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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
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Review of the
Draft NTP Monograph

SYSTEMATIC REVIEW OF FLUORIDE
EXPOSURE AND NEURODEVELOPMENTAL
AND COGNITIVE HEALTH EFFECTS

Committee to Review the NTP Monograph on the
Systematic Review of Fluoride Exposure and
Neurodevelopmental and Cognitive Health Effects

Board on Environmental Studies and Toxicology

Division on Earth and Life Studies

A Consensus Study Report of

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This project was supported by Contract HHSN263201800029I between the National Academies of Sciences, Engineering, and Medicine and the Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-67313-6
International Standard Book Number-10: 0-309-67313-5
Digital Object Identifier: https://doi.org/10.17226/25715

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2020 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. https://doi.org/10.17226/25715.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

Image

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

Image

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

COMMITTEE TO REVIEW THE NTP MONOGRAPH ON THE SYSTEMATIC REVIEW OF FLUORIDE EXPOSURE AND NEURODEVELOPMENTAL AND COGNITIVE HEALTH EFFECTS

Members

DAVID A. SAVITZ (Chair), Brown University School of Public Heath, Providence, RI

KEVIN M. CROFTON, R3Fellows, Durham, NC

AKHGAR GHASSABIAN, New York University School of Medicine, New York, NY

JUDITH B. KLOTZ, Drexel University Dornsife School of Public Health, Philadelphia, PA

JULEEN LAM, California State University, East Bay, Hayward, CA

PAMELA J. LEIN, University of California, Davis, CA

GERMAINE M. BUCK LOUIS, George Mason University, Fairfax, VA

MICHAEL L. PENNELL, The Ohio State University, Columbus, OH

CRAIG STEINMAUS, University of California, Berkeley, Oakland, CA

CHARLES V. VORHEES, University of Cincinnati College of Medicine, Cincinnati, OH

KIMBERLY YOLTON, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH

Staff

ELLEN K. MANTUS, Project Director

SUSAN MARTEL, Senior Program Officer

RADIAH ROSE-CRAWFORD, Manager, Editorial Projects

SARAH HARPER, Senior Program Assistant

Sponsor

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY

Members

WILLIAM H. FARLAND (Chair), Colorado State University, Fort Collins, CO

LESA AYLWARD, Summit Toxicology, LLP, Falls Church, VA

ANN M. BARTUSKA, Resources for the Future, Washington, DC

GERMAINE M. BUCK LOUIS, George Mason University, Fairfax, VA

E. WILLIAM COLGLAZIER, American Association for the Advancement of Science, Washington, DC

FRANCESCA DOMINICI, Harvard University, Boston, MA

GEORGE GRAY, The George Washington University, Washington, DC

R. JEFFREY LEWIS, ExxonMobil Biomedical Sciences, Inc., Annandale, NJ

LINSEY C. MARR, VA Polytechnic Institute and State University, Blacksburg, VA

R. CRAIG POSTLEWAITE, Department of Defense, Burke, VA

REZA J. RASOULPOUR, Corteva Agriscience, Indianapolis, IN

IVAN RUSYN, Texas A&M University, College Station, TX

DEBORAH L. SWACKHAMER, University of Minnesota, St. Paul, MN

JOSHUA TEWKSBURY, Future Earth, Boulder, CO

SACOBY M. WILSON, University of Maryland College Park, MD

Staff

CLIFFORD S. DUKE, Director

RAYMOND A. WASSEL, Scholar and Director of Environmental Studies

LAURA LLANOS, Finance Business Partner

TAMARA DAWSON, Program Associate

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×

Acknowledgments

This consensus study report was reviewed in draft form by persons chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets institutional standards of quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following for their review of this report:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report, nor did they see the final draft before its release. The review of the report was overseen by Martin Philbert, University of Michigan, and Jonathan Samet, Colorado School of Public Heath, who were responsible for making certain that an independent examination of the report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

The committee gratefully acknowledges the staff of the National Institute of Environmental Health Sciences for their presentations to the committee during open sessions. The committee is also grateful for the assistance of Norman Grossblatt who served as the report editor.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Review of the Draft NTP Monograph: Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. Washington, DC: The National Academies Press. doi: 10.17226/25715.
×
Page R10
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The National Toxicology Program (NTP) conducted a systematic review of the evidence of adverse neurodevelopmental and cognitive effects of fluoride exposure. NTP's conclusions are summarized in the monograph Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects.

At the request of NTP, a committee convened by the National Academies reviewed their monograph to ensure the integrity of that report. It is important to note that the committee was tasked with reviewing the monograph and focused its efforts on evaluating whether evidence as presented in the monograph supported NTP's conclusions. Thus, it did not conduct its own independent evaluation of the evidence, and it did not conduct a data audit. However, it did review some key literature to enable its review of the monograph. Review of the Draft NTP Monograph contains findings and suggestions for improvements and some overarching findings concerning methods, assessment of animal and human evidence, and NTP's hazard conclusion.

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