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Thursday, 13 October 1983
Page: 1802

Question No. 383

Dr Everingham asked the Minister for Health, upon notice, on 24 August 1983:

(1) Is he able to say how the official Soviet Union policy on (a) water fluoridation, (b) fluoride dietary supplements, (c) topical use of fluorides and (d) milk fluoridation differs from that of (i) the World Heath Organisation and (ii) the National Health and Medical Research Council of Australia.

(2) Is he also able to say whether the report of the Safe Drinking Water Committee of the United States National Research Council National Academy of Sciences of 1977 or the WHO monograph Fluorides and Human Health recommended (a) better criteria for diagnosing dental fluorosis, (b) assessment of fluorosis in communities with 1 ppm fluoride in water supplies, (c) bone and blood fluoride levels in patients with chronic renal disease in high and low fluoride communities be correlated with x-ray, histology and clinical findings, (d) determination of inorganic components in food fluoride, (e) repetition of Rappaport's mongolism study and, if confirmed, intensive case-finding to supplement his figures, (f) mortality statistics comparing fluoridated and other areas, (g) in vivo studies of possible cellular tolerance to fluoride, (h) repetition of Manocha et al (1975) primate enzyme studies with 5 ppm water and better controls, (i) repetition of low F chromosomal studies of mice, (j) dominant lethal studies in rodents by mating males on various F dosages with normal females and (k) more evaluation or cancer and congenital deformity rates in fluoridated versus other cities.

(3) Have any of the recommendations referred to in part (2) been (a) publicly acknowledged, (b) supported and (c) acted upon by Australian authorities; if so, which recommendations.

Mr Dawkins —The Acting Minister for Health has provided the following answer to the honourable member's question:

(1) (a) The Australian Embassy in Moscow has advised that the USSR supports the fluoridation of water, and at present 120 cities are using fluoridated water while the procedure is being introduced in a further 60 cities.

The World Health Organization and the National Health and Medical Research Council of Australia NH and MRC recommend the fluoridation of water. The World Health Assembly of WHO adopted the following resolution in 1978:

'Urges Member States to consider, within national plans for the prevention and control of oral disease, the fluoridation of public water supplies, where and when appropriate.'

The NH and MRC first recommended fluoridation in 1953 and has reaffirmed this support on a number of occasions, the most recent being in 1979.

(b) The Committee of Inquiry into the Fluoridation of Victorian Water Supplies reported (page 269) that fluoride tablets are used in USSR as a dietary supplement.

While WHO has not made a recommendation specifically concerning fluoride dietary supplements, the World Health Assembly of WHO adopted the following resolution in 1978:

'Where fluoridation of public drinking water supplies is not feasible for technical or other reasons, alternative methods of achieving an optimum daily intake or application of fluoride should be considered.'

In 1977 NH and MRC made the following recommendation:

'Council recommends that in non-fluoridated areas the following dietary fluoride supplements should be taken-

0-12 months-0.25 mg fluoride as fluoride ion daily

12.24 months-0.5 mg fluoride as fluoride ion daily

24 months-1 mg fluoride as fluoride ion daily.

Ideally these supplements should be taken until the age of 18 years.'

(c) The report of the Committee of Inquiry into the Fluoridation of Victorian Water Supplies states (page 269) that fluoride solutions are used for topical application in USSR.

The WHO and NH and MRC support the topical use of fluorides to assist in the control of dental caries. In 1978 NH and MRC adopted the following recommendation:

'A fluoride dentrifice be used in home dental care for children and adults. A fluoride prophylactic paste be used in dental practice for the removal of plaque , and other cleaning and polishing procedures. The application of fluoride preparations by trained personnel should be encouraged in non-fluoridated areas, and that the need for such application in fluoridated areas should be assessed by a dentist.'

(d) Information is not currently available concerning the use of milk as a vehicle for fluoride in USSR.

Neither WHO nor NH and MRC has expressed a policy specifically concerning the fluoridation of milk.

(2) The Safe Drinking Water Committee of the United States National Academy of Science's National Research Council did make research recommendations along the lines of the eleven recommendations abstracted by the honourable member. The 1970 WHO monograph Fluorides and Human Health, comprising a series of review papers, made no recommendations.

(3) The matters referred to in the above recommendations, related specifically to the findings of particular American studies. They were considered, however, by the Committee of Inquiry into the Fluoridation of Victorian Water Supplies. While its recommendations did not specifically refer to those of the US Safe Drinking Water Committee, it was concluded in Section 19.7 of the Report that:

'Assertions that fluoridation of water supplies at recommended levels has toxic , carcinogenic, mutagenic, teratogenic or allergenic effects on humans are not supported by sound, scientific evidence. Whilst a null proposition can never be proved, there is massive evidence to show that fluoridation at recommended levels has no harmful effect on the health of the community'.