In January of 1997, Brisbane Australia considered the possibility of fluoridating the water supply. Knowing the political firestorm which errupts when fluoridation is considered, the city wanted an unbiased analysis of whether it was actually needed. A number of experts from the Dental Association, Medical Association, University of Queensland, Society for Environmental Medicine and other professionals were asked to join. A balanced task force was created with persons with a variety of existing viewpoints.

In October of 1997, the Task Force issued their report after having reviewed the following considerations:

History and Legal Issues
Ethical Considerations
Dental Costs and Benefits
Human Health Effects
Environmental Impact
Consideration of Economic Cost/Benefit Analysis
Public Consultation
Assessment of Benefits and Risks

The Task Force Report is written for the lay person and is easy to understand. What follows are selected quotes.

11.10 Conclusions
A significant proportion (23%) of Taskforce members shifted position from strong support for fluoridation, or in one case uncertainty, to opposition.

It is clear from responses that the case presented by the medical/dental experts on the Taskforce, as well as the literature supporting fluoridation, failed to convince these members about a number of areas of concern:

[Editor: These are the claims which the Task Force found unconvincing]

that the dental caries problem in Brisbane was sufficiently serious to
require fluoridation (in the light of declining decay rates);

that health risks were negligible, particularly in relation to increased risk of
hip fracture; the possible effects of accumulation of fluoride over a lifetime
of exposure; and excessive total intake by babies and young children;

that the margin of safety between a toxic and safe dose was significantly

some commented that health professionals who supported fluoridation
were not prepared to carry out research in Australia to prove that
fluoridation was still effective or, more importantly, completely safe.

Many Taskforce members were unconvinced by assurances that serious risks to health were negligible or non-existent. In particular, there was concern about ambiguous scientific evidence of an association between water fluoridation and
higher levels of hip fracture.

The Taskforce noted that the 1991 NHMRC Working Group, which had supported fluoridation, had expressed considerable concern about the fact that it could not point to a single Australian study which had monitored adequately the
impact of possible adverse consequences of fluoridation (NHMRC 1991, Section 8). The majority of the Taskforce was concerned that these inadequacies have still not been addressed.

There was also concern about the lack of scientific research on the lifetime effects of an accumulation of fluoride in the body, in spite of the 1991 NHMRC Working Group statement that ‘it was imperative that public health recommendations in the future be based on accurate knowledge of the total fluoride intake of Australians’ (NHMRC 1991, Section 8.3). This aspect was highlighted by most Taskforce members as an area which required further scientific investigation.

4.3 Toxicity of Fluorides:
The physical and chemical properties of the various compounds of fluorine vary considerably, and the toxic properties range from extremely toxic to completely non-toxic. Fluoride salts are widely used as insecticides and poisons for rodents. In concentrated form they act as very powerful inhibitors of the enzymes which produce the energy requirements of living cells.

At doses in excess of 2 grams this effect could also be fatal in humans. The fluoride salts commonly used in fluoridating public water supplies are sodium fluoride; sodium fluorosilicate; and fluorosilicic acid. These are primarily by-products of the
phosphate fertiliser industry.

Basic Argument: The basic argument in favour of fluoridation is that the state ought to act to achieve fundamental benefits for its citizens. The paper explores two main areas of ethical concern about fluoridation:

The Safety Objection: can a decision to fluoridate be ethical if fluoridation may have harmful effects?
The Compulsion Objection: is the state justified in compelling people to consume fluoridated water?

6.12.4 Benefits Mainly Topical:
The Taskforce agreed that most of the caries prevention effect of fluoridated water was topical, i.e. it results from the effects of fluoride at the surface of the teeth rather than systemically (via the bloodstream), as used to be thought. Consequently, there was limited value from actually swallowing the water.

6.12.5 Excessive Ingestion Causes Dental Fluorosis
Excessive ingestion of fluorides by children under the age of six can lead to dental fluorosis. The extent of the damage to teeth depends on the level of fluoride intake, and the length of time these levels are maintained.

6.12.6 Fluorosis Not Simply a Cosmetic Problem
WHO [World Health Organization] stated that dental mottling is a definitive sign of fluoride toxicity . The Taskforce agreed that any level of dental fluorosis in children was undesirable.

8.2 Environmental Impact of Fluoride
Fluoride was taken up by animals and stored mainly in the skeletal or exoskeletal parts of the body. Fluoride is a chemical element and the introduction of any fluoride will produce a toxic response in the environment. Some species of animals and plants would adapt to the introduction of additional fluoride. However, fluoride would affect some species and at different stages of their life cycle e.g. an adult form of a species may be more sensitive that the juvenile (e.g. rainbow trout).

The introduction of fluoride to the environment would present a relative (increased) risk to livestock, some terrestrial and agricultural plants, sensitive freshwater plants and animals, and freshwater creeks (especially under low flow conditions) found in the Brisbane area.

Task Force Report