Thread by @DBrozeLiveFree

Day 8 of the 2nd Phase of the #FluorideLawsuit is beginning.

Judge Chen just walked in the court. FAN Attorney Michael Connett will continue his cross examination of Dr. David Savitz.

If you missed Day 7, here is:

Part 1:

Part 2:

Part 3: threadreaderapp.com/thread/1755992…
threadreaderapp.com/thread/1756023…
threadreaderapp.com/thread/1756051…

EPA attorney Brandon Adkins and FAN Michael Connett are working out some scheduling issues with Judge Chen.

EPA is asking for Judge Chen to be able to view one of the EPA's witnesses (which is a prerecorded deposition) separately from the courtroom since its a 2 hour video. He agrees.

EPA & FAN agree to go to Dr. Stanley Barone after Savitz bc he is here in person.

Judge Chen is now saying he might want the parties to do closing statements at a separate time via zoom, so the Judge has time to review everything.

Both sides are asking the judge to do this within 1-2 weeks. Judge Chen suggests Tuesday the 20th at 9:30 pacific.

Judge Chen is going to take some time to think it over, whether it would be in person or over zoom.

FAN Connett resumes his cross examination of EPA's expert witness Dr. David Savitz.

Connett asks Savitz about the Dewey, 2023, study looking at cognitive development. Asks him if he thinks its quality. Savitz says he does think it is, more than some of the other cohorts.

Connett showing Savitz a table related to the Dewey, 2023, study related to IQ.

Connett mentions that Dewey also looked at "executive function" relating to fluoride exposure.

Connett: the Dewey study found an association between fluoride and executive function for girls, correct?

Savitz: Agrees but says "there is a broad hypothesis about executive function" and then there are much more focused hypothesis which find nothing.

Connett: to be clear, they did find a statistically significant association between fluoride and impact on executive function? Savitz offers a qualified yes.

Connett reads from the study, "these findings suggest that exposure to levels of fluoride recommended for dental health in community water supply during pregnancy may be associated with adverse effects on executive function abilities in young children, particularly girls"

This is Dewey 2023, btw ncbi.nlm.nih.gov/pmc/articles/P…

Connett: are you aware that the EPA treats statistically significant results with credibility? EPA objects, Judge Chen allows the questioning.

Connett asks Savitz if he only testified to the results showing no impact from fluoride and not this association with girls.

Savitz: offers a long winded yes.

Connett: do you think its important to disclose to the reader that these results exist, even if you dont think its important?

Savitz: "this is an editorial choice by the authors, it is factually correct, I agree with that."

Judge Chen interjects, reminds Connett he has limited time left. Asks Savitz if he can find anything wrong with the Dewey association, some bias?

Savitz says its a mistake to "overemphasize" these findings but not pay attention to the other findings (which found no association)

Savitz says if you do more research and cant replicate the findings he would consider it to be an error. "File that away" and study later.

"I would not place a premium on this scientific finding"

Savitz says this is an "interpretation issue", the numbers are correctly cited, but encourages the judge not give it too much weight.

Connett continues his questioning of Savitz.

Asks him about the L.G. Do study from 2022 pubmed.ncbi.nlm.nih.gov/36214232/

Connett asks Savitz if he is aware of the authors work in promoting water fluoridation? He says no.

Connett asks Savitz if he spoke on an online webinar with L.G. Do. Asking if he is aware that Do is a promoter of fluoridation.

Connett asks Savitz if he is aware that Do has never before studies the neurodevelopmental issues associated with fluoride.

He says he is aware.

Connett asks Savitz if its true the NTP found that a number of the Chinese studies that were considered high quality. Savitz does.

Connett asked Savitz about the Chinese studies used by the NTP and their cross sectional approach.

Asks Savitz about a paper he wrote in the past discussing the benefits of such studies.

Connett asking Savitz about his own studies in China, including a cross sectional study.

Connett reading Savitz own words where he noted the benefits of cross sectional studies.

Connett asks Savitz about one of his studies focused on arsenic in drinking water.

Connett asks Savitz about a statement in the study noting that exposure to "modest levels" of arsenic may be associated with a slight elevation in population blood pressure.

Savitz agrees but says its all relative to the population and the local standards.

Connett now directing Savitz attention back to water fluoridation levels, asks Savitz about his statements regarding fluoride levels where he used words like "limited relevance" or "no relevance".

Connett now discussing Savitz' expert report on the Epidemiologic Evidence on Fluoride and Neurodevelopment". Says Savitz used one Chines study in his report to show "no association" between fluoride and "most of the outcomes including those directly related to ADHD".

Savitz says there may be other studies published since 2020 but he says he's not sure. "I didn't do an exhaustive search".

(what an expert report!)

Connett reads a statement from the Chinese study Savitz attempted to use to debunk fluoride and IQ connection. A statement which mentioned "increase" in "psychosomatic problems", but Savitz failed to mention or acknowledge.

Connett is showing another study, Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12 Years of Age in Mexico, which Savitz mentioned in a footnote of his expert report. (Dr. Howard Hu was involved in this)

ncbi.nlm.nih.gov/pmc/articles/P…

Connett: other more recent studies have found "internalizing symptoms" associated with fluoride exposure? Judge Chen interjects to ask what that means, Savitz says he's not an expert on that topic.

Connett shows Adkins, 2022, which Savitz discussed in his expert report. This study of 12 year old children in Cincinnati, examining the association between urinary fluoride levels and "internalizing symptoms".

Connet now wants to talk about "sex specific differences", which have been a hot topic during this trial.

Connett is now showing statements from Savitz' deposition relating to these sex specific differences, and the reasons girls and boys might show different results relating to fluoride exposure.

Connett asks Savitz about the testimony of Dr. Joyce Tsuji, EPA witness, relating to sex specific effects from neurotoxicants. Asks him if he is aware of these differences.

Savitz says he can speak as an epidemiologist and that he doesnt think sex specific effects are typical.

Connett asks Savitz about the paper "Sex Differences in Neurotoxicogenetics". Savitz says he doesnt know the paper.

Connett: so its fair to say that your opinion or lack thereof is not based on this paper?

Savitz says no, offers explanation.

Connett showing another paper relating to sex differences. Appears to be showing that Savitz is not well informed on sex differences relating to neurotoxicant effects.

Connett moves to the NTP's 2016 review on animal studies on fluoride.

Connett showing Savitz statements from the NTP report where there the NTP is calling for more research on "characterization of differences in response associated with sex". Asks Savitz if he agrees or disagrees.

Savitz says he is agnostic.

Connett shows testimony from Dr. Kristina Thayer, who used to work with the NTP and now works with the EPA. Shows statements relating to animal studies on fluoride, including "a decision was made to focus on the males, since it seemed like they might have been more sensitive".

Connett moves to talk about the Ibarluzea study, 2022. This is the INMA study which found that fluoride INCREASES IQ in boys.

Connett asking Savitz about the study and the idea that the positive results from Ibarluzea could nullify the negative results found in other studies. EPA objects, Judge Chen sustains.

Connett says he will quote from Dr. Savitz directly.

Connett now showing a statement from Savitz where he does appear to say that the Ibarluzea data can be used to discount the negative results of the other studies.

Connett is asking Savitz about his work on Ibarluzea and what math he used to come to his conclusions. Connett seems to show Savitz only relied on data from the boys in the Ibarluzea study, Savitz says if so that would be a mistake. Connett confirms that's what he did.

Judge Chen is now asking Dr. Savitz about his math and what he keeps calling a "back of the envelope" calculation.

Savitz' expertise is definitely being put to the question with this cross examination.

Connett asks Savitz about his awareness of the use of creatinine adjustment in the studies on fluoride and IQ.

Connett reads testimony from Savitz deposition where he agreed about the creatinine adjustment.

Connett: you agree that the impact of creatinine adjustment in the Ibarluzea study leads to a "rather dramatic" change in the findings?

Savitz agrees that there is a surprising change.

Connett: you testified last week about using water fluoridation levels over urinary fluoride levels? Savitz agrees.

Connett: are you aware that Ibarluzea did collect data on water fluoride on every individual in the Basque cohort? Savitz said he was not aware.

Connett: are you aware that Ibarluzea published a study on water fluoride levels in 2018?

Savitz says he is not aware

Connett: do you think Ibarluzea should have examined the urinary fluoride levels and the water fluoride levels separately?

Savitz: I think there's merit to both.

Connett asks Savitz about sardines and anchovies and consumption in the Basque area.

Connett asks Savitz about the Ibarluzea study and whether there were different controls and data for seafood consumption. Connett asking about certain fish having certain oils which can benefit the brain and whether this data should have been controlled for as a covariant.

Connett: would you agree its more important to control for seafood intake when you are dealing with a population with a high level of seafood intake vs a low intake?

Savtiz: it depends on the underlying assumptions...

Connett showing a table relating to the Ibarluzea study, including published data (adjusted for creatinine) and unpublished data (not adjusted for creatinine)

Connett moves on to show Savitz his testimony from last week.

Connett going over how the Ibarluzea study presented their data relating to creatinine levels.

Connett shows Ibarluzea supplementary table s3 looking at urinary fluoride levels in pregnant mothers.

Connett: as we discussed, an increase 1 mg / g Creatinine was associated with an increase of IQ by 15 points, correct? Savitz agrees. Connett asks the same about .75 mg/ L of urinary fluoride also associated with an increase of 15 IQ pointis. Savitz is uncertain.

Judge Chen seems confused too. Connett says this is an example that Dr. Savitz has provided.

Savitz: "I'd have to do some scratching and scrawling" to see if the math is right.

Connett is showing how the math is wrong. "is it fair to say that as this stands right now, you wouldn't stand by this answer?"

Savitz admits he would do the math different, not sure if its right or wrong, but he sees how the math is confusing.

Connett: so fair to say that you would ask us to reconsider your testimony about this?

Savitz: I'd have to go back and rework that.

Connett shows Savitz this new study, Systematic review of epidemiological and toxicological evidence on health effects of fluoride in drinking water, & notes even though they were aware of the Ibarluzea study they still found an association between fluoride & lower IQ.

Connett moves on to talk about Savitz prior work and funding he has received.

Connett is showing how Savitz has received funding relating to mercury amalgams (filling). Showing it was funded by the American Dental Association, among others.

Connett asks Savitz about why his study on abortion and mercury found an association between mercury exposure and spontaneous abortion was not published. Savitz said he always encourages the teams he works with to publish.

Connett shows that Savitz was part of a team who received $17 Million from the National Institute of Dental and Craniofacial Research, who are a huge promoter of water fluoridation.

Connett ends his questions.

EPA picks i back up for redirect.

EPA asks Savitz if he remembers Connett asking him about a table this morning. He does. EPA says he wasnt shown the table, so they now call for it to be shown to Savitz.

EPA asks Savitz to explain the table to the court.

Savitz says the table looks boys and girls exposure to fluoride during pregnancy, boys and girls who were not exposed, some who exposed part of pregnancy, etc.

EPA asks Savitz to show where the study found statistically significant effects.

Savitz points to the last column and the first column. EPA asks about the 2 other columns. Asks if there were any SS effects for boys alone.

EPA says the table only shows 4 different effects across 24 categories.

Savitz: it's hard to resist the temptation, but the positive findings at some support for a very specific hypothesis.

Savitz: The misperception is that only the positive ones are important, the other ones we will put aside. It's either all informative or none of it is. I think all of it is.

EPA reads from a statement from the recently released Taher study tandfonline.com/doi/full/10.10…

EPA showing Savitz more from this study where they say that the current data on fluoride is still unclear.

EPA shows another statement that says "evidence for such effects below 1.5 mg/L remains uncertain". Asks Savitz if this is consistent with his research. He says yes.

EPA is reading the supplemental material of Taher, 2024, which does state the authors believe the data below 1.5 mg/L is "unclear".

EPA: last week plaintiffs raised the point of "cherry picking", there was some insinuation that we had "cherry picked" the studies we were showing you in this graphic. Why is the Till study not in this table?

Savitz: its addressing a different hypothesis.

EPA showing Savitz a table relating to fluoride intake during pregnancy and the impacts on cognitive function.

EPA: what might be driving the longitudinal effect found in table 4?

Savitz: its the same scale, its the same sex.

EPA: does table 4 show the results of boys & girls combined?

Savitz: No.

Savitz is explaining why he thinks the Cantoral study general found no effects, save for a few exceptions. If he was the author he said he would put the no effects up front and then get into the exceptions.

Judge Chen asks clarifying question, asks if one could lend plausibility to the Till study even though its post-natal.

Savitz: it's different but it's still relevant. It's addressing the same phenomena.

EPA: when you were reviewing the fluoride literature were you looking for absolute causation?

Savitz: No, I have written that epidemiologists never reach absolute certainty but hopefully we provide analyses that leads to better decision making.

Savitz: it cant just be on study, there has to be significant confidence, and then we can go forward.

EPA asks Savitz his confidence in the case that fluoride exposure is associated with lower IQ in children.

Savitz says the data is "quite fragile".

He says the data "suggests it", but "when you zero in on that question, is there a reasonably firm basis for saying there is an association, I dont think we've arrived at that point."

EPA asks Savitz about the studies he conducted on EMFs, which Connett mentioned this morning.

Savitz elaborates on his work and says the group who funded it are "very good" at "shielding" scientists from conflicts of interest.

EPA asks Savitz if it was his study that found problems associated with EMF exposure. Savitz explains.

EPA says later research came along and allegedly concluded that EMFs are not dangerous.

EPA concludes redirect.

Judge Chen asks some questions, gets Savitz to confirm that although he wont assign a number to the weight of the evidence, he acknowledges its not zero.

Judge Chen asks Savitz if he agrees with the conclusions that there is concerns of harm around 1.5 mg/ L.

Savitz says he cant narrow it down but he would place it in the range of 1-2 mg/ L. but says you need studies from people in that range.

Judge Chen asks about the studies showing harm over 2 mg/ L.

Savitz says "for a number of reasons" he would "down rank" those studies.

Savitz says the dose-relationship response needs to be explored further.

Judge Chen wraps up questions. Connett has more questions but Judge Chen calls for a break.

1st break begins!