Day 6 of the 2nd Phase #FluorideLawsuit is resuming.
FAN Connett is making it clear that Dr. Thiessen has to leave by 11:30 am to make it to her rental car and flight.
EPA objects they have at least an hour and 15 left for her. FAN is asking if its she can continue on zoom.
FAN Connett is making it clear that Dr. Thiessen has to leave by 11:30 am to make it to her rental car and flight.
EPA objects they have at least an hour and 15 left for her. FAN is asking if its she can continue on zoom.
Judge Chen says he already ruled all experts needed to be in person. He doesnt want to change that, suggests she get a later flight.
They decided to proceed as quickly as possible and see what happens.
They decided to proceed as quickly as possible and see what happens.
EPA is discussing Dr. Grandjean's BMCL and asks Dr. Thiessen if she used his work in her analysis. She agrees.
EPA: you believe you can approximate community water fluoridation using a urinary sample, correct?
Thiessen: in principle it can be done, but the preferred way would be to start with the community water fluoridation level.
Thiessen: in principle it can be done, but the preferred way would be to start with the community water fluoridation level.
EPA: the fluoridated communities in the U.S. have about .7 mg/ L in water, correct?
Thiessen: yes.
EPA: there are many sources of fluoride beyond water fluoridation, correct?
Thiessen: yes
Thiessen: yes.
EPA: there are many sources of fluoride beyond water fluoridation, correct?
Thiessen: yes
EPA: the amount of fluoride observed in the urine sample is also dependent on the body weight and metabolism of an individual, correct?
Thiessen: yes.
EPA asks if someone was to stop drinking fluoride they would still find fluoride in their body afterwards. Thiessen agrees.
Thiessen: yes.
EPA asks if someone was to stop drinking fluoride they would still find fluoride in their body afterwards. Thiessen agrees.
EPA in your view the best you can do is approximate fluoride intake with urinary fluoride levels, correct?
Thiessen agrees.
Thiessen agrees.
Thiessen: for most individuals in fluoridated areas, the fluoride content in the body is driven by the fluoride in the water.
EPA: let's talk more about this concentration of fluoride in urine and fluoride concentration in the water.
EPA: in your 3rd supplemental report you said there is substantial info relating to urinary fluoride and pregnant mothers. you cited 2 reports. I want to talk about both of these studies in the context of converting urinary fluoride into fluoride intake.
EPA: In Till, 2018, the average urinary fluoride value was higher than the average water fluoride concentration, right?
Thiessen agrees.
Thiessen agrees.
EPA attempting to poke holes in Thiessen's testimony using Thippeswamy study.
EPA: the average maternal urinary fluoride levels were actually lower than the fluoride drinking water levels, correct?
Thiessen: yes.
EPA: and this study is in conflict with the Till study, correct?
Thiessen: yes.
Thiessen: yes.
EPA: and this study is in conflict with the Till study, correct?
Thiessen: yes.
EPA: are you familiar with a PBPK model?
Thiessen: yes.
Thiessen: yes.
EPA is claiming Dr. Grandjean's BMCL level is lower than the "background" that Thiessen has stated she thinks is concerning.
Thiessen agrees but offers some caveats.
Judge Chen asks if the data is based on the 3rd trimester. Thiessen believes its an average, doesnt recall.
Thiessen agrees but offers some caveats.
Judge Chen asks if the data is based on the 3rd trimester. Thiessen believes its an average, doesnt recall.
EPA wraps questions of Dr. Thiessen. Jokes maybe she can make her flight still.
FAN Connett prepares for redirect.
FAN Connett prepares for redirect.
Connett: I'd like to start by looking at the dose-response relationship from the NTP's analysis.
As Connett gets deeper into this discussion, Judge Chen interrupts to say he is lost. Asks Connett to restate the facts. Connett is going to pull up some exhibits to make the discussion easier.
Connett: Remember yesterday you were talking about the data the NTP used for the forest plot, can you explain to the court what data the NTP used for the dose-response analysis for the Bashash study?
Thiessen: for the means-effect analysis, these were the means of two groups divided above and below .8 mg/L of the urinary fluoride of the children, and not adjusted for any covariants. In later drafts the NTP did adjust for this.
Connett making the point that the data being used from Bashash is not adjusted for covariants and looked at the child's urinary fluoride content, not the mothers.
Connett asks Thiessen which would analysis would be more robust, an analysis looking at individual urinary levels vs a group analysis with binary conclusions.
Thiessen is explaining to Judge Chen why the individual analysis is superior.
Thiessen is explaining to Judge Chen why the individual analysis is superior.
Connett asks Thiessen about a question asked by the EPA. Discussing turning a water fluoride level into a dose concentration.
EPA objects, Judge Chen overrules.
EPA objects, Judge Chen overrules.
Thiessen the intake level of water is very broad. if your POD starts with a concentration then that has to be defined in terms of an intake level.
Connett moves to discuss the thippeswamy study.
(Remember, Thiessen is supposed to leave by 11:30 if she is going to return her rental car and make her flight!)
(Remember, Thiessen is supposed to leave by 11:30 if she is going to return her rental car and make her flight!)
Thiessen is explaining that all the different samples in Thippeswamy showed some impact of fluoride.
The cord blood level was correlated with fluoride levels.
The cord blood level was correlated with fluoride levels.
Thiessen: Basically, whatever was going through the mothers blood was going into the fetus.
Connett ends his questioning of Thiessen. She is free to go.
Connett ends his questioning of Thiessen. She is free to go.
The plaintiffs rest their case!
The EPA is up to begin their case and call their first witness.
The EPA is up to begin their case and call their first witness.
EPA calls 1st witness, Dr. David Savitz, Professor of Epidemiology. vivo.brown.edu/display/dsavitz
EPA asks Savitz if he believes the epidemiological evidence supports an association with fluoride and lower IQ relating to 1.5 mg/ L in the water.
Connett objects and says that Savitz agreed that he had no opinion on the levels above 1.5 mg/L.
Connett objects and says that Savitz agreed that he had no opinion on the levels above 1.5 mg/L.
Connett says Savitz is there to speak about concentration.
Judge Chen asks if there is a "surprise element here". Connett says there is bc Savitz previously said he wasnt focus on this particular area so the plaintiffs did not focus on this area.
Judge Chen asks if there is a "surprise element here". Connett says there is bc Savitz previously said he wasnt focus on this particular area so the plaintiffs did not focus on this area.
Connett: Dr. Savitz testified that his scope was expressly limited to concentrations below 1.5 mg/L.
Judge Chen says let me see the report.
Judge Chen says let me see the report.
EPA says this shouldn't be a surprise. EPA says in the rebuttal report, Dr. Savitz makes references to exposures above 1.5 mg/ L.
Connett is arguing that Savitz had expressed no interest in levels of 1.5 mg/ L.
Connett is arguing that Savitz had expressed no interest in levels of 1.5 mg/ L.
EPA: Savitz did a broader review, I dont think this means he cant speak above levels of 1.5.
Connett quotes from Savitz deposition, "the question I was asked to address is whether fluoride at levels of 1.5 mg/ L have adverse effect."
Connett quotes from Savitz deposition, "the question I was asked to address is whether fluoride at levels of 1.5 mg/ L have adverse effect."
Judge Chen doesnt agree Savitz cant talk about levels above 1.5 mg/L.
Connett says multiple times in his deposition Savitz said he hasnt focused on studies above 1.5 mg, and thus shouldnt be able to discuss such.
EPA is disagreeing with this assessment.
Connett says multiple times in his deposition Savitz said he hasnt focused on studies above 1.5 mg, and thus shouldnt be able to discuss such.
EPA is disagreeing with this assessment.
Judge Chen says maybe its a question of degree. Savitz is not prohibited from talking about in a general context, but cant go int justifying or giving weight or power to studies compared to others.
EPA says their questions for Savitz related to the various studies will be focused on the impacts below 1.5 mg/L.
EPA continues questions for Savitz.
EPA continues questions for Savitz.
EPA is having Dr. David Savitz to explain his credentials and various appointments in universities.
While describing his credentials, Dr. David Savitz has a Freudian slip, refers to the CDC as the "Center for Disease Promotion".
EPA asks Savitz about his experience studying water exposure, whether he has studied neurodevelopment with children, whether he is involved in scientific journals, etc.
EPA is going deep into Savitz credentials, discussing his appointments, his experience at NASEM, his awards/honors for his work at NASEM.
Savitz finally gets to his work with NASEM reviewing the NTP monograph on fluoride and IQ.
EPA: what was NASEM's charge?
Savitz: our charge was narrow, we had to review the monograph to see if they followed their rules, and if the conclusions were supported by the evidence.
Savitz: our charge was narrow, we had to review the monograph to see if they followed their rules, and if the conclusions were supported by the evidence.
EPA asks Savitz if he was aware of controversy surrounding water fluoridation. He says he was aware in the past but not this particular lawsuit.
EPA asks if Savitz had been researching fluoride previously. Savitz said no.
EPA asks if Savitz had been researching fluoride previously. Savitz said no.
EPA asks Savitz is there a reason researchers with no experience in researching fluoride might be selected to review a study on fluoride?
Savitz says the goal is to have people who would come in with an open mind and be able to take in all the evidence in an unbiased manner.
Savitz says the goal is to have people who would come in with an open mind and be able to take in all the evidence in an unbiased manner.
EPA asks Savitz if he plans to study fluoride in the future. He says he would be academically interested but recognizes that there would be the appearance of bias to some who might think he wouldn't reach conclusions which would contradict the EPA.
Savitz now begins discussing this new study by Health Canada which was mentioned earlier this morning.
EPA asks Savitz what Health Canada's goal was.
EPA asks Savitz what Health Canada's goal was.
Savitz was part of the Expert Panel which reviewing the Health Canada data in 2023.
Here: canada.ca/content/dam/hc…
Here: canada.ca/content/dam/hc…
EPA is laying foundation for Savitz as an expert witness, who participated in this new study from Health Canada, that conveniently dropped yesterday.
EPA: what was the Health Canada's expert panels conclusion?
EPA: what was the Health Canada's expert panels conclusion?
Savitz discusses that the Point of Departure chosen by Health Canada was dental fluorosis.
Connett objects to the line of questioning. Judge Chen says its a late, breaking development and something the court should consider. He allows testimony.
Connett objects to the line of questioning. Judge Chen says its a late, breaking development and something the court should consider. He allows testimony.
EPA asks Savitz to explain the statements by Health Canada.
Savitz said there were "sufficient uncertainties", therefore the recommendation was to focus on moderate dental fluorosis as the POD until further research on fluoride is better defined.
Savitz said there were "sufficient uncertainties", therefore the recommendation was to focus on moderate dental fluorosis as the POD until further research on fluoride is better defined.
Savitz acknowledges that there was a 1942 study by Dean that is still seen as quality. He says Health Canada used this study to development their POD for dental fluorosis.
EPA is now asking Savitz about this study here:
Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water
Which was just published yesterday.pubmed.ncbi.nlm.nih.gov/38318766/
Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water
Which was just published yesterday.pubmed.ncbi.nlm.nih.gov/38318766/
EPA asks for a bathroom break. Judge Chen agrees. Final break begins.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
