The Fluoride Reference Group was an expert committee that offered an unbiased review and analysis of scientific material relating to the use of fluoride as a widespread public health initiative. The committee was active from 2014 - 2017. Members came from a range of fields including oral health, child health, toxicology, cancer, water management and health ethics.
The Fluoride Reference Group was a working committee established by a CEO delegate, under section 39 of the National Health and Medical Research Council Act 1992. The committee was selected to ensure appropriate expertise in the key areas of science and review methodology, in order to assess and synthesise the evidence. The committee comprised highly-regarded experts in the fields of public health, oral health, epidemiology, child health, toxicology, cancer, bone biology, neurodevelopment, Aboriginal and Torres Strait Islander health, water management and health ethics. The Fluoride Reference Group was not established on the basis of pro or anti fluoridation views.
Terms of reference
Members were informed that in 2007, NHMRC undertook a systematic review of the evidence relating to the efficacy and safety of fluoride interventions, with emphasis upon those able to be delivered as a widespread public health initiative. The review was used to develop the NHMRC Public Statement: The Efficacy and Safety of Fluoridation (2007).
The committee was responsible for working with NHMRC to update the body of evidence to include more recent studies since the 2006 review and assess their relevance in the Australian context.
The Fluoride Reference Group was tasked with:
- Guiding the development of an evaluation of the evidence on the health effects of water fluoridation, focusing on studies published since 2006
- Considering the outcomes of the evaluation, and using the findings to:
- Inform the development of an evidence evaluation report that synthesises the evidence and identify critical gaps in the evidence base
- Guide the identification of key issues to be considered by the Council and CEO of NHMRC as the Office of NHMRC translated the evidence review into an information paper on the artificial fluoridation of drinking water;
- Considering comments received during consultation on the draft information paper.
- The Fluoride Reference Group reported to NHMRC's Council.
Appointments to the Fluoride Reference Group commenced on 31 May 2014 and were effective until 30 May 2017.
Member information and Disclosure of Interests
NHMRC asked each Fluoride Reference Group member to document their interests prior to appointment, as part of the process of the establishment of any NHMRC committee. Members were asked to consider perceived interests as well as real interests.
Members were specifically asked to identify, to the best of their ability, interests including:
- employment by an entity having commercial or other interests in fluoride or fluoridation
- financial interests or relationships including ownership, board membership, honoraria, consultancies, or research funding related to fluoride or fluoridation
- publications, speeches or expert testimony regarding fluoride or fluoridation
- involvement in the development of guidelines, standards, education material or fact sheets related to fluoride or fluoridation
- affiliations or associations with any organisation having an interest either for or against fluoridation.
Throughout the project members were required to inform NHMRC of any changes to their interests, and management strategies were put in place as needed.
Emeritus Professor, John Curtin School of Medical Research, the Australian National University.
- Emeritus Professor Judith Whitworth is a former Director and Howard Florey Professor of Medical Research at the John Curtin School of Medical Research at the Australian National University.
- She has previously been Chief Medical Officer of the Commonwealth and Chair of the World Health Organization's Global Advisory Committee on Health Research.
- Her research interests include hypertension, systems physiology, public policy, preventive medicine, public health and health services.
- Chairs an advisory committee for the Australian and New Zealand Clinical Trials Registry
- Member of the Board of Therapeutic Innovation Australia.
Director, Clinical Sciences Research, Murdoch Childrens Research Institute
Director, Psychology, The Royal Children's Hospital
Professorial Fellow, School of Psychological Sciences, The University of Melbourne
- Professor Anderson is a paediatric neuropsychologist whose research focuses on disorders of childhood that impact on the central nervous system.
- Professor Anderson was a Member of the Australian Health Ethics Committee, a Principal Committee of NHMRC, in the 2012–15 triennium.
Lecturer in Environmental Engineering, Melbourne School of Engineering, The University of Melbourne
- Doctor Arora is an environmental engineer with research expertise in urban water management and water quality.
- She contributed to the development of a defluoridation plant to provide safe drinking water to communities in rural India which are exposed to high levels of naturally occurring fluoride.
- Has published studies regarding fluoride in water and its possible effects on human health.
- Appointed as Guest Editor for a special issue "The Health Effects of Water Fluoridation" in the International Journal of Environmental Research and Public Health in 2016.
Director, Centre for Population Health, Western Sydney Local Health District
Conjoint Associate Professor, School of Public Health, University of Sydney and Western Clinical School, Westmead
- Associate Professor Corbett is a public and environmental health physician.
- His research interests include environmental health risk assessment and management, regulatory policy and practice, chronic disease prevention, air and water quality and health, environmental lead contamination and remediation, bioaerosols, food borne illness and Aboriginal health.
- Member of the Australian Faculty of Public Health Medicine.
- Former non-executive Board Member, Sydney Catchment Authority.
- Current non-executive Board Member, Food Standards Australia and New Zealand.
- Co-authored a 1993 paper on fluoride and health in NSW
Professor of Epidemiology and Biostatistics, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne; Research Fellow, Cancer Epidemiology Centre, Cancer Council Victoria.
- Professor English is an epidemiologist specialising in cancer epidemiology and cancer screening.
- He is a Senior Principal Research Fellow at the Cancer Council Victoria.
Professor, Faculty of Medicine, Nursing and Health Sciences, Monash University
- Professor Gillespie is a cell biologist with research expertise in bone cell biology and bone cancers.
- He is a former Director and Head of Bone, Joint and Cancer, Prince Henry's Institute and past President of the Australian and New Zealand Bone and Mineral Society.
Member of NHMRC Audit Committee
Paediatrician at the Centre for Community Child Health, Royal Children's Hospital
Co-Group Leader of Policy Equity and Translation, Murdoch Childrens Research Institute
Professor, Department of Paediatrics, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne
- Professor Goldfeld is a paediatrician and public health physician whose research interests include child health and development, equity and intervention studies.
- She is a Senior Medical Advisor to the Victorian Department of Education and Early Childhood Development.
Co-authored an oral health position statement for the Royal Australasian College of Physicians and spoke at the launch of the position statement.
Executive Dean: Faculty of Science, Medicine and Health, University of Wollongong
Clinical Toxicologist, Blacktown Hospital.
- Professor Jones is a clinical toxicologist whose research expertise includes public health, poisons, risk assessment and preventive medicine.
- Member of the Board for the Australian Strategic Policy Institute and for Medical Deans Australia and New Zealand.
- Received fees for providing advice to Coroners NSW and the Australian Medical Council.
- Has held NHMRC research grants.
- Is contracted to provide NSW Health with toxicology advice, including advice on fluoride. The money from this contract goes into a University of Wollongong research fund which provides research costs and educational travel costs for staff and students for the School of Medicine, including Professor Jones. Professor Jones authorises expenditure on those funds, except where she is a beneficiary, which is then reviewed and signed by the Senior Deputy Vice Chancellor
- Assisted the NSW Chief Health Officer with education initiatives about the benefit/ risk of water fluoridation in 2013, and the Ballina/ Byron Bay open meeting in 2014.
- Appointed to The Fluoridation of Public Water Supplies Advisory Committee for NSW, which provides advice on water fluoridation to the NSW Government.
Associate Professor and Head of Discipline, Soil Water and Energy, School of Environment, Griffith University
- Associate Professor Leusch is an environmental toxicologist whose research expertise includes biotechnology, endocrine disruption and health risk assessment of alternate water sources (purified recycled water, managed aquifer recharge, storm water).
- Until recently, he was Program Leader for Water Quality and Diagnostics at the Smart Water Research Centre, Griffith University.
- Received consultancy fees from the water industry for work unrelated to fluoride.
- Has held grants from the water industry for work unrelated to fluoride.
- Teaches students about water quality issues at Griffith University.
- Chair of the NHMRC Water Quality Advisory Committee.
- Appointed to the Project Review Team of Water Research Australia.
- Has been the Associate Editor on environmental toxicology for Chemosphere since 2014.
School of Dentistry, The University of Adelaide
- Adjunct Professor Roberts-Thomson is an oral health epidemiologist whose research expertise includes public health interventions, Aboriginal health, health promotion, inequality in oral health and access to dental care.
- Has published studies and spoken publically about fluoridated water and its effects on oral health.
- Involved in the development of pamphlets and information sheets on fluorides and dental decay, co-funded by the University of Adelaide and Colgate Oral Care.
- NHMRC grants for research regarding the effects of fluoride and fluoridated water on oral health.
- Former Director of the Dental Practice Education and Research Unit at the Australian Research Centre for Population Oral Health. The Dental Practice Education and Research Unit is a joint venture between The University of Adelaide and Colgate Oral Care.
- Co-Chair of the Australian chapter of the Alliance for a Cavity-Free Future which is a group of experts promoting caries prevention and management for all age groups. While the alliance receives some sponsorship from the Colgate Oral care, Adjunct Professor Kaye Roberts-Thomson receives no remuneration for this position.
Professor of Clinical Ethics, Department of Clinical Medicine and Department of Philosophy, Macquarie University
- Professor Rogers is a bioethicist with expertise in public health ethics, the ethics of evidence-based health care, vulnerable populations, justice in research and conflicts of interest.
- Professor Rogers was a Member of the Australian Health Ethics Committee, a Principal Committee of NHMRC, in the 2012–15 triennium.
Professor of Social and Preventive Dentistry, School of Dentistry, The University of Adelaide
- His research expertise includes dental public health and dental services, dental caries and fluorosis, oral health and quality of life and oral epidemiology.
Professor Spencer was the Professor of Social and Preventive Dentistry and the Founding Director of the Australian Research Centre for Population Oral Health at the University of Adelaide.
- Deputy Chair of the National Advisory Council on Dental Health 2011–2012.
- Editorship of the journal Community Dentistry and Oral Epidemiology.
- Co-led the Australian Research Centre for Population Oral Health 2005 Workshop on the use of fluorides in Australia.
- Presented at the Australian Research Centre for Population Oral Health 2012 Fluoride Consensus Workshop and co-developed the subsequent publication on the Outcome of the Fluoride Consensus Workshop 2012 to review the Fluoride Guidelines from 2005 published in the Australian Dental Association News Bulletin 2013.
- Gave lectures on Water Fluoridation to students at the University of Adelaide.
- Examined PhD theses related to fluorides, caries and fluorosis.
- Held an unpaid advisory role contributing to the update of the Federation Dentaire Internationale Policy Statement on Promoting Oral Health through Water Fluoridation.
- Expert Witness on water fluoridation in the Land and Environment Court of NSW cases of Rous Water and Euorobodalla Shire Council.
- Member and received consulting fees from the Nutritional Reference Values Fluoride Expert Working Group 2013-2014 for revision of the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes.
- Received lecture honorariums and travel costs from the New Zealand Dental Association for continuing professional education lectures on water fluoridation, and honorarium for paper and presentation at International Association for Dental Research 2017 symposium on Guidelines for fluoride intake.
- Received the Burrow Award for caries prevention involving the use of fluorides in 2012 from the International Association for Dental Research,
- Received the Distinguished Scientist Award from the Behavioural, Epidemiologic and Health Services Research Group in 2013 from the International Association for Dental Research.
- Has held a research grant from Queensland Health and multiple NHMRC grants for research regarding fluoridation and dental services. Some of these research projects have received support from Colgate Oral Care in the form of oral care gift packs for participants in oral examinations.
- Consulting, National Oral Health Project, Primary Health Care Organization, Qatar.
- Has published studies related to water fluoridation and fluorides.
- Has been associated with the Australian Research Centre for Population Oral Health, Dental Practice Education Research Unit that promotes prevention in dental practice with the institutional support of Colgate Oral Care.
- Associated with the Australian Dental Association.
Associate Director and Clinical Professor, Centre for Research and Education on Ageing, Concord Clinical School of The University of Sydney and Concord General and Repatriation Hospital
- Professor Wright has research expertise in health promotion, geriatric dentistry, and ageing and dental service utilisation.
- He is the former Chair of the National Oral Health Promotion Advisory Committee and a former Chief Dental Officer for the NSW Government.
- Has published studies related to water fluoridation/fluorides and dental health.
- Presented a lecture series on Dental Public Health to students at Charles Sturt University and other universities.
- Provided expert testimony to the Land and Environment Court of NSW during the proceedings of Oshlack v Rous Water, Ballina Shire Council, Lismore, 2011–2012.
- Has been involved in the development of guidelines and other materials for NSW Health as Chief Dental Officer from 2005–2012.
- Is associated with the Australian Dental Association, the Public Health Association of Australia, the International Association for Dental Research, and the Royal Australasian College of Dental Surgeons.
Member, Consumers Health Forum Australia
- Ms Petrys was nominated by the Consumers Health Forum Australia as a Member suitable to provide a consumer perspective to the Fluoride Reference Group.
- She has worked in public health for many years.
- She is a former General Manager of National Programs for the Council on the Ageing.