence to prove
that water fluoridation does not work and/or is harmful they will be
happy to recommend that it should cease and vice versa.
(14) Agreed that the Forum’s report should clearly
state that the members examined both sides of the fluoridation argument
in a clear and unbiased manner.
The Council of the CAI also said that in their opinion
the public would like an open Forum - more than just submissions - perhaps
have a meeting/ conference which is open to the public where interested
individuals could contribute.
(15) Agreed that it is important to invite speakers
to meet the Forum but also important to send representatives of the
Forum to meet other individuals/ recognised groups. Suggested that
representatives meet with the Council of the CAI - Ms Gallagher to check
with Mr Dermott Jewell, Chief Executive of CAI, if this is
(16) Letter from the Irish Doctors’ Environmental
Association read to the Forum - in view of the discussion just held it
was agreed that the Chairman would write to the Minister asking that Dr
Elizabeth Cullen (or another representative of the IDEA) be appointed to
the Forum; if the Minister agrees to this it is hoped to invite the
relevant nominee to the Forum’s meeting on 14 December 2000.
(17) Agreed that any representatives of the Forum who
meet with outside groups/individuals should give the Forum’s terms of
reference and details of the work of the Forum and not any personal
views on the subject which they might hold. Important that Forum members
use such meetings as a listening exercise to get people’s views on the
issue of fluoridation and then convey these back to the Forum.
(18) Questionnaire which will be issued should be
constructed carefully so as not to direct responses.
Informal presentation by Dr O’Connor
Dr O’Connor was involved in the drafting of
"Water Fluoridation and Public Health", October 1999 (Faculty of
Public Health Medicine, Royal College of Physicians of Ireland) and gave
details on this. The members of the Faculty did not necessarily have any
views on this issue before drafting the report which was completed in
(19) "Water Fluoridation and Public Health"
is to be read by the members before the meeting of 14 December 2000 and
to be discussed further.
Informal presentation by Dr Mullen
Appreciated the fact that Dr Connett met the Forum in
spite of opposition from the anti-fluoridation lobby but was not impressed
by the content of his presentation as it was emotive rather than
scientific. Had initially recommended Dr Connett as a speaker on the basis
of his environmental interest/ expertise but was disappointed that he did
not address this area comprehensively in his presentation. However, the
Forum should address the "50 Questions" put by Dr Connett as
several important issues are raised.
If the levels of fluorosis which Professor Limeback
described occurred in Ireland it would be a cause for concern but Dr
Mullen and his colleagues have not found this.
Important that informed anti-fluoridation speakers be
invited to address the Forum.
Observations from other members:
- Dr Connett’s comment concerning osteoporosis in his critique of
the Phipps article (circulated prior to this meeting) is incorrect
- Dr Connett appears to be more impressive in his written
submissions rather than his oral presentation - members agreed that
how the information was conveyed is unimportant but the content
should be examined carefully - some of the points raised by Dr
Connett are very important
- while Dr Connett has provided further documentation supporting his
claims, Professor Limeback has not yet done so - Secretariat to
follow this up. It may be useful to put specific questions to
Professor Limeback - Professor O’Mullane to liaise with
Secretariat in this regard.
(20) Suggestion that it would be useful to have a
Toxicologist as a member of/ advisor to the Forum - Dr Gavin to ask
Professor Jan Ekstrand for submission in this regard.
(21) Copy of oral health statistics to be circulated
for discussion purposes - information with regard to toothbrushing
particularly useful - Professor Kelleher to assist Secretariat in this
(22) Professor Kelleher invited to forward
documentation for circulation to the Forum members concerning the points
she would like raised during discussions.
(23) Professor O’Mullane mentioned that he was
misquoted in an article concerning fluoridation in a recent edition of
the Irish Medical Journal. Members of the Forum discussed how this issue
might be handled.
(24) Forum to address the alleged linkages between
osteoporosis and fluoridation.
(25) Professor O’Brien to give presentation on
osteoporosis at a future meeting of the Forum.
(26) Secretariat to contact each member of the Forum
concerning information to be put on the web site.
(27) Sub-group to draft response to Dr Connett’s
Dr Owens and Professor O’Mullane to co-ordinate
this - contact between members to be via email to ensure it is done as
quickly as possible.
(28) Forum may require Spokesperson - suggestion that
Dr Owens may fulfil this role - to be discussed further.
(29) Interim report due for Minister in December -
Professor Fottrell to meet with Secretariat and Dr Owens regarding
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