Subject: Re: Fluoridated water

From: [email-masked] (Steven B. Harris )
Date: 5 Sep 1995 06:25:17 GMT

In <[email-masked]> [email-masked] (Shera) writes: 
>
>  Maybe 
>>Medic-Alert bracelets could also be upgraded with social victimology 
>>status:  "Attention, physician: Longtime NutraSweet-induced chronic 
>>fatigue sufferer. Call Searle for details."
>>
>>                                      Steve Harris, M.D.
>>
>This struck me, as a sufferer of severe fibromyalgia (a.k.a. "chronic 
>fatigue" syndrome) as an extremely unkind statement.  It was hurtful
to 
>me and would be to anyone who suffers the pain I do, to read your
flippant
>and sarcastic remark.  No amount of credentialing excuses ignorance,
and 
>no amount of ignorance excuses rudeness.  How can you ever hope to
inspire
>a patient to belief in your capabilities?
>
>Shera, PhD in Crabbiness
>
>
>

Dear Ms. Crabby:

   Try to read more carefully.  Fun was being poked at people who
believe their chronic fatigue is caused by NutraSweet, not at people
who have chronic fatigue in general.  

   By the way, although many people with the chronic fatigue syndrome
have fibromyalgia, having the latter does not automatically qualify you
as having chronic fatigue.  Not even fibromyalgia plus crabbiness does.

                                           S. Harris, M.D.

---

From: [email-masked] (Shera)
Date: 5 Sep 1995 05:35:23 GMT

Maybe 
This struck me, as a sufferer of severe fibromyalgia (a.k.a. "chronic 
fatigue" syndrome) as an extremely unkind statement.  It was hurtful to 
me and would be to anyone who suffers the pain I do, to read your flippant
and sarcastic remark.  No amount of credentialing excuses ignorance, and 
no amount of ignorance excuses rudeness.  How can you ever hope to inspire
a patient to belief in your capabilities?

Shera, PhD in Crabbiness

---

From: [email-masked] (Matthew H. Fields)
Date: 5 Sep 1995 18:29:35 GMT

In article <[email-masked]>,
Elke Babiuk  <[email-masked]> wrote:
}}    No, I'm not confusing anything.  Some hip fracture studies have 
}} used epidemiological methods to compare communities with natural 
}} water fluoride, but most have looked at artificial fluoridation, 
}} which is usually either sodium or hydrogen fluoride (there is no 
}} difference once it hits both drinking water, then your stomach-- 
}} fluoride is a free anion in weak solution and cannot "tell" your 
}} body what it was once attached to). 
}
}Dr. Harris, face it--you still don't know very much about fluoride!
}They DON'T put hydrogen fluoride in water. Call your water
}authority, they'll set you straight. 

Hmmm, Elke Bubiuk, face it-- you still don't know very much about
basic high school chemistry.  If you were to attribute toxicity to
sodium flouride not present in hydrogen flouride, you'd have to realize
that the difference is the toxicity of sodium.

}}}}You are WRONG about the correlation between hip fractures and
}} fluoride. Of the many recent studies which have been performed
}} and published in peer-reviewed journals, MOST show a positive
}} correlation with increased hip fracture rates and fluoride levels in
}} drinking water. Others looking at fluoride therapy for osteoporosis
}} also report increased hip or other fracture rates from the drug.<<
}} 
}}     No.  Results are mixed with the large prospective osteoporosis 
}} studies, which use very large levels of fluoride (one review I ran 
}} across reports 2 of these studies that report more fractures, 2 
}} that report fewer).  As for the hip fracture studies in water 
}} fluoridation (a very different question, with a very different 
}} dose of mineral), we have a problem in how to evaluate epidemiologic 
}} studies, which I always hit when trying to explain study results to 
}} untrained people reading them.

}Isn't it a little presumptuous of you to assume that I don't have the
}requirements to evaluate epidemiologic studies? 

Your inability to see that hydrogen flouride is in solution after you
put sodium flouride into water suggests exactly that.

[300+ lines of citations deleted]

I'm not involved in these stupid flouride debates, but I must say,
the level of pretentiousness that I see here amazes me.

I'm still wondering how you're hoping to acquire hydrogen flouride
in "mineral" form.  Anybody got a CRC handy, can tell us the condensation
point for HFl?

---

From: Elke Babiuk <[email-masked]>
Date: 5 Sep 1995 04:53:29 GMT

>[email-masked] (Steven B. Harris ) wrote:

>     >>Dr. Harris, when you mention the hip fracture studies, you 
> seem to be confusing hydrogen fluoride with sodium fluoride (also, 
> instead of sodium silicofluoride, many cities which fluoridate use
> hydrofluosilicic acid--a waste by-product of fertilizer manufacturing
> which contains about 24% fluoride).<<
> 
>    No, I'm not confusing anything.  Some hip fracture studies have 
> used epidemiological methods to compare communities with natural 
> water fluoride, but most have looked at artificial fluoridation, 
> which is usually either sodium or hydrogen fluoride (there is no 
> difference once it hits both drinking water, then your stomach-- 
> fluoride is a free anion in weak solution and cannot "tell" your 
> body what it was once attached to). 

Dr. Harris, face it--you still don't know very much about fluoride!
They DON'T put hydrogen fluoride in water. Call your water
authority, they'll set you straight. 

>>>You are WRONG about the correlation between hip fractures and
> fluoride. Of the many recent studies which have been performed
> and published in peer-reviewed journals, MOST show a positive
> correlation with increased hip fracture rates and fluoride levels in
> drinking water. Others looking at fluoride therapy for osteoporosis
> also report increased hip or other fracture rates from the drug.<<
> 
>     No.  Results are mixed with the large prospective osteoporosis 
> studies, which use very large levels of fluoride (one review I ran 
> across reports 2 of these studies that report more fractures, 2 
> that report fewer).  As for the hip fracture studies in water 
> fluoridation (a very different question, with a very different 
> dose of mineral), we have a problem in how to evaluate epidemiologic 
> studies, which I always hit when trying to explain study results to 
> untrained people reading them.

Isn't it a little presumptuous of you to assume that I don't have the
requirements to evaluate epidemiologic studies? 

Even though you say results are mixed in osteoporosis trials, isn't this
because you are comparing uncontrolled trials (weaker data) to the
controlled studies? According to Kleerkoper M., & Balena R.
("Fluorides and Osteoporosis," Annu. Rev. Nutr. 11:1991), when one
looks at the controlled trials, "...sodium fluoride has no significant
therapeutic advantage over placebo with respect to VFR [vertebral
fracture rate]. These observations are in sharp contrast to uncontrolled
trials that almost uniformly report a dramatic effect of the drug in
reducing VFR." 

In late 1989, the chairman of the FDA advisory committee which
reviewed fluoride's effect on fracture incidence, was quoted as saying
the FDA "should quietly forget" about fluoride (Medical World News,
Nov.13, 1989). Then, the study published in the 1990 NEJM, by
Riggs L., et al., finally alerted the research community to the toxic
effect of fluoride on bones. 

>  Epidemiology shows correlation only.  Correlation is not causation, 
> since the correlation can be one of "proxy" or "marker" variables.  

That may be true of ONE study, but in epidemiological studies, one
must consider the "weight of evidence" (a series of studies which all
show a positive trend). In other words, the more studies which show
correlation, the more one favors causation. Correct?

> Because there is more ice cream sold in the Summer, and more juvenile 
> delinquency in the Summer, for instance, does not mean that ice cream 
> causes delinquency.   On the other hand, LACK of correlation is usually 
> pretty good evidence *against* causation, because it is very difficult 
> to have no correlation between variables which do in fact have a causal 
> relationship.  The reason is, for this to happen, you have to have 
> TWO causal processes, acting in opposite directions, and by coincidence 
> canceling each other out-- and the odds of this are low.  An example 
> (the only one I know of!) is un-irrigated corn growth rate and average 
> daily temperature during the year, which is statistically not well 
> correlated, but only because the actual large positive temperature 
> effect is being cancelled out by a positive rainfall effect which 
> correlates negatively with temperature, and cancels this effect during 
> the year almost entirely out (!)  Again, this kind of thing doesn't 
> happen often.
> 
>    The result of all this, though I know you hate to accept it, is 
> that studies showing no statistical correlation between fluoride 
> use and hip fracture, are more powerful than those that show one.  

Sorry, but it is not whether**I** will accept it, but many authorities
around the world disagree with you. More comments below

> Studies which show an effect have many possible alternative 
> explanations, not least of which is that many of them end up 
> tacitly comparing different communities.  Hip fracture rates are 
> different for metro and rural populations, for example,
> for reasons still poorly understood, and they have been 
> since before fluoridation.  If the rural/metro difference 
> is not taken into account when looking at fluoridation 
> epidemiology, results tend to get skewed due to the fact 
> that metropolitan areas historically fluoridate more often, 
> and fluoridate first.   

>    >>In the latest French study (a large one), the increased 
> risk was 86% for seniors who lived in areas where water contained 
> between 0.11 and 1.83 parts per million (equivalent to milligrams 
> fluoride ion per liter of water) fluoride, compared to those in 
> areas with <0.11 ppm.  The results were statistically significant 
> and were corrected for major individual risk factors (Jacqmin-Gadda, 
> H., et al., Fluorine Concentration in Drinking Water and Fractures 
> In the Elderly,  Journal of the American Medical Association, 
> 273:10 (letters-which, as I understand, are also peer-reviewed), 
> March, 8, 1995, pp 775-776).<<
> 
>     This is exactly the kind of study I'm talking about; as is the 
> positive Utah study below, also published in JAMA.  These kinds of 
> positive studies are intrinsically NOT as powerful as the negative 
> studies, nor are they as reliable in general as epidemiologic studies 
> comparing matched communities, or studies comparing single communities 
> with themselves through time as fluoridation is introduced (for reasons 
> which I hope will be obvious).  Examples of both, finding NO effect of 
> fluoridation on hip fractures, are appended.  One of them is a 
> Canadian study which you must surely be aware of.  How come you 
> didn't mention it?  In general, studies such as your JAMA letter,
> which show an effect of fluoride, are of lesser intrinsic quality 
> than studies showing no effect.

What a lot of rubbish Dr. Harris. Where on earth did you get your
medical degree? Both the Utah study and the French study were
solid epidemiological studies. 

Professor L. Lyon, one of the authors of the Utah study recently
elaborated on their study. Some comments:
"We adjusted for differences in age between the fluoridated
community and the two control communities, age being the strongest
risk factor for hip fracture. We also chose the control communities to
have similar proportions of members of the Church of Jesus Christ
of Latter-day Saints (Mormons) as the fluoridated community to
adjust for potential differences in cigarette and alcohol use, two other
risk factors."

Do you have any idea what this means Dr. Harris? No of course you
don't. Let me explain. Because there were so many mormons in this
study (remember they don't drink coffee or alcohol, and they live a
healthier lifestyle than most North Americans), **the statistically
significant positive effect of fluoridation on increased hip fractures
was all the more plain to see.***

You MAY have understood this if you had read more than just the
abstract, although with your distorted view of epidemiology that's
not necessarily a given.

As to the French study in JAMA being of "lesser intrinsic quality,"
get a grip! All the risk factors were accounted for and long-term
residence (ONE OF THE MOST IMPORTANT variables which
can skew a study of this kind) was factored in. 
 
The Canadian study (Suarez-Almazor ME et al) you mentioned as
showing no differences in hip fractures between fluoridated and
non-fluoridated communities and therefore more "powerful," didn't
adjust for any risk factors--unlike the Utah and French studies you
so readily dismiss.

You have to know the demographics here to appreciate how
weak this study is. Calgary, one of the cities under study and
my home town, is probably one of the fastest growing cities in
Canada. Much of the in-migration has come from the east
(which is mostly fluoridated!). According to the statistics, our
population growth outstrips Edmonton's by a wide margin. If
you don't consider long-term residence, this is an obvious
confounding factor for a city which was unfluoridated at the
time of the study.

The period understudy was also narrow and covered only the
years 1981-1987. Did you notice, Dr. Harris, that the authors
found a "statistically significant increase in the risk of hip
fracture," among fluoridated Edmonton men. Even though the
increase is relatively small, it was nonetheless significant.

As to the article that you like so much in the AM. J. of Public Health,
by Jacobsen SJ ; O'Fallon WM; Melton LJ 3d, there are some major
flaws in it. See the review by Dr. John Lee, published in the
Journal "Fluoride" (J. of the International Society of Fluoride
Research), 26:4 (Ocotber, 1993). Yes it's peer-reviewed.

>    >>Please also clue us to the literature you have read which leads 
> you to assume that the "good effects seem to outweigh any bad." Could 
> it be that perhaps your reading of the subject is a might limited?<<
> 
>    Could it be that yours is?  I'll include an abstract of an excellent
> review.  I recommend you read the review itself, of course, as I have.  
> Having access to all the study papers in the world will do you no good 
> if you have no idea how to evaluate a scientific study, and judge the 
> value of its findings.  Talk to some people in public health, or take 
>an epidemiology class or two.  It won't hurt, and may save you from much 
> embarrassment.

The last people I would go to for advice is anyone in public health, Dr.
Harris. I prefer to discuss these studies with research scientists, not
pencil-pushing bureaucrats, even if they are doctors. I'm not the one who
needs to be saved from embarrasment Dr. Harris. 

As stated below, the author (RIPA) of the "review" you included, is a
well known proponent of fluoridation Dr. Harris. This article is mostly
"commentary," as the title states, and thus opinionated. It's not
impressive. I prefer to get my information from more respected
scientific journals and publications than this one. Why don't you try
"Fluoridation Contention won't go away," by Bette Hilleman,
Chemical & Engineering News, 66:31 (1988). It may be old, but
at least the article is unbiased.

>     >> Should you be interested in coming up to speed on this issue, 
> please consider tuning into the locations in my signature file.
> Regards, Elke Babiuk (Executive-Director).  HANS, Alberta Chapter
>  "Fluoridation is the greatest case of scientific fraud of the 
> century."  (Robert Carton, Ph.D., former U.S. EPA Scientist)<<
>                                       Steve Harris, M.D.

This part edited. It doesn't become an educated man.
You should also know that, unlike yourself, the man you discredited,
Dr. Carton, is a scientist, a 20-year veteran of the United States
Environmental Protection agency.

Regards, Elke Babiuk

************************************************************************
 "Fluoridation is the greatest case of scientific fraud of the century."
       (Robert Carton, Ph.D., former U.S. EPA Scientist)
       http://www.santarosa.edu/~dmontgom/fluoride.htm
       http://emporium.turnpike.net/P/PDHA/healthb.htm
************************************************************************

> Fluoride abstracts of interest: 

Are these the best that you can do? Really, Dr. Harris, there are so many
in this location  http://www.santarosa.edu/~dmontgom/fluoride.htm
Remember Dr. Harris, one must consider the weight of evidence!

POSITIVE ASSOCIATION:
How come you forgot this one?-- Cooper C., et al., "Water Fluoridation
and Hip Fracture," JAMA, 266:4 (Letters: July 24/31, 1991). 

POSITIVE ASSOCIATION:
Or this one? Jacobsen, SJ, et al., "Regional Variation in the Incidence 
of Hip
Fracture, US White Women Aged 65 Years and Older," JAMA, 264:4
(July 25, 1990). 

POSITIVE ASSOCIATION:
Or this one? Sowers MR., et al., "A Prospective Study of Bone Mineral
Content and Fracture in Communities with Differential Fluoride
Exposure," Am. Journal of Epidemiology, 133:7 (1991)--looked at
varying calcium levels and 1.0 and 4.0 ppm fluoride in water.
----
POSITIVE ASSOCIATION:
> AU  - Jacobsen SJ ; Goldberg J ; Cooper C ; Lockwood SA
> TI  - The association between water fluoridation and hip fracture among
>       white women and men aged 65 years and older. A national ecologic
>       study.
> AB  - For the past 45 years, there has been a great deal of debate
>       regarding the health issues surrounding the fluoridation of
>       public water supplies. In order to assess the association between
>       fluoridation and hip fracture, we identified 129 counties across
>       the United States considered to be exposed to public water
>       fluoridation and 194 counties without exposure. Data from the
>       Health Care Financing Administration and the Department of
>       Veterans Affairs were used to calculate the incidence of hip
>       fracture among white persons, aged 65 years or older, in
>       fluoridated and nonfluoridated counties. There was a small
>       statistically significant positive association between fracture
>       rates and fluoridation. The relative risk (95% confidence
>       interval) of fracture in fluoridated counties compared to
>       nonfluoridated counties was 1.08 (1.06 to 1.10) for women and
>       1.17 (1.13 to 1.22) for men. As comparisons were made at the
>       grouped level, it may be inappropriate at this time to draw
>       inferences at the individual level. The relationship observed at
>       the county level needs to be duplicated at the individual level
>       with more precise measures of fluoride exposure.
> SO  - Ann Epidemiol 1992 Sep;2(5):617-26
-------
 POSITIVE ASSOCIATION:
> AU  - Danielson C ; Lyon JL ; Egger M ; Goodenough GK
> TI  - Hip fractures and fluoridation in Utah's elderly population [see
>       comments]
> AB  - OBJECTIVE--To test the effect of water fluoridated to 1 ppm on
>       the incidence of hip fractures in the elderly. DESIGN--Ecological
>       cohort. SETTING--The incidence of femoral neck fractures in
>       patients 65 years of age or older was compared in three
>       communities in Utah, one with and two without water fluoridated
>       to 1 ppm. PATIENTS--All patients with hip fractures who were 65
>       years of age and older over a 7-year period in the three
>       communities, excluding (1) those with revisions of hip fractures,
>       (2) those in whom the hip fracture was anything but a first
>       diagnosis, (3) those in whom metastatic disease was present, or
>       (4) those in whom the fracture was a second fracture (n = 246).
>       OUTCOME MEASURE--Rate of hospital discharge for hip fracture.
>       RESULTS--The relative risk for hip fracture for women in the
>       fluoridated area was 1.27 (95% confidence interval [CI] = 1.08 to
>       1.46) and for men was 1.41 (95% CI = 1.00 to 1.81) relative to
>       the nonfluoridated areas. CONCLUSIONS--We found a small but
>       significant increase in the risk of hip fracture in both men and
>       women exposed to artificial fluoridation at 1 ppm, suggesting
>       that low levels of fluoride may increase the risk of hip fracture
>       in the elderly.
> CM  - Comment in: JAMA 1992 Aug 12;268(6):781-2 ; Comment in: JAMA 1993
>       Apr 28;269(16):2087
> SO  - JAMA 1992 Aug 12;268(6):746-8
-------
The title "'Please Pass the Roach Poison' Again" (Comment-JAMA August 12,
1992)  was interesting don't you think?
-------
NO ASSOCIATION FOR COMBINED POPULATION, BUT POSITIVE
FOR MEN (a weak study, reasons above):
> AU  - Suarez-Almazor ME ; Flowerdew G ; Saunders LD ; Soskolne CL ;
>       Russell AS
> TI  - The fluoridation of drinking water and hip fracture
>       hospitalization rates in two Canadian communities.
> AB  - OBJECTIVES. The purpose of this study was to compare hip fracture
>       hospitalization rates between a fluoridated and a non-fluoridated
>       community in Alberta, Canada: Edmonton, which has had fluoridated
>       drinking water since 1967, and Calgary, which considered
>       fluoridation in 1991 but is currently revising this decision.
>       METHODS. Case subjects were all individuals aged 45 years or
>       older residing in Edmonton or Calgary who were admitted to
>       hospitals in Alberta between January 1, 1981, and December 31,
>       1987, and who had a discharge diagnosis of hip fracture. Edmonton
>       rates were compared with Calgary rates, with adjustment for age
>       and sex using the Edmonton population as a standard. RESULTS. The
>       hip fracture hospitalization rate for Edmonton from 1981 through
>       1987 was 2.77 per 1000 person-years. The age-sex standardized
>       rate for Calgary was 2.78 per 1000 person-years. No statistically
>       significant difference was observed in the overall rate, and only
>       minor differences were observed within age and sex subgroups,
>       with the Edmonton rates being higher in males. CONCLUSIONS. These
>       findings suggest that fluoridation of drinking water has no
>       impact, neither beneficial nor deleterious, on the risk of hip
>       fracture.
> SO  - Am J Public Health 1993 May;83(5):689-93
------
NO ASSOCIATION (flaws reviewed by Dr. John Lee, and
published in the Journal "Fluoride" (J. of the International Society of 
Fluoride Research--yes it's peer-reviewed), 26:4 (Ocotber, 1993).

> AU  - Jacobsen SJ ; O'Fallon WM ; Melton LJ 3d
> TI  - Hip fracture incidence before and after the fluoridation of the
>       public water supply, Rochester, Minnesota.
> AB  - Recent ecological comparison studies have suggested a positive
>       association between fluoridation and hip fracture. Using data
>       from the Rochester Epidemiology Project, we found the incidence
>       of hip fracture for the 10 years before the fluoridation of the
>       Rochester, Minn, public water supply was 484 per 100,000,
>       compared with 450 per 100,000 in the following 10 years. When the
>       effects of calendar time and age were controlled for, the
>       relative risk associated with fluoridation was 0.63. These
>       ecologic trend data suggest that the fluoridation of public water
>       supplies is not associated with an immediate increase in rates of
>       hip fracture. Further studies of this association at the
>       individual level are clearly required before public policy
>       decisions can be made.
> SO  - Am J Public Health 1993 May;83(5):743-5
-----
RIPA is a well known proponent of fluoridation Dr. Harris. This article
is mostly "commentary," as the title states, and thus opinionated. It's
not impressive. I prefer to get my information from more respected
scientific journals and publications than this one. Why don't you try
"Fluoridation Contention won't go away," by Bette Hilleman,
Chemical & Engineering News, 66:31 (1988). It may be old, but
at least the article is unbiased.

> AU  - Ripa LW
> TI  - A half-century of community water fluoridation in the United
>       States: review and commentary.
> AB  - The nearly 50-year history of community water fluoridation is

Sorry had to delete the abstract. Can't post less than the original.

> RF  - REVIEW ARTICLE: 171 REFS.
> SO  - J Public Health Dent 1993 Winter;53(1):17-44

---

From: [email-masked] (Lewcifer)
Date: Wed, 6 Sep 1995 07:27:33 GMT

Matthew H. Fields stopped to think, then wrote:
:
: Hmmm, Elke Bubiuk, face it-- you still don't know very much about
: basic high school chemistry.  If you were to attribute toxicity to
: sodium flouride not present in hydrogen flouride, you'd have to realize
: that the difference is the toxicity of sodium.

My dear Matthew... you've overlooked the obvious.  If you irridate
sodium flouride with Polonium atoms, it can be quite toxic.

: Your inability to see that hydrogen flouride is in solution after
: you put sodium flouride into water suggests exactly that.

This reminds me of the time I was dieting while working for a large
defense contractor.  One of the feeder lines broke to the callander,
and lime deposits got into the water.  We thought it was chunks of
hydrogenated sodium, but it turned out to be lyme.

: I'm still wondering how you're hoping to acquire hydrogen flouride
: in "mineral" form.  Anybody got a CRC handy, can tell us the
: condensation point for HFl?

I could give you a simple checksum, but I've lost touch with the
algorithms for computing CRC's.  In either case, I believe mixing
liquid nitrogen with the hydrogen flouride should do the trick.

-- 
Opinions expressed are those of the majority.  |     Digitally mastered in
You have a right to disagree, inasmuch as you  | { { S E N S U R R O U N D } }
have the right to be wrong & in the minority.  |  (C) by Lew Payne Publishing

---

From: Frog <[email-masked]>
Date: Mon, 11 Sep 1995 22:04:20 -0400

On 9 Sep 1995, Steven B. Harris wrote:

>   >R. Carnrike, M.N.,M.H. 
> >P.S. If you don't know  what this is, M.N.= Master's in Nutrition 
> >                                      M.H.= Master's in Herbology
> 
>    That's nice.  Mail order degrees?  Correspondance school classes? 
> Many months of hard part-time study?
> 
>                                      Steve Harris, M.D.
> 
Have you got something against alternative educational paths like 
correspondence and part-time study, Dr. Stevie?  Do grow up.

---

From: [email-masked] (Steven B. Harris )
Date: 12 Sep 1995 07:59:45 GMT

>correspondence and part-time study, Dr. Stevie?  Do grow up. 

I am grown up.  I have nothing against part time study, just little
study.  As for correspondance school, may you one day get an airline
pilot or surgeon trained that way.

                                          S.