ATMOSPHERIC POLLUTION (FLUORINE) (Hansard, 14 May 1953)

§ Dr. Barnett Stross (Stoke-on-Trent, Central)
My purpose tonight in bringing before the House this problem of environmental fluorosis is in order to ask the Parliamentary Secretary and the Minister to instigate a piece of medical research in my own division or some other part of Stoke-on-Trent where my division is located. Such a piece of research is long overdue and would benefit possibly very many parts of the world wherever certain types of industries are involved. I hope at the end of this debate that the Parliamentary Secretary will be able to assent.
This House has heard again and again the question of fluoride poisoning as it affects cattle raised with the Minister of Agriculture, and with the Minister of Labour where the health of the workers is involved. I am asking whether or not the time has not arrived when an investigation should be specifically made into the hazards which are run by people who live near factories and industrial undertakings which, as by-products of their activity, produce fluoride gas or fluoride compounds into the atmosphere.
In Lincolnshire some few years ago an examination was made of the open calcining of iron ore which contained 1557 1,200 parts per million of fluorine. It was noted in the neighbourhood that farm windows were etched and the occupants complained of the following symptoms: stiff joints, or stiff back, or stomach trouble or a cough. As early as 1937 in a factory where cryolite was being worked in Copenhagen an investigation by Roholm found that workers engaged in the process showed marked boney changes, including increased density of bones. X-rays showed that there was osteosclerosis and marked exostoses of the bones, jutting out of fragments from the shin-bone. More recently, the experimental work of A. M. Bond and Professor Murray on rats has shown that long before there are boney changes the ingestion of fluorine compound beyond what can be safely taken or excreted brings harmful changes to the kidneys.
I remember that in my own constituency, during the war, when I examined many youngsters entering the Cadet Force, I noticed changes in the teeth of an appreciable number. They had the fluoride spots of which many hon. Members have heard. At that time, and until recently, in certain parts of Hanley and Fenton in Stoke-on-Trent there was appreciable etching of the windows of houses near certain installations. Certain steps have been taken which I will mention in a moment and which have given us some remedy in this matter. It is fair to say that it is thought that there is no etching of the teeth of schoolchildren today in Stoke-on-Trent. I have had this last observation from the chief education officer, but I do not agree with it, for last week I saw a case in a child of 10—quite a typical case. I believe, therefore, that some is still being caused.
An investigation with schoolchildren such as I am asking for human beings generally who live near certain installations where we know this trouble has certainly existed until recently, and I am sure still exists, could very easily be carried out. It would have to be under the guidance of someone who is conversant with the research technique in this matter. Whoever was in charge— appointed, of course, by the Minister-would make use of the medical officer of health of the city, who is interested in and conversant with this problem, our school medical officers, our school dental 1558 officers, our radiological department, which is first class, and our health visitors.
I can state simply in a sentence or two the technique which I think would be used. The Minister would arrange that certain specimens collected by this team —specimens of drinking water, of certain dusts, of urine from human beings who were examined—would have to be analysed at Weybridge. At Weybridge is the laboratory which is attached to the Ministry, and therefore there would be no problem and no difficulty. In fact, the Parliamentary Secretary is probably aware that my colleague, the hon. Member for Stoke-on-Trent, South (Mr. Ellis Smith) brought up this matter with reference to cattle in his division which are sick and diseased, with broken, brittle or worn out teeth, staring coats and inability to eat, and which die prematurely; and tests are being carried out at Weybridge in connection with that investigation. But that is for animals, and I want tests for human beings, because we have the greater problem; cattle can be moved from pastures which are contaminated by dusts of this kind, but we must live there.
I hope the Minister will recognise that there can be no serious difficulty about these investigations. The sources of fluorine are, of course, water, tea. fish and fish products, and some drinking water contains more fluorine than other drinking water. I hope the Minister would never agree to the fluoridation of any drinking water in this country unless very careful investigation had first been made of the fluorine content of the surrounding atmosphere.
May I briefly give some of the sources from which this fluoride contamination reaches or may reach human beings. First of all, there is firing in tunnel ovens of pottery ware, while it is in a biscuit state, which means the first firing. In the body of the ware there is often Cornish stone and sometimes fluorspar, which is Derbyshire spar. We estimate that about 300 tons of Cornish stone are used in the industry a month. This would mean, say, each month about 20 to 25 tons of fluorine compounds in the atmosphere. That is about 300 tons a year of pure fluorine compounds. Therefore, that is one potent source.
Secondly, of course, there is the use of coal, mostly in domestic grates as well as in industrial installations, and many 1559 coals contain 100 parts of a million of fluorine. We estimate that perhaps 150,000 to 250,000 tons of coal are burnt each month in Stoke-on-Trent. That would give five to eight tons of fluorine, a very much smaller amount, of course, than we get from the 300 tons of Cornish stone.
To get as much fluorine from coal burnt either in domestic grates or furnaces as from Cornish stone, we would have to use about I million tons of coal. I would remark in passing that although coal is not so guilty as the other substance I mentioned which is used in pottery, this coal emits each month into the atmosphere some 3,000 to 5,000 tons of sulphur gas, which is a very unpleasant thing. We have many amenities, of course, in Stoke-on-Trent, but we do not boast that we are exactly a spa, and it must be apparent that like other industrial centres we have difficulties.
The third, and I think a smaller industry, but much more likely to be guilty, is where fluorides are manufactured for the vitreous enamel industry for making enamel which is later applied to metal. There cryolite is used, which is sodium aluminium fluoride, and this is probably the most potent localised source of giving a neighbourhood risk.
Fourthly and lastly, we have a great steel works in my constituency and we know that in recent years fluorspar is being used more and more as a flux for combining different types of metal together. I do not think, for my small researches, that there is much of this being used in this particular iron and steel industry, but some, of course, is used, and that would not be denied.
We in Stoke-on-Trent are not in a panic about this. We are too tough to be afraid of this sort of thing, particularly in view of the fact that a few years ago it was worse. There is less etching of glass now. I am told that glass which was taken out a few years ago, or recently, because people could not see through it and which has been replaced by new glass has not etched greatly. On the other hand, workers have told me that in a certain factory they cannot see out of the windows although the factory is a fairly new one.
Our industrialists have taken action in some cases, and in many cases they have 1560 dispersed the contamination by putting in high chimneys. Other have put in plant for washing these exhaust gases, so that we have at least some remedy.
As I said earlier, our school dentists do not think there is much mottling of teeth, although I can vouch for what I saw in the very rooms I occupy in my constituency in a boy of 10. I have a fragment of glass from a green-house and the contamination on it, which will not wash off with sugar soap, is only of a year's duration, because last year I saw it cleaned with an acid, which is the only thing that will clean it off.
We are dealing, I think, with a localised problem, and it may be that it is not a serious one. But I am assured by those who know much more about it than I do—and perhaps more than anyone here—that it is most desirable that a fragment of work should be done on human beings, and that it should be done in my constituency, or in South Stoke. No one in the world has done it, and it would be valuable for many other countries.
We want to know, not whether there is very marked exacerbations of serious poisoning, but whether there is an earlier stage, such as early kidney disease. It would not be at all difficult, as I have informed the hon. Lady. A fortnight's survey would do it, and with the results of this survey we would then know whether there is a problem, how serious it is, if at all, and if we see there is a problem we can then bend our minds towards some remedy. The Ministry must be deeply concerned with possibilities of illness from new industrial processes. We can take difficulties in our stride if we know the magnitude of the problem. If there is no problem we shall be delighted, and it may well be, with some of the difficulties we have suffered in the past, I have the right to ask for this particular favour.

§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
I am grateful to the hon. Gentleman for raising a matter which is of particular interest to his constituency. His general suggestion that it might be a danger to the public must necessarily be of interest to the Ministry because we are naturally very concerned 1561 with anything which can be considered a danger to public health.
As the hon. Gentleman will know, the Medical Research Council are constantly following up such lines of investigation, but they obviously cannot call for any inquiry unless they are satisfied that there is not only some but sufficient evidence to justify a full-scale and detailed inquiry. When I say a full-scale and detailed inquiry it is fair to say that no superficial inquiry could have behind it the authority of the Medical Research Council, and, therefore, if an inquiry was called for it would have to be indeed a thoroughly detailed one, thorough in all its aspects, and one upon which a really firm decision by the Council could be taken.
As far as fluorine compounds are concerned, it is agreed that they proceed from various industrial processes, and are discharged into the air, particularly in the various processes which the hon. Gentleman quoted. But we are assured, and we have investigated the local evidence available in the hon. Gentleman's constituency, that there is no concrete clinical evidence to suggest that they constitute a risk in themselves to the general health of the public.
In 1949 there was an inquiry by the Medical Research Council in the report of the Fluorosis Committee, which specifically went into an area where there were factories manufacturing aluminium, one of the industries the hon. Gentleman mentioned as a particularly bad one in this respect. The inquiry was conducted in Inverness-shire, and it was done in a thoroughly detailed fashion. Clinical, biochemical and radiological examinations were made of groups of workers in the factories where it was known the discharge was at its highest. The people living' in the surrounding area were also examined.
The result of that most detailed and thorough investigation was—whilst it was established that a large amount of fluorine was liberated from the factories, with all the workers near and closely exposed to these discharges—that the effects were absolutely minimal on their general health, and none of those examined were suffering from any clinical disability. In the whole survey, of those affected at all, there were three or four who showed definite evidence of fluorine, 1562 and they had been exposed to the discharge for over 50 years. The percentages of the report included all radiological abnormalities which were not otherwise explained, and even those which were not necessarily fluorosis of the bone. There was no sign of injury to the health of residents in the surrounding neighbourhood.

Dr. Srross
Has the hon. Lady forgotten the fact that out of 373 women and children in the area who were examined, 21 had mottled teeth?

§ Miss Hornsby-Smith
I am coming to the teeth.
Sheep and cattle are not the responsibility of my Department, but I accept that there is more danger in their case, in that animals are more exposed. The situation is admittedly more serious in that animals eat grass impregnated with fluorine discharge, and the amount that they consume in a short time would take a human being a lifetime to breathe from the atmosphere.

§ Mr. Thomas Oswald (Edinburgh, Central)
May I point out that in the report of the Medical Research Council there is a photograph of one worker employed in an area other than Fort William. Inverness-shire where most of the research work was done, that there was deterioration of the lumbar vertebrae and that the locum tenens was treating him primarily for lumbago and arthritis, whereas he was suffering from fluorosis from deposits from the factory?

§ Miss Hornsby-Smith
I said that four cases were established. In a detailed survey that was by no means an abnormal number or as many as those who did the investigation expected to find.
As for the general allusion to industrial processes, there are two inquiries under way which will have some bearing on this topic. Firstly, my right hon. Friend has established an inquiry into the fog deaths in London, and, secondly, the Ministry of Housing and Local Government are carrying out an investigation into air pollution over the whole country, and particularly in industrial towns. Quite obviously, the incidence of cases and evidence on fluorine will be featured in the inquiries, particularly in the one on pollution in industrial towns.
1563 We have been in contact with the Medical Officer of Health for Stoke-on-Trent, but he and the school dental officers claim that they have no evidence whatsoever of a case of mottling of teeth due to fluorine. As to windows, although etching of the glass was reported to be bad in one factory and present in neighbouring houses, new washing plant has been installed there and the windows which have been replaced have not shown any deterioration since.
Investigations of this kind, made on medical grounds, are made on the recommendation of the Medical Research Council to my right hon. Friend. If the Council regarded any danger as sufficient to warrant an investigation, I am sure that there would be no hesitation on the part of my right hon. Friend in endorsing that recommendation. As to the question whether Stoke-on-Trent might be considered as a centre for investigation, if it were thought desirable and necessary to have an inquiry, I must say that the scale of investigation suggested by the hon. Member for Stoke-on-Trent, Central (Dr. Stross) would be grossly inadequate to produce reports sufficiently extensive and reliable for the Medical Research Council to come to a decision upon them.
He did mention a report, but I am sure that, with his great medical knowledge, even he will agree that the investigation was not sufficiently deep and detailed as 1564 would certainly justify an inquiry by the Medical Research Council. He mentioned stiff joints and stiff limbs. Some of us have them at the end of an all-night Sitting, but we cannot lay the blame on fluorine. While I am sure that the suggestion was put forward in all good faith, I think the hon. Member will realise that if it were necessary to carry out such an inquiry it would be a much bigger job than could be done in the fortnight he suggests.
I can assure him that all the evidence we have does not lead us or the Medical Research Council to believe that an inquiry in that area is essential, but the wider problem of fluorine will quite obviously have to be one of the items covered in the wider investigations now being undertaken by my right hon. Friend the Minister of Housing and Local Government into air pollution, as particularly applied to industrial areas.
With regard to the question of fluorine in water supplies, the hon. Member knows that there has been a British mission to North America inquiring into this. Their report will be published at the end of the month and, pending a full study of that report, I would not wish to add anything on that particular topic this evening.