Minutes of proceedings of the Plenary Meeting of the Irish Expert Body on Fluorides and Health held in the Royal College of Physicians of Ireland, No 6 Kildare Street, 
Dublin 2 on Wednesday, 11th June 2008

Present:	Dr Seamus O’Hickey (Chairman), Dr Brian O’Herlihy (Vice-Chair), Professor Denis O’Mullane, Professor John Clarkson Councillor Jack Bourke, , Mr Michael Kilcoyne, Mr Denis Lyons,  Dr Joe Mullen, Mr Ray Parle , Dr Margaret Shannon 

In attendance: 	Ms Deirdre Sadlier, Ms Etain Kett, Ms Pheena Kenny, Secretariat

Apologies:	Mr Stephen McDermott, Ms Hilary Coates, Dr Máire O’Connor, Mr Colm Keenan, Mr Rowland Reece, Dr Wayne Anderson, Mr Chris Fitzgerald, Ms Ursula O’Dwyer

EB Minute 44/08:  Apologies
Apologies for the meeting were noted.

EB Minute 45/08:  Minutes of the last meeting (27th February 2007)
These minutes were agreed subject to minor amendments and were then signed by the Chairman.

EB Minute 46/08:  Matters Arising
It was noted that the submission from the Expert Body for the Oral Health Strategy was circulated to all members of the Expert Body. 
Professor John Clarkson gave a briefing on the progress to date of the Core Policy Group. It was noted that 7 meetings of the Core Policy Group have taken place and that 76 submissions were received. It was further noted that approximately 10 common areas have emerged as requiring serious consideration. It is hoped that an interim report will be ready for the Minister in July and that the final report will be submitted by the autumn of 2008.
It was noted that a meeting was held with the Consultative Panel, 9th June 2008 to inform them of the progress to date.
It was noted that a group who promote and install water filtration systems are giving misinformation to the public. It was agreed that this was outside the remit of the Expert Body but suggested that the FSAI and the Director of Corporate Enforcement might be contacted in relation to it.
It was noted that the NEI Sub-Committee will be reviewing the New Zealand draft standards for the addition of fluoride to bottled water.
It was further noted that Irish bottled Natural and Spring Waters cannot have any additions to them including fluoride (S.I. No. 225 of 2007)
EB Minute 47/08:  Correspondence
Correspondence was noted from Lidl to the FSAI agreeing to stop the sale of fluoridated salt in their Irish Supermarkets.
It was agreed to send a letter to the FSAI, thanking them for their contribution to this successful outcome.
EB Minute 48/08:  EU Directive
It was noted that existence of the EU Directive and its implications were brought to the attention
of the Council of European Chief Dental Officers at their meeting in Ljubljana in May.
It was further noted that the EU Commission has also been informed and the copies of
correspondence in relation to this will be forwarded to Dr Seamus O’Hickey.
It was noted that the EU Directive is not running parallel with the recommendations of the
Forum on Fluoridation. It was further noted that the Expert Body has fulfilled its role by
 highlighting the issues to the Department of Health and Children.
It was noted that Dr Margaret Shannon on behalf of the Department of Health and Children is
drafting a response questioning the evidence on which this directive is based.
It was agreed that Professor John Clarkson and Professor Denis O’Mullane will assist the
Department if requested.
It was suggested that an information leaflet could be developed for doctors and dentists re the
EU Directive by the Communication Sub-Committee but it was agreed that a reasonable amount
of time should be left before doing so in order to avoid confusion with the “Fluorides and Public
Health” Leaflet.

EB Minutes 49/08: Report of the Sub-committees
It was agreed that Mr Ray Parle will act as interim Chair of the QA Sub-Committee
The Quality Assurance Sub-committee reported the following:
•	There has been a delay in the implementation of the Protocol for the Independent Testing of Hydrofluosilicic Acid. The HSE has undertaken to put in place the Independent Testing for HFSA.
•	It was noted that Population Health, HSE has extended the tender for the supply of HFSA for another 12 months
•	The Service Contract for the National Audit of the Water Fluoridation Process at Local Authority Water Supply Schemes between TOBIN Consulting Engineers and the Expert Body has been signed. It is expected that an interim report will be ready by September 2008 outlining the costs for remedial works. It is hoped that the final report will be ready in late January 2009
•	It was noted that a liaison committee has been set-up to maintain governance on the audit process. It was further noted that payments are to be linked to deliverables.
•	A brief report was given on the National Steering Committee on Fluoridation.  It was noted that a service level agreement between the local authorities and the HSE is being examined. It was further noted that measurement of uncertainty is being examined and that queries from some Dublin engineers re the new fluoride limits highlight issues with pump capacity; these will be followed up by the QA Sub-Committee 

The New and Emerging Issues Sub-committee reported the following:
•	It was noted that “Exposure to water fluoridation and caries increment” (Spencer et al, 2008) was reviewed. This longitudinal study was an important contribution to the evidence base supporting the effectiveness of water fluoridation. It was noted that “Low-Fluoride Dentifrice and Caries lesion Control in Children with Different Caries Experience: A Randomised Clinical Trial (Lima et al 2008) was reviewed and that it is supporting recommendations of the Forum in regard to low fluoride toothpaste.
•	It was noted that “Scientific Consensus Statement on Environmental Agents Associated with Neurodevelopment Disorders” was reviewed and that there were no new and emerging issues
•	It was noted that the following documents were reviewed:
•	“Draft Guidelines: Topical Fluorides for Caries Prevention” – Consultation Draft
•	Fluoride Intake in Infants – Oral Health Services Research Centre, Cork
•	The STROBE initiative and its implications for public health was summarised for the group.The statement was welcomed by the Expert Body as it regards the type of studies that have been carried out on Fluoridation in Ireland as having acceptable scientific merit.

The Communications/Public Health/Health Promotion Sub-committee reported the following:
•	Media Monitoring – it was noted that there were several articles in some of the local provincial newspapers in relation to water fluoridation
•	A report was given by the Secretariat on the MANDEC Meeting “Can we reduce dental inequalities in children?” It was agreed to circulate the presentation slides of this report to the members.
•	It was agreed that the Secretariat would seek to establish associated costs for international monitored media in relation to fluorides and water fluoridation
•	It was noted that the Secretariat implement their knowledge management strategy regarding daily media alerts
•	It was agreed that the Secretariat would ask Dr Peter Cooney, Chair FDI if a network between interested countries has been set up as previously suggested.

The Ad-hoc Committee to develop Priority Research reported the following:
•	Approval for the award of the tender for baseline research has been received by the Secretariat (DoH&C Correspondence to Secretariat 11th June 2008 (faxed) refers)
•	It was noted that all of the tenderers who made a submission would be made aware of their success/failure in award of the contract.

EB Minute 50/08:  Report of Executive Committee
•	The Report on the Executive Committee’s meeting held on 8th May 2008 was noted and accepted.
.
EB Minute 51/08:  Irish Expert Body on Fluorides and Health – Progress Report
•	It was agreed to progress to publication which will be signed off by the Executive Committee. 

EB Minute 52/08:  Fluoride Intake in Infants
•	A presentation was given by Professor Helen Whelton on Fluoride Intake in Infants. It was noted that the conclusions of the research were in agreement with a previous risk assessment carried out by the FSAI.
•	It was further noted that the mean fluoride intake for infants 8 – 16 weeks solely on formula feed (fluoride 0.8 – 1.00ppm) was 0.64mg/day or 0.11mgF/bw kg
•	It was agreed that the Expert Body can now proceed to complete its draft statement on the use of infant formula and fluoridated tap water.
•	It was agreed that the Secretariat will circulate the presentation slides of this research to all Expert Body members.
•	It was noted that breast-feeding habits have not changed between the years 1984 – 2002 but that fluorosis has increased; it was suggested that a possible reason for this is the increased usage of fluoridated toothpaste.

EB Minute 53/08:  AOB
It was noted that the Swiss Federal Institute of Aquatic Science developed a model to estimate the concentrations of global groundwater contamination which featured in an online article on Chemistry World; 23 April 2008. This will be assessed by the NEI Sub-Committee

EB Minute 43/07:  Date of Next Meeting
The next Plenary Meeting is scheduled for Wednesday, 29th October 2008 commencing at 10:30am in the Royal College of Physicians of Ireland, No 6 Kildare Street, Dublin 2.

The Chairman thanked all for their attendance and declared the meeting closed at 13:20pm

Signed:	______________________________

Date: 		______________________________