The Greatest Fraud Fluoridation: Ch IX by Doctor Philip R.N. Sutton-2d
Errors and Omissions in
Experimental Trials - 2d
ADDITIONAL OBSERVATIONS ON THE
EVANSTON, GRAND RAPIDS AND NEWBURGH TRIALS
1. Gross numerical errors in
statements of the number of children examined.
The Evanston Trial
These
comments on the Evanston trial were published in 1980 in the present author's
book Fluoridation Scientific Criticisms and Fluoride Dangers. It was stated:
"Additional
Errors in the Evanston Trial Data.
In
January, 1967, which was the twentieth anniversary of the commencement of the
Evanston Trial, an entire special issue of the Journal of the American Dental
Association was devoted to a report on that study (Blayney and Hill, 1967). In
this, the original tables, complete with their gross numerical errors, were
reproduced, despite the fact that these [errors] had been pointed out eight
years earlier (Sutton, 1959) and some of them had been acknowledged by the
authors (Sutton, 1960). In addition, several faulty tables were published for
the first time.
The
tables [in this issue of the J. Amer. Dent. Ass.] then showed three different
statements regarding the number of children aged 6-8 years who were examined in
Evanston during the 1946 examination:
(i) 1991 children - see Tables 10,
11,30,40 and 47.
(ii) 1985 children - see Tables 7,8,16,18,21 and 32.
(iii) 1754 children - see Tables 24 and 25.
(ii) 1985 children - see Tables 7,8,16,18,21 and 32.
(iii) 1754 children - see Tables 24 and 25.
There
were also no fewer than six different statements in that article of the number
of children aged 12-14 years examined in Evanston in 1946:
(i) 1703
children - see Tables 15 and 32.
(ii) 1702 children - see Table 47.
(iii) 1701 children - see Tables 11,30,41,44 and 45.
(iv) 1697 children - see Tables 7,9,12,13,17,19,22 and 31.
(v) 1556 children - see Table 26.
(vi) 1146 children - see Table 46.
(ii) 1702 children - see Table 47.
(iii) 1701 children - see Tables 11,30,41,44 and 45.
(iv) 1697 children - see Tables 7,9,12,13,17,19,22 and 31.
(v) 1556 children - see Table 26.
(vi) 1146 children - see Table 46.
Between
the sum of the two highest statements of the number of children examined in
Evanston in 1946, and the sum of the two lowest statements of children examined
in the same year in the same study in the same city, there is a difference of
794 children (1991 + 1703 - 1754 - 1146 = 794).
The
number of children stated to have been examined in Evanston is even more
divergent in the original papers than in this special article. Blayney and
Tucker (1948) and Hill et al. (1950)
both gave a figure of 4375 children, compared with the number of 3310 in Hill et al. (1957b), a difference of 1065
children.
It was
these differences which the medical journalist Anne-Lise Gotzsche, in a letter
to the Lancet in 1975, said that she had showed to workers in other fields, and
that they had "simply laughed" at the statistics (see Fig. 5, p.
167).
In that
book (Sutton, 1980) - prepared as a submission to the Committee of Inquiry into
the Fluoridation of Victorian Water Supplies (1980) - it was stated (p. 203):
"These
errors were mentioned [by the present author] 12 years ago to the Tasmanian
Royal Commission on Fluoridation. Since that time I have not heard of any
mention of them or of a criticism having been made of the numerical data
published in that report."
It
appears that, in the manner common in fluoridation trials, those erroneous tables
have been accepted at their face value, without investigation.
More than
thirty years ago it was pointed out (Sutton and Amies, 1958b) that:
'This
uncritical attitude to these studies is rife." "Also it has been
assumed that associations and individuals that ... accepted the responsibility
of publicly advocating fluoridation, have undertaken independent examinations
of the data, and not merely repeated the opinions of others."
This
situation was referred to by Professor John Polya (1964) in his book Are We
Safe? He wrote:
"It
is immaterial that other evidence in favour of fluoridation is not always
false; the point is that persons, bodies and arguments that knowingly or in
simplicity acquiesce in one blatant falsehood are unreliable witnesses before a
jury either of scientists or of lay common sense."
He
continued:
"The
scandal created by the exposure of this absurdity resulted in the admission
that the first figure (4,375) was correct. In defence of the other claims it
was explained that "out of range" children were eventually excluded
from the survey, but then further critical check revealed more numerical
inaccuracies, not to speak of the magnitude of a correction exceeding 1,000. In
better examples of scientific work the author sticks to his experimental group;
discarding on the scale quoted strongly suggests that the experiment had to be
altered to fit pre-conceived results. This is one of the common consequences of
working without control of observer bias."
It is
pertinent to point out that, in the Foreword to that article in the special
edition of the Journal of the American Dental Association, in January 1967, Dr
F.A. Arnold, Jr., the Assistant Surgeon General, Chief Dental Officer, U.S.
Public Health Service (and formerly the chief experimenter in the study in
Grand Rapids) stated:
"Here,
in a single report, are data on the effect of water fluoridation on dental
caries so completely documented that the article is virtually a text book for
use in further research. It is an important scientific contribution towards the
betterment of the dental health of our nation. It is a classic in this
field."
It is
indeed a classic - a first-class example of the errors, omissions and
misstatements which abound in the reports of these fluoridation trials.
2. False information in the Abstracts of papers
2. False information in the Abstracts of papers
The
abstracts of reports on fluoridation trials are unusually important, for it is
likely that lay people, and politicians in particular, will confine their
reading of the report to the Abstract, assuming that it accurately reflects the
findings, and will base their opinions and actions on its statements.
The Grand Rapids Trial. The final report of the Grand
Rapids study was published in 1962. Reading the Abstract which preceded the
body of the article it would seem that, at last, the authors (Arnold et al., 1962) had come to realize the
necessity for comparing the results from the test city with those from the
control one for they stated that the results had been "...compared with
the caries attack rates in the control group of children in Muskegon,
Mich." This claim was not made in the body of the article, which included
the statement that: "... fluorides were introduced to this [Muskegon]
water supply in July, 1951" Therefore at that time Muskegon ceased to be a
control city, some eleven years before this final report (Arnold et al., 1962) from Grand Rapids.
How then,
in 1962, could the final result from the test city be compared with data from a
non-existent control one?
The claim
of Arnold et al. (1962) that they compared
the Grand Rapids caries rates with those in the "control group of children
in Muskegon, Mich." is shown to be false by their statement that:
"...in subsequent [after 1954] analyses of Grand Rapids data, comparison
has been made with the original Grand Rapids findings and with those for
Aurora."
This is
confirmed by the statement in the Abstract that:
"Caries
attack rates were lowered by 57 per cent in children 12 to 14 years old in
1959." This figure of 57 per cent is obtained by averaging the figures of
57.0, 63.2 and 50.8 per cent for the ages of 12, 13 and 14 years shown in their
Table 2 to be the "per cent reduction in DMF teeth (19441959)" in
Grand Rapids (not between Grand Rapids and its control city of Muskegon).
The Newburgh Study. Similar mis-information regarding
comparisons being made between test and control cities was published in the
same year (1962) by Dr David Ast, the senior author of the Newburgh study. In
the Abstract of that paper (Ast and Fitzgerald, 1962) he wrote:
"Among
children 12 to 14 years old in the four study areas, reductions in the DMF
rates as compared to the rates in control cities ranged from 48 to 71 per
cent."
Table 2
is the only one in that paper showing DMF rates for children aged 12-14 years
(in one case 13-14 years). In the first two studies listed, Grand Rapids and
Evanston, no reference is made to a control, the "reduction" in
Evanston, shown as 48.4 per cent, is obviously the 48 per cent mentioned in the
Abstract. This "difference" is between the rates in Evanston in 1946
and 1959, not between Evanston and a control, as stated in the Abstract. The
Grand Rapids rates are also shown between that city in 1944-45 and 1959, no
control data being used. Indeed Ast and Fitzgerald stated in the main text:
"In
the Grand Rapids and Evanston studies the control cities were lost before the
study was completed, so that the current data have been compared with the base
line data."
Not with
control cities, as they stated in their Abstract.
There
should not have been any confusion regarding the use of the term
"control", for the co-author of that paper, Bernadette Fitzgerald,
was described as the "senior biostatistician, division of special health
services, New York State Department of Health." Therefore the authors'
incorrect statement that they compared the caries rates "in the four study
areas" with rates in control cities is unlikely to have been made
inadvertently.
3. Continuing publication of false
statements.
It has
just been shown that Dr Ast (the senior author of the Newburgh study) and Dr
Arnold (the senior author of the Grand Rapids study) continued to disseminate
false statements regarding their studies many years after those ten-year
studies were concluded, Also, the arrogance of Drs Blayney and Hill (the
authors of the Evanston study) in publishing an article in 1967, which
repeated, in a special issue of the Journal of the American Dental Association,
figures which they had acknowledged seven years earlier were faulty (Sutton,
1960), indicates the reckless disdain of all those authors for the truth, and
for the members of the scientific community (which normally trusts statements
made in established journals by senior scientists, for it is not used to being
misled by such readily-verified deceptions).
Their
false statements do not engender confidence in the reliability of the data
published and the statements made by those senior scientists in their original
reports of what are still regarded by fluoridation advocates as three of the
four main fluoridation studies on which the case for fluoridation mainly relies
- those in Newburgh, Grand Rapids and Evanston in U.S.A.
Commenting
on the Grand Rapids study, Ziegelbecker (1983) pointed out that the
experimenters had examined "all" children from 79 schools in Grand
Rapids at the commencement of the trial, but that:
"After
5 years in 1949 they selected children at only 25 schools in Grand Rapids for
their investigation and observed children at the same time at all schools in
Muskegon (the control city)."
For
instance, the number of children aged 12 to 16 years who were examined in Grand
Rapids at the commencement of the trial was 7,661, but only 1,031 were examined
in 1959 (Arnold et al., 1962).
In 1988,
Colquhoun stated:
"In
the control city of Muskegon all children were examined throughout the period.
From the year-by-year figures for six-year-olds which were published three
years later in 1953, it is revealed that an impossible 70.75% reduction was
recorded in the first year of the trial (Arnold et aL,1953) and that there was then an increase and no overall
reduction in the following years. Examination of similar data for other age
groups shows that the sample of 25 schools could not have been representative
of the population being studied."
He
pointed out that:
"The
reported DMF of several of the age groups in this sample, approximately one
year after the initial examinations, was lower than that of the same children
when they were a year younger."
He
concluded:
"Fluoridated
water cannot turn decayed, missing or filled teeth into sound ones. It follows
that the caries experience of the children had not been reduced as claimed. The
large recorded reductions, which were mostly in the first year only, were a
result of selection of data."
4. Fictional results?
In 1954
De Stefano reported the findings of professional statisticians regarding the
Grand Rapids study. They raised the question whether "... the reported
results are merely the fiction of a biased sample."
Ziegelbecker
(1983) also, studied this situation. He stated:
"We
must conclude from this result that the sample in Grand Rapids was not
representative for all children and with respect to the basic examination. In
the following years from 1946 to 1949 (and later to 1954) the 25 schools in the
sample were the same each year and we see that the caries experience in the
sample was not reduced by fluoride in 1946-1949.
If we
accept that the sample was representative for the children, aged 6, in the 25
schools in those years then we must conclude that fluoride in the drinking water
had not reduced the dental caries experience of children, aged 6, in Grand
Rapids in the years before the US Public Health Service released the policy
statement [endorsing fluoridation] to the American Dental Association."
He
concluded:
"We
must conclude from these results that a fluoride content of 1 ppm in the public
water supply does not reduce dental caries experience."
Colquhoun
stated in 1988:
"In
their final study in Grand Rapids, published in 1962 after 15 years of
fluoridation, American health officials [including the director of the U.S.
National Institute of Dental Research, Dr F.A. Arnold, Jr.] wrote: "... no
such dramatic and persistent inhibition of caries in large population groups
had ever been demonstrated by any other means than fluoridation of a domestic
water supply."
Colquhoun
commented:
'That
statement, which could be described as the dogma of fluoridation, is now
considered by an increasing number of critics to be unscientific and
untrue."
In view
of the disclosure of the types of error which have just been mentioned, such a
grandiose claim, although it was widely accepted at the time, can no longer be
considered to be true.
More than thirty years ago Sutton
and Amies (1958a) commented on this sudden initial decrease in caries reported
from Grand Rapids (and from other studies considered). It was stated that the
results reported were not those which would be expected if the hypothesis was
correct that fluoride "strengthens" developing teeth and makes them
more resistant to attack by caries. Despite the fact that the results published
from fluoridation studies do not support this hypothesis, it is still
mentioned. For instance, the ten members of the task group which in 1984 wrote
the latest WHO book on this subject: Environmental Health Criteria 36. Fluorine
and Fluorides, referred to the importance of "lifelong consumption"
of fluoridated water.
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