NHMRC fluoride paper: relax, Australian citizens, your pineal glands are safe

Michael Vagg, Deakin University

When not being forced to waste their time and formidable expertise researching furphies like wind turbine syndrome or homeopathy, the National Health and Medical Research Council (NHMRC) can get on with producing exemplary public health statements like their newest one on water fluoridation.

Begun in 2014 in response to this sort of conspiracy-mongering, the NHMRC has collected an overwhelming weight of evidence in support of the safety and benefit of adding tiny amounts of fluoride to drinking water supplies.

This document is a draft released for public comment. I would love to be able to read the public submissions they are going to get. None of the favoured conspiracy claims are supported.

It most emphatically did not find any evidence that fluoride lowers IQ, as suggested by a badly done and even more badly reported paper from 2012.

Neither did it find any support for the idea that fluoride at levels obtained by current fluoridation practices caused significant dental fluorosis, such as brittle or discoloured teeth from excessive fluoride being incorporated into teeth.

Still less was there any support for fluoride acting as a mind control agent!

The draft paper sets out in excellent prose the value of its work and how it has been done. It is easy to understand and reading through it, I was struck by how well the considerable scientific grunt work had been made to sound easy and logical. In particular, the couple of pages the authors have devoted to their methodology is outstandingly clear and easily understood.

Sections are also included on the ethics and cost-effectiveness of water fluoridation, distilled into useful factoids such as:

• For every A$1 spent on fluoridation, A$7-18 is saved in dental treatment costs
• Over the last 25 years in Victoria, around A$1 billion dollars has been saved in treatment costs and reduced absenteeism
• Stopping water fluoridation would increase health inequality in the nation as a whole.

I would recommend the NHMRC fluoride paper as a public document for anyone with an interest in the issue, or indeed as a basic study of how to do public health policy. Most people I suspect will just go about their lives secure in the knowledge that sensible, reasonable public health professionals are making good decisions in the national interest.

Or at least, that’s what we would be thinking given that we are apparently docile and obedient from all the fluoride accumulating in our pineal glands…

Michael Vagg, Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist, Deakin University

This article was originally published on The Conversation. Read the original article.

 

The Fallacy of Faulty Risk Assessment

by Tim Harding

(An edited version of this essay was published in The Skeptic magazine, September 2016, Vol 36 No 3)

Australian Skeptics have tackled many false beliefs over the years, often in co-operation with other organisations.  We have had some successes – for instance, belief in homeopathy finally seems to be on the wane.  Nevertheless, false beliefs about vaccination and fluoridation just won’t lie down and die – despite concerted campaigns by medical practitioners, dentists, governments and more recently the media.  Why are these beliefs so immune to evidence and arguments?

There are several possible explanations for the persistence of these false beliefs.  One is denialism – the rejection of established facts in favour of personal opinions.  Closely related are conspiracy theories, which typically allege that facts have been suppressed or fabricated by ‘the powers that be’, in an attempt by denialists to explain the discrepancies between their opinions and the findings of science.  A third possibility is an error of reasoning or fallacy known as Faulty Risk Assessment, which is the topic of this article.

Before going on to discuss vaccination and fluoridation in terms of this fallacy, I would like to talk about risk and risk assessment in general.

What is risk assessment?

Hardly anything we do in life is risk-free. Whenever we travel in a car or even walk along a footpath, most people are aware that there is a small but finite risk of being injured or killed.  Yet this risk does not keep us away from roads.  We intuitively make an informal risk assessment that the level of this risk is acceptable in the circumstances.

In more formal terms, ‘risk’ may be defined as the probability or likelihood of something bad happening multiplied by the resulting cost/benefit ratio if it does happen.  Risk analysis is the process of discovering what risks are associated with a particular hazard, including the mechanisms that cause the hazard, then estimating the likelihood that the hazard will occur and the consequences if it does occur.

Risk assessment is the determination of the acceptability of risk using two dimensions of measurement – the likelihood of an adverse event occurring; and the severity of the consequences if it does occur, as illustrated in the diagram below.  (This two-dimensional risk assessment is a conceptually useful way of ranking risks, even if one or both of the dimensions cannot be measured quantitatively).

By way of illustration, the likelihood of something bad happening could be very low, but the consequences could be unacceptably high – enough to justify preventative action.  Conversely, the likelihood of an event could be higher, but the consequences could low enough to justify ‘taking the risk’.

In assessing the consequences, consideration needs to be given to the size of the population likely to be affected, and the severity of the impact on those affected.  This will provide an indication of the aggregate effect of an adverse event.  For example, ‘high’ consequences might include significant harm to a small group of affected individuals, or moderate harm to a large number of individuals.

A fallacy is committed when a person either focuses on the risks of an activity and ignores its benefits; and/or takes account one dimension of risk assessment and overlooks the other dimension.

To give a practical example of a one-dimensional risk assessment, the desalination plant to augment Melbourne’s water supply has been called a ‘white elephant’ by some people, because it has not been needed since the last drought broke in March 2010.  But this criticism ignores the catastrophic consequences that could have occurred had the drought not broken.  In June 2009, Melbourne’s water storages fell to 25.5% of capacity, the lowest level since the huge Thomson Dam began filling in 1984.  This downward trend could have continued at that time, and could well be repeated during the inevitable next drought.

Melbourne’s desalination plant at Wonthaggi

No responsible government could afford to ‘take the risk’ of a major city of more than four million people running out of water.  People in temperate climates can survive without electricity or gas, but are likely to die of thirst in less than a week without water, not to mention the hygiene crisis that would occur without washing or toilet flushing.  The failure to safeguard the water supply of a major city is one of the most serious derelictions of government responsibility imaginable.

Turning now to the anti-vaccination and anti-fluoridation movements, they both commit the fallacy of Faulty Risk Assessment.  They focus on the very tiny likelihood of adverse side effects without considering the major benefits to public health from vaccination and the fluoridation of public water supplies, and the potentially severe consequences of not vaccinating or fluoridating.

Vaccination risks

The benefits of vaccination far outweigh its risks for all of the diseases where vaccines are available.  This includes influenza, pertussis (whooping cough), measles and tetanus – not to mention the terrible diseases that vaccination has eradicated from Australia such as smallpox, polio, diphtheria and tuberculosis.

As fellow skeptic Dr. Rachael Dunlop puts it:  ‘In many ways, vaccines are a victim of their own success, leading us to forget just how debilitating preventable diseases can be – not seeing kids in calipers or hospital wards full of iron lungs means we forget just how serious these diseases can be.’

No adult or teenager has ever died or become seriously ill in Australia from the side effects of vaccination; yet large numbers of people have died from the lack of vaccination.  The notorious Wakefield allegation in 1998 of a link between vaccination and autism has been discredited, retracted and found to be fraudulent.  Further evidence comes from a recently published exhaustive review examining 12,000 research articles covering eight different vaccines which also concluded there is no link between vaccines and autism.

According to Professor C Raina MacIntyre of UNSW, ‘Influenza virus is a serious infection, which causes 1,500 to 3,500 deaths in Australia each year.  Death occurs from direct viral effects (such as viral pneumonia) or from complications such as bacterial pneumonia and other secondary bacterial infections. In people with underlying coronary artery disease, influenza may also precipitate heart attacks, which flu vaccine may prevent.’

In 2010, increased rates of high fever and febrile convulsions were reported in children under 5 years of age after they were vaccinated with the Fluvax vaccine.  This vaccine has not been registered for use in this age group since late 2010 and therefore should not be given to children under 5 years of age. The available data indicate that there is a very low risk of fever, which is usually mild and transient, following vaccination with the other vaccine brands.  Any of these other vaccines can be used in children aged 6 months and older.

Australia was declared measles-free in 2005 by the World Health Organization (WHO) – before we stopped being so vigilant about vaccinating and outbreaks began to reappear.  The impact of vaccine complacency can be observed in the 2015 measles epidemic in Wales where there were over 800 cases and one death, and many people presenting were of the age who missed out on MMR vaccination following the Wakefield scare.

After the link to autism was disproven, many anti-vaxers shifted the blame to thiomersal, a mercury-containing component of relatively low toxicity to humans.  Small amounts of thiomersal were used as a preservative in some vaccines, but not the MMR vaccine.  Thiomersal was removed from all scheduled childhood vaccines in 2000.

In terms of risk assessment, Dr. Dunlop has pointed out that no vaccine is 100% effective and vaccines are not an absolute guarantee against infection. So while it’s still possible to get the disease you’ve been vaccinated against, disease severity and duration will be reduced.  Those who are vaccinated have fewer complications than people who aren’t.  With pertussis (whooping cough), for example, severe complications such as pneumonia and encephalitis (brain inflammation) occur almost exclusively in the unvaccinated.  So since the majority of the population is vaccinated, it follows that most people who get a particular disease will be vaccinated, but critically, they will suffer fewer complications and long-term effects than those who are completely unprotected.

Fluoridation risks

Public water fluoridation is the adjustment of the natural levels of fluoride in drinking water to a level that helps protect teeth against decay.  In many (but not all) parts of Australia, reticulated drinking water has been fluoridated since the early 1960s.

The benefits of fluoridation are well documented.  In November 2007, the NHMRC completed a review of the latest scientific evidence in relation to fluoride and health.  Based on this review, the NHMRC recommended community water fluoridation programs as the most effective and socially equitable community measure for protecting the population from tooth decay.  The scientific and medical support for the benefits of fluoridation certainly outweighs the claims of the vocal minority against it.

Fluoridation opponents over the years have claimed that putting fluoride in water causes health problems, is too expensive and is a form of mass medication.  Some conspiracy theorists go as far as to suggest that fluoridation is a communist plot to lower children’s IQ.  Yet, there is no evidence of any adverse health effects from the fluoridation of water at the recommended levels.  The only possible risk is from over-dosing water supplies as a result of automated equipment failure, but there is inline testing of fluoride levels with automated water shutoffs in the remote event of overdosing.  Any overdose would need to be massive to have any adverse effect on health.  The probability of such a massive overdose is extremely low.

Tooth decay remains a significant problem. In Victoria, for instance, more than 4,400 children under 10, including 197 two-year-olds and 828 four-year-olds, required general anaesthetic in hospital for the treatment of dental decay during 2009-10.  Indeed, 95% of all preventable dental admissions to hospital for children up to nine years old in Victoria are due to dental decay. Children under ten in non-optimally fluoridated areas are twice as likely to require a general anaesthetic for treatment of dental decay as children in optimally fluoridated areas.

As fellow skeptic and pain management specialist Dr. Michael Vagg has said, “The risks of general anaesthesia for multiple tooth extractions are not to be idly contemplated for children, and far outweigh the virtually non-existent risk from fluoridation.”  So in terms of risk assessment, the risks from not fluoridating water supplies are far greater than the risks of fluoridating.

Implications for skeptical activism

Anti-vaxers and anti-fluoridationists who are motivated by denialism and conspiracy theories tend to believe whatever they want to believe, and dogmatically so.  Thus evidence and arguments are unlikely to have much influence on them.

But not all anti-vaxxers and anti-fluoridationists fall into this category.  Some may have been misled by false information, and thus could possibly be open to persuasion if the correct information is provided.

Others might even be aware of the correct information, but are assessing the risks fallaciously in the ways I have described in this article.  Their errors are not ones of fact, but errors of reasoning.  They too might be open to persuasion if education about sound risk assessment is provided.

I hope that analysing the false beliefs about vaccination and fluoridation from the perspective of the Faulty Risk Assessment Fallacy has provided yet another weapon in the skeptical armoury against these false beliefs.

References

Rachael Dunlop (2015) Six myths about vaccination – and why they’re wrong. The Conversation, Parkville.

C Raina MacIntyre (2016) Thinking about getting the 2016 flu vaccine? Here’s what you need to know. The Conversation, Parkville.

Mike Morgan (2012) How fluoride in water helps prevent tooth decay.  The Conversation, Parkville.

Michael Vagg (2013) Fluoride conspiracies + activism = harm to children. The Conversation, Parkville.

 Government of Victoria (2014) Victorian Guide to Regulation. Department of Treasury and Finance, Melbourne.

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How fluoride in water helps prevent tooth decay

Mike Morgan, University of Melbourne

The most effective way to prevent tooth decay is delivered to most Australian homes every day through their water pipes. It is, of course, fluoride distributed via the water supply.

Dental decay occurs when acid destroys or demineralises the outer surface of the tooth – the enamel. Bacteria in the mouth from food and drinks containing sugar produces acid and fluoride repairs demineralisation before it becomes permanent. It does this by encouraging remineralisation or repair of the enamel surface. Fluoride also helps strengthen the mineral structure of developing teeth.

Fluoride is a naturally occurring compound found in plants and rocks and, in very low levels, in almost all fresh water. Sometimes, fluoride is found naturally in the water supplies of Australian communities at exactly the level recommended to reduce dental decay, but this is rare and happens by chance.

Community water fluoridation is the adjustment of fluoride in drinking water to a level that helps protect teeth against decay. Drinking water in many parts of Australia has been fluoridated since the early 1960s.

Fluoride helps strengthen the mineral structure of developing teeth.
Jens Gyldenkærne Clausen

Although widely accepted and applauded as a crucial public health policy, fluoridation has attracted some vocal critics. Fluoridation opponents over the years have claimed that putting fluoride in water causes health problems, is too expensive and is a form of mass medication. Some go as far as to suggest that fluoridation is a communist plot and affects children’s IQ.

Despite these claims, fluoridation is supported by many national and international organisations including the World Health Organization, World Health Assembly, World Dental Federation, Australia’s National Health and Medical Research Council (NHMRC), Australian Dental Association and the Public Health Association of Australia.

In 2006, the WHO and the International Dental Federation and the International Association for Dental Research, released a statement endorsing community water fluoridation.

And the Centers for Disease Control and Prevention (CDC) in the United States includes water fluoridation in its list of the top ten health initiatives of the twentieth century, alongside immunisation, compulsory seat belt wearing and smoking bans.

In November 2007, the NHMRC completed a review of the latest scientific evidence in relation to fluoride and health. Based on this review, the NHMRC recommended community water fluoridation programs as the most effective and socially equitable community measure for protecting the population from tooth decay. The scientific and medical support for the benefits of fluoridation certainly outweighs the claims of the vocal minority against it.

Luc De Leeuw

The recommended level varies around Australia and depends on the annual average maximum daytime temperature. In Victoria, for instance, the maximum level of fluoride added to drinking water is one milligram per litre or one part per million as recommended by the World Health Organization.

In hotter climates where people drink more, the recommended level can drop to around 0.7 parts per million. As a comparison, the amount of fluoride in children’s toothpaste is 400 to 500 parts per million. In regular toothpaste, it’s 1,000 parts per million.

We’ve known about the role of fluoride in reducing dental decay since the early part of the twentieth century and some countries, such as the United States, have been adding it to water and toothpastes since the 1950s.

Canberra was the first Australian capital city to be fluoridated – back in 1964. Melbourne has had community water fluoridation since 1977. And other parts of Australia have had fluoridated drinking water for more than 50 years.

Joost Nelissen

Some communities in regional and rural Australia, previously without optimal water fluoridation, have recently started to receive fluoride through their drinking water as part of a program to prevent tooth decay and improve oral health. Australia has now achieved overall population coverage of 90%.

But tooth decay remains significant problem. In Victoria, for instance, more than 4,400 children under 10, including 197 two-year-olds and 828 four-year-olds, required general anaesthetic in hospital for the treatment of dental decay during 2009-10. Indeed, 95% of all preventable dental admissions to hospital for children up to nine years old in Victoria are due to dental decay.

Children under ten in non-optimally fluoridated areas are twice as likely to require a general anaesthetic for treatment of dental decay as children in optimally fluoridated areas.

Community water fluoridation remains a vital public health activity and has a key role to play in preventing dental decay and improving oral health for all Australians. The provision of drinking water through our pipes was never more important.

Mike Morgan, Professor, Colgate Chair of Population Oral Health, Melbourne Dental School & Program Leader, Oral Health CRC, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Flawed study overstates link between fluoride and ill health: experts

By Reema Rattan, The Conversation

Researchers have widely criticised a new study that questions the safety of water fluoridation, arguing the findings were overstated and the study poorly designed.

The paper, published in the Journal of Epidemiological & Community Health, links fluoridated water to increased rates of hypothyroidism, which occurs when the thyroid gland is under active, causing weight gain, hair loss, fatigue and depression, among other symptoms.

The study authors question the safety of water fluoridation as a public health measure.

“It’s simplistic and it’s extremely overreaching in its conclusions,” said Mike Morgan, chair of population oral health at the University of Melbourne.

“To do a study like this and say there’s an association without taking into account other factors, and then say, we should reduce the levels of fluoride, well it beggars belief that they should be able to say that in a reputable publication,” he added.

The study looked at 2012 levels of fluoride in drinking water in the United Kingdom and the national prevalence of underactive thyroid diagnosed by family doctors across the country. They then compared an area that had fluoridated water supply with another that did not and found an association between rates of hypothyroidism and fluoridated water.

“The main problem with this particular study is that it’s not only observational, it’s ecological,” said John Attia, professor of medicine and clinical epidemiology at the University of Newcastle. “That means you’re making correlations between variables at a geographic level, not an individual level, so the link between cause and effect is very distal.

“The reason this kind of observational epidemiology is the lowest grade of evidence is because there are, as in any relationship between two variables, many potential confounders,” he said. “You can never know whether the variable you have chosen is causing the effect or if it is one of an infinity of potential other variables that are associated with it that is actually driving the effect.”

Professor Morgan said the paper failed to take these confounding factors into account, despite the existence of statistical tools for doing this, and there were many things that hypothyroidism may be related to that the study was not picking up on.

In an email interview, study author Stephen Peckham, professor of health policy at the Centre for Health Services Studies at the University of Kent said since the study was conducted at the GP level, the data was fine-grained enough to not require statistical analyses that could take some of these confounders into account.

“While this is the first study to look at fluoride and hypothyroidism in a large population, and cannot prove that fluoride causes hypothyroidism,” he said, “it is a comprehensive and methodologically solid study and should be an important red flag.”

The study authors noted that fluoride was used in the 1950s to help reduce the activity of an overactive thyroid (hyperthyroidism), but such evidence is out of date, said Creswell Eastman, who is a clinical professor of medicine at the University of Sydney and an endocrinologist specialising in thyroid disorders.

Professor Attia said the discussion about fluoride’s purported use to treat an overactive thyroid gland was particularly misleading.

“What they didn’t mention is that all this effect on the thyroid takes very large doses, and occurs because both fluorine and iodine are in the same chemical family – small bits of iodine stimulate the thyroid but large doses inhibit it,” he said. “Those studies in the 1950s, I’m sure used huge doses of fluoride, not the milligram doses that we’re talking about here.”

The only time you see hypothyroidism is when you’ve got extremely high concentrations of fluoride, Professor Eastman added. “We’re talking about 10 to 100 times the amount added to the water.”

He explained that fluoride had very little physiological function in the body but in really large amounts, could block the uptake of iodine by the thyroid gland, which needs it to make thyroxine.

“It’s only in situations of iodine deficiency that you’ve got a problem with fluoride excess,” Professor Eastman said, taking issue with the paper’s discussion of iodine levels in the UK population.

The study authors note:

In the UK, while iodine intake levels have been considered adequate since the middle of the 20th century, concern has been expressed about iodine deficiency in pregnant women and teenage girls.

“That sentence is an incorrect spin in my view,” said Professor Eastman. “What they’ve done is played down the iodine deficiency component in their interpretation, when it could be the reason for hypothyroidism.”

He added that mothers who are iodine deficient have children who are slower, and have low IQ, and this has recently been shown in research in the United Kingdom.

“I would have thought it’s far more important to get on and save the brains of the generation that’s currently in utero than start pulling the fluoride out of the water,” Professor Eastman said.

Professor Peckham said the study looked carefully looked at the issue of iodine, most of which comes from nutritional sources in the United Kingdom.

“In the post-war period iodine intake has been seen as adequate. However, recent studies of teenagers and young pregnant women have suggested that levels are decreasing,” he said. “Given we focused on a 40+ years population it is likely that iodine levels were sufficient.”

Professor Attia said it was irresponsible for the paper’s peer reviewers to not have asked the authors to tone down their conclusions.

“To make such sweeping statements about this research having implications for fluoridation generally when it’s the lowest level of evidence within the lowest band of study types, that should have been picked up at the peer reviewer level,” he said.

“Water fluoridation has been with us for over 50 years and no existing evidence suggests the levels used in Australia has any health impact apart from reducing dental caries,” said Professor Morgan.

“The only risk when you have it in this low dosage is very mild fluorosis, which is a white flecking on the tooth surface that everyone seems to be keen on these days anyway.”

The head of the National Health and Medical Research Council has issued a statement reaffirming that “fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride”. The Council says evidence for such position statements are regularly reviewed and the current review is expected to endorse water fluoridation’s safety again.

This article was originally published on The Conversation. (Reblogged by permission). Read the original article.

Fluoride conspiracies + activism = harm to children

By Michael Vagg, Barwon Health, 2 September 2013.

I’ve discussed in an earlier piece the origins of fluoride conspiracy theory in post-war Europe. Other articles on The Conversation have set out the science behind our understanding that optimising levels of fluoride in drinking water is a safe and effective intervention (albeit one with a modest effect size) for the good of public health.

What I didn’t put into that earlier piece was a few personal anecdotes. The SMH article was completely consistent with them, so I might as well add my bit of anecdotal colour to the debate.

The region where I live has been one of the last in Victoria to add fluoride. This has partly been for logistical reasons, but also because the region is home to one of the better organised and more vociferous anti-fluoridation groups. In fact, my Letters to the Editor of the local paper pointing out the numerous factual errors of these groups ended up getting me personal nasty replies from the Editor herself, along with solemn and binding commitments on her behalf never to publish my ill-formed opinions again.

As a Pain Specialist, many of my colleagues are anaesthetists, and they have for years never looked forward to the paediatric dental lists here. So many children getting general anaesthesia for multiple extractions due to decay. The children wake up dazed, in pain, crying, vomiting and bleeding. Even though they bounce back pretty quickly afterwards, it’s not a very rewarding job to do. Anaesthetic trainees rotating down from big city hospitals where they rarely see such lists are about the only ones who benefit from such a cavalcade of needless misery. The risks of general anaesthesia are not to be idly contemplated for children, and far outweigh the virtually nonexistent risk from fluoridation.

Since fluoridation was introduced to Geelong in 2009, my colleagues are much happier, as severe dental abscesses requiring tricky anaesthetic techniques are much less common, and tend to mainly come from areas in the region which still aren’t fluoridated. A quick chat with one of our local dentists confirmed they had the same belief. The rate of kids needing GAs for dental work is approaching that of their metropolitan counterparts, though the list remains disappointingly long.

The other anecdote I wanted to share was that one of my colleagues who had worked in Europe for a few years went away with 3 children under the age of 6, who were the same age and social demographic as our own children. When they returned from living in a non-fluoridated European city 3 years later, 2 of his 3 children had needed dental treatment under GA and all 3 had fillings compared to none of any of their peers in our social circle who stayed in Australia. That’s a nice little case-control study right there, as if any further anecdotal evidence was needed to add to the overwhelming scientific evidence for fluoride optimisation.

So again, please don’t buy into fluoride conspiracy-mongering. Let’s not voluntarily give up the advantages of access to first-world public health measures because of manufactured scare campaigns. Maybe many anti-fluoride activists are sincere and reasonable people at heart. They certainly seem to hold their views with conviction. It’s just that on this issue, they couldn’t be more demonstrably wrong. The consequences of their misguided support for non-fluoridation are causing direct and measurable harm to children who deserve better than wilful ignorance and ersatz health consciousness.

Faulty risk assessment

by Tim Harding B.Sc., B.A.

‘Risk’ may be defined as the probability of something bad happening multiplied by the resulting cost/benefit if it does happen.  Risk analysis is the process of discovering what risks are associated with a particular hazard, including the mechanisms that cause the hazard, then estimating the probability that the hazard will occur and its consequences.

Risk assessment is the determination of the acceptability of risk in two dimensions – the likelihood of an adverse event occurring; and the severity of the consequences if it does occur,[1] as illustrated in the diagram below.

By way of illustration, the likelihood of something bad happening could be very low, but the consequences could be unacceptably high – enough to justify preventative action.  Conversely, the likelihood of an event could be higher, but the consequences could low enough to justify ‘taking the risk’.

In assessing the consequences, consideration needs to be given to the size of the population likely to be affected, and the severity of the impact on those affected.  This will provide an indication of the aggregate effect of an adverse event. For example, ‘major’ consequences might include significant harm to a small group of affected individuals, or moderate harm to a large number of individuals.[2]

A fallacy is committed when a person focuses on risks in isolation from benefits, or takes into account one dimension of risk assessment without the other dimension.  To give a practical example, the new desalination plant to augment Melbourne’s water supply has been called a ‘white elephant’ by some people, because it has not been needed since the last drought broke. But this criticism ignores the catastrophic consequences that could have occurred had the drought not broken. In June 2009, Melbourne’s water storages fell to 25.5% of capacity, the lowest level since the huge Thomson Dam began filling in 1984. This downward trend could have continued at that time, and could well be repeated during the next drought.

Melbourne’s desalination plant at Wonthaggi

No responsible government could afford to ‘take the risk’ of a major city of 4 million people running out of water.  People in temperate climates can survive without electricity or gas, but are likely to die of thirst in less than a week without water, not to mention the hygiene crisis that would occur without washing or toilet flushing.  The failure to safeguard the water supply of a major city is one of the most serious derelictions of government responsibility imaginable.

A similar example of fallacious reasoning is in the area of climate change, where the public debate wrongly focusses on whether the science is true or false, rather than on the risks and consequences of it being true or false. This video explains the fallacy quite well.

Other examples of this fallacy are committed by the anti-vaccination and anti-fluoridation movements, often accompanied by conspiracy theories.  They both focus on the very tiny likelihood of adverse side effects without considering the major benefits to public health from the vaccination of children and the fluoridation public water supplies.  Hardly anybody has ever died or become seriously ill in Australia from the side effects of vaccination or fluoridation [3]; yet large numbers of people have died from the lack of vaccination.[4] The allegation of a link between vaccination and autism has been discredited, retracted and found to be fraudulent.  The benefits of fluoridation are well documented. The risks of general anaesthesia for multiple tooth extractions are not to be idly contemplated for children, and far outweigh the virtually nonexistent risk from fluoridation.[5]

---

[1] This is based on the Australian/New Zealand Standard for Risk Management.

[2] State Government of Victoria (2007) Victorian Guide to Regulation 2^nd edition. Department of Treasury and Finance, Melbourne.

[3] In 2010, increased rates of high fever and febrile convulsions were reported in children under 5 years of age after they were vaccinated with the bioCSL Fluvax^® vaccine. bioCSL Fluvax^® has not been registered for use in this age group since late 2010 and therefore should not be given to children under 5 years of age. The available data indicate that there is a very low risk of fever, which is usually mild and transient, following vaccination with the other vaccine brands: Agrippal^®; Fluarix^®; Influvac^®; and Vaxigrip^®.  Any of these vaccines can be used in children aged 6 months and older. This and further information on flu vaccination is available here.

[4] The former Commonwealth Chief Medical Officer, Prof. Jim Bishop has argued that the flu vaccination program “changed dramatically the flu outlook for this country”, with admissions to intensive care from swine flu falling from 681 in 2009 to just 60 in 2010, and hospitalisations dropping from nearly 5000 to 600. Swine flu killed 191 Australians in 2009 and 36 in 2010. In contrast, seasonal flu killed 1796 Australians that year – but, unlike swine flu, the victims were mainly the frail and elderly. Prof. Bishop cautioned that one in every three hospital patients were “perfectly fit and well” before they caught swine flu, which was severe in pregnant women, teenagers who had lost their innate childhood immunity and indigenous people who tend to suffer underlying health problems. Three pregnant women died of swine flu, and 280 ended up in intensive care.  

[5] https://theconversation.com/fluoride-conspiracies-activism-harm-to-children-17723

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The Scientific Conspiracy Fallacy

by Tim Harding

The 2013 National Australian Skeptics Convention was held from 22 to 24 November in Canberra.  The theme was Science, Skepticism and Conspiracy Theories.  We understand the connection between science and skepticism, but where do conspiracy theories fit in?

You may have noticed that irrational beliefs such as anti-vaccination, anti-fluoridation, anti-GM foods and extra-terrestrial visitations are often associated with conspiracy theories allegedly involving scientists.

The late Christopher Hitchens described conspiracy theories as “the exhaust fumes of democracy” – the unavoidable result of a large amount of information circulating among a large number of people.  Conspiracy theories appear to make sense of a world that is otherwise confusing.[1]  They do so in an appealingly simple way – by dividing the world into bad guys versus good guys. They also enable people to believe whatever they want to believe, without the bothersome burden of conclusive evidence.

The Scientific Conspiracy Fallacy takes roughly the following form:

   Premise 1: I hold a certain belief.

   Premise 2: The scientific evidence is inconsistent with my belief.

   Conclusion: Therefore, the scientists are conspiring with the Big Bad Government/CIA/NASA/Big Pharma (choose whichever is convenient) to fake the evidence and undermine my belief.

It is a tall order to argue that the whole of science is genuinely mistaken. That is a debate that even the conspiracy theorists know they probably can’t win. So the most convenient explanation for the inconsistency is that scientists are engaged in a conspiracy to fake the evidence in specific cases.

In informal logic, many fallacies can be demonstrated by citing a counter-example.  In this case, a possible alternative explanation for the inconsistency is simply that the scientific evidence is right and the conspiracy theorist’s belief is wrong.  The notion that scientists are regularly engaged in conspiracies is implausible, because amongst other things, published scientific papers are required to explain the experimental methods used so that the experiments can be repeated and tested by anybody.  And as Prof. Lawrence Krauss has said, “scientists become famous by proving their colleagues wrong”.[2]

Endnotes 

[1] Van der Linden (2013) Why People Believe in Conspiracy Theories.  Scientific American 18 August, 2013. 

[2] ABC1 TV program ‘Q&A – A Show About Nothing ‘ Transcript 18 February, 2013. http://www.abc.net.au/tv/qanda/txt/s3687812.htm

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