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Ireland might relax fluoride rules

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7249.1560 (Published 10 June 2000) Cite this as: BMJ 2000;320:1560
  1. Doug Payne
  1. Dublin

    The Republic of Ireland is to consider relaxing laws that require the fluoridation of all drinking water amid mounting controversy over the alleged health risks of the practice.

    Michael Martin, the Irish health minister, has appointed a committee of environmental and health specialists to examine the evidence on fluoridation and advise on any need for new legislation.

    Sweden, Norway, Denmark, and Finland banned water fluoridation during the 1970s and 1980s because not enough was known about the long term health effects. In 1975, Germany rejected the practice as “foreign to nature, unnecessary, inefficient, irresponsible and harmful to the environment.” A year later, the Dutch rewrote their constitution to outlaw fluoridation. France's chief of public health declared in 1980 that fluoridation was “too dangerous.”

    In the United Kingdom, the practice is permitted rather than required, but only about 10% of drinking water is fluoridated. In 1996, 25 of 26 councils in Northern Ireland voted against fluoridating their drinking water. In the Republic of Ireland, when Dublin City Council and the county councils in Donegal and Sligo voted last year to suspend fluoridation in their regions on safety grounds, they were overruled by the Department of Health.

    Mr Martin said that the new forum on fluoridation would consider the “genuine concerns” expressed by all sides on the scientific, medical, and ethical debate. In addition, his department and the country's health boards have commissioned a joint research project from Trinity College, Dublin, and University College, Cork, to look into all aspects of fluoride use.

    Some politicians have welcomed the forum, which is expected to report in a year's time, but others have been critical of it. The Green Party, which opposes fluoridation, has called the exercise a “political whitewash.” Mr Martin has promised the public that the forum would give opponentsof fluoridation an opportunity to voice their concerns.

    The forum will be composed of about 20 people; so far Mr Martin has named experts from the dental, medical, public health, and academic fields to sit on the panel. Representatives will also be appointed by the environment department, the Environmental Protection Agency, the Irish Dental Association, and the Food Safety Authority of Ireland.

    Ireland is now almost the only country in the European Union to insist on mandatory fluoridation of piped water supplies. Fluoridation was introduced in 1963, and the Department of Health says that rates of dental decay have since been reduced by 70% During the same period, however, fluoridation has been stopped by other European countries because some studies have suggested that itwas associated with environmental and health problems, or because not enough was known about longterm effects. Experts, however, remain divided over epidemiological research that has suggested that water fluoridation might be linked to osteoporosis, dental fluorosis, irritable bowel syndrome, and other health problems. Equally, they are divided over studies that suggest there is no association.

    Mr Martin, who supports fluoridation, said the forum would examine alleged links between fluoridation and cancer and osteoporosis. “It will look at the research that has taken place already and what the outcome of that research has been, not just in terms of dental health but in terms ofthe other issues which from time to time have come to the surface,” he said.

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