Kia ora Spencer,

 

Thank you for your request under the Official Information Act 1982 (the
Act), received by the Ministry of Health on 4 June 2025. You requested:

 

1. Detailed Review of NTP Reports (2024–2025):
• Provide the full review, analysis, or evaluation document conducted by
the Ministry or Director-General of the National Toxicology Program’s
August 2024 Monograph and January 2025 meta-analysis
(https://aus01.safelinks.protection.outlo...),
which found a moderate confidence link between fluoride exposure above 1.5
mg/L and lower IQ in children, with effects suggested below this level.
• Clarify whether the consideration cited in H2025065288
(www.health.govt.nz/information-releases/director-general-of-health-consideration-of-community-water-fluoridation-under-the-new-zealand-bill)
includes a specific assessment of New Zealand’s 0.85 mg/L exposure level
and multi-source risks (e.g., toothpaste, tea). If not, provide this
assessment.
• Explain the scientific methodology and evidence supporting your
conclusion that these reports do not alter safety assessments, addressing
the 95% consistency of 52/55 studies showing IQ reduction.

2. Post-August 2024 Scientific Reviews:
• Provide copies of all reviews, studies, or analyses conducted or
commissioned since August 2024 on fluoride in drinking water, including
the October 2024 Cochrane Review and the Ministry’s 2024 evidence review
([http://]www.health.govt.nz, 2024-12-04).
• Include any assessments of neurodevelopmental risks, dental fluorosis
trends, or transdermal absorption, given noncompliance with targets
(Belotti et al., 2024) and public health concerns.
• If no such reviews exist, confirm this and justify the absence despite
international developments (e.g., EPA reassessment, Utah ban).

3. Decision-Making Process Under Section 116C:
• Detail the criteria, methodologies, and guidelines used to evaluate
“relevant evidence” under Section 116C(4), including how the NTP findings
and High Court rulings (2023–2024) were incorporated.
• Provide the cost-benefit analysis for New Zealand’s 0.85 mg/L level,
weighing IQ risks against dental benefits, and address equity impacts in
high-deprivation areas.

4. Transdermal Absorption and Health Risks:
• Provide studies or risk assessments on fluoride absorption through the
skin from fluoridated drinking water, given its use in showers and
anecdotal reports of adverse effects.
• If none exist, explain why this exposure route has not been evaluated,
despite its relevance to compulsory treatment debates.

5. Correspondence and Monitoring Data:
• Provide copies of internal/external correspondence (e.g., emails,
meeting minutes) since August 2024 regarding NTP reports, neurotoxicity,
or Bill of Rights compliance.
• Supply fluoride concentration data (1992–2025) for all 25 supplies
studied by Belotti et al. (2024), detailing compliance with 0.7–1.0 mg/L
targets and exceedances above 1.5 mg/L.

6. Legal and Ethical Compliance:
• Provide the full Bill of Rights Act 1990 analysis (Section 11)
supporting the 2024 directive reconfirmation, including how NTP evidence
and public inquiry demands (e.g., FFNZ) were considered.
• Explain any plans to align with EPA’s reassessment (2025-04-08) or
respond to the 2023 High Court ruling’s process error.

7. Response to Legislative Reform – Fluoridation (Referendum) Legislation
Bill 2025:
• Provide any internal correspondence, legal advice, or briefing papers
held by the Ministry relating to the introduction of the Fluoridation
(Referendum) Legislation Bill by New Zealand First in 2025.
• Include assessments of how repeal of the 2021 Amendment Act would affect
the Director-General’s current fluoridation directives and Ministry public
health policy.
• Confirm whether the Ministry has prepared contingency plans or legal
risk advice in relation to this Bill and its potential implementation.

 

The reference number for your request is H2025068090. As required under
the Act, the Ministry will endeavour to respond to your request no later
than 20 working days after the day your request was received:
http://www.ombudsman.parliament.nz/.   

 

If you have any queries related to this request, please do not hesitate to
get in touch ([1][email address]).

 

 

Ngā mihi 
 
OIA Services Team 
[2]Ministry of Health information releases 

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References

Visible links
1. mailto:[email address]
2. https://www.health.govt.nz/about-ministr...

Kia ora,

 

Please find attached the response for your request for official
information.

 

Ngā mihi 

 

OIA Services Team

Ministry of Health  | Manatū Hauora 

M[1]inistry of Health information releases 

 

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References

Visible links
1. https://www.health.govt.nz/about-ministr...

Kia ora Spencer,

 

Thank you for your email. The Ministry of Health stands by the information
we have already provided and has nothing further to add in order to
respond to your initial request for information. 

 

While it is permissible to seek information by asking questions under the
Act, a distinction must be drawn between questions which seek information
that is ‘held’, and questions which seek to elicit an opinion or
explanation. The primary purpose of the Act is to allow requesters to seek
information ‘held’ by agencies. It is not a mechanism for requesters to
seek an explanation or opinion from an agency, or to create or compile new
information in order to satisfy a request.

 

As such, the Ministry is not required to provide additional explanation of
material which addressed your initial request for information. A
distinction must be drawn between clarifying a response an agency has
provided and a new request for information.

 

The Ministry responds to all official information requests made in good
faith in accordance with the requirements of the Act. Rather than refuse
your follow up request as frivolous or vexatious at this stage, we ask
that any future requests are submitted in more appropriate terms.

 

Please be advised that using the Act in this manner, where a clarification
email could be construed as a new request or asking the Ministry to
compile or create information, or provide an explanation or opinion could
result in such requests being refused under section 18(h) of the Act.

 

For further information please see the following Ombudsman guidance:
[1]https://www.ombudsman.parliament.nz/reso....

 

Under section 28(3) of the Act, you have the right to ask the Ombudsman to
review any decisions made under your requests. The Ombudsman may be
contacted by email at: [2][email address] or by calling 0800
802 602.

 

Ngâ mihi  

 

OIA Services Team

Ministry of Health  | Manatû Hauora 

M[3]inistry of Health information releases 

 

 

 

------------------------------------------------------------------------

From: SPENCER JONES <[FOI #31211 email]>
Sent: Thursday, 3 July 2025 12:07
To: OIA Requests <[email address]>
Subject: Re: Response to your official information act request, ref:
H2025068090 CRM:0001765

 

Dear OIA Requests,

**Subject**: Clarification and Request for Further Information – OIA
H2025088090 Response Incomplete

**Kia ora Ministry of Health OIA Team,**

Thank you for your response dated 2 July 2025 regarding OIA request #31211
(Ref: H2025088090).

Upon careful review, I respectfully submit the following follow-up points
and clarification requests, pursuant to sections 13 and 28(3) of the
Official Information Act 1982 (OIA). The response provided fails to supply
several key categories of information sought, relies heavily on
generalised or outdated evidence, and omits consideration of recent
international developments that the Ministry is reasonably expected to
have reviewed, particularly in exercising compulsory powers under section
116C of the Health Act 1956.

---

## 1. **Clarification of Legal Reference – Section 116C vs 116E**

My prior reference to section 116C(4) was a typographical error. The
intent was to reference **Section 116E(3)**, which sets out the
Director-General’s duty to consider “any relevant evidence or information”
before issuing a fluoridation directive.

Please therefore confirm the following:

* What internal frameworks, guidance documents, or review criteria does
the Ministry use to determine what constitutes “relevant evidence or
information” under s116E(3)?
* Were the **NTP 2024 Monograph**, **NTP 2025 meta-analysis**, **Belotti
et al. (2024)**, **EPA reassessment**, or the **October 2024 Cochrane
review** considered as part of this evidence threshold?
* If not, please explain why the Ministry believes it can lawfully
continue to issue fluoridation directives without assessing such material.

---

## 2. **Targeted Evaluation of Recent Scientific Reviews**

You did not supply or confirm whether the Ministry (or University of Otago
under contract) has reviewed:

* The **National Toxicology Program (NTP)** Monograph (August 2024) or
meta-analysis (January 2025),
* The **Cochrane Review (October 2024)** on water fluoridation,
* Or responded to international regulatory developments (e.g. **EPA’s
proposed classification of fluoride as a neurotoxicant**, **Utah’s
legislative ban**, or **EU safety guidance** on fluoride in infant
exposure).

Please confirm:

* Whether any **internal memos, correspondence, or analysis** of the above
were produced or held by the Ministry.
* Whether the 2024 MoH “evidence review” directly assessed these
documents.
* If not, please explain how the Ministry can claim fluoridation remains
“safe and effective” in the absence of a robust review of these recent
findings.

---

## 3. **Exposure Risk Assessment at NZ Fluoride Concentration (0.85
mg/L)**

You declined to provide any analysis of cumulative fluoride exposure risks
at the **current NZ level (0.85 mg/L)**, taking into account common
additive exposures (e.g., toothpaste, tea consumption, infant formula).

Please now provide:

* Any documentation held that examines **total daily fluoride exposure**
in New Zealanders, segmented by age group, including potential exceedances
of the **WHO tolerable upper intake level**.
* If no such data exists, please explain why the Ministry has not
commissioned such analysis before issuing population-wide directives.

---

## 4. **Transdermal Absorption and Showering Risk Assessments**

You stated the Ministry holds no studies of transdermal fluoride
absorption from bathing or showering, and that this route is unlikely to
contribute significantly.

Given growing anecdotal evidence and published hypotheses of transdermal
absorption in high-use scenarios (e.g., eczema, prolonged showering),
please clarify:

* Whether any **international scientific reviews** of this exposure route
have been considered by the Ministry.
* Why this pathway has not been investigated domestically, despite
mandatory dosing via public supply.

---

## 5. **Internal Correspondence – Narrowing Request Scope**

While I acknowledge your interpretation of the correspondence request as
relating to “substantive” documents, please now provide:

* Any **email correspondence, internal briefings, or meeting notes**
involving Ministry officials, panel advisors, or external scientists
between **August 2024 and present** that mention:

* The **NTP Monograph or meta-analysis**,
  * **Neurotoxicity**, **IQ effects**, or fluoride-related **cognitive
risk**,
  * The **Fluoridation (Referendum) Legislation Bill 2025**,
  * Or the **NZ Bill of Rights Act 1990**, s11 analysis and the
Director-General’s obligations under s116E.

This includes draft assessments, review comments, or scientific summaries
not previously released.

---

## 6. **Access to Fluoride Concentration Compliance Data**

You declined the request for fluoride concentration data from the
**Belotti et al. (2024)** study on the grounds that it was not conducted
by the Ministry.

Please confirm whether:

* The Ministry holds **any equivalent historical fluoride concentration
data (1992–2025)** for the 25 local supplies listed in Belotti et al., or
from the **National Drinking Water Register**,
* Or can retrieve this data from the relevant local authorities as part of
your statutory oversight role.

If the Ministry does not hold or track this data, please explain how it
monitors compliance with **fluoridation concentration ranges (0.7–1.0
mg/L)** and exceedances beyond **1.5 mg/L**, which may have public health
implications.

---

## 7. **Omissions Regarding Legal and Ethical Risk Management**

You provided a copy of the February 2024 NZBORA s11 assessment for 14
fluoridation directives but did not address:

* Whether the **NTP findings** or international calls for **independent
inquiry** (e.g., Fluoride Free NZ) were considered in that legal
assessment;
* Whether the Ministry intends to update the risk assessment following the
**EPA reassessment (April 2025)**;
* Or whether it has reviewed the **2024 High Court ruling** on press error
and delegated authority.

Please confirm whether such updates, legal reviews, or risk management
responses are underway or planned.

---

## 8. **Response to Legislative Reform – Fluoridation (Referendum) Bill
2025**

You refused this request under s18(g)(i), stating the Ministry does not
hold information regarding:

* The **Bill of Rights Act 1990 analysis** of the proposed Bill,
* Legal advice or contingency planning in the event of repeal of the
Fluoridation Amendment Act 2021.

Please confirm:

* Whether any **briefings, impact assessments, or draft advice** have
since been initiated regarding the Referendum Bill;
* Whether the Ministry has prepared **contingency plans** for regulatory
or legal challenges to its current fluoridation directives under repealed
powers.

---

## 9. **Right to Complain**

I respectfully reserve the right to lodge a complaint with the Ombudsman
under section 28(3) of the OIA, should the Ministry continue to avoid
substantive engagement with:

* The post-2024 international scientific record,
* The statutory requirement to evaluate “relevant evidence” under s116E,
* And its duty to act transparently and lawfully when exercising coercive
public health powers.

---

Kind regards,

SPENCER JONES

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