Despite government assurances that Singapore tap water is perfectly safe, many Singaporeans choose to install water filters at home, at the office and drink bottled mineral water. Is it really necessary to buy bottled water? Should we be installing filters? And if so, how does one shift through the marketing hype to select the best ones? We pull the lid off of this complicated topic and give you our ultimate guide starting off with Part 1: Fluoride.
Do we really need water filters?
OK first, let's look at the indisputable facts. Singapore's tap water contains small amounts of chlorine, pesticides, lead and other heavy metals, nitrates, nitrites, fluoride and possibly other people’s medical drugs. Why? The chlorine and fluoride are added to kill bacteria and allegedly strengthen our teeth. The pesticides, lead, heavy metals, nitrates and nitrates all end up in our water supply from run-off due to us living in a modern, industrialised and increasingly toxic environment. When people take medical drugs, some of it is absorbed and some excreted by urine and faeces and end up back in the water supply as these particles are so small they cannot be filtered out buy conventional filters.
However, all these compounds are “within the Guidelines for Drinking-Water Quality set by the World Health Organization (WHO)” as stated by Public Utilities Board (PUB) of Singapore. Not surprisingly, other developed countries around the world also follow these same practices. Essentially, what this means is that WHO reviews a load of clinical studies in animals and observational studies in humans to work out what the safe levels are. They then, make recommendations about what these maximum levels should be so that the drinking water can be declared “safe”. Let’s take a look at fluoride first and see how the WHO comes up with its' guidelines.
Part 1: Fluoride
We’re going to really take a deep dive into fluoride here and give this more attention than the other toxins found in our water supply. This is really just to highlight that here, at Levitise, we really take this stuff seriously. We look at both sides of the coin, and don’t just rehash other people’s arguments to support a dogmatic view. OK, let’s get stuck in.
Fluoride and animals studies
I pulled this paper off of the WHO’s website1 where they have the following results highlighted from some scientific studies:
STUDY ONE: “Effects on the skeleton, such as inhibition of bone mineralization and formation, delayed fracture healing and reductions in bone volume and collagen synthesis, have been observed in a variety of studies in which rats received fluoride orally for periods of 3–5 weeks at doses in excess of 16 mg/litre.”
STUDY TWO: “In subchronic studies, altered bone remodelling, hepatic megalocytosis (EDITOR: liver toxicity), nephrosis (EDITOR: kidney disease), mineralization of the myocardium (EDITOR: heart disease) and necrosis or degeneration of the seminiferous tubules in the testis (EDITOR: fertility) were observed in mice administered fluoride in drinking-water (>4.5 mg/kg of body weight per day) over a period of 6 months.”
STUDY THREE: “In mammalian cells in vitro, fluoride causes genetic damage through chromosomal aberrations at cytotoxic concentrations only (≥10 mg/litre)”
STUDY FOUR: “There was a statistically significant trend of an increased incidence of osteosarcomas (bone cancer) in male rats with increasing exposure to fluoride”.
So that's a green tick for the WHO who are not averse to highlighting some of the detrimental affects of fluoride in animal studies.
Fluoride and human studies
So, these are some of the clinical scientific studies from the WHO’s website around animals. The studies in humans are observational and show that:
- Fluoride can have an adverse effect on tooth enamel and may give rise to mild dental fluorosis at drinking-water concentrations between 0.9 and 1.2 mg/litre (Dean, 1942).
- Elevated fluoride intake can also have more serious effects on skeletal tissues.
- Persons suffering from certain forms of renal impairment have a lower margin of safety for the effects of fluoride than the average person.
The WHO, in 2002, did conclude that there is not enough evidence of carcinogenicity in laboratory animals to support the hypothesis that fluoride causes cancer in humans OR that there is any association between babies born with Down Syndrome or congenital malformation to pregnant mothers. However, we looked at several studies that the WHO did not cover and presumably chose to ignore. These studies held some startling facts such as:
|Arthritis||“After examining over 7,000 individuals from six regions, the authors found that the rate of osteoarthritis was significantly increased at water fluoride levels of just 1.7 ppm” (Ge 2006)|
|Brain||There have been 53 human studies linking moderately high fluoride exposures with reduced intelligence2|
|Cancer||“A national case control study published in 2006 by Harvard scientists found that boys exposed to fluoridated water had a significantly elevated risk of developing osteosarcoma (bone cancer).” (Bassin 2006)|
|Heart disease||“Fluoride in drinking water consumed over time is harmful not only to bones and teeth but also to the cardiovascular system…” (Fluoride, 1997)|
|Diabetes||“Sufficient fluoride exposure appears to bring about increases in blood glucose or impaired glucose tolerance in some individuals and to increase the severity of some types of diabetes.” (National Research Council, 2006)|
|Kidney Disease||"A fairly substantial body of research indicates that patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity. These patients may develop skeletal fluorosis even at 1 ppm fluoride in the drinking water." (Dr. Helmut Schiffl, 2008)|
|Fertility||"The enhancing overload caused by fluorides represents a potential factor, having an impact on function of sperm, hence contributing to a growing infertility in the human population.” (Animal Reproduction Science, 2008)|
So, after reading all of these studies, or not, the WHO go on to conclude that to produce signs of acute fluoride intoxication, minimum oral doses of at least 1 mg of fluoride per kg of body weight are required. Furthermore, their guidelines recommend that drinking water should have an absolute upper limit of 1mg/litre.
In this report they state that in Singapore, public water supplies contain 0.7mg/litre of fluoride3. So, if you drink 10 glasses of water a day that’s 1.75mg of fluoride a day or just over 12mg a week. Is that really OK? Well, according to the WHO, it’s fine.
Conclusion regarding fluoride
To be honest if, like us, you find it all very confusing let wrap up by looking at some hard facts and then, you can draw your own conclusions.
FACT 1: Fluoride in high doses is bad
Everyone agrees that high levels of fluoride in drinking water is incredibly harmful causing arthritis, gastrointestinal problems, brain impairment, kidney disease, cancer, male infertility, cardiovascular diseases, skeletal fluorosis, endocrine disruption, thyroid disease and exacerbating existing conditions such as, diabetes.
FACT 2: Fluoride might be bad in small doses
There are 100s, if not 1000s, of studies that demonstrate that added fluoride to drinking water may be detrimental to your health. There are many other studies that show that it is not. Several governments (such as the US, Australia and Singapore) and bodies (WHO) have decided that the studies demonstrating that adding fluoride to drinking water is detrimental to your health are inconclusive.
FACT 3: 97% of Western Europe has rejected water fluoridation
At present, 97% of the western European population drinks non-fluoridated water. This includes: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, Netherlands, Northern Ireland, Norway, Portugal, Scotland, Sweden, Switzerland, and approximately 90% of both the United Kingdom and Spain.
FACT 4: Only 11 countries in the world have more than 50% of their population drinking fluoridated water
And that includes Australia, Brunei, Chile, Guyana, Hong Kong, the Irish Republic, Israel, Malaysia, New Zealand, Singapore and the United States.
We’ll leave it up to you to make your own decision as to whether you want to continue drinking fluoridated tap water or not. Moving on, I'd like to share that in part 2, we explore all the other goodies found in drinking water such as, chlorine, pesticides, lead and other heavy metals, nitrates, nitrites and other people’s medical drugs. Click here to go straight to part 2: Should Singaporeans use water filters? Part 2: Chlorine and other Toxins.
The Levitise Team
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1. Fluoride in Drinking-water, Background document for development of WHO Guidelines for Drinking-water Quality, 1996. http://www.who.int/water_sanitation_health/dwq/chemicals/fluoride.pdf
2. FLUORIDE & IQ: THE 53 STUDIES, 2016. http://fluoridealert.org/studies/brain01/
3. Fluoridation of public water supplies in Singapore, 1984. https://www.ncbi.nlm.nih.gov/pubmed/6497322