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, 25th April 2007

Present:	Dr Seamus O’Hickey (Chairman), Dr Brian O’Herlihy (Vice-Chair), Dr Wayne Anderson, Professor John Clarkson, Mr Colm Keenan, Mr Michael Kilcoyne, Mr Stephen McDermott, Dr Máire O’Connor, Mr Ray Parle, Dr Justin Roche, Dr Margaret Shannon

In attendance: 	Ms Deirdre Sadlier, Ms Patricia-Gilsenan-O’Neill, Ms Etain Kett, Secretariat

Apologies:	Councillor Jack Bourke, Ms Hillary Coates, Mr Chris Fitzgerald, Mr Denis Lyons, Dr Joe Mullen, Ms Ursula O’Dwyer, Professor Denis O’Mullane, Mr Darragh Page, Mr Rowland Reece

EB Minute 13/07:  Apologies
Apologies for the meeting were noted.

EB Minute 14/07:  Minutes of the last meeting (28th February 2007)
These minutes were agreed and were then signed by the Chairman.

EB Minute 15/07:  Matters Arising
The Department of Health and Children hope to have the Adult Dental Health Survey available on their website by Friday, 2nd March 2007. (EB Minute 03/07 refers).

It was noted that oral health and fluoridation is to be an item on the Agenda for the World Health Assembly in May.  It was further noted Professor John Clarkson is due make a presentation on current research at the Assembly (EB Minute 11/07 refers).

EB Minute 16/07:  Correspondence
Correspondence was noted from the Kathy Sinnott, MEP for Ireland South, EU Committee on Environment, Public Health and Food Safety regarding Hydrofluorosilicic Acid in drinking water dated 27th March 2007, forwarded to the Secretariat from the Public Health Division, Department of Health and Children on 12th April 2007.  It was agreed that a response will be prepared by the NEI and QA Sub-committees in consultation with the Secretariat.

EB Minute 17/07:  Joint Oireachtas Committee on Health and Children
The Chairman of the Expert Body has been advised by the Public Health Division, Department of Health and Children, in writing, on 24th April last, that as a result of a meeting on 5th April 2007, the Joint Oireachtas Committee on Health and Children agreed the following motion:

The Joint Committee on Health and Children calls on the Minister for Health and Children to direct the Health Services Executive to carry out a national study of total fluoride intake; and for the draft Terms of Reference on such a study to be forwarded to the Joint Committee for its consideration before they are finalised by the Minister.

EB Minute 18/07:  Advice to the Minister for Health and Children
Following a review of the draft advice circulated to the Plenary Body, it was agreed that the members will email any suggested changes to the Secretariat.  It was agreed that the advice should specifically state what is being measured.  It was further agreed that the Executive Committee will give final clearance on the draft.  

EB Minute 19/07:  Fluoridation of Water Supplies Regulations 2007
It was noted that Statutory Instrument No 42 of 2007 will be enacted on 1st July 2007 and all Local Authorities must start to comply with the amendments after this date.

It was noted that the water treatment plants will not have to make any adjustments themselves as the Hydrofluosilicic Acid will be delivered to them from the supplier in reduced concentrations.  The Chairman proposed that an acknowledgement should be sent to the supplier, Chemifloc, in this regard.

On behalf of the Department of Health and Children Dr Shannon thanked the Expert Body and the Secretariat for their work on the Regulations.

EB Minutes 20/07: Report of the Sub-committees

The Quality Assurance Sub-committee reported the following:

•	It was noted that approval is awaited for the Protocol for Independent Testing of HFSA from the HSE.
•	It was agreed to request a Foreword to the Code of Practice by the Department of Health and Children and the Department of Environment, Heritage and Local Government.
•	The EU drinking water regulations 2007 were noted.
•	In relation to the National Audit it was noted that a pre-audit questionnaire is currently being developed.  It is hoped that the tender process will be in place by the second quarter of 2007.
•	It was noted that a meeting with the Assistant National Director of Environmental Population Health is scheduled for 11th May 2007.  A full Report will be made at the Plenary Meeting in June.

The New and Emerging Issues Sub-committee reported the following:

•	It was noted that informal contact was made with the ADA re their Interim Guidance Statement on Infant Formula.  It was noted that the ADA are waiting for further research to be carried out before issuing a definite statement.  
•	It was noted that research conducted by the Oral Health Services Research Centre, Cork on fluoride intake in infants is to be made available.
•	It was noted that currently in the peer review journals that have been examined; to date there has been no evidential link between Irritable Bowel Syndrome and Fluoride.
•	It was noted that the National Fluoride Information Centre (NFIC) would like to meet with representatives of the Expert Body.  A meeting is to be arranged to discuss Recommendations 4 and 6.
•	A briefing on the Slán Survey 2007 was given by the Secretariat.  It was noted that it is possible for the Expert Body to forward a proposal for inclusion in the Survey, it was agreed that the Secretariat would find out what details will be assessed medically as they might fulfil the requirement under the Health (Fluoridation of Water Supplies) Act, 1960.  It was suggested that a proposal for finger nail clippings might be put forward.  It was further noted that a European Interview Study is also planned; more details of this will be discussed at the next NEI Sub-committee meeting.

Ad Hoc Committee – Oral Health Care Industry reported the following:

•	With regard to the differing levels of fluoride in toothpastes, it was agreed that less than approximately 400-500ppm F toothpastes provided little if any caries preventive action.  In terms of caries prevention, the effect is most beneficial in the 1000-1500ppm F range.  Regarding the risk of fluorosis, authors of 2 papers reviewed are to be contact for further clarification as inconsistency exists between the papers and the Draft UK Guidelines for toothpaste use.
•	It was agreed that clarification is to be sought regarding the age at which commencement of brushing with a fluoride toothpaste should begin for a child with special needs; the age of the child when parental supervision of brushing might end; and public advice in relation to the use of a ‘pea-sized’ amount, a ‘smear’ and a ‘cross-brush’ amount of paste.
•	It was noted that the Committee is currently assessing guidelines in the UK as the draft advice for the use of fluoride toothpaste by children under 6 years as opposed to 7 years in Ireland.

The Communications/Public Health/Health Promotion Sub-committee reported the following:

•	A review of the Communications Strategy and target audiences was provided.
•	It was noted that the Committee is examining the feasibility of linking into existing and planned HSE regional/area training programmes.
•	It was agreed to review leaflets supplied by Colgate at the recently held IDA Conference.
•	A media monitoring report was circulated by the Secretariat.  

EB Minute 21/07:  Report of Executive Committee
•	A written Report on the Executive Committee’s meeting was tabled.
•	It was noted that it was agreed at the meeting with the Department of Health and Children on 22nd March 2007 that the Expert Body should produce a Report on work to date.  This Report should include the period April 2004 – June 2007.  Its contents will reflect the extent and range of achievements of the Expert Body.  The Report should also act to inform the wide range of audiences concerned with fluorides and health.  It was agreed that the Secretariat will draft a Report for review at the June Plenary Meeting.  It was further agreed that the full membership would then be given 2 weeks to forward amendments/comments to the Secretariat.  On completion the Report will be presented to the Department of Health and Children.
•	It was agreed that Weber Shandwick will provide advice on the most appropriate Communications style to be used in the Report.
•	It was noted that an audit of attendees was provided to the DOH&C.  It was agreed that Dr Iona Pratt, President of the Irish Society of Toxicologists, name should be forwarded to the Department for their consideration as a possible new member of the Expert Body.
•	It was agreed that Dr Margaret Shannon would transfer from the NEI Sub-committee to the Communications/Public Health/Health Promotion Sub-committee as there is no dentist currently serving on this Committee.
•	It was agreed that a representative from the Health Promotion Policy Unit in the Department would be a welcome member on the Body.
•	It was agreed to cancel the Plenary Meetings scheduled for 26th September and 28th November and hold a meeting on 17th October instead.
•	It was further agreed that the Executive Committee will review the number of meetings required for 2008 and report back at the June Plenary Meeting.
•	Professor O’Mullane provided a written Report of his attendance at the IADR Conference in New Orleans, his attendance was supported by the Expert Body.  Professor Clarkson also provided feedback on the Conference.
•	It was noted that a job advertisement has been placed with the Irish Times to appear in Friday, 27th April 2007 edition inline with filling the vacancy within the Secretariat.  

EB Minute 22/07:  AOB
It was noted that the Expert Body has been granted observer status at the forthcoming CECDO meeting to be held in Jerusalem in May 2007. Dr Mullen, the Expert Body representative, will provide a full report at the June Plenary Meeting.

It was also noted that the 2007 World Assembly is taking place in Geneva in May with oral health formally part of its Agenda for the first time in 35 years.  Professor Clarkson who is part of the programme will report back to the Expert Body on this Assembly.

EB Minute 23/07:  Expert Body Plenary Meeting 
The next Plenary Meeting is scheduled for Wednesday, 13th June 2007 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 12:15pm.

Signed:	______________________________

Date: 		______________________________