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, 28th February 2007

Present:	Dr Seamus O’Hickey (Chairman), Dr Brian O’Herlihy (Vice-Chair), Councillor Jack Bourke, Mr Michael Kilcoyne, Mr Denis Lyons, Mr Stephen McDermott, Dr Máire O’Connor, Mr Ray Parle, Mr Rowland Reece, Professor Denis O’Mullane, Dr Justin Roche, Ms Hillary Coates

In attendance: 	Ms Patricia-Gilsenan-O’Neill, Mr Tom Rogers, Ms Etain Kett, Secretariat

Apologies:	Dr Wayne Anderson, Mr Chris Fitzgerald, Ms Ursula O’Dwyer, Professor John Clarkson, Mr Colm Keenan, Dr Joe Mullen, Dr Margaret Shannon, Mr Darragh Page, Ms Martina Queally

EB Minute 01/07:  Apologies
Apologies for the meeting were noted.

EB Minute 02/07:  Minutes of the last meeting (29th November 2006)
These minutes were agreed and were then signed by the Chairman.

EB Minute 03/07:  Matters Arising
It was noted that Ms. Hillary Coates was representing HIQA at the meeting (EB Minute 45/06 refers).

The draft risk management strategy is still in under review with the sub-committees (EB Minute 50/06 refers).

There is no agreed date as yet for the launch of the Adult Dental Health Survey but feedback will be given to the Expert Body when this is known (EB Minute 51/06 refers).

Ms. Ursula O’Dwyer will give feedback to the NEI Sub-Committee about developments in relation to infant formula guidelines (EB Minute 52/06 refers).

EB Minute 04/07:  Correspondence
Correspondence was noted from the Department of Health and Children issuing an invitation to the Chairman  and representatives of the Expert Body to meet and discuss the “Progress Report on Business Plan 2005 and Financial Projections 2007-2010”.

EB Minute 05/07:  Joint Oireachtas Committee on Health and Children
A letter from the Joint Oireachtas Committee on Health and Children to the Chairman, Expert Body dated 15th February 2007 was noted.  The letter contained a series of questions, a response to which is currently being drafted.  It was noted that the JOCH&C was informed of an error in the minutes of the meeting at which the representatives from the Expert Body appeared before them.

Both the Vice-Chair Dr Brian O’Herlihy and Mr Stephen McDermott thanked the Secretariat and the Communication Advisors for the preparatory work carried out in advance of the presentation.  

The Chairman Dr O’Hickey informed the Expert Body of Dr Jacinta McLoughlin’s appearance on “Prime Time”, the DVD was played and it was agreed that Dr McLoughlin maintained the objectivity of the Expert Body.

EB Minute 06/07:  Fluoridation of Water Supplies Regulations 2007
The Expert Body was informed that the Regulations have been signed by the Minister for Health and Children and are currently laid before the Oireachtas for 21 sitting days since the 8th  February 2007.  If passed by the Oireachtas the new Regulations will take effect from the 1st July 2007.

EB Minute 07/07:  Report of the Sub-committees
The Quality Assurance Sub-committee reported the following:

•	The Regulations are now off the Agenda as a completed piece of work and they should be ready by late March/early April (EB Minute 06/07 refers).
It was agreed that the HSE and the local authorities need to be informed of their responsibilities in relation to the Regulations.

•	Agreed amendments have been made to the Code of Practice and the Statutory Instrument number has been incorporated.  The Expert Body is waiting for the HSE to indicate their agreement with the Protocol for the Independent Testing of HFSA.  The Secretariat has had discussions with the Department of Health and Children and the Department of Environment, Heritage and Local Government re the drafting of a foreword for the Code of Practice.

•	The Draft Protocol for the Independent Testing of HFSA prepared by the QA Sub-committee, Public Analyst Laboratory and the Secretariat, which has already been sent out for consultation to stakeholders is currently under consideration by PCCC and the Population Health Directorate of the Health Service Executive.  It was agreed that Mr McDermott will contact the Assistant National Director on Environmental Health and ask for feedback in relation to the draft protocol.  

•	The Irish Medicines Board has stated that HFSA is not a medicine and is covered by an Act of the Oireachtas and therefore it is not unlawful to use in the fluoridation of water.  

•	It is hoped to have the tender for the National Audit in place by the second quarter 2007. The Fluoridation Self-Assessment Questionnaire is ‘work in progress’.

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

•	The North/South Survey on Children’s Oral Health is nearing completion. Photographs re fluorosis are currently being scored by the Oral Health Research Services Centre Cork .

•	It has been agreed to undertake Baseline Research to examine what effect the new regulations will have on fluorosis and tooth decay. An Ad-Hoc Committee has been set up to progress this matter. 

•	The ADA interim guidance in relation to infant formula feeding was noted.  It was further noted that the circumstances in the US are different, levels of fluoride of 4ppm are permitted (due to a large number of water supplies being naturally high in fluoride) and it is against this background that the statement is made. Therefore based on current information it is not necessary to alter the recommendation by the Forum to use boiled tap water for infant formula in Ireland.

The meeting was informed that at approximately 4-6 months when babies are weaned, the infant formula changes and it contains more calcium (this binds the free fluoride ions and gives a 30% reduction of fluoride absorption).  Further information is being sought on sodium content of bottled water.  The Expert Body was informed that the NEI Sub-Committee is awaiting results from the Oral Health Research Services Centre Cork in relation to fluoride intake levels in infants.  Both Irritable Bowel Syndrome and Serotonin levels are under review by the NEI Sub-committee and will be reported on in due course.

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

•	It was agreed that Dr O’Connor was endorsed as Chairperson of the Communications Sub-Committee.

•	It was noted that Dr Maria Lordon Dunphy has accepted an invitation to become a member of the Sub-Committee.

•	It was noted that the Ad-Hoc Committee is reviewing Recommendation 3 as a matter of priority. The Forum recommends that fluoride toothpaste should not be used until 2 years of age and that paediatric toothpastes should not be used at all. The Ad Hoc Committee has contacted the Oral Health Care Industry and no new evidence has emerged on this issue, therefore it was noted that there will be sign-off on this evidence review and there will be a final sign-off meeting for this Ad-Hoc Committee shortly.  These recommendations will be presented to the Plenary meeting for discussion.

•	The appointment of a Communications Advisor to the Expert Body was noted.  Out of the 3 tenders invited to present to the Sub-Committee Weber Shandwick was the successful tenderer.

•	It was agreed that appropriate material in the form of fact sheets and leaflets should be prepared for key audiences.

•	A proactive communication approach is planned inline with the implementation of the new Statutory Instrument and the publication of the Code of Practice.

•	It was agreed that the Health Spokesperson from each of the main political parties should be invited to a briefing on the Irish Expert Body on Fluorides and Health and their role in water fluoridation policy.

•	It was agreed that media training should be given to some members of the Expert Body (Chairs of the various Sub-committees and members of the Expert Body with environmental and paediatric expertise).

•	A media monitoring report was given by the Secretariat.  

EB Minute 08/07:  Report of Executive Committee
•	A written Report on the Executive Committee’s meeting with the DOH&C was tabled at the meeting.

EB Minute 09/07:  Proceedings of the UK Conference “Researching Water Fluoridation: Evaluation & Surveillance, 31st January 2007
•	It was noted that the National Fluoride Information Centre is an independent organisation and that the conference was very informative and gave clear evidence.  The conference presentations will be forwarded to the Expert Body members.

•	A Report by the Pure Water Association was also tabled.

EB Minute 10/07:  EU Directives
•	Briefings were given by the Secretariat on Regulation (EC) No 925/2006 of the European Parliament and of the Council of 20th December 2006 on the addition of vitamins and minerals and of certain other substances to foods and also on the REACH Regulations (Registration, Evaluation, Authorisation and Restriction of Chemicals) 

EB Minute 11/07:  AOB
A briefing was given by the Secretariat on WHO – Oral Health: action plan for promotion and integrated disease prevention. It was noted that oral health and fluoridation is to be an item on the Agenda for the World Health Assembly.

EB Minute 12/07:  Expert Body Plenary Meeting 
The next Plenary Meeting is scheduled for Wednesday, 25th April 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 13:20pm.

Signed:	______________________________

Date: 		______________________________