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Fluoridation and cancer. Age dependence of cancer mortality related to artificial fluoridation
Abstract
Data indicating a more rapid increase in cancer death rate in fluoridated than in nonfluoridated cities were analyzed to determine to what extent the net increase observed in fluoridated cities could be attributed to age, race, or sex. Between 1952 and 1969, no significant fluoridation-linked increase in cancer death rate could be observed in populations 0-24 and 25-44 years of age. In populations 45-64 years of age, a fluoridation-linked increase in cancer death rate of 15/100,000 population was observed (P < .02); in populations 65+ years of age, an increase of 35/100,000 was observed (P < .05). The fluoridation-linked increase in cancer death rate could not be ascribed to changes in the racial or sex compositions of the fluoridated and nonfluoridated populations.
... The relationship between the consumption of fluoridated drinking-water and morbidity or mortality due to cancer has been examined in a large number of epidemiological studies, performed in many countries. These studies were largely prompted by a report by Yiamouyiannis & Burk (1977) that found an increase in overall cancer mortality in two of several broad age groups in 10 US cities following the implementation of drinking-water fluoridation. Although dismissed based on a variety of methodological flaws (see Doll & Kinlen, 1977;Smith, 1980;Kinlen & Doll, 1981;Chilvers, 1982;IARC, 1982IARC, , 1987Knox, 1985), the Yiamouyiannis & Burk (1977) study stimulated a large number of other ecological studies, performed in Australia, Canada, China and the Province of Taiwan, England and Wales, New Zealand, Norway and the USA (Hoover et al., 1976;IARC, 1982IARC, , 1987Knox, 1985;Hrudey et al., 1990;Mahoney et al., 1991;Cohn, 1992;Freni & Gaylor, 1992;Yang et al., 2000), that found no consistent relationship between deaths due to any type of cancer and the consumption of fluoride-containing (fluoridated or with naturally high fluoride content) drinking-water. ...
... These studies were largely prompted by a report by Yiamouyiannis & Burk (1977) that found an increase in overall cancer mortality in two of several broad age groups in 10 US cities following the implementation of drinking-water fluoridation. Although dismissed based on a variety of methodological flaws (see Doll & Kinlen, 1977;Smith, 1980;Kinlen & Doll, 1981;Chilvers, 1982;IARC, 1982IARC, , 1987Knox, 1985), the Yiamouyiannis & Burk (1977) study stimulated a large number of other ecological studies, performed in Australia, Canada, China and the Province of Taiwan, England and Wales, New Zealand, Norway and the USA (Hoover et al., 1976;IARC, 1982IARC, , 1987Knox, 1985;Hrudey et al., 1990;Mahoney et al., 1991;Cohn, 1992;Freni & Gaylor, 1992;Yang et al., 2000), that found no consistent relationship between deaths due to any type of cancer and the consumption of fluoride-containing (fluoridated or with naturally high fluoride content) drinking-water. Although some age-and sex-related increases in tumour incidence over time for cancer of the bones and joints and osteosarcomas were observed in one study (US DHHS, 1991), these increases were not related to the length of time that the water had been "fluoridated." ...
This document focuses on environmental exposure to fluoride derived mostly from inorganic sources and its effects on humans, animals and other biota. Data on hydrogen fluoride, calcium fluoride, sodium fluoride, sulfur hexafluoride and silicofluorides are covered, as these compounds are considered to be the most relevant of the inorganic fluorides on the basis of quantities released to the environment, environmental concentrations and toxicological effects on living organisms. 1.1 Identity, physical and chemical properties and analytical methods Hydrogen fluoride (HF) is a colourless, pungent liquid or gas that is highly soluble in organic solvents and in water, in which it forms hydrofluoric acid. Calcium fluoride (CaF2) is a colourless solid that is relatively insoluble in water and dilute acids and bases. Sodium fluoride (NaF) is a colourless to white solid that is moderately soluble in water. Sulfur hexafluoride (SF6) is a colourless, odourless, inert gas that is slightly soluble in water and readily soluble in ethanol and bases. The most common procedure used to quantify free fluoride anion is the fluoride ion-selective electrode. Microdiffusion techniques are considered to be the most accurate methods of sample preparation (i.e., liberation of free ionic fluoride from organic and inorganic complexes). 1.2 Sources of human and environmental exposure Fluorides are released into the environment naturally through the weathering and dissolution of minerals, in emissions from volcanoes and in marine aerosols. Fluorides are also released into the environment via coal combustion and process waters and waste from various industrial processes, including steel manufacture, primary aluminium, copper and nickel production, phosphate ore processing, phosphate fertilizer production and use, glass, brick and ceramic manufacturing, and glue and adhesive production. The use of fluoride-containing pesticides as well as the controlled fluoridation of drinking-water supplies also contribute to the release of fluoride from anthropogenic sources. Based on available data, phosphate ore production and use as well as aluminium manufacture are the major industrial sources of fluoride release into the environment. Hydrogen fluoride is an important industrial compound that is used mainly in the production of synthetic cryolite (Na 3AIF6), aluminium fluoride (AIF3), motor gasoline alkylates and chlorofluorocarbons, with an annual world consumption in excess of 1 million tonnes. It is also used in etching semiconductor devices, cleaning and etching glass, cleaning brick and aluminium and tanning leather, as well as in commercial rust removers. Calcium fluoride is used as a flux in steel, glass and enamel production, as the raw material for the production of hydrofluoric acid and anhydrous hydrogen fluoride, and as an electrolyte in aluminium production. Sodium fluoride is used in the controlled fluoridation of drinking-water, as a preservative in glues, in glass and enamel production, as a flux in steel and aluminium production, as an insecticide and as a wood preservative. Sulfur hexafluoride is used extensively in various electronic components and in the production of magnesium and aluminium. Fluorosilicic acid (H2SiF6) and sodium hexafluorosilicate (Na 2SiF6) are used for the fluoridation of drinking-water supplies. 1.3 Environmental transport, distribution and transformation Fluorides in the atmosphere may be in gaseous or particulate form. Atmospheric fluorides can be transported over large distances as a result of wind or atmospheric turbulence or can be removed from the atmosphere via wet and dry deposition or hydrolysis. Fluoride compounds, with the exception of sulfur hexafluoride, are not expected to remain in the troposphere for long periods or to migrate to the stratosphere. Sulfur hexafluoride has an atmospheric residence time ranging from 500 to several thousand years. The transport and transformation of fluoride in water are influenced by pH, water hardness and the presence of ion-exchange materials such as clays. Fluoride is usually transported through the water cycle complexed with aluminium. The transport and transformation of fluoride in soil are influenced by pH and the formation of predominantly aluminium and calcium complexes. Adsorption to the soil solid phase is stronger at slightly acidic pH values (5.5-6.5). Fluoride is not readily leached from soils. The uptake of fluoride by biota is determined by the route of exposure, the bioavailability of the fluoride and the uptake/excretion kinetics in the organism. Soluble fluorides are bioaccumulated by some aquatic and terrestrial biota. However, no information was identified concerning the biomagnification of fluoride in aquatic or terrestrial food-chains. Terrestrial plants may accumulate fluorides following airborne deposition and uptake from soil. 1.4 Environmental levels and human exposure Fluoride levels in surface waters vary according to location and proximity to emission sources. Surface water concentrations generally range from 0.01 to 0.3 mg/litre. Seawater contains more fluoride than fresh water, with concentrations ranging from 1.2 to 1.5 mg/litre. Higher levels of fluoride have been measured in areas where the natural rock is rich in fluoride, and elevated inorganic fluoride levels are often seen in regions where there is geothermal or volcanic activity (e.g., 25-50 mg fluoride/litre in hot springs and geysers and as much as 2800 mg/litre in certain East African Rift Valley lakes). Anthropogenic discharges can also lead to increased levels of fluoride in the environment. Airborne fluoride exists in gaseous and particulate forms, which are emitted from both natural and anthropogenic sources. Fluoride released as gaseous and particulate matter is deposited in the general vicinity of an emission source, although some particulates may react with other atmospheric constituents. The distribution and deposition of airborne fluoride are dependent upon emission strength, meteorological conditions, particulate size and chemical reactivity. In areas not in the direct vicinity of emission sources, the mean concentrations of fluoride in ambient air are generally less than 0.1 μg/m3. Levels may be slightly higher in urban than in rural locations; however, even in the vicinity of emission sources, the levels of airborne fluoride usually do not exceed 2-3 μg/m3. In areas of China where fluoride-rich coal is used as a source of fuel, reported concentrations of fluoride in ambient air have reached 6 μg/m3. Fluoride is a component of most types of soil, with total fluoride concentrations ranging from 20 to 1000 μg/g in areas without natural phosphate or fluoride deposits and up to several thousand micrograms per gram in mineral soils with deposits of fluoride. Airborne gaseous and particulate fluorides tend to accumulate within the surface layer of soils but may be displaced throughout the root zone, even in calcareous soils. The clay and organic carbon content as well as the pH of soil are primarily responsible for the retention of fluoride in soils. Fluoride in soil is primarily associated with the soil colloid or clay fraction. For all soils, it is the soluble fluoride content that is biologically important to plants and animals. Fluorides can be taken up by aquatic organisms directly from the water or to a lesser extent via food. Fluorides tend to accumulate in the exoskeleton or bone tissue of aquatic animals. Mean fluoride concentrations of >2000 mg/kg have been measured in the exoskeleton of krill; mean bone fluoride concentrations in aquatic mammals, such as seals and whales, ranged from 135 to 18 600 mg/kg dry weight. Fluoride levels in terrestrial biota are higher in areas with high fluoride levels from natural and anthropogenic sources. Lichens have been used extensively as biomonitors for fluorides. Mean fluoride concentrations of 150-250 mg/kg were measured in lichens growing within 2-3 km of fluoride emission sources, compared with a background level of <1 mg fluoride/kg. Most of the fluoride in the soil is insoluble and, therefore, less available to plants. However, high soil fluoride concentrations or low pH, clay and/or organic matter can increase fluoride levels in soil solution, increasing uptake via the plant root. If fluoride is taken up through the root, its concentrations are often higher in the root than in the shoot, due to the low mobility of fluoride in the plant. Most fluorides enter plant tissues as gases through the stomata and accumulate in leaves. Small amounts of airborne particulate fluoride can enter the plant through the epidermis and cuticle. Vegetation has been widely monitored in the vicinity of anthropogenic fluoride emission sources. Correlations between fluoride concentrations in vegetation and annual growth increments, wind pattern, distance from fluoride source and hydrogen fluoride concentrations in aerial emissions have been observed. Fluoride accumulates in the bone tissue of terrestrial vertebrates, depending on factors such as diet and the proximity of fluoride emission sources. For example, mean fluoride concentrations of 7000-8000 mg/kg have been measured in the bones of small mammals in the vicinity of an aluminium smelter. Fluoride is ubiquitous in the environment; therefore, sources of drinking-water are likely to contain at least some small amount of fluoride.
... In a study with elderly postmenopausal osteoporotic females receiving 23 mg elemental fluoride/day for a mean period of 4.2 years (ranging from 1.4 to 12.6 years) (equivalent to an intake of 470 µg/kg body weight per day in an individual weighing 58 kg), no clinically adverse alterations in blood and urine chemistries or in the frequency of sister chromatid exchange in peripheral blood lymphocytes were observed in the fluoride-exposed patients (n = 25) compared with controls not administered fluoride (Jackson et al., 1994 The relationship between the consumption of fluoridated drinking-water and morbidity or mortality due to cancer has been examined in a large number of epidemiological studies, performed in many countries. These studies were largely prompted by a report by Yiamouyiannis & Burk (1977) that found an increase in overall cancer mortality in two of several broad age groups in 10 US cities following the implementation of drinking-water fluoridation. Although dismissed based on a variety of methodological flaws (see Doll & Kinlen, 1977;Smith, 1980;Kinlen & Doll, 1981;Chilvers, 1982;IARC, 1982IARC, , 1987Knox, 1985), the Yiamouyiannis & Burk (1977) study stimulated a large number of other ecological studies, performed in Australia, Canada, China and the Province of Taiwan, England and Wales, New Zealand, Norway and the USA (Hoover et al., 1976;IARC, 1982IARC, , 1987Knox, 1985;Hrudey et al., 1990;Mahoney et al., 1991;Cohn, 1992;Freni & Gaylor, 1992;Yang et al., 2000), that found no consistent relationship between deaths due to any type of cancer and the consumption of fluoride-containing (fluoridated or with naturally high fluoride content) drinking-water. ...
... These studies were largely prompted by a report by Yiamouyiannis & Burk (1977) that found an increase in overall cancer mortality in two of several broad age groups in 10 US cities following the implementation of drinking-water fluoridation. Although dismissed based on a variety of methodological flaws (see Doll & Kinlen, 1977;Smith, 1980;Kinlen & Doll, 1981;Chilvers, 1982;IARC, 1982IARC, , 1987Knox, 1985), the Yiamouyiannis & Burk (1977) study stimulated a large number of other ecological studies, performed in Australia, Canada, China and the Province of Taiwan, England and Wales, New Zealand, Norway and the USA (Hoover et al., 1976;IARC, 1982IARC, , 1987Knox, 1985;Hrudey et al., 1990;Mahoney et al., 1991;Cohn, 1992;Freni & Gaylor, 1992;Yang et al., 2000), that found no consistent relationship between deaths due to any type of cancer and the consumption of fluoride-containing (fluoridated or with naturally high fluoride content) drinking-water. Although some age-and sex-related increases in tumour incidence over time for cancer of the bones and joints and osteosarcomas were observed in one study (US DHHS, 1991), these increases were not related to the length of time that the water had been "fluoridated." ...
An expert assessment of both the beneficial and toxic effects to human health posed by the use of fluorine and fluorides. Conclusions and recommendations are based on a critical analysis of well over 400 clinical and laboratory investigations. The introductory sections consider methods for the measurement of fluorides in inorganic and organic materials, sources and magnitude of exposure, and effects on health as determined through a large number of laboratory investigations. The most extensive section is devoted to a critical review of data on beneficial and toxic effects in humans. Beneficial effects of fluoride in drinking water, salt, milk, tablets, and topical applications are considered in terms of the preventive effects on dental caries and their use in the treatment of osteoporosis. Toxic effects reviewed include various forms of fluorosis, effects on renal function, hypersensitivity and dermatological reactions, and carcinogenic and teratogenic risks. On the basis of this review, the report confirms the beneficial effects of fluoride in the prevention of caries, while noting that long-term exposure to high quantities may damage enamel and bone; very high doses cause acute toxic effects and may be lethal.
Available on-line at: http://www.inchem.org/documents/ehc/ehc/ehc36.htm
... could not be ascribed to changes in the racial or sex compositions of the fluoridated and nonfluoridated populations. 3 In 1978 Waldbott et al. noted that the conclusions of Yiamouyiannis and Burk on cancer mortality had not been invalidated. 4 Yiamouyiannis and Burk noted that, according to the dogma current in 1977, 20-30 years must pass before a substance alters the cancer death rate. ...
Two papers in the current issue of Fluoride report that (i) the insulin resistance induced by excessive fluoride intake in rats may be mediated by activation of inflammatory signaling pathways; and (ii) fluoride exposure, in humans with skeletal fluorosis, may alter the expression of two pathways relevant to cancer: pathways in cancer and proteoglycans in cancer. If the effects of fluoride on inflammation and cancer are added to the other known effects of fluoride, including those on thyroid hormone metabolism, oxidative stress, and excitotoxicity, the potential field for fluoride research becomes very broad and would include conditions commoner in fluoridated communities compared to nonfluoridated communities, particularly where the water is soft, such as asthma, chronic obstructive pulmonary disease, obesity, rheumatoid arthritis, ischaemic heart disease, sarcoidosis, osteosarcoma, prostate cancer, leukaemia, pancreatic cancer, brain cancer, skin cancer, and melanoma.
... Scientists have studied, with a variety of methods, the concern that exposure to water fluoridation could cause osteosarcoma and have built an evidence base that provides ever greater confidence that CWF does not increase the risk of cancer. Yiamouyiannis and Burk first claimed an association between fluoride in drinking water and cancer in 1977 [33]. They reported a higher rate of all cancer mortality in 10 U S. cities with fluoridated drinking water than in 10 nonfluoridated cities, findings subsequently criticized for being at high risk for bias [27,34,35]. ...
Community water fluoridation (CWF) and its effect in reducing the burden of dental caries (tooth decay) is considered one of ten public health achievements in the 20th century. In the U.S., three-quarters (74.4%) of people on community water supplies have optimally fluoridated water, and each year approximately 90 communities actively consider starting or discontinuing CWF. CWF exists within the policy environment and includes actions taken by local community councils, health and water boards, and groups; state legislatures and health departments; national regulatory and science agencies; independent science entities; and professional and non-profit organizations. Epidemiologists have been in the forefront of CWF. Experience with the past 70 years reveals that the coming decades will bring additional questions, recommendations and challenges for CWF. The continued involvement of epidemiologists as part of multi-disciplinary teams is needed in research, surveillance, peer-review of studies, assessment of systematic review findings, and in the translation and communication of science findings to audiences with limited science/health literacy. This paper’s purpose is to: 1) examine how epidemiologic evidence regarding CWF has been translated into practice and policy, 2) examine how recommendations for and challenges to CWF have affected epidemiologic research and community-decision-making; and 3) identify lessons learned for epidemiologists.
... Further studies have confirmed a 6.9 fold increase in bone cancer in young males [28]. Earlier studies had found a 5% increase in all types of cancers in fluoridated communities [29]. Cancer researchers have found a 17% rise in 16 years of cancers in towns in the USA that is fluoridated in comparison with those that are not. ...
... In 1975, Yiamouyiannis and Burk reported to the U.S. Congress that a set of 20 U.S. central cities had almost identical cancer mortality rates (cancer deaths per 100,000 people per year) between 1940 and 1950, but that since fluoridation started (in 1952-1956) in a group of ten of these cities their cancer death rate increased faster than that of the ten cities remaining non-fluoridated (Fig. 3). The study was later published in the Journal "Fluoride" [Yiamouyiannis and Burk 1977] and caused quite a stir. Early in 1976, a representative of the National Cancer Institute (NCI) claimed in a letter to Congressman Delaney that the NCI´s re-analysis showed that the increase was entirely due to changes in the age, race and sex structure of the population in question [Fredrickson 1976]. ...
... The literature places a huge burden of discrimination on the reader. Yiamouyiannis and Burk (1977) 35 compared the pattern of cancer death rates for the 10 largest fluoridated cities in the United States with the ten largest cities not fluoridated in 1969, but with a cancer death rate of 155 per 100,000. Fig. 19 shows the comparison. ...
of Contents ii If we teach only the findings and products of science – no matter how useful and even inspiring they may be – without communicating its critical method, how can the average person possibly distinguish science from pseudoscience? . . . Many, perhaps most, textbooks for budding scientists tread lightly here. It is enormously easier to present in an appealing way the wisdom distilled from centuries of patient and collective interrogation of nature than to detail the messy distillation apparatus. The method of science, as stodgy and grumpy as it may seem, is far more important than the findings of science.
... Another long-term focus of fluoridation's opponents, the alleged hazards of fluoride to human health, received a great deal of attention during the 1970s (44,45). This issue too has been somewhat muted in recent years, perhaps since the 1983 Strathclyde court decision in Scotland, though some concerns have been aired recently about supplemental uses of fluoride rather than water fluoridation. ...
Recent questions about the effectiveness of water fluoridation have come from Diesendorf in Australia and Colquhoun in New Zealand. This report examines the arguments of both authors in detail and finds errors in each. Diesendorf employed an outdated view of how fluoride exerts its anticariogenic action and took a number of quotations out of context. Colquhoun's data are questionable. Neither author has produced evidence to challenge the established safety and effectiveness of water fluoridation.
... First, Strassburg & Greenland pointed out that the three nonfluoridated cities -Boston, Cincinnati and New Orleans-with, respectively, 200%o, 2607o and 270%o higher cancer death rates than the national average, had been excluded from Yiamouyiannis' study on the grounds that they were "aberrant" cities, their higher cancer rates having been linked previously to other water-borne contaminants, such as chlorine, chlorinated hydrocarbons, pesticides and herbicides. However, in the subsequent publication (30) by Yiamouyiannis & Burk, in 1977, the three cities mentioned were included. Second, it was pointed out by Strassburg & land that the fluoridated cities had the highest cancer death rates in 1950, as well as in 1970, and that the rate of increase in the nonfluoridated cities during this period was exactly the same (1507o) as in the fluoridated cities. Thirdly, the authors demonstrated that the level of industrialization, as measured by the percentages of the work force employed in manufacturing indus- tries, (2) Changes in cancer mortality by 5-year periods before, during, and after fluoridation. ...
Since 1945, artificial fluoridation of water supplies has been used with success to reduce the incidence of dental caries in many areas where the natural fluoride content of the water is low. However, since 1975, it has been maintained that such artificial fluoridation is followed by an increased risk of cancer. These allegations originate from a single source. The present review, which covers re-examinations of the same data as well as evidence from scientific and governmental bodies in many countries, shows these assertions to be erroneous.
In 2017 the Australian National Health and Medical Research Council (NHMRC) released a draft information paper on the health effects of water Fluoridation that completely ignored thousands of peer-reviewed scientific publications regarding Fluoride toxicity, by using contrived exclusion criteria and time limits. Similar tactics were employed by the NHMRC in its Fluoridation review published in 2007. This submission, one of the 32 made public, formally records some of the science that has been deliberately ignored.
Acute and chronic poisoning of the gastrointestinal tract by ingested Fluoride has been studied for over 130 years with the measurable damage documented from the oral cavity through to the intestines.
There are foods that are healthy, and there are many that are not. Many forms of cancer can be prevented by dietary and lifestyle changes, and eating good foods can aid in recovery from cancer. A healthy person will do better than an unhealthy one. The foods we eat everyday have been formed largely by habit. Thus changes to eating patterns will take practice to form new habits. This chapter examines the evidence that diet does contribute to cancer, and about foods that may assist in preventing cancer, as well as assisting patients with cancer. This includes foods that may be added to diet and those which should be minimised or eliminated. It sets out thirteen dietary principles that may be discussed with the patient, and incorporated into a Wellness Plan.
Only a few epidemiological studies have been conducted to determine the relationship between minerals and the incidence of cancer in humans. This is mainly due to the difficulty of identifying populations with significantly different intakes of the various minerals. In contrast, there have been numerous studies on the carcinogenic effects of many metals, administered at high doses to the animals parenterally. However, the results of these animal studies have shed little light on the potential carcinogenic risk from these elements in the amounts occurring naturally in the diet of humans.
Discusses how dental and medical scares have resulted in a “culture of fear” which has damaged patients and dentists. Forty years of pessimism have created a demoralised and risk-averse society. The reality of a steadily improving world demands a new attitude of rational optimism and a healthy scepticism about new scares.
Although a very wide range of environmental factors have been associated, at one time or another, with adverse health outcomes, there are certain basic characteristics of the problems raised which will affect the approach to their investigation. These characteristics relate mainly to the area and length of time of exposure to the potential hazard. First, area: a potential hazard may be isolated in one particular spot (e.g. a toxic waste dump) or diffused throughout large areas (e.g. lead from car exhausts). Second, a possible hazard may arise from a single event (e.g. an accidental chemical discharge) or from longer-term or continuous exposure (e.g. long-term nuclear waste disposal). Clearly, such divisions may not be completely exclusive of each other. It may not always be clear, for example, whether several ‘spot’ hazards should be treated as a ‘diffused’ hazard. These issues will be discussed further, but there is some advantage in making these distinctions, at least initially, for the insight they give into problems of assessing a possible hazard. The categories of area and time combine (Figure 2.1) to produce three basic types of potential hazards: (1) spot single event; (2) spot long-term; (3) diffused long-term. In theory, a fourth possible category, diffused single events, could be included. However, nature may be able to produce hazardous single events diffused over large areas (storms), but few if any man-made environmental hazards would be able to accomplish this.
Experimental toxicological studies in laboratory animals and epidemiological human studies have reported a possible association between water fluoridation and osteosarcoma (OSA). To further explore this possibility, a case-control study of individual dogs evaluated by the UC Davis Veterinary Medical Teaching Hospital was conducted using ecologic data on water fluoridation based on the owner's residence. The case group included 161 dogs with OSA diagnosed between 2008-2012. Two cancer control groups included dogs diagnosed with lymphoma (LSA) or hemangiosarcoma (HSA) during the same period (n = 134 and n = 145, respectively). Dogs with OSA were not significantly more likely to live in an area with optimized fluoride in the water than dogs with LSA or HSA. Additional analyses within OSA patients also revealed no significant differences in age, or skeletal distribution of OSA cases relative to fluoride status. Taken together, these analyses do not support the hypothesis that optimal fluoridation of drinking water contributes to naturally occurring OSA in dogs.
Trace elements often have a bimodal or even a trimodal effect. Severe deficiency of certain trace metals can result in death or severe crippling of an animal or in birth defects of the newborn. The next level of intake is the nutritional level where chronic deficiency over a lifetime may cause major diseases such as cancer and heart disease. The next level of intake is the toxic level which may result in severe crippling or death of the animal. The primary area of concern in this chapter will be the nutritional intake level and the deficiency level and their relationship to animal or human disease. The trace elements described in this chapter are: chromium; cobalt; copper; fluorine; iodine; iron; manganese; molybdenum; nickel; silicon; selenium; tin; vanadium; and zinc.
Rao and Thakur have shown that the antioxidants melatonin and alma (Emblica officinales, Indian gooseberry) are effective, both individually and in combination, against fluoride-induced genotoxicity in human peripheral blood lymphocyte cells, which was first described in humans in 1994. Some animal and human work also suggests that fluoride (F) can impair the defensive response to genotoxicity by being deposited in high concentrations in the pineal gland and, through an enzyme-inhibiting action, reducing the secretion of melatonin, a powerful antioxidant able to eliminate free radicals and protect DNA. In having the capacity to be both genotoxic and impair melatonin secretion, F is similar to electromagnetic radiation, at power line frequencies and above, and both have very low or zero thresholds for causing toxicity. In view of the seriousness of neoplasia, the effect of fluoride on melatonin secretion warrants further research.
This chapter discusses water contaminants that may contribute to the human cancer burden. Specifically, it addresses the epidemiologic evidence for several contaminants and includes information on their levels and environmental distribution, as well as individual susceptibility, where data exist. The three categories of drinking water contaminants that may be carcinogenic and that have been studied most systematically are arsenic, disinfection by-products, and nitrate. In addition, radionuclides, microbiological agents, organic compounds from human commerce, and asbestiform particles have been reported to cause cancer, either as they occur in drinking water or in other media, giving rise to suspicion about their carcinogenicity when ingested. Future research priorities and prevention strategies are discussed.
A lively account of fluoridation and its discontents. Since its first implementation in Grand Rapids, Michigan, in 1945, public drinking water fluoridation and its attendant conflicts, controversies, and conspiracy theories serve as an object lesson in American science, public health, and policymaking. In addition to the arguments on the issue still raging today, the tale of fluoridation and its discontents also resonates with such present concerns as genetically modified foods, global warming response, nuclear power, and environmental regulation. Offering the best current thinking on the issue, The Fluoride Wars presents a witty and detailed social history of the fluoridation debate in America, illuminating the intersection of science and politics in our recent past. This reader-friendly assessment explores the pro- and anti-fluoridation movements, key players, and important events. Full of amusing and vivid anecdotes and examples, this accessible recounting includes: A careful and non-condescending look at the hard science, popular science, pseudo-science, and junk science involved. A look at fluoride issues including dosage, cost, financial and funding interests, fluorosis, and problems of risk-cost-benefit analysis. The back-and-forth drama between pro- and anti-fluoridation factions, with all its claims, counterclaims, insults, acrimony, and lawsuits. Case studies of various cities and their experiences with municipal water fluoridation initiatives. Fluorophobia and popular conspiracy theories involving fluoride. The colorful characters in the debate including activists, scientists, magicians, and politicians. A richly and considerately told tale of American science and public life, The Fluoride Wars offers an engrossing history to both interested general readers and specialists in public health, dentistry, policymaking, and related fields.
Environmental-dental burdens are immunologic relevant stress factors caused by dental materials and additives and by root-treated teeth. The effective direction thus is not only an allergic, but in every way also a toxic kind and as a result of these chronic-toxic burdens, mutagen and hormonal stresses will be identified. In this way they are verified as immunologic problems.
Environmental-dental burdens are immunologic relevant stress factors caused by dental materials and additives and by root-treated teeth. The effective direction thus is not only an allergic, but in every way also a toxic kind and as a result of these chronic-toxic burdens, mutagen and hormonal stresses will be identified. In this way they are verified as immunologic problems.
This chapter provides an introduction to surgical and dental materials, dietary preparations and sweeteners, dyes and colorants, miscellaneous organic compounds, and miscellaneous inorganic compounds. The high polymerization temperature of acrylic cement is considered to be the main factor responsible for bone necrosis. An intrauterine device (IUD) is thought to break the protective barrier of cervical mucus because of the vaginal thread attached to it. This can facilitate infections with quite unusual flora around the IUD and provoke serious pelvic inflammation. Besides local reactions to paraffin used in plastic surgery the deposits and reactions can occur at sites remote from the area of introduction. Diarrhoea in infants, due to lactose intolerance, can be treated with lactase preparations. Like any other form of protein, this enzyme can produce hypersensitivity reactions. Hypersensitivity was clinically confirmed by intracutaneous injection of 10-4 dilution of the preparation. Deliberate inhalation of fluorocarbon propellant can result in sudden death. Usually cardiovascular failure, due to a sudden onset of cardiovascular arrhythmia is the underlying factor.
This report presents the findings of a review of the evidence carried out by a team at the Evidence Centre of the Health Research Board (HRB) on the health impacts of community water fluoridation (CWF).
Inorganic Fluorides are potent bio-accumulative poisons with no nutritional value and there is abundant evidence from the published literature that they are genotoxic carcinogens affecting numerous organs. Fluoride interferes with the tumour suppression by Melatonin. Fluoride will increase the deposition of Hydroxyapatite crystals in the tissues and these crystals accelerate malignant cancer growth.
Fluorosis ranks high among the major environmental health problems in India. Non-ulcer dyspeptic complaints are common in humans and it is a known fact that fluoride in drinking water, food and other items can cause these symptoms.
Fifty adult outpatients (mean age: 35.2±12.7y) with chronic abdominal pain of unexplained origin were tested for their serum, urinary, and drinking water fluoride (F) concentrations. These concentrations were compared with those of 50 asymptomatic outpatients (mean age: 37.4±11.5y) and analysed statistically.
Serum F concentrations were higher than normal in 62% of the study group I and in 42% of the control group II with a mean of 0.065±0.03ppm (range: 0.010-0.421) in the former and 0.023±0.028ppm in the latter. Statistical analysis of the data by Student's t-test (unpaired) revealed a significant correlation (p<0.05) between chronic abdominal pain and elevated serum F. Urinary fluoride concentrations in group I were 0.87±1.67 (0.01-3.7)ppm. Seventy-three percent of the patients examined for urinary fluoride concentrations were having higher values than normal, whereas 27% patients had normal range urinary fluoride concentrations despite raised serum fluoride concentrations.
In the cases of chronic pain abdomen, chronic fluoride ingestion from drinking water and other sources can be the cause and should be evaluated in patients in which other parameters are normal.
Fluoride occurs naturally in soil, water, plants and animals in trace quantities. When fluoride is ingested, some is taken up by body tissues, with long-term deposition in teeth and bones. Following the demonstration of a significant reduction in dental caries in childhood within populations exposed to higher levels of fluoride in drinking water, between 1964 and 1975 several Local Authority water fluoridation schemes were introduced in England and Wales, whereby the fluoride content was artificially increased to a level of 1ppm (1mgL−1). Although evidence continues to support the premise that fluoride in water helps protect children's teeth against caries, there are a number of potential adverse impacts, notably dental fluorosis (mottling of teeth). The situation is complicated by the fact that many individuals receive additional exposure to fluoride through the use of fluoride toothpaste, for example. Nonetheless, fluoridation of water continues to be generally regarded as a safe, simple and cost-effective public health measure to reach children most at risk and reduce the incidence of dental caries.Available evidence on risk of hip and other bone fractures suggests no effect of fluoride in water, although a small percentage change (in either direction) cannot be ruled out. There appears to be no link between water fluoridation and either cancer in general or any specific cancer type, but an updated analysis of UK data on fluoridation and cancer rates has nonetheless been recommended. Evidence for additional health outcomes suggested by some to be associated with fluoride ingestion, and on other concerns related to the chemicals that are added during the fluoridation process and indirect effects such as increased leaching of lead from pipes and aluminium from cooking utensils, is weak but the area deserves to be kept under review.
In this chapter, I explain how I became involved in the fluoridation issue, how I found internal contradictions and misrepresentations in the pro-fluoridation case, how I campaigned against fluoridation, how the establishment ‘experts’ tried to suppress me, and conclude by offeringsome lessons. Boxes are included on (1) the fluoridation power structure and (2) howfluoride acts on teeth.There is also an Appendix summarising my critique of fluoridation.
Fluoridation: breaking the silence barrier. Available from: https://www.researchgate.net/publication/228601887_Fluoridation_breaking_the_silence_barrier [accessed Jun 14, 2016].
‘Water is life,’ so central to human life, yet over one billion people across the world have no access to safe drinking water. Of late, there has been increasing global attention focused on resolving water quality problems especially in developing countries, as the lack of access to clean water denies the most essential of all rights, the right to life. The latest estimates suggest that around 200 million people, from among 25 nations the world over, are under the dreadful fate of fluorosis. India and China, the two most populous countries of the world, are the worst affected. India is plagued with numerous water quality problems due to prolific contaminants mainly of geogenic origin and fluoride stands first among them. The weathering of primary rocks and leaching of fluoride-containing minerals in soils yield fluoride rich groundwater in India which is generally associated with low calcium content and high bicarbonate ions. The unfettered ground water tapping exacerbates the failure of drinking water sources and accelerates the entry of fluoride into groundwater. Most of the scientific literature substantiates the benefits of low fluoride concentrations in preventing dental decay. However, as a surprising paradox, incidence of dental, skeletal and crippling skeletal fluorosis was reported in India with average fluoride concentrations as low as 0.5, 0.7 and 2.8 ppm respectively. Fluorosis, turns out to be the most widespread geochemical disease in India, affecting more than 66 million people including 6 million children under 14 years age. Though fluoride has spread its tentacles in 36,988 habitations and the number of people falling prey to fluoride poisoning have been steadily increasing, an exact exposure-health relationship is yet to be properly elucidated. There is an essential relation between poverty and fluorosis as malnutrition is found to play an aggressive role in its severity.
Fluoridation is not a Communist Plot; it is an attempt by industry to camouflage their deadliest pollutant, with government officials and Madison Avenue advertisers beating the drums. The fluoridation empire is like a castle built on quicksand.1855 Smelters in Freiburg, Germany first paid damages to neighbors injured by fluoride emissions. (See 1893) 1893 The smelters in Freiburg, Germany paid out 80,000 marks in damages for fluorine contamination injuries and 644,000 marks for permanent relief. (See 1855, 1900, 1907). 1900 The existence of the smelting industry in Germany and Great Britain is threatened by successful lawsuits for fluorine damage and by burdensome laws and regulations. 1907 The smelters in Freiburg, Germany (see 1893) are identified as the cause of crippled cattle in the area since 1877, and fluorides are identified as the culprit. 1916 The first evidence of brown mottling of teeth is reported in the United States, and would be eventually found to be caused by fluorides in water. 1922 Aluminum production (along with production of toxic by-product sodium fluoride) increases. Aluminum cookware is mass introduced in the US, beginning the gradual accumulation of aluminum in the brains of Americans. Additional aluminum is injected into society in "antacids" and toothpaste tubes, which aggravate the action of toxic fluorides. 1928 The equivalent of the U.S. Public Health Service is under the jurisdiction of Treasury Secretary Andrew W. Mellon, a founder and major stockholder of ALCOA aluminum, a major producer of toxic fluoride wastes. Mellon would step down from control of the Public Health in 1931. 1928 Edward L.Bernays, nephew to Sigmund Freud, writes the book Propaganda, in which he explains the structure of the mechanism which controls the public mind, and how it is manipulated by those who wish to create public acceptance for a particular idea or commodity. Says Bernays, "those who manipulate this unseen mechanism of society constitute an invisible government which is the true ruling power of our country. Our minds are molded, our tastes are formed, largely by men we have never heard of." Bernays represents another connection to Germany and would be essential in the fluoride campaign in the United States. Wrote Bernay's, "if you can influence group leaders, either with or without their conscious cooperation, you automatically influence the group which they sway." (See Bernay's, 1947, and the fluoride campaign).
: Adult female mice were allowed ad libitum access to tap water containing 0, 100, 200 and 300 ppm sodium fluoride (NaF) for either 4 weeks or 12 weeks. The effect of NaF exposure on fertility was assessed in terms of the numbers of pregnant mice, implantations, viable fetuses, and resorptions. Exposure to NaF for 4 weeks did not have much effect on fertility, although there was a significant increase in the relative ovary weights and a decrease in the embryo weights in mice exposed to 300 ppm NaF. However, exposure to NaF for 12 weeks resulted in a significant reduction in the percentage of pregnancies at all concentrations used. Mice exposed to 200 and 300 ppm NaF showed a significant increase in relative ovary weights and a decrease in the number of viable fetuses. Furthermore, exposure to 300 ppm NaF for 12 weeks resulted in a significant decrease in number of implantations. These results indicate that long-term exposure of female mice to NaF causes ad-verse effects on the reproductive system and fertility.
The amount of fluoride ions adsorbed on laboratory fired brick clay varies with the initial concentration according to Type I adsorption isotherm for firing temperatures up to 700 °C, forming inner-sphere complexes between fluoride and mineral surfaces of brick clay. Type II isotherm is valid above this firing temperature forming outer sphere complexes. The turbidity of suspensions of low fluoride concentrations is negligible with brick clay fired at 300°C to 600°C. Moreover, the removal of fluoride by brick clay fired at intermediate temperatures is high followed by a decrease at high firing temperatures.
This study examines the contentious public health policy of treating community water with fluoride in the United States. The question for scholarly investigation is why water fluoridation has been unsuccessful in several parts of the United States relative to the rest. It addresses this question by looking into the processes of scientific discovery and information dissemination, benefits and risks of science-based health policy, related issues of provision and production, and spatial dimensions of policy development. The case method based on New Jersey's experience in public water fluoridation, was opted for this study. We find that policy debates, which are confined to single key issues, tend to breed binary choices and bipolar debates and result in policy stalemates. Consumer accessibility and desirability of merit goods thus become sharply conflicting social welfare values. They undermine the intent of science-based policies and often make alternative and second-best policies more practical to adopt.
For all the 121 municipalities in Southern Norway where 60% or more of the inhabitants get water from registered water supplies, the municipal average concentration of natural fluoride in the water has been determined and the municipalities divided into three groups with fluoride level 0--0.05 mg/1, 0.06--0.10 mg/1, and 0.11--0.50 mg/1, respectively. The average, age-adjusted municipal mortality rate of cancer in the mouth and throat was then determined for each of these groups by sex. The resulting figures show that the mortality rate declines for both sexes with increasing fluoride level: For males from 4.7 deaths per 100 000 per year on the low fluoride level, to 3.9 deaths per 100 000 per year on the medium fluoride level, and to 3.1 deaths per 100 000 per year on the high fluoride level. For females the corresponding figures are 1.5, 1.3 and 0.5. Arguments to show that these figures are unbiased from different tobacco consumption habits, differences between urban and rural municipalities, and differences in population size are presented. Possible, explicatory models are discussed.
The standardized cancer mortality ratios for selected localities in New South Wales with fluoridated and non-fluoridated water supplies were examined. The cancer mortality ratios for both fluoridated and non-fluoridated localities were spread along a continuum. Two localities (one fluoridated, one non-fluoridated) had standardized mortality ratios significantly lower than the New South Wales State average. No relationship was found between cancer deaths and whether water supplies had been fluoridated or not.
Because osteosarcomas may develop in rats exposed to fluoridated water, water fluoridation might pose a cancer risk to humans.
A time trend analysis of the cumulative risk (CR) of bone cancer for the period 1958-1987 for 40 cancer registry areas showed an increased risk for young males in Canada, Europe, and the United States, and a decreased lifetime risk for either sex in Europe.
This was unrelated to water fluoridation and may have resulted from changes in coding practices. Bone cancer risk was inversely related to the incidence of cancers of unknown origin, suggesting that bone metastases were erroneously coded as primary bone cancer. In 1968-1972, most areas recorded more bone cancer deaths than new cases of the disease.
The mortality/incidence ratio, but not the incidence rate (IR), has dropped sharply since then, which erodes the basis of past inferences relating cancer mortality to fluoridation.
This summarizes current knowledge of the benefits and risks of fluoride ingestion. The preponderance of evidence indicates that fluoride can reduce the incidence of dental caries and that fluoridation of drinking water can provide such protection. Due to the ubiquitous nature of exposures to fluoride sources other than drinking water, it is currently impossible to draw firm conclusions regarding the independent effect of fluoride in drinking water on caries prevalence using an ecologic study design. Moderate dental fluorosis occurs in 1 to 2% of the population exposed to fluoride at 1 mg/l in drinking water and in about 10% of the population at 2 mg/l; moderate/severe fluorosis occurs in variable percentages ranging up to 33% of the population exposed to fluoride at 2.4 to 4.1 mg/l in drinking water. The issue of whether moderate or severe dental fluorosis represents an adverse health effect is still controversial. There is no evidence of skeletal fluorosis among the general U.S. population exposed to drinking water fluoride concentrations lower than 4 mg/l. Radiographically detected osteosclerosis after chronic exposure to fluoride in drinking water at 8 mg/l was not associated with clinical symptoms. Reports of crippling skeletal fluorosis associated with low concentrations of fluoride in drinking water in tropical countries have been attributed to other dietary factors. The available data suggest that some individuals may experience hypersensitivity to fluoride-containing agents. Further studies on hypersensitivity are required. There is no evidence of increased incidence of renal disease or renal dysfunction in humans exposed to up to 8 mg fluoride per liter in drinking water. Structural changes in kidneys of experimental animals have been detected at doses exceeding 1 to 5 mg fluoride per kilogram per day. Based on four case reports, individuals with renal insufficiency who consume large volumes of naturally fluoridated water at 2 to 8 mg/l are possibly at increased risk of developing skeletal fluorosis. Studies on the effects of fluoride in individuals with renal insufficiency are needed. There is no evidence that chronic exposure to concentrations of fluoride reported to be greater than 2 mg/l in drinking water increases human cancer mortality or incidence. A study of lifetime exposure to fluoride on cancer incidence in rats and mice has been completed, but assessment for cancer has not been completed. There is no evidence that fluoride is genotoxic except in some in vitro assays at cytotoxic concentrations. There is no in vivo evidence that fluoride affects human cellular enzyme activities.(ABSTRACT TRUNCATED AT 400 WORDS)
The fifty-year-old fluoridation hypothesis has not been confirmed. Despite this, millions of people are still medicated with fluoride by government decree, on the assumption that this process has been proved to be entirely safe, and very efficacious in reducing dental caries. In fact, the scientific basis of fluoridation is very unsatisfactory. It is promoted, in the main, by emotion-based 'endorsements' rather than by scientifically-acceptable evidence.
It has been 40 years since the first community in the United States added a regulated amount of fluoride to its public water supply to prevent tooth decay. Despite the proven benefits of fluoride, today only 61 percent of the U.S. population on public water supplies receives fluoridated water. Progress in fluoridating water is impeded by antifluoridation campaigns and a change in the way Federal funds are allocated for State and local fluoridation programs. Despite profluoridation efforts by the Public Health Service, American Dental Association, and other organizations, the well-publicized claims of fluoride hazards by opponents have prevented many communities from initiating water fluoridation and have caused other communities to discontinue their programs. The law and half a century of research are on the side of fluoridation, as are new scientific findings indicating that optimal amounts of fluoride may reduce the incidence or severity of osteoporosis.
The controversy surrounding fluoridation persists. In recent years opponents of fluoridation have resorted to the courts with increasing frequency and have achieved a few victories in the trial courts. To date, however, no appellate court has ruled against fluoridation. This article discusses the constitutional basis for the court decisions upholding fluoridation and the main arguments put forth by the antifluoridationists. Five of the more recent cases are summarized, as is the first fluoridation case to be appealed to the US Supreme Court. The article concludes that the legal validity of fluoridation in the United States has been thoroughly tested in the courts and confirmed. It appears that the antifluoridationists will concentrate their future legal attacks on the "harmful effects" of fluoridation on health and the environment. If they can convince the courts that even a few people were truly harmed, the delicate balance between the rights of the state to fluoridate in order to protect the public's health and the rights of the individual not to be harmed could well shift. In closing, the question is raised whether the US Congress has the power to pass legislation either to mandate or forbid fluoridation.
Basically, epidemiology is the making of measurements of known reproducibility, in a bias-free manner, on representative samples of subjects drawn from defined communities. Epidemiology has become a relatively precise science and its value in medicine is widely appreciated. So too are its limitations: the difficulties in achieving a high response rate, in identifying and controlling confounding factors in the examination of an association, and the ultimate difficulties in distinguishing causation from association. While the value of community-based studies seems to be recognized by those interested in man and his environment, the need for the strict application of epidemiological procedures, and the limitations imposed on conclusions drawn from studies in which these procedures have been compromised, does not seem to be adequately understood. There are certain known links between trace elements in the environment and disease: for example the level of iodine in soil and water and the prevalence of goitre; the level of fluoride in water and the prevalence of dental caries. The investigation of other possible associations is difficult for a number of reasons, including interrelationships between trace elements, confounding of trace element levels (and disease) with social and dietary factors, and the probability that relationships are generally weak. Two conditions in which associations are likely are cardiovascular disease and cancer. Despite research along a number of lines, the relevance of trace elements to cardiovascular disease is not clear, and certainly the apparent association with hardness of domestic water supply seems unlikely to be causal. The same general conclusion seems reasonable for cancer, and although there are a very few well established associations which are likely to be causal, such as exposure to arsenic and skin cancer, the role of trace elements is obscure, and likely to be very small.
Mortality in Anglesey from cancer (all sites), cancer of trachea, bronchus, and lung, cancer of stomach, and cancer of all other sites has been compared with mortality in England and Wales at two periods; 1949-53 (before fluoridation) and 1979-83 (after 20 years and more of fluoridation). No evidence has been found to support the hypothesis that water fluoridation affects cancer mortality.
When exposing rats to drinking water containing 100 p.p.m. fluoride for 8 weeks, no effect could be detected in biochemical parameters of the liver, such as the concentrations of the polyamines putrescine, spermidine and spermine; the levels of microsomal protein and cytochrome P-450; or the activities of two associated monooxygenases, aryl hydrocarbon hydroxylase and ethylmorphine N-demethylase. Neither was there any increase in plasma glutamic-oxalacetic transaminase indicative of liver damage.
A recent experience as an expert witness in a legal action intended to prevent the fluoridation of water supplies has emphasized to me some of the problems of explaining statistical reasoning to persons unfamiliar with the mode of thought. The procedures of cross-examination are not ideal for clarifying scientific truth, and regrettably the language of statistics offers much scope for misunderstanding when words used technically are read with more colloquial meaning. I illustrate this by discussing the meaning of significance tests and by examples relating to the combination of independent test results, the misunderstanding of independence, covariance analysis, the use of interpolation, the relation between source of data and interpretation, and spurious correlation.
The possibility of a cancer risk associated with fluoridation of public water supplies is re-examined using mortality data
for 35 US cities, 20 with fluoridated water supplies and 15 with non-fluoridated water. Crude cancer death rates, and mortality
ratios standardized for age, sex, and ethnic group are examined, using four alternative sets of standard rates and three different
combinations of pericensal years' deaths. Changes in cancer mortality before and after fluoridation in the fluoridated cities
are compared with changes in the non-fluoridated cities over the same time period. In none of the analyses have differences
in mortality trends been found that could not be due to chance alone. Thus, these results do not support the suggestion of
an association between fluoridation of water supplies and cancer mortality.
Site-specific cancer mortality data for 20 United States cities have been abstracted from United States Government publications to explore further the hypothesis that fluoridation of water supplies causes cancer. Changes in mortality (standardised for age, sex, and ethnic group) between 1958-62 and 1968-72 in 10 fluoridated and 10 non-fluoridated United States cities have been examined. Of the seven sites (or groups of sites) examined, for only one is there a statistically significant difference between the fluoridated and non-fluoridated cities with respect to average change in mortality. This difference, for cancers of the genital organs, favours the fluoridated cities. These data do not provide evidence of a positive association between fluoridation of water supplies and cancer of any of the sites considered.
The mortality from cancer in the 10 largest cities in the USA that have had fluoridated water supplies since before 1957 was somewhat higher in 1970 than in the large non-fluoridated cities that we have examined. The relative excess has not increased since 1950, if allowance is made for changes in the sex, age, and ethnic group constitution of the population by any of the standard methods. On the contrary, it has decreased slightly no matter which of the appropriate methods of comparison is chosen. We thank Angela Hewitt for help with the analyses and the National Center for Health Statistics, Maryland, for making available mortality data relating to the cities covered by this study.
Examination of the trend in mortality for cancer in the seven cities in England and Wales with populations of over 400000 and in England and Wales as a whole between 1959-63 and 1974-8 provides no reason to suppose that any unique factor, such as fluoridation of the water supplies, has affected the death rate for cancer in Birmingham since 1964.
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