§ Mr. CrausbyTo ask the Secretary of State for Health what research has been commissioned to investigate the change in the incidence of thyroid disease in fluoridated areas. [114276]
§ Ms BlearsA review by the University of York into the fluoridation of water listed three studies in which the incidence of thyroid (goitre) disease was the outcome of interest. Two of these studies (Gedalia and Brand (1963), "The relationship of fluoride and iodine in drinking water in the occurrence of goiter, Arch Int Pharmacodyn, 142, 312–315)"; Jooste et al. (1999) "Endemic goiter in the absence of iodine deficiency in schoolchildren of the Northern Cape Province of South Africa, Eur J Clin Nutr, 53(1), 8–12)" found no significant association with water fluoride level. The third (Lin et al. (1991) "The relationship of a low iodine and high fluoride environment to subclinical cretinism in Xinjiang," Xinjiang Institute for Endemic Disease Control and Research, Office of Leading Group for Endemic Disease Control of Hetian Prefectural Committee of the Communist Party of China and County Health and Endemic Prevention Station, Yutian, Xinjiang—unpublished report submitted through national health service centre for Reviews and Dissemination website) found a significant positive association between combined high fluoride/low iodine levels and goitre.
The Department of Health asked the Medical Research Council (MRC) to suggest where it might be possible to strengthen the evidence currently available. In their report, MRC concluded that, because the 1991 study looked at combined fluoride/iodine uptakes and has not been published in a peer-reviewed journal, the findings should be treated cautiously. The MRC reported in September 2002 and on their recommendation, we have commissioned a study to investigate the effect of water hardness and source of fluoride ion on bio-availability of fluoride in drinking water. The study is due for completion in autumn 2003.
The Chief Medical Officer and the Chief Dental Officer have been asked to advise on the implications of the other MRC recommendations for Government policy.
§ Mr. CrausbyTo ask the Secretary of State for Health what plans he has for public consultation prior to introducing fluoride into public drinking water. [114278]
§ Ms BlearsThere is already a statutory requirement for local consultations on fluoridation. We have asked for advice from the Chief Medical Officer and Chief Dental Officer on research priorities and the conduct of consultations. We wish to ensure that relevant research findings are accessible to the local population, together with the views of both supporters and opponents of fluoridation, so that people may make a well-informed decision on whether or not to have their water fluoridated.
§ Mr. WrayTo ask the Secretary of State for Health what health problems have been found to be a result of fluoridation of water supplies. [114704]
§ Ms BlearsThe Government commissioned an up to date review of the evidence on the relationship between fluoride and health from the national health service1130W centre for Reviews and Dissemination at the University of York. The report of the review was published in October 2000. The review found that the evidence showed that fluoridating water helps to reduce tooth decay. In areas of comparable social mix, dental health is much higher if the water is fluoridated.
The review found no clear evidence of other adverse effects on general health associated with water fluoridation, other than the increased risk of dental fluorosis—mottling of the teeth, which, in its more extreme forms, will leave some people concerned about the appearance of their teeth. Nevertheless, the strength of the teeth is not affected, they are still endowed with extra resistance to decay and, where it is cosmetically unacceptable, the effect can often be removed by routine dental treatment.
§ Mr. WrayTo ask the Secretary of State for Health pursuant to the answer of 17 December 2002,Official Report, column 672W, on fluoridation, what easily accessible and reliable information on fluoridation has been supplied by the Department to local communities; and what further research is being undertaken to improve the understanding of fluoridation. [114819]
§ Ms BlearsWe have asked for advice from the Chief Medical Officer and Chief Dental Officer on the conduct of consultations including the range and format of information to be made available in local consultations. We have also commissioned a study to investigate the effect of water hardness and source of fluoridation on bio-availability of fluoride in drinking water. The study is due for completion in autumn 2003.
§ Mr. WrayTo ask the Secretary of State for Health whether people will have their water fluoridated against their will under the Department's proposals to extend the fluoridation of water; and if he will make a statement. [114952]
§ Ms BlearsThere is a statutory requirement for local consultations on fluoridation. We have asked for advice from the Chief Medical Officer and Chief Dental Officer on how best to conduct consultations to ensure all views are taken into account.
§ Mr. CrausbyTo ask the Secretary of State for Health what plans he has to monitor the ingestion of fluoride in order to minimise the effects of toxicity. [114277]
§ Ms BlearsThe Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) is evaluating estimates of fluoride intake. The estimates are based on analysis of samples from the 1997 Total Diet Study, a market basket study that allows the levels of food constituents in the average UK household diet to be estimated, and on information on fluoride levels in the UK public water supply. COT is an independent scientific committee which provides advice to the Food Standards Agency (FSA), the Department of Health and other Government Departments and Agencies on matters concerning the toxicity of chemicals.
The Department is funding analyses of fluoride in drinking-water samples taken as part of the National Diet and Nutrition Survey (NDNS) of British adults aged 19–64 years. NDNS is a joint initiative between the Department and FSA. Fieldwork for the study was 1131W undertaken in 2000–01, and also included urine samples, which have, been analysed for fluoride. These data are expected to provide further information on fluoride intake and absorption.
The Department is considering the research recommendations, on total exposure and uptake of fluoride, from the Medical Research Council working group report "Water fluoridation and health" published in September 2002, including other potential uses of the NDNS programme.