Tuesday, October 23, 2012

Public Health Cover Up by Health Service Executive on Water Fluoridation

In response to parliamentary questions dated 17th October 2012 in the houses of the Oireachtas in the Republic of Ireland, it is evident that the Health Service Executive has again deliberately misled elected public representatives on information regarding Fluoride chemicals added to drinking water supplies in Ireland, providing false and misleading information in response to clear parliamentary questions..

The Minister for Health and Children directed the Health Service Executive to respond to specific technical questions by Deputy Luke Flanagan T.D on the supply and source of fluoridation chemicals added to drinking water supplies since commencement of this policy in Ireland inthe 1960's.

Mr. Gavin Moore, Assistant National Director, Environmental Health and Emergency Management, responded on behalf of the HSE in writing providing clearly misleading information in an obvious attempt to hide specific information that would demonstrate once again the lack of appropriate risk management, due diligence and duty of care by the HSE in protecting public health, by exposing consumers to harmful toxins in their drinking water. Toxins that are still required to be added to drinking water by parliamentary legalisation enacted by the Health Service Executive, before Ireland joined the EU. Ireland remains the only EU country of the 27 EU members states with a national legislative policy demanding the mandatory fluoridation of drinking water supplies.

On behalf of the HSE, Mr. Moore stated that the contract for water fluoridation chemicals was awarded to Albatross Fertilisers in 1990 and that Albatross sourced powdered fluoride from North Africa. Mr. Moore further noted in response to Deputy Flanagan, that the contract for fluoridation chemicals was awarded to Chemifloc for the period 1991-1995, noting that Chemifloc supplied the chemical product from a new source in Spain.

Mr. Moore importantly goes on to state that the contract was awarded once more to Albatros Fertilisers for the period 1996 to 2005 noting specifically that Albatros Fertilizers continued to source the product from Spain. This statement is factually incorrect.

Mr. Moore continued by stating that in 2005, the contract was awarded to Chemifloc, who continue to supply the HSE and local authorities with water fluoridation chemicals. In October 2012 this contract was renewed for a period of two years at an approximate cost of €3.4million.

What Mr. Moore neglected to mention is that on the
20th February 1997, Mr. Ed Storey, Managing Director of Chemifloc Ltd. wrote to former Deputy and Minister of State Trevor Sargent T.D outlining that Albatros Fertilizers sourced their product from Holland and Mr. Storey noted with some concern that it was product contaminated with high levels of arsenic from the fertilizer industry. The source of the product would have been a by product from industrial scrubbers where it was used as a method to remove atmospheric pollutants from industrial stack chimneys.

While Deputy Flanagan sought all information relating to the dates of contract, source and supply of water fluoridation chemicals, it is evident from the response provided by Mr. Moore  of the HSE that this important information was deliberately withheld.

In reality what occurred, as documented in Oireachtas parliamentary questions between
Deputy Enda Kenny T.D (current Taoiseach) and former Minister for Health and Children, Michael Martin T.D. in 2001 (reference: http://debates.oireachtas.ie/dail/2001/11/20/00236.asp) was that, Albatross Fertilisers sourced their chemicals from Holland between 1997-1999, providing over one million gallons of fluoride chemicals that were highly contaminated with arsenic which was subsequently added to drinking water supplies in Ireland. This information was clearly withheld from an elected public representative by the HSE in their letter dated 22nd October 2012.

In 2000, a Spanish company took over the sourcing of the supply of the fluoride chemical from Albatros Fertilizers, in what could be construed as an attempt to hide from public view any information that would potentially provide evidence of harm to the Irish public, or negatively impact on the findings of the Forum for Fluoridation review which was undertaken in 2002. The Forum for Fluoridation, in their clearly biased and flawed report never mentioned that Albatros Fertilisers sourced their product from Holland, nor that it was a by product of the fertilizer industry, one that was contaminated with dangerous heavy metals including arsenic, a listed carcinogenic substance even in trace amounts. Yet despite the change in source of fluoride chemicals in 2000 arsenic continues to remain a known and quantifiable contaminant in water fluoridation chemicals.

The U.S EPA, U.S Agency for Toxic Substances and Diseases Registry (ATSDR) and U.S Department of Health and Human Services (DHHS) has determined that inorganic arsenic is known to be a human carcinogen. Oral exposure to low levels of inorganic arsenic has resulted in effects on the gastrointestinal tract (nausea, vomiting), central nervous system (CNS) (headaches, weakness, delirium), cardiovascular system (hypotension, shock), liver, kidney, and blood (anemia, leukopenia) skin cancer and also to bladder, liver cancer. All of these cancers are known to be more prevalent in the Republic of Ireland compared to non-fluoridated Northern Ireland. (National Cancer Registry Ireland data)

Why is this important? Because from a public health perspective we need to trust the people in charge of public health policy and the provision of services. When it comes to water fluoridation this trust has clearly been broken, by the HSE and the Irish Expert body who continually mislead the pubic, as well as public representatives, of the true dangers of exposure to silicofluorides and fluoride compounds in drinking water. Both bodies also fail to ensure adequate safety precautions to protect the most vulnerable in our society, including bottle fed babies, diabetics and others who are exposed to high levels of fluoride through consumption of fluoridated water.

It is scientifically known that not all fluoride compounds are the same and that silicofluoride are considerably more toxic than sodium fluoride, while sodium fluoride is more toxic than naturally occurring to calcium fluoride. As the products have changed over the years so too has the toxicity and the health dangers for consumers.

Professor Masters a neurotoxicologist has previously warned the Government of Ireland of the dangers of silicofluorides in drinking water and while this warning has gone unheeded the incidence of neurological disorders in Ireland continues to rise dramatically especially in children.

In the period when the HSE switched from powered fluoride products to liquid silicofluoride products we have witnessed an alarming and somewhat overwhelming rise in childhood neurological disorders as well as diabetics, cancer and general medical ailments in the wider population to the level that today one in three adults suffers from a chronic disease. These facts has also has been ignored by the HSE who have yet to undertake a singe clinical medical study to investigate if exposure to fluoride chemicals is contributing to the rise in medical ailments experienced in Ireland in recent years.

This is deeply disturbing given that both the
Journal of Community Dentistry and Oral Epidemiology (1997, 25:291-5) and the Journal of Dental Medicine (1961 Volume 16. No 4) both documented that exposure to fluoride resulted in increased incidence of medical ailments in the wider community including neurological, gastrointestinal and dermatological disorders. 

Of course the HSE and the Expert Body on Fluoride don’t want the public to know these scientifically documented facts, as they are ultimately the parties responsible for promoting and injecting known toxins into the drinking water supply of consumers in Ireland.

In addition to misleading public representatives on the scientific facts of water fluoridation the HSE also appear willing to mislead public representatives on the financial costs of this policy. In response to Deputy Flanagan’s parliamentary question (17th Oct 2012) the HSE estimated that the actual costs of purchasing fluoridation chemicals was
€1.75million annually. 

Yet in response to a similar parliamentary question in 2010 Minister of State Deputy Roisin Shortall stated on parliamentary record that the annual cost was €4.75million. 

That’s €3,000,000 of a difference presenting yet another example of financial irregularities and inaccurate accounting within public bodies.

Of course this figure does not include the fixed costs for equipment, further management and supervision costs associated with fluoridation including auditing costs for the 250 fluoridation plants throughout the country (total cost for one audit alone was
€4.1million), the cost of upkeep and maintenance of plant and machinery, the financial costs of environmental monitoring, regulatory assessment, insurance.

In response to Deputy Flanagan’s question seeking from the HSE the full cost of installation of water fluoridation infrastructure for the 250 water treatment plants, the HSE would only provide the costs for the last 3 years, deliberately excluding the bulk of costs that would have been accrued for the remaining 250 water fluoridation plants in operation.

The costs for the last
three years for infrastructure was approximately €4,000,000.
The overall infrastructure costs for all 250 water treatment plants are likely to be in the
hundreds of millions of euros, but again this information was withheld.

Finally, despite the
World Health Organisation publishing a report on Oral Health in Europe this year, which conclusively proves that water fluoridation is ineffective in preventing dental caries as Ireland had the worst dental health of all western EU member states. This is astonishing given that the Irish Expert body and Dental Health Foundation Ireland both claim that water fluoridation is proven to be the most effective method to prevent such disease.  Considering that Ireland is the only EU member state to pursue such a policy while its citizens also have access to fluoridated toothpaste, there is no question but that we should not be on the bottom of the league table for dental health amongst our European partners.

Remarkably the evidence documented by the WHO illustrates clearly that 20 years ago dental health was better in Ireland that our European partners, yet today they all outperform Ireland in improved dental health without the need for water fluoridation. These facts cannot be disputed.

Incredibly the findings of the WHO report also support similar findings from the largest public dental health surveys undertaken in the USA on 36,000 children in fluoridated and non fluoridated communities as well as in Japan which found that increased exposure to fluoride through fluoridation of drinking water resulted in a decline in dental health in children, possible due to dental fluorosis and overexposure to fluoride in their diet, for which we also now know from recent EU studies, Irish children are also top of the league in Europe.

Finally while local governments across the developed world, in the few countries that do still fluoridate their water supplies, are actually discontinuing the practice of water fluoridation due to heath, environmental and financial costs the HSE signed a new contract in October 2012 to extend the contract for water fluoridation in Ireland at a time when the Minister for Health is cutting funding to essential services and when more and more scientific evidence (including the scientific report by environmental scientist Declan Waugh) is coming to light on the negative health impacts of exposure of the population to fluoride.

Sunday, October 21, 2012

Fluoride, Endocrine Disruption and Implications for Public Health and Environment

I’m sitting on the train to Dublin reading the Sunday newspapers and I see that the front page of The Observer has the following headline, Boys are reaching puberty earlier, reveals US study.

The journalist, Paul Harris writing from New York, reports on what he refers to as a comprehensive new study by the American Academy of Paediatrics (AAP), which demonstrated that American boys are showing signs of puberty six months to two years earlier than previously assumed. Mr Harris notes that the surprise findings builds on previous discoveries reported in the U.S. Journal of Pediatrics  in 2010 that appeared to show girls have also been developing faster. 

Now it appears the AAP study is showing the same trends in boys. While not identifying what may be causing the biological change, the study did mention diet and environmental toxins as possible contributors.  The Observer article notes that all this has led to speculate that weight gain might be a possible factor, as body fat is linked to production of the female hormone oestrogen. Interestingly the study also showed that ethic race also play a role in the early onset of puberty  with black American boys showing signs of puberty earlier than either white or Hispanic counterparts.

So why do I find this interesting?....well it has previously  been clinically documented in human population and ecological studies that exposure to Fluoride may affect the endocrine system, resulting in children living in fluoridated communities  entering puberty earlier than in non fluoridated communicties. It has also been suggested that fluoride toxicity may be a contributory factor in the development of obesity, due to Fluoride being a metabolic inhibitor.   

Luke J et al. of the University of Surrey and the Royal Hospital London published a scientific report in 2001 in the Journal Caries Research on how Fluoride effects the Pineal Gland, and made the following conclusion :
“the human pineal gland contains the highest concentration of fluoride in the body. Fluoride is associated with depressed pineal melatonin synthesis by prepubertal gerbils and an accelerated onset of sexual maturation in the female gerbil. The results strengthen the hypothesis that the pineal has a role in the timing of the onset of puberty.”

This risk was further acknowledged by the U.S. National Academy of Sciences National Research Council in their published findings on Fluoride in 2006 where they acknowledged:
“that recent information on the role of the pineal organ in humans suggests that any agent that affects pineal function could affect human health in a variety of ways, including effects on sexual maturation, calcium metabolism, parathyroid function, postmenopausal osteoporosis, cancer, and psychiatric disease.”

The potential consequences of disturbances to functions of the pineal gland and resultant human health impacts from increased absorption of fluoride through dietary intake from water fluoridation cannot be underestimated. The first step in assessing a health risk by a substance to humans is the identification of its harmful effects on animals. A health risk to humans is assessed using results from human epidemiological studies in conjunction with results from animal studies. As far back as 1956 The Newburgh-Kingston Study (Schlesinger et al., 1956) identified that bone defects, anaemia and earlier female menstruation occur more often in children living in the fluoridated Newburgh than in non-fluoridated Kingston community.

Yet remarkably very little if any research has been undertaken since then to verify or examine these findings further. This is quite astonishing, even more so that the distinguished American Academy of Paediatrics or the Journal of Pediatrics  in reporting on the early onset of puberty would either  not be aware of else deliberately ignored these findings. This is particularly so when in 2001 the  U.S Agency for Toxic Substances and Disease Registry, US Department of Health and Human Services, similarly reported that fluoride negatively affected  endocrine systems.[1]

It is also very significant because the U.S EPA reported[2] in 2010 that with an average Fluoride concentration of 0.9ppm in drinking water, the relative source contribution of fluoridated drinking water to total fluoride exposure can be as high as 70% for infants and for certain adults 60%. They noted that children under seven years of age may be at risk of severe dental fluorosis as a result of this level of exposure. Severe dental fluorosis is a physical visible sign of chronic overexposure to fluoride. The EPA documented that the major source of fluoride to their diets will be fluoridated drinking water, followed by commercial beverages, solid foods and swallowed toothpaste.  Furthermore the EPA noted that in recent decades the total dietary Fluoride intake of the population  is increasing due to a combination of dietary sources.

So why else is the latest study in the NAP journal interesting?.. well because it found that the early onset of puberty was influenced by ethnicity. Yet another fascinating fact about fluoride is that numerous studies have found that African American’s (blacks), followed by Hispanics, appear to be the most sensitive ethic groups to fluoride toxicity.[3] It may well be that DNA and genetic makeup plays an important role in sensitivity or intolerance to fluoride.  This might explain why homogeneous populations are more at risk and poses particular concerns for fluoridated communities  such as the Republic of Ireland, the only EU country with a mandatory policy of fluoridation of drinking water. Which by its geographic remoteness on the edge of Europe, small population, low inward migration and its historical religious and social practices which encouraged members of the same religious community to marry, has ultimately resulted untill very recently in a relatively homogenic population compared to other European or developed countries.

Genetic breeding certainly appears to be the case for certain breeds of horses have been found to be particularly sensitive to fluoride toxicity, as noted in the Journal Fluoride and as documented by Professor Krook, Professor of Pathology, the College of Veterinary Medicine, Department of Biomedical Sciences, Cornell University in 2005. Cornell University found that pure breed quarter horses suffered from chronic fluoride poisoning after ingestion of fluoridated water, which was their principal dietary exposure to Fluoride at levels of 1ppm due to artificial fluoridation. Interestingly, as a result of the Universities extensive studies on these poisoned horses, fluoridation was discontinued in the community from which they were resident.

The ability of Fluoride to stimulate early sexual maturity in freshwater aquatic species was also reported in the peer reviewed scientific Journal Chemosphere (2003)  by environmental eco-toxicologist  Dr. Camargo, of the University of  Madrid.  Camargo reported that Fluoride stimulated female fecundity (stimulating reproductive fertility) in certain aquatic freshwater species.[4],[5],[6]

All of this information was included in the recent report published by Irish Environmental Scientist, Declan Waugh of Enviro Management Services  in his independent report on the Human Health, Environmental Impact and Legal Implications of Water Fluoridation, dated March 2012.

Finally, why is all this important? well for apart from shortening childhood years, early sexual maturation has both physiological and psychological consequences in humans. For girls, it is also associated with an increased risk of certain cancers in later life.[7],[8]  

The implication’s therefore of fluoride exposure for long-term health or the environment cannot be overlooked. It is also important to be aware, that many of the man-made substances that are listed as known endocrine disruptors by the European Commission‘s Community Strategy for Endocrine Disruptors‘ (COM (1999)706), are also fluoridated compounds.

It is inexcusable that public health authorities continue to ignore the adverse health effects of fluoride intoxication of the population. It is criminally neglicent that they still have not conducted any detailed toxicological studies examining the wider toxicological impacts for populations to ingest silicofluoride chemical compounds that are used to fluoridate drinking water especially when they are being medicated without being informed of the risks.

Public health authorities are also failing in their duties not to have commissioned detailed epidemiological health studies or not to have provided appropiate safety standards for the most sensitive subgroups of the population to prevent overexposure to Fluoride in particular babies, diabetics or individuals who are iodine deficient or who suffer from any thyroid disorder. Obviously, its not in their interest, as after all they are the very instigators of this crime in the first place, and the last thing they would wish is to further incriminate themselves.

[1] ATSDR (Agency for Toxic Substances and Disease Registry) (2001) Toxicological profile for fluoride. US Department of Health and Human Services, Atlanta, Georgia.
[2] Fluoride: Exposure  Relative Source Contribution Analysis, Health and Ecological Criteria Division
Office of Water, U.S EPA, December 2010
[3] Russell, 1962; Butler et al., 1985; Williams and Zwemer, 1990; Beltrán-Aguilar et al., 2005; Martinez-Mier and Soto-Rojas, 2010
[4] Camargo, J.A. Fluoride toxicity to aquatic organisms: a review. Chemosphere. 2003 Jan;50(3):251-64.
[5] Connell, A.D., Airey, D.D., 1982. The chronic effects of fluoride on the estuarine amphipods Grandidierella lutosa and G. lignorum. Water Res. 16, 1313–1317
[6][6] McClurg, T.P, 1984. Effects of fluoride, cadmium and mercury on the estuarine prawn Penaeus indicus. Water SA 10, 40–45.
[7] Reproductive History and Breast Cancer Risk, Factsheet, U.S National Cancer Institute, National Institutes of Health, Department of Health and Human Services
[8] Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, and Berenson GS, Relation of Age at Menarche to Race, Time Period, and Anthropometric Dimensions: The Bogalusa Heart Study, Pediatrics 2002; 110:e43

Thursday, October 18, 2012

Duty of Care and Failure of Public Health Bodies to Examine the Health Risks of Fluoride Exposure

In 1961 Dr. Reuben Feltman and biochemist George Kosel published a scientific paper titled “prenatal and postnatal ingestion of fluorides-fourteen years of investigation” in the Journal of Dental Medicine (Volume 16. No 4. October 1961).

This investigation remains one of the most comprehensive studies on fluoride undertaken using a double blind placebo controlled examination. The study recorded clinical observations and revealed that a percentage of the subjects were sensitive to fluoride at relatively low levels similar to those found in fluoridated water in Ireland or in the few other countries that artificially fluoridate drinking water supplies.

Remarkably the sensitivity to fluoride presented as dermatologic, gastro-intestinal and neurological disorders amongst the population. It was found that in sensitive sub groups exposure to fluoride resulted in eczema also known as atopic dermatitis (inflammatory skin disorder) urticaria (hives), epigastric distress (pain from the esophagus, stomach, duodenum, pancreas, colon or gallbladder with associated symptoms of nausea and vomiting), emesis (vomiting) and headache and that these conditions disappeared upon the use of placebo tablets only to recur when the fluoride was, unknowingly to the patient, reintroduced.

Many of these conditions are common especially in infants, who happen to be one of the most sensitive subgroups in the population to fluoride, due to the fact that their kidneys are not fully functioning and that 90% of fluoride they are exposed to remains absorbed in their bodies.  This is a worrying fact, especially for babies that are fed formula made up from fluoridated water which is the case in Ireland for over 90 percent of babies at 6 months of age. It is interesting therefore to note that studies have shown that up to twenty percent of children in Ireland have suffered eczema by the age of four. According to the Charles Institute, University College Dublin, in Ireland each year, 15% of all GP visits are attributed to a skin complaint. The prevalence of skin diseases such eczema has increased steadily over the past 20 years which coincidentally coincides with the ever growing exposure of the population to fluoride exposure in their diet from both water and dietary sources.  And today, between 25% and 33% of the Irish population suffer from a dermatological condition at any one time.
It is important to remember that Ireland remains the only EU Member State with a mandatory policy for fluoridation of drinking water supplies. This water is also used for making beverages, cooking, washing, and bathing. Dr. Feltman conclusively demonstrated using double blind studies and with the use of placebos that fluoride contributed to to a variety of conditions in the general population. In the conclusion to his study Dr. Feltman highlighted that much more research on the biological effects of fluoride is necessary. 

It is also important to note that Dr. Feltman was honoured by the American Academy of Oral Medicine for his outstanding contributing to medicine. Yet despite his recommendations, in Ireland or elsewhere, no public health study has ever been undertaken to examine the wider health implications associated with fluoride exposure, providing further evidence of the failure of public health bodies and related professions to meet their duty of care obligations to the public. This is especially the case when these very same bodies recommend and enforce mandatory fluoridation of the population through fluoridation of public water supplies, without undertaking adequate public health risk assessments.

Meanwhile Dental Health Foundation Ireland whose members sit on the Irish expert Body on Fluoride say that “Fluoridation of the public piped water supplies is the safest, most effective and most efficient method of preventing tooth decay.” and “Fluoride toothpaste is helpful but not as effective as water fluoridation.”

Yet unquestionably scientific evidence demonstrates  that despite Ireland being the only fluoridated country in the EU its children have the worst dental health. So clearly water fluoridation doesn’t work. Twenty years ago many other European countries had worse dental health than Ireland now Ireland lags behind them despite nearly all its children been exposed to fluoride from birth. The facts just don’t add up.

Regarding dental decay, the truth is that more and more research and scientific evidence shows that water fluoridation is actually associated with increased tooth decay. The most comprehensive US review carried out by the National Institute of Dental Research on 39,000 school children aged 5-17 years showed no improvement in dental health from water fluoridation. What it did show was that high decay cities have 9.34 percent more tooth decay in the children who drink fluoridated water.

It further demonstrated that nine fluoridated cities with high dental decay rates had 10 percent more decay than nine equivalent non-fluoridated cities. Meanwhile the worlds largest study  on dental decay, which examined 400,000 students, revealed that decay increased 27 per cent with a 1ppm fluoride increase in drinking water. In Japan, fluoridation caused decay increase of 7 per cent in 22,000 students (one of the reasons Japan stopped water fluoridation) while in the US a decay increase of 43 per cent occurred in 29,000 students when 1ppm fluoride was added to drinking water. This latest data from the WHO appears to support these findings as Ireland with the only policy of mandatory water fluoridation now has the worse dental health in Western Europe.  

Despite evidence to the contrary dental professionals by and large (a growing number of dentists are raising concerns on fluoride toxicity) still refuse to accept that fluoridation of water may expose individuals to unnecessary health risks. Dental bodies continue to claim that the only known impact of water fluoridation is dental fluorosis and that this is not a health concern. However this was not always the case, in fact, before water fluoridation ever commenced the journal of American Dental Association (Volume 31, page 1360, October 1944) highlighted the risks of overexposure to the population from fluoridation of drinking water and opposed any such policy on the grounds of health risks.

To find out why this advise changed, I would recommend that you read “Understanding the Fluoride Fraud” by Dr. Jim Maxwell DDS which is available to download here:

I would also recommend that you read the following books.

The Struggle with Titans: Dr. George Waldbott
Fluoridation The Great Dilemma. Dr James Beck, Dr Paul Connett
The Case against Fluoride: Dr Paul Connett
The Devils Poison: How Fluoride is Killing You: Dr. Dean Murphy
Fluorides in the Environment: Dr. Weinsteen and Dr. Davison
The Fluoride Deception: Christopher Bryson Award winning journalist and former BBC producer

Tuesday, October 16, 2012

Mechanism of Fluoride Toxicity on Biological Systems

N. Agalakova and G. Gusev, Molecular Mechanisms of Cytotoxicity and Apoptosis Induced by Inorganic Fluoride. Russian Academy of Sciences, International Scholarly Research Network, Journal of Cell Biology, Volume 2012, Article ID 403835


While a lot has been written about the potential beneficial effect of low levels of fluoride for dental health, however the adverse effects of fluoride exposure on human health has received very little attention. This is one of the first major reviews of fluoride toxicity published in a peer reviewed scientific journal on cell biology. In this work, scientific experts in molecular biology and biochemical toxicology from the Russian Academy of Sciences have focused attention on the intracellular molecular mechanisms proven to be responsible for cytotoxicity and development of cell death induced by inorganic fluoride as well as the effect of fluoride on critical biological pathways in the body. The authors state that although the toxicity of fluoride is well known, it has been ignored for a long time and highlight that while the WHO recommends an optimal level of fluoride in drinking water, for the preventing of dental caries, when fluoride in drinking water is added to other dietary sources such as toothpaste or rinses, as well as fluoride in other foodstuffs and beverages, the optimal daily uptake for individuals is often exceeded. This results in uncontrolled and unpredictable consumption of fluoride which may often exceed it’s therapeutic value thereby inducing negative health impacts within the population as a whole. The author’s note that during the last decades fluoride was established to be a potent inducer of cell death in many cultured cell types and experimental animal models. Fluoride when ingested into the body alters virtually all known intracellular signalling pathways including G protein- dependent pathways, caspases, and mitochondria- and death receptors-linked mechanisms, as well as triggers a range of metabolic and transcription alterations, including the expression of several apoptosis-related genes, ultimately leading to cell death. Fluoride has been shown to negatively influence many metabolic, structural, and functional cellular functions. The toxic fluoride effects include an induction of inflammatory reactions, cell contractile responses, inhibition of protein synthesis and cell cycle progression, oxidative stress, and DNA damage. Fluoride has been found to alter critical physiological and pathological processes for the body’s defence and repair mechanisms. Fluoride was found to reduce the body’s antioxidative defence mechanism impairing the ability of the body to eliminating free radicals and fight disease. Fluoride effects cellular calcium concentration, interferes with the body’s natural calcium stores and acts to suppress both the Ca2+-pump, or activation of Ca2+ channels in the body as well as interfere with functions of  the brain, heart, kidney,  liver, pineal gland and pancreas. Fluoride interferes with the bodies cellular antioxidant defence systems and stimulates lipid peroxidation (LPO). It is now believed that excessive LPO may be involved in carcinogenesis. Fluoride has also been shown to directly affect Bcl-2 Family Proteins which are critically important for fighting cancer. Fluoride is found to be a known inhibitor of enzymes of glycolytic pathway and the author’s note that while this effect is known for some time it is often underestimated or ignored in the studies of fluoride cytotoxicity and cell death. Fluoride is known to reduce insulin secretion and may contribute to obesity in individuals with diabetics. The authors highlight that knowledge of the intracellular pathways involved in the development of fluoride-induced cell death is still incomplete, noting that this is probably due to complexity and diversity of the molecular events underlying fluoride toxicity and conclude that intensive investigations are required to identify the whole series of events involved in the development of fluoride-induced cytotoxicity and cell death, as well as the mechanisms of their regulation in the human body

Among the scientific findings highlighted by the scientific researchers the following are included:

•    The authors begin by noting that although the toxicity of fluoride is well known, it has been ignored for a long time. It is highlighted that while the WHO recommends an optimal level of fluoride in drinking water, for the preventing of dental caries, when fluoride in drinking water is added to other dietary sources such as toothpaste or rinses, as well as fluoride in other foodstuffs and beverages, the optimal daily uptake for individuals is often exceeded. This the authors point out results in uncontrolled and unpredictable consumption of fluoride which may often exceed it’s therapeutic value thereby inducing negative health impacts within the population.

•    The authors note that there is no convincing evidence on the role of fluoride as essential element for normal human growth and development. In contrast it is highlighted that in recent decades, numerous investigations have established the toxicity of fluoride for cells of different tissues and biological systems.

•    The authors document that the toxicity of fluoride is associated with its high chemical and biological activity. Fluoride freely and rapidly migrates across the biological membranes. After ingestion, fluoride is rapidly and virtually totally absorbed into the blood.

•    The authors find that approximately 50% of the fluoride ingested by our body each day is retained in our bodies (more for certain sensitive subgroups Including babies and diabetics) and distributed between organs and tissues where it accumulates in bones, teeth, pineal glands, and other tissues. The authors observe that the effects of fluoride on cellular metabolism and physiology vary according to cell type, concentration, and time of exposure and that much greater research is required to fully understand the complexity of many of the processes of fluoride toxicity.

•    The report documents that Fluoride has been shown to negatively influence many metabolic, structural, and functional cellular functions. The toxic fluoride effects include an induction of inflammatory reactions, cell contractile responses, inhibition of protein synthesis and cell cycle progression, oxidative stress, and DNA damage. Many of these cellular events ultimately lead to cell death or apoptosis.

•    The report outlines the morphological changes typical for apoptosis include condensation of nuclear chromatin, DNA fragmentation, disintegration of mitochondria, cell shrinkage, membrane blebbing, and formation of apoptotic bodies.

•    The report explains that the molecular mechanisms underlying fluoride-induced apoptosis are different by nature and include the stimulation of G protein-dependent signaling systems, oxidative stress, ATP depletion, activation of the cell surface death receptors, disruption of outer mitochondria membrane, activation of caspases, alterations in the ratio of anti-apoptotic-apoptotic Bcl-2 proteins, upregulation of p53 expression, expression of apoptosis-related genes, endoplasmic reticulum stress and disturbances in protein synthesis.

•    The report identifies that Fluoride exposure increases protein kinase C (PKC) activity which induces cell death.

•    The report documents in detail how Fluoride interferes with Gprotein signalling resulting in inhibition of enzymes and interference with many metabolic reactions in the cells. It is noted that Gproteins are one of the most important classes of proteins in living organisms  which are  involved in transmitting chemical signals. For all essential purposes G proteins are essentially both the gatekeepers and molecular messengers of the cell, transmitting signals from inside to outside. They mediate virtually every important physiological process, from immune system function to taste and smell to the fight-or-flight response in humans. Naturally occurring small molecules which bind to G proteins include adrenaline, prostaglandins, dopamine, somatostatin and adenosine. It is documented that in the pulmonary artery activation of G proteins can initiate a series of events leading to increases in phosphoinositide hydrolysis which plays an important role in regulating cell function resulting in Ca2+ mobilization from intracellular stores. The researchers highlight that scientific evidence found Fluoride to interfere with the body’s natural calcium stores and acted to suppress both the Ca2+-pump, or activation of Ca2+ channels. Increase in Ca2+ concentration might play a key role in the mechanism of  contraction of aortic rings as well as renal injury and necrosis of renal tubules in fluorosis. Further recent scientific research has documented that fluoride calcium interactions may contribute to calcification of human arteries that will increase the risk of coronary disease and stroke.

•    The authors presented evidence  to show how  fluoride effects cellular calcium concentration causes low sperm hyperactivation.

•    In addition the report identifies how Fluoride was found in pancreatic cells to actively interfere with genisteinsensitive tyrosine kinases which is essential for protein, DNA synthesis.

•    The report documents that fluoride inhibited insulin receptors by direct binding to the receptors, as well as fluoride-induced cytotoxicity and cell death.

•    Fluoride was also found to inhibit Mitogen-activated protein kinases (MAPKs). MAPKs are involved in directing cellular responses to a diverse array of stimuli, such as mitogens, osmotic stress, heat shock and proinflammatory cytokines. They regulate proliferation, gene expression, differentiation, mitosis, cell survival, and apoptosis characterised by biochemical events which lead to disintegration of cells and cell death. Importantly the researchers found an increased level of dead cells in the brain of fluoride intoxicated animals.

•    Fluoride was shown to be potent nonspecific inhibitor of protein phosphatases (PPs) activities which affect protein stability, and regulate enzyme activity. Fluoride was found to cause an imbalance in the ionic gradients across the plasma membrane and disturbances in membrane potential while exerting diverse and complicated effects on K+ and Na+ transport across the membrane, loss of cellular K+ and suppression of the erythrocyte membrane critical for antibodies and immunity to disease.

•    Fluoride was found to cause chronic or acute reactive oxygen species (ROS) overproduction, exceeding the capacity of cellular antioxidant defence systems, cause oxidative damage to macromolecules such as DNA and proteins, peroxidation of membrane phospholipids, and mitochondrial depolarization, thus initiating cell disintegration and cell death as well as organ lesions.

•    The authors highlight the general acceptance that Fluoride causes oxidative stress, a recognized mode of fluoride action and toxicity. The author’s further note that this was particularly pronounced in some cell types such as by Fluoride-induced cell death of hair follicles.

•    The authors acknowledges that another important, although indirect, mechanism of fluoride-induced cytotoxicity demonstrated in the cells of many tissues is lipid peroxidation (LPO). Oxidative stress was also shown to be linked to significant changes to lipid peroxidation. A growing body of evidence has shown that excessive LPO may be involved in carcinogenesis.  It was documented that Fluoride exposure in pregnant animals and their offspring during first month of life leads to kidney tissue changes and LPO in the first and second generation of animals. I t was also acknowledged that a direct link between fluoride-induced cell destruction and cell death and elevated LPO was scientifically demonstrated in the different mammals in animal studies.

•    The report highlights how Fluoride may influence superoxide anion  radicals (•O2−) as well as hydrogen peroxide, peroxynitrite, and hydroxyl radicals, all critical physiological and pathological processes for the body’s defence and repair mechanisms.

•    The report addresses how Fluoride was found to enhance Reactive Oxidative Stress (ROS) particularly in the blood, liver, kidneys, and brain of animals consuming fluoride in drinking water. 

•    It was noted that significant morphological abnormalities and apoptosis (cell death) were also observed in the sperm cells of animals exposed to high fluoride doses.

•    Animal studies found reduced fertility of males sub chronically exposed to fluoride.

•    Importantly Fluoride was found to reduce the body’s antioxidative defence mechanism of the body to fight disease. Alongside with aforementioned oxidative stress-related events, fluoride is proven to alter the activity of many antioxidant enzymes such as SOD, GSH-Px, and CAT, playing an important role in the antioxidative cell defence and eliminating free radicals.

•    Equally important a decrease in the activity of free radical scavenging enzymes, SOD, CAT, GST, and GSH-Px, was found in the blood of people exposed to fluoride along with a reduction in antioxidant enzymes in liver, kidney and brain.

•    Other Biochemical Changes induced by fluoride cytotoxicity are elevated Nitric Oxide (NO) generation in blood serum and in the liver of fluoride intoxicated animals. NO is an important signalling molecule and is critical for cellular health.

•    Other cellular compounds notedto be affected by fluoride are transaminases (AST and ALT), creatine kinase (CK), total lipids (TLs), cholesterol, triglycerides (TGs), and low-density lipoproteincholesterol (LDL-c) and high-density lipoprotein-cholesterol (HDL-c); all of which are critical for breaking down amino acids and converting energy storage molecules in the liver. It is als now documented that elevated transaminases are associated with liver damage.

•    The red blood cells of animals exposed to fluoride in drinking water exhibited significant inhibition of the parameters related to heme synthesis pathway like δ-aminolevulinic acid dehydratase and δ-aminolevulinic acid synthetase, accompanied by the depletion of whole brain biogenic amine levels.   Hemoproteins have critically biological functions including the transportation of diatomic gases, chemical catalysis, diatomic gas detection, and electron transfer ATP Depletion. ATP depletion and decreased ATP synthesis are frequently associated with both hypoxic and chemical (toxic) injury. Depletion of ATP to <5% to 10% of normal levels has widespread effects on many critical cellular systems in particular cellular energy metabolism. In humans exposed to fluoride decreases between 70-90% in ATP content have been documented as well as a direct link between F-induced inhibition of glycolysis and apoptosis. Fluoride is a well known inhibitor of enzymes of glycolytic pathway and while this effect is known for some time it is often underestimated or ignored in the studies of fluoride cytotoxicity and cell death. The authors note that since energy supply is a limiting factor in a variety of biochemical processes, ATP depletion can arrest many crucial cellular functions like transmembrane ion transport and protein phosphorylation, disturb membrane potential, and membrane-cytoskeleton interactions, what may finally lead to cell death ATP depletion leads to inhibition of NA+-K+ pump, GSH synthesis and GSH/GSSG membrane transport, thus ATP depletion might be the primary process in the chain of events impairing GSH replenishment and antioxidant defence.

•    Fluoride exposure has been shown to result in DNA fragmentation and DNA damage as well trigger the mitochondria-dependent cell death due to reduction of the enzymatic antioxidant.

•    Fluoride has been shown to directly effect Bcl-2 Family Proteins critically important for fighting cancer. BCL-2 was the first anti-death gene discovered, a milestone with far reaching implications for tumour biology and oncology.

•    Fluoride exposure has been found to alter the levels of p53 protein accompanied by a fall in cell survival rate. p53 plays a major role to the regulation of normal metabolic homeostasis, senescence, fertility, differentiation, and regulation of stem cells and is a tumour suppressor protein that responds to extrinsic and intrinsic stress stimuli, including DNA damage, oncogene activation, and hypoxia. It acts to control the mitochondria redox balance and integrity, and contribute to the regulation of oxidative phosphorylation, glycolysis, nucleotide biosynthesis, fatty acid oxidation, and antioxidant response.

•    Fluoride has been found to alter several cell types, both normal and pathological. Research has demonstrated that human exposure to fluoride in drinking water has been found to alter human genes related to the regulation of the cell cycle and apoptosis as well as inflammation in blood cells. The authors note that similar gene alteration was found in animal studies examining the impact of fluoride on sperm cells where it was demonstrated to affect approximately 100 genes involved in the signal transduction, amino acid phosphorylation, oxidative stress, cell cycle, electron transfer, glycolysis, chemotaxis, spermatogenesis, and apoptosis. Furthermore analysis of the kidney, liver, and cardiac muscle samples of fish exposed to fluoride  similarly found significant alteration of proteins critical for cellular toxicity, nuclear signalling, chromosome segregation  and DNA repair leading to chromosome instability and cell death.

•    Animal studies examining the neurotoxicity of fluoride on the hippocampal neurons in the brain reported that fluoride exposure in addition to DNA damage and cell-cycle regulation, suppressed the expression of neural cell adhesion molecules necessary for the maintenance of cognitive functions of the brain such as learning and memory, while enhancing the gene expression factors which can both promote cell death in response to oxidative stress, thus contributing to neurological dysfunctions.

•    The authors note that there is clear evidence to demonstrate that fluoride is able to induce endoplasmic reticulum (ER) stress which activates the self-protecting mechanisms termed unfolded protein response (UPR) resulting in altering protein essential for healthy DNA function and repair.

•    Accumulating evidence suggests that endoplasmic reticulum (ER) stress plays a role in the pathogenesis of diabetes, contributing to pancreatic β-cell loss and insulin resistance. It was further noted that ER stress may also link obesity and insulin resistance in type 2 diabetes.

•    The authors note that Fluoride induced ER stress was also found in pancreas cells leading to another type of cell death called autophagy.