Thread by @DBrozeLiveFree

The final session of Day 7 of the 2nd phase of the #FluorideLawsuit is beginning.

FAN attorney Michael Connett will be cross examining the EPA's witness, Dr. David Savitz.

Connett pulls up a book written by Savitz titled, Interpreting Epidemiologic Evidence.

Connett quoting directly from Savitz, where he states that "inaction is still an action", in terms of assessing risk.

Connett reads more from Savitz, EPA objects, suggests that these are long quotes and should be shown to Savitz.

Savitz says he agrees with his own words, but his goal with writing this was that epidemiologists need to have an "even handed" approach when drawing conclusions.

Connett breaks down the quote into parts and asks Savitz if he agrees with the individual statements.

He does, with caveats.

Connett quotes Savitz based on his writing if it was best to use higher dose exposures, he agrees.

Connett mentions that in studies of PFAS, Savitz has relied on higher exposures. Savitz agrees.

Connett continues to quote from Savitz' book, and now reading from his statements submitted to the court.

Savitz takes issue with something he wrote in his book, the use of the word "never", but says he will fix that on the next update.

Connett moves to read Savitz' deposition testimony.

Connett: you have written that assessment of a study's methodology requires substantive expertise. Here we are dealing with fluoride's toxicity.

You agree when dealing with the epidemiological evidence of fluoride's neurotoxicity you need experts on these topics.

He agrees.

Connett says no one will question his general expertise, but lets deal with your experience relating to the specific studies involved here.

When you joined the NASEM review of the NTP monograph you wrote that you were a "newcomer" to this topic, correct? Yes.

Connett: during your time on the NASEM review, you personally read and reviewed only about 4-5 studies on fluoride, correct?

Savtiz: I would put it a little higher, maybe 8-10.

Connett reads deposition testimony showing Savitz saying he only read 4-5 papers.

Connett asks Savitz if he would consider himself an expert on fluoride's toxicity.

Savitz: I certainly was familiar with how the research was done.

Connett goes to deposition to show Savitz previously said "I would not say that I had done the necessary work" to be an expert."

Connett asks Savitz if at the time of his deposition last fall if he had read the work of Kaj Roholm. Savitz said no.

Connett now listing different areas of research relating to fluoride and asking Savitz if he was aware of such research at the time of his deposition.

Connett asks Savitz if he was familiar with the NRC's 2006 conclusion regarding fluoride and neurotoxicity. Savitz agrees.

Connett asks the same of Savitz about animal studies. Savitz says that is correct as well.

Connett is going to lengths to make it clear that Savitz is not an expert on fluoride, or at least, was not so when he was deposed by FAN attorneys.

Connett goes back to quotes from Savitz' book on epidemiology.

Connett gets Savitz to confirm he is not a risk assessment scientist.

Connett: so while you were examining the evidence in this case you were unaware of how the EPA defines hazard?

Savitz gives a meandering non-answer.

Connett restates, you did not know how the EPA finds hazard or determines risk?

Savitz agrees. Connett asks if he looked at the definitions under the amended TSCA for hazard assessment.

Savitz agrees he did not.

Connett: at the time of your deposition, you did not know if and why the EPA uses uncertainty factors, correct?

Savitz: I am generally aware of how the EPA uses uncertainty factors, Maybe I dont understand the question?

Connett pulls up deposition testimony.

Connett continues to ask Savitz about specific terms and their definitions, and processes used by the EPA in their TSCA hazard assessment.

Connett is attempting to make it clear that Savitz isnt/wasnt an expert in this topic, despite reviewing some of the NTP monograph.

Connett asks Savitz if its true he did not read any studies based on the exposure level of 1.5-2 mg/L. Savitz agrees.

Connett: When I deposed you in the case, you were unaware that the Bashash study used non-linear models to assess a dose-response relationship?

Savitz: I was aware of the conclusions, but not the models.

Connett: you agree that the NTP is likely to have identified all relevant studies within their cutoff period? Savitz agrees.

Connett is getting Savitz to acknowledge that, generally speaking, he does agree with the conclusions of the NTP, even though he lacks direct expertise with fluoride's neurotoxicity.

Connett moves to talk about the recently published systematic review based on Health Canada's study on fluoride.

pubmed.ncbi.nlm.nih.gov/38318766/

Connett showing Savitz a statement from the Risk Sciences International report prepared for Health Canada in April 2023.

Now showing Savitz the members of the Expert Panel which reviewed Health Canada's study on fluoride, showing members of the panel are advocates of fluoride.

Connett shows one member, Steven Levy, has a background in dentistry and promotes fluoride. Savitz says he did not know.

Judge Chen asks how people were selected for this "Expert Panel" organized by Health Canada.

Judge Chen asking Savitz if he is aware of whether members of the panel have advocated for or against water fluoridation.

Savitz says he does not know.

Connett resumes, returns to the published study from this week. Quotes:

"the overall evidence identified to date strongly suggests that fluoride can affect cognitive outcomes in children, at levels close to those currently seen in N.A. drinking water."

quote continued:

"Hence, the selection of the most appropriate endpoint requires a comparison of the point of departure for moderate dental fluorosis and the point of departure for IQ effects."

Connett: are you aware that the EPA uses an uncertainty factor of 10 for assessing the risk?

Savitz does not know.

Connett reading another statement from the newly published study:

"available evidence demonstrated a moderate to strong magnitude (strength) of association between fluoride & neurocognitive effects with consistent evidence across studies for the impact on childhood IQ...

at fluoride exposures relevant to current North American drinking water levels."

Connett shares another quote.

Savitz says he doesnt know how they came to these conclusions and has not read their assessment to see where he diverges.

Connett asks Savitz about cherry picking and if he would question the conclusions of any review which "cherry picked" data.

Savitz agrees.

Connett shows a graphic which was previously used by the EPA when questioning Savitz.

Connett: are you aware that the MIREC study found a statistcally significant loss of IQ in girls when examining for drinking water?

Savtiz provides a non-answer.

Savitz is explaining that there is some good in the "negative" studies, and some bad in the "positive" studies.

Connett: are you familiar with the Till, 2020 study? Savitz confirms.

Connett asks if he know the Till study found an association with lower IQ in prenatal exposure.

Savitz says bc Till is based on the MIREC cohort, its not a separate study. Connett says the NTP disagrees.

Connett is showing a quote from the NTP which said "although not every analysis found a SS association, together the 3 studies provided consistent evidence" of lower IQ in children exposed to higher levels of fluoride.

Connett: in your expert report, you never disclosed that the Cantoral study found ANY association with prenatal fluoride exposure and cognitive impacts?

Savitz: does not answer directly.

Connett asks Savitz again if there is any mention in his reports about the association with fluoride and adverse effects.

Savitz says he doesnt always disclose every single finding. Connett asks why he doesnt disclose about an association to his readers.

Connett reads from the Cantoral study: Averaging across the 12- and 24-month cognitive outcomes using mixed-effects models revealed a similar association: a 0.5 mg/day increase in overall dietary fluoride intake was associated with a 3.46-point lower cognitive outcome in boys.

Connett: when you were speaking to the court earlier today you never disclosed this finding, correct?

Savitz: I wasnt looking at it and saying, is there something in there that suggests an adverse effect. I was looking at the overall message.

Connett is hammering Savitz now for what he considers cherry picking results.

Connett is going hard on this point, EPA objects for argumentative, Judge Chen overrules.

Connett reads from Savitz analysis of the NTP report where he claimed there was no association of harm.

Connett says we are close to time. Judge Chen calls it for today.

We break for the weekend, resume at 8:30 Pacific Monday.

Thanks to everyone who is following along and sharing!

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