Those individuals living in communities where drinking water has low levels of calcium and magnesium would be at a risk of calcium and magnesium deficiency and at higher risk of developing neurological or cardiovascular disease as well as hypocalcemia and sarcoidosis in addition to certain cancers.268 The WHO have also reported that concern for calcium deficiency would be directed mostly at individuals who consume little or no milk and rely on drinking water for their main source of the mineral. It is most likely that clusters of disease would develop in geographic locations with non-calcareous bedrock resulting in naturally low calcium concentrations in drinking and groundwater.
Logically the risk would be increased significantly by artificial fluoridation of water, as fluoride ions would further reduce the bio-availability of calcium for consumers. It is alarming therefore that data on drinking water quality for calcium and magnesium is not published in EPA drinking water reports.269 It is apparent from the published reports that neither element is monitored consistently by either the EPA or local authorities. This is a matter that should
266 Environmental Protection Agency (2008a) The Provision and Quality of Drinking Water in Ireland - A Report for the Years 2006-2007. EPA, Wexford
267 Environmental Protection Agency (2007) Water Quality in Ireland 2006: Key Indicators of the Aquatic Environment. EPA, Wexford.
268Calcium and Magnesium in Drinking-Water Public Health Significance, World Health Organization, 2009
269 The Quality of Drinking Water in Ireland Reports for the Years 2000-2010 inclusive, Office of Environmental Enforcement Environmental Protection Agency
Given the obvious importance of both essential elements to general health and the hugely significant interactive properties of fluoride with both calcium and magnesium, the potential health consequences of adding fluorine compounds to soft water should be of paramount importance for the protection of public health and the provision of safe potable drinking water for human consumption.
require urgent attention by the EPA and HSE because of the growing concern that individuals may not be receiving clinically important levels of calcium and magnesium from drinking water as it is now known that many drinking water sources available to consumers in Ireland may contain insufficient levels of Ca2+and Mg2+. It is recommended that physicians should encourage patients to check the mineral content of their drinking water, whether tap or bottled, and choose water most appropriate for their needs.270
In spite of the knowledge of the health importance of Ca2+and Mg2+ in drinking water there is no apparent health surveillance and bio-monitoring of the population in high risk areas to ensure that individuals consume the recommended dietary intake in accordance with WHO recommendations. It is most likely that local authorities would have difficulty meeting the interim recommended limits for both Ca2+and Mg2+ in most geographic areas of the country. This may itself explain why no data is readily available. It is imperative that the concentrations of both these substances are known prior to fluoridating drinking water. It is also essential to be aware of how the addition of fluoride to water may impact negatively on overall water quality.
The EPA in Ireland found that groundwater is generally low in both calcium and magnesium levels.271 Calcium levels range from 17-89mg/l and magnesium levels range from 3.3 to 23mg/l. In both instances the lower concentrations are associated with Devonian bedrock geology found principally in the Southern part of Ireland. Devonian bedrock geology is principally located in the environs of Cork city, West Cork, East Cork, North Cork, South Limerick, South Kerry, North Waterford and parts of Clare, Tipperary, Roscommon, Leitrim and Cavan.
The communities living in these geographic areas would be considered the most vulnerable and at risk to the reported health risks and diseases from consuming drinking water low in Ca2+and Mg2+ as reported by the WHO.272 Individuals living in such areas, with low background concentrations of Ca2+and Mg2+ in drinking water, are exposed to a further cumulative risk with increased fluoride concentrations in the drinking water.
As fluoride actively seeks out calcium and magnesium, it further reduces the availability of these important ions for metabolism in the body. In areas with low Ca2+and Mg2+, the toxicity of the fluoride ion and any silicafluoride derivative compounds will be more aggressive on the body. This may have further negative implications for health due to the enhanced toxic effect of the fluoride ion on the body.
270 Azoulay, A., Garzon, P., Eisenberg, M, J,. Comparison of the Mineral Content of Tap Water and Bottled Waters, J Gen Intern Med. 2001 March; 16(3): 168–175.
271 Environmental Protection Agency (2005) A Methodology for the Determination of Natural Background Quality of Groundwaters (2002-W-DS/7), Environmental RTDI Programme 2000-2006, EPA, Wexford.
272 Calcium and Magnesium in Drinking-Water Public Health Significance, World Health Organization, 2009
Figure 3. Vulnerable geographic locations and high risk communities to water fluoridation in Ireland. All areas idenfied as yellow are low calcium waters with the softest water located below red line due to geological bedrock found in County Cork and South Kerry.
It is likely therefore that the risk of developing health complications would increase, especially when the reactive ion fluoride is added to drinking water in low Ca2+and Mg2+ areas. As fluoride interacts with both calcium and magnesium ions, the likely consequence would be acute calcium and magnesium deficiencies in sensitive groups of the population. In a recent study of the Irish population aged between 18-64 year olds, it was found that there was a significant prevalence of calcium deficiency particularly amongst women.273
The bio-availability of fluoride and the role of calcium were also reported as a matter of some concern by the UK Medical Research Council (MRC) in 2002. 274 The MRC raised serious questions as to the health risks of water fluoridation in geographic areas with low calcium and magnesium levels.
It is noteworthy therefore that the highest incidence of cancer and mortality for prostrate, pancreatic and colorectal cancer in Ireland, as noted in the National Cancer Register, was found to be in County Cork.275 A similar finding was found for incidence and mortality from cardiovascular disease.276
It is not surprising therefore that it has been found that the Southern region of Ireland, representing Cork City, West Cork and West Kerry, has the highest incidence of premature mortality from certain cancers and cardiovascular disease in Ireland. It is even more disturbing that the cumulative additive risk of injecting silicafluorides, containing the most reactive known chemical element fluoride, as well as its derivative compounds, into public water supplies and the inherent health risks that may be associated with this practice, have not been examined to date. Given the risks to human health this is not only unacceptable but entirely incomprehensible.
273 Irish Universities Nutrition alliance (2008), National Teens Food Survey
274 UK Medical Research Council Working Group Report: Water Fluoridation and Health, September 2002
275 National Cancer Registry Ireland: 1994-2005.
276 Ireland Take Heart Progress on the implementation of building Healthier Hearts 1999-2005, Health Service Executive.
It is truly astonishing despite the known risks and high incidences of these diseases in populations consuming low levels of Ca2+and Mg2+ in drinking water, that the Health Service Executive would appear to be unaware of the health risks posed to the population. If they were aware they would ensure that both elements were monitored in drinking water and more especially they would not support the addition of a known Ca2+andMg2+ inhibitor being added to drinking water via water fluoridation. It is extremely alarming and disturbing that to my knowledge there is no reference in any public health reports for Ireland highlighting the health risk of low calcium and magnesium. Nor has any concern previously been raised regarding the impact of fluorine compounds being added to ‗soft‘ drinking water or the increased risk of developing serious if not fatal diseases in the population as a consequence of calcium or magnesium deficiencies.
Kidney and bladder cancer incidences are relatively high for women in Ireland (9th & 4th highest respectively of 31 countries surveyed). It is known that age- standardised mortality rates from cancer of the kidney have been increasing steadily for men (by 1.9% a year) and women (by 1.2% a year) since at least the 1960‘s (note Ireland commenced fluoridation in 1967). There has been a dramatic increase in the percentage of Stage I kidney cancers, from 5% of the total in 1994-1998 to 37% in 2004-2008 while Stage II cancers increased from 0% in 1994-1998 to 12% in 2004-2008. For bladder cancer, there has been a small increase in Stage III and IV cancers while the percentage of unstaged cancers remained high, at over forty per cent.277
In a recent study278, undertaken in the U.S.A., researchers analysed data from 1,040,381 male and 1,011,355 female incident cancer cases diagnosed between 2000-2007 and collected by population-based cancer registries in the National Cancer Institute's Surveillance, Epidemiology and End Results Program. They found that the level of unstaged disease was greater in more lethal cancers (e.g., liver, oesophagus, and pancreas) compared with less deadly cancers (i.e., colon, urinary bladder and female breast).
It was reported that unstaged disease increased with age and is greater among non-married patients. Blacks compared with whites experienced significantly higher levels of unstaged cancers of the stomach, rectum, colon, skin (melanoma), urinary bladder, thyroid, breast, corpus, cervix, and ovaries, but lower levels of unstaged liver, lung and bronchial cancers. Males compared with females experienced significantly lower levels of unstaged cancers of the liver, pancreas, oesophagus and stomach, but significantly higher levels of unstaged lung and bronchial cancer and thyroid cancer.
There is no reason not to believe, given the size of the database in this study, that a similar pattern of cancer incidence may exist in Ireland. This being the case, given that the racial and ethnic demographics of Ireland have changed significantly in the past twenty years; it is to be expected that cancer incidence rates will increase significantly in southern regions, particularly County Cork. This is likely to occur as the number of high risk individuals (including Black African ethnicity and people of any other Black background) increase in a geographic location where the incidences of such cancers is already significantly above normal. In additiont to cancer incidences increasing there is a risk that the incidence of cardiovascular disease in this region will also increase due to the interaction of fluoride with low calcium and magnesium levels in drinking water and its increased toxic bio-availability in the body.
It is reasonable to hypothesise that the addition of silicafluoride compounds to drinking water with low calcium and magnesium levels only acts a cumulative additive risk of initiating such cancers, as fluoride interacts with both elements reducing their bio-availability in the human body.
277 National Cancer Registry, Cancer of the Kidney, Ureter and Bladder, Nov 2011 278Merrill RM, Sloan A, Anderson AE, Ryker K. Unstaged cancer in the United States: a population-based study. BMC Cancer. 2011 Sep 21;11:402.
That the toxic effect of the fluoride ion plays a key role in acute magnesium deficiency is well known.279,280,281
The amount of fluorideassimilated by living organisms constantly increases as Magnesium absorption diminishes. The same principle applies to Ca2+. The median fluoride natural background level in groundwater is estimated to be 0.1mg/l and less than 0.2mg/l in surface waters. In fluoridated drinking water it varies from 0.7-1.5mg/l.
Previous research findings have suggested that serum concentrations of fluoride influence the rate of calcification. It is now known that higher blood fluoride concentrations have shown greater enhancement of calcification.282
It has further been demonstrated that as concentration in municipal water supplies increased with artificial fluoridation the mean blood fluoride concentration of the inhabitants increased threefold from 0.014 to 0.040 p.p.m.283 This is confirmed by further research demonstrating that plasma fluoride concentration increased significantly with increased fluoride intake.284
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279 A Machoy-Mokrzynska, Fluoride-Magnesium Interaction, Institute of Pharmacology and Toxicology, Pomeranian Medical Academy, Szczecin, Poland. Fluoride Vol. 28 No. 4; November, 1995, pp 175-177
280 Marier J R. Observations and implications of the (Mg F) interrelations in bio-systems: a review and comments on magnesium intake and fluoride intake in the modern-day world. Proceedings of the Finnish Dental Society 76. 82-92, 93-102, 1980. (Abstracted in Fluoride 14, 142 1981).
281 Guminska M. The effect of magnesium on metabolism in living organisms and
medical consequences of its deficiency in man. Folia Medica Cracoviensia 26 1-2, 5-28, 1985.
282 Donald R. Taves, W.F. Neuman, From the Department of Radiation Biology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA, Factors controlling calcification in vitro: Fluoride and magnesium Archives of Biochemistry and Biophysics, Volume 108, Issue 3, December 1964, Pages 390–397
283 Smith, Frank A.; Gardner, Dwight E.; Hodge, Harold C. Metabolism of fluoride. II. Fluoride content of blood and urine as a function of the fluoride in drinking water, Journal of Dental Research (1950), 29, 596-600 CODEN: JDREAF; ISSN: 0022-0345. 284 Singer, Leon; Armstrong, W. D. Regulation of human plasma fluoride concentration, Journal of Applied Physiology (1948-1976) (1960), 15, 508-10 CODEN: JAPYAA; ISSN: 0021- 8987
The significance of any association between fluoride and calcium and magnesium deficiencies and other critical diseases cannot be underestimated. These findings are of major significance demanding, in the interests of public health and safety, an immediate response from the State requiring the cessation of the water fluoridation policy without delay.