About this publication on Fluoridation

1. Source for this Publication
   
2. The Scientific Committee on Health and Environmental Risks (SCHER)
   
3. Background to the SCHER opinion on Fluoridation
   
4. Specific questions put to the SCHER by the European Commission
   

1. Source for this Publication

The texts in level 3 are directly sourced from
“Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water”, a report produced in 2011 by the SCHER (Scientific Committee on Health and Environmental Risks) of the European Commission.

Levels 1 and 2 were written by Dr Jon Turney.

2. The Scientific Committee on Health and Environmental Risks (SCHER)

The Scientific Committee on Health and Environmental Risks (SCHER) is one of three independent non-food committees which give scientific advice on consumer safety, public health and the environment.

The SCHER was set up in 2004 to offer opinions on environmental pollutants and their health and environmental risks, sand how these may best be assessed. The Committee which produced this report had 17 members, and convened a working group of 7, assisted by advice from 4 additional external experts.

For further information on the SCHER see: http://ec.europa.eu/health/scientific_committees/environmental_risks/index_en.htm 

3. Background to the SCHER opinion on Fluoridation

Water fluoridation has been adopted as a public health measure in some EU countries to help prevent tooth decay. Fluoride’s costs and benefits and effects have been investigated by the European Food Safety Authority, in 2005 and 2008, and the Commission Scientific Committee on Consumer Products, in 2009.

There is recurrent controversy over the benefit of water fluoridation. The Commission asked the SCHER to review the latest evidence on fluoride’s health and environmental effects.

4. Specific questions put to the SCHER by the European Commission

In its report, the Scientific Committee was asked to answer the following:

1. Taking into consideration the SCCP opinion of 20.09.05 (SCCP2005) on the safety of fluorine compounds in oral hygiene products, the EFSA NDA opinion of 22.2.05 on the Tolerable Upper Intake Level of Fluoride, and the EFSA CONTAM panel opinion of 22.06.05,

a. Critically review any information that is available in the public domain on the hazard profile and epidemiological evidence of adverse and/or beneficial health effects of fluoride. In particular the Committee should consider evidence that has become available after 2005, but also evidence produced before which was not considered by the SCCP and EFSA panels at the time.

b. Conduct an integrated exposure assessment for fluoride covering all known possible sources (both anthropogenic and natural). In doing so, and in the case of uncertainties or lack of actual exposure data, the SCHER is requested to conduct a sensitivity analysis that includes a range of possible exposure scenarios (e.g. sources, age group), and describe using appropriate quantitative or qualitative means the weight-of-evidence behind each scenario, the uncertainties surrounding each scenario, and the probability of it occurring in real life.

c. On the basis of its answers above, the SCHER is also asked:

c1 – To evaluate the evidence of the role of fluoride in tooth decay prevention and rank the various exposure situations as to their effectiveness in offering a potential tooth decay preventive action.

c2 – To make a pronouncement as to whether there may be reasons for concern arising from the exposure of humans to fluoride and if so identify exposure scenarios that may give rise to particular concern for any population subgroup.

d. Identify any additional investigative work that needs to be done in order to fill data gaps in the hazard profile, the health effects and the exposure assessment of fluoride.

2. Assess the health and environmental risks that may be associated with the use of the most common drinking water fluoridation agents, silicofluorides (e.g. (hydro)fluorosilicic acid, sodium silicofluoride, disodium hexafluorosilicate or hexafluorosilicate or hexafluorosilicic acid), taking into account their hazard profiles, their mode of use in water fluoridation, their physical chemical behaviour when diluted in water, and the possible adverse effects they may have in exacerbating fluoride health effects as reported in some studies.