Information Crusader/Cruzadora de Informação

For whatever reason, I always find myself writing extensively researched responses to inaccurate statements or articles. For example, when a doctor I saw in college told me that NFP (that's family planning based on a woman's natural fertility signs) had a "failure rate," I spent hours researching and writing an e-mail to him comparing the efficacy and long-term health effects of hormonal birth control (which also has has a "failure rate") to natural methods. Maybe it's a tick, but whenever I see something that is wrong or misleading, I get annoyed.

This time it was two articles in Gwangju News, a monthly magazine put out by the Gwangju International Center, a non-profit organization that serves the expat community here. The magazine has great coverage of local artists and events, and for the most part is a pretty good read. However, it is reliant on volunteer contributions and compiled and edited by volunteers, so I guess some questionable stuff occasionally makes it through. The articles, on the "dangers" of water fluoridation ("Don't Drink the Water!" in the April issue) and "radioactive seafood" ("Fukushima: A Tsunami of Radioactive Seafood?" in the August issue) really raised my public health hackles, so I wrote an e-mail to the editorial team expressing my concerns. I have posted it below for your amusement.

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Dear Gwangju News Editorial Team,

My husband and I recently moved to Gwangju and joined the GIC, and we have been reading the Gwangju News with great interest. For the most part, we like the magazine: it has great coverage of the arts and culture scene here, and we really appreciate most of the features. However, we (and I in particular, as a public health professional by training) have been concerned at some of the misinformation and fearmongering in a few of your recent articles, specifically the ones on water fluoridation and radiation in seafood.

Let me begin by providing my credentials: I have a B.S. in Biomedical Science and a Master of Public Health (MPH), which a focus on Environmental Health. After I received my MPH in December of 2008, I worked for one year as a fellow with the CDC's National Institute for Occupational Safety and Health, and more recently, for two years as a consultant to the Texas Department of State Health Services on a project with the Agency for Toxic Substances and Diseases Registry, a sister agency of the CDC. I have also been an active member of the American Public Health Association's International Health Section for the last two and a half years, serving as the Communications Committee chair since the Annual Meeting in 2010, and have written public health content for blogs with the International Health Section, Medscape, and End the Neglect (which focuses on neglected tropical diseases). As someone who has worked in public health communications, I can particularly appreciate the value of accurate portrayal of public health issues and the harms that can be caused by misinformation, even from well-meaning individuals.

The Fluoride Article

The first article that I feel was misrepresentative of a public health issue, and the one that bothered me the most, was the article on fluoride ("Don't Drink the Water!") in the April 2012 issue. First off, there were several blatantly incorrect statements:

1. "adding fluoride to water constitutes forced drugging" - Frankly, this is ridiculous. Fluoride cannot be called a drug in any way, as it does not alter the body's function or affect behavior. It is a naturally-occurring mineral and cannot be called a drug any more than magnesium, iron, or calcium can. Therefore it is not in any way "illegal" to add it to the water supply.

2. "The US Centers for Disease Control has labeled fluoride as a level four hazardous substance" - This is also false. ATSDR has classified fluorine, hydrogen fluorine, and hydrofluoric acid (all industrial compounds) as highly toxic and hazardous substances (because they are), but fluoride is a different compound entirely. To put it in perspective, pure sodium metal is highly corrosive, but we eat it all the time as sodium chloride (table salt). For more information, see ATSDR's overview here: http://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=38

There were also several misleading statements, including references to Nazi concentration camps, mind control, and recent legislation passed in the US. To clarify, the idea that the Nazis put fluoride in camp water to control prisoners is an urban myth that has no basis in historical fact (more information on this: http://www.politifact.com/florida/statements/2011/oct/06/critics-water-fluoridation/truth-about-fluoride-doesnt-include-nazi-myth/). Besides, even if the Nazis fluoridated the drinking water in the camps, they also provided medical care to sick or injured prisoners. Should we then say that treating people for tuberculosis, or setting broken bones, or providing universal health care, is unethical because it was done in a concentration camp? (For an in-depth account of life in a concentration camp, I recommend Survival in Auschwitz by Primo Levi.)

The truth is that the CDC has hailed public water fluoridation as one of the ten greatest public health achievements of the 20th century, and multiple respected public health and professional associations have come out in support of it, basing their statements on multiple reputable scientific studies and meta-analyses. In summary, the article on fluoridated drinking was poorly researched, based on misinformation, and completely fallacious.

More information from the CDC: http://www.cdc.gov/fluoridation/
Wikipedia: http://en.wikipedia.org/wiki/Water_fluoridation and http://en.wikipedia.org/wiki/Water_fluoridation_controversy

The Radioactive Seafood Article

This article was not nearly as disturbing, and I can appreciate its timeliness as the international community continues to debate the pros and cons of nuclear power in the aftermath of the Fukushima disaster. However, I still felt that the information what somewhat misrepresented and misleading.

1. "imagine fish that swam through irradiated waters for 6,000 miles being...served to thousands of people" - This is a grossly inaccurate statement. First of all, "irradiated" means that something has been exposed to radiation, usually intentionally. While some radiation from the Fukushima plant was released into the ocean, this statement implies that the entire Pacific Ocean was exposed to colossal radiation waves.

2. "Thailand, the Philippines, and Malaysia...have been proactive in banning Japanese food imports for fear of radioactive contamination" - This fails to take into account ulterior motives or politics. Japan is an industrialized nation with a highly efficient agricultural production system, so naturally they export a lot of produce and food products. It is easy for other Southeast Asian countries to use the Fukushima disaster as an excuse to ban food imports in order to protect their own rice farmers, for example, without drawing international condemnation for unfair international trade policies or foreign policy consequences.

3. The article makes repeated references to finding "trace amounts" of radioactive contaminants in seafood and citing this as a reason for concern. The term "trace amount" is indicates that the compound is present in the sample being tested, but at a level that is barely above the detection limit. What this means is that some machine could pick up some tiny amount of the compound in some of the samples.

The Japanese government destroyed all of the harvested produce that had radioactive materials above its own legal limits, which are even lower that international standards set by the World Health Organization. Furthermore, to expect no radiation in any of your food is ludicrous; radiation occurs naturally throughout nature and can be found in bananas and granite countertops (for additional perspective, refer to this chart: http://xkcd.com/radiation/). As the article itself mentioned, we are exposed to radiation at much higher levels during medical procedures and airline flights that has been detected in any tuna samples. To generate public fear about it is unproductive and potentially harmful to farmers and fishers, as avoidance of these foods will affect their livelihoods.

I understand that the magazine relies on contributions from volunteers and that people should be able to express, and write about, their opinions freely. However, these articles in particular were poorly researched and the ignorance of the authors painfully obvious to anyone with a scientific background. Neither of them listed any education or training in public health, environmental science, or (in the case of the radiation article), nuclear science. As editors, I know you understand the importance of making sure your contributions are factually accurate and well-researched. If you receive any contributions in the future about health-related articles, I would be more than happy to review them for any misinformation or inaccuracies.