World Health Recommendations for Water Fluoridation

Response to this request is delayed. By law, Department of Health and Social Care should normally have responded promptly and by (details)

Dear Department of Health and Social Care,

For the record I wish to place the Department of Health and Social Care with the following knowledge and require that the question be answered.

Before embarking on expanding the English Water Fluoridation programme, could the person/s responsible for making Water Fluoridation decisions provide up-to-date research which persuades him/her that there is no need to measure fluoridated people's total exposure (including from food, other liquids and absorption via bath water) in line with the WHO’s recommendation, of which he/she is aware.

Explanatory note: The WHO recommends that individuals should not be exposed to intakes of fluoride approaching 6mg fluoride/day. People drink varying amounts of fluoridated water and those who drink the most are more likely to approach or even exceed the 6mg F/day. The WHO recognises that over-exposure to fluoride leads to dental fluorosis and skeletal fluorosis and is keen to limit intake in countries where people are exposed to too much, whether in water and in food products such as tea etc. Empirical evidence exists that fluoride is absorbed when taking a bath. There is a possibility of these bone diseases occurring in England if the DHSC does not now take action to measure people’s exposure. 1.5mg F/litre is not the recommended concentration of fluoride: it's the maximum concentration. In the USA, the concentration has been reduced to 0.7mg F/litre in drinking water in an attempt to prevent dental fluorosis which is endemic in the population.

The WHO’s recommendation is: "In setting national standards or local guidelines for fluoride or in evaluating the possible health consequences of exposure to fluoride, it is essential to consider the average daily intake of water by the population of interest and the intake of fluoride from other sources (e.g. from food and air). Where the intakes are likely to approach, or be greater than, 6 mg/day, it would be appropriate to consider setting a standard or local guideline at a concentration lower than 1.5 mg/l."

Ref: Guidelines for Drinking Water Quality, 4th edition [WHO 2022, p.405

https://www.who.int/publications/i/item/...

Yours faithfully,

Leigh Puddifoot

Leigh Puddifoot

Dear Department of Health and Social Care,

I should be due to receive a reply to the above question no later than 20th May.

However, are you able to confirm that the question is receiving the Departments attention which will be fully answered on or before the date stated above?

Thanking you for your kind attention with the above request I remain.

Yours faithfully,

Leigh Puddifoot

Department of Health and Social Care

1 Attachment

Dear Ms Puddifoot,

Please find attached the Department of Health and Social Care's response
to your recent EIR request (our ref: EIR-1506670).

Yours sincerely, 

Freedom of Information Team
Department of Health and Social Care

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Leigh Puddifoot

Dear Department of Health and Social Care,

THIS IS NOT A REQUEST FOR AN INTERNAL REVIEW.

My original question relates to a recommendation by the World Health Organisation of 6 mg fluoride/day from all sources and NOT to the 1.5 mg f/litre water maximum to which you were alluding when you referred me to Community water fluoridation expansion in the north east of England - GOV.UK (www.gov.uk).

So, for clarity I repeat the question.

"Before embarking on expanding the English Water Fluoridation programme, could the person/s responsible for making Water Fluoridation decisions provide up-to-date research which persuades him/her that there is no need to measure fluoridated people's total exposure (including from food, other liquids and absorption via bath water) in line with the WHO's recommendation, of which he/she is aware?"

Thanking you for your kind attention with the above request I remain.

Yours faithfully,

Leigh Puddifoot

Leigh Puddifoot

Dear Department of Health and Social Care Freedom of Information Team,

I sincerely appreciate how incredibly busy you must all be, however I have to send this as a reminder that the statutory 20 working days have elapsed. May I have a substantive reply to my question regarding the WHO's 6 mg Fluoride/day recommendation?

Please note that I AM NOT REQUESTING AN INTERNAL REVIEW.

Thank you for your kind attention with the above matter, I remain.

Yours faithfully,

Leigh Puddifoot

FreedomofInformation, Department of Health and Social Care

Dear Ms Puddifoot,

Thank you for your email.

Your follow up request, which was in response your previous request EIR-1506670 was received on 16 May, and we aim to respond to this request by 14 June 2024.

Yours sincerely,

Freedom of Information Team
Department of Health and Social Care

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Leigh Puddifoot

Dear FreedomofInformation,

As far as I am aware and in the absence of a new FoI No., the request for an answer to my original question is outstanding because your first response did not address the 6 mg fluoride/day from all sources issue.

Therefore, there is no justification for adding a further 20 days to the process. From my point of view, because you have misunderstood the original question, the ball is back in your court to re-read and understand the question and to then answer the question without misunderstanding it again.

To make it crystal clear, 6 mg fluoride/day is the daily dose maximum whilst 1.5 mg fluoride/litre is the maximum concentration per litre. I already knew about the 1.5 mg fluoride/litre maximum guideline and did not require that to be explained.

My original question concerned the DHSC’s consideration of the daily exposure of 6 mg fluoride/day from all sources recommendation by the WHO.

Please answer my original question which is repeated below for the sake of clarity.

“Before embarking on expanding the English Water Fluoridation programme, could the person/s responsible for making Water Fluoridation decisions provide up-to-date research which persuades him/her that there is no need to measure fluoridated people's total exposure (including from food, other liquids and absorption via bath water) in line with the WHO’s recommendation, of which he/she is aware.”

I AM NOT REQUESTING AN INTERNAL REVIEW but merely seek to have the original question addressed and answered..

I remain.

Yours sincerely,

Leigh Puddifoot