ࡱ> MON5@ Mbjbj22 02XXI```````t84H,t&D(H %%%%%%%$G(R*%`G^%``%"``%%7:2$,``$t po.^$ .%T%0&h$R++$tt````$0+`$D:S3%%tt X"ttXTHE PAEDIATRIC SOCIETY OF NEW ZEALAND Secretariat: Email: Denise Tringham P O Box 22 234 Wellington Tel: (04) 938 4827 Fax: (04) 976 4827  HYPERLINK "mailto:psnz@paradise.net.nz" psnz@paradise.net.nz   17 August 2004 Policy Group (Folic Acid) New Zealand Food Safety Authority PO Box 2835 WELLINGTON To Whom it may concern Reducing Neural Tube Defects in New Zealand: Consultation Document No 2/04 Thank you for the opportunity to comment on this document. The following is the Paediatric Society of NZs formal response which supports the individual responses from members. Question 1: Voluntary fortification is not effective in achieving adequate folic acid levels in the target population. It is unlikely that voluntary fortification plus pre-conception folic acid supplementation will significantly reduce incidence of neural tube defect even with a sustained publicity campaign. This is because of the high rate of unplanned pregnancy (50%) and the likelihood that Many women will not be reached by whatever publicity campaign is conducted Many women even if informed will not get around to taking supplements Women in already disadvantaged socioeconomic groups are less likely to be reached and respond to a campaign, or may be disadvantaged by the cost of purchasing supplements Question 3: Mandatory fortification is effective at reducing neural tube defects as shown in the research presented in the policy document. A higher level of fortification such as planned in Britain (240(g per 100g flour) is likely to be more effective as this is likely to raise more of the target population towards the 400(g daily recommendation. There is even at this higher level of supplementation a large safety margin (in terms of likelihood of individuals exceeding recommended limits and subsequent risk of masking B12 deficiency). Question 4: Concerns from a very small but vocal minority of the population are likely. However, if an education campaign is conducted explaining folic acid is a natural substance found in green vegetables, the impact on the attitudes of this minority on public opinion is likely to be small. There is no or virtually no public concern regarding the long-term practice of iodine supplementation of salt. Question 5: Impact on producers is minimal as all are equally affected, so there is no imbalance in market forces and all producers can recover initial costs equally through minor increase in cost to the consumer. Ongoing costs are minimal compared with the annual turnover of the vehicle product. Question 6: Both monitoring of the actual levels of folic acid in vehicle product (i.e. flour) and produced foods (i.e. bread) plus monitoring of the total rate of neural tube defect (termination of pregnancy rate due to suspected NTD and birth/stillborn NTD rate) Question 7 As well as reducing the risk of NTDs, mandatory fortification is likely to reduce the incidence (and cost) of serious congenital heart disease. Question 8: The Paediatric Society of NZ supports Option 2: introduction of mandatory fortification as the most effective means of reducing neural tube defect with minimal if any negative health consequences to the population. The emotional and financial consequences to an affected individual, to his/her family, and to society, of spina bifida and other neural tube defects necessitates a pro-active response from society. This is particularly the case when prevention strategies are easy, safe and have proven effectiveness. Even when neural tube defects are detected in utero and termination is performed, this has a significant and potentially long-term emotional impact to the parents. We would be happy to provide any further information should you require it. Yours sincerely Veronica Casey Chief Executive Officer PO Box 5159 Dunedin Phone: 03455 2729 Fax 03 455 3729 Mobile: 025861788. Email:  HYPERLINK "mailto:vcasey@xtra.co.nz" vcasey@xtra.co.nz  HYPERLINK "http://www.paediatrics.org.nz" www.paediatrics.org.nz Health of our children: Wealth of our nation '()BC   # $ & ' ( ) * + , 㵥hYTPBPjhY&UmHnHuhY& hY&5h:A&hY&0JCJOJQJ0jh:A&hY&B*CJOJQJUph!h IhY&B*CJOJQJph$jhY&B*CJOJQJUphhY&5B*CJOJQJphhY&B*CJOJQJphhY&5B*CJ(OJQJphhY&5B*CJ$OJQJphhY&5OJQJ%jhY&5OJQJUmHnHu()6789:<C`|$ !Sn#$Ifa$gdq$ !n#'$If^'`a$gdq$ !Sn#$Ifa$gdq$ !Sn#$Ifa$gdq x$Ifgdq  $Ifgdq IL' ( ) , VMHgdY&  !gdY&pkd$$IfT\ K2%?%aT$ !n#$Ifa$gdq$ !Sn#$Ifa$gdq$ $Ifa$gdq, - . = > ? 9 :  & Fx^`gdP{gdP{gdP{gd8\7$a$ $^a$gdP{$a$gdB$a$gdw$a$gd8\7  !gd8\7, - . < = ? 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PLP^P`LhH.h ^`hH.h ^`hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.+S7b_*`                 ob:z c ???z c  Y&8\7&iP{OBqw(3be)C'(  N"@0{Mp@Unknown G: Times New Roman5Symbol3& : Arial?Bodoni BookEAGaramond BoldA& Arial NarrowG,Goudy Old StyleG& Eras Medium ITC5& zaTahoma"hhFH H !24dBB 3qH(?&i[RESPONSE TO CONSULTATION DOCUMENT: FOLIC ACID SUPPLEMENTATION TO PREVENT NEURAL TUBE DEFECTpcdtamVeronica Casey  Oh+'0 ,8L dp    \RESPONSE TO CONSULTATION DOCUMENT: FOLIC ACID SUPPLEMENTATION TO PREVENT NEURAL TUBE DEFECTESPpcdtamEcdtcdt Normal.dot Veronica CaseyS5roMicrosoft Word 10.0@ԭ@io@xك@ioH ՜.+,D՜.+,\ hp  <Capital Coast Health Ltd.aBA \RESPONSE TO CONSULTATION DOCUMENT: FOLIC ACID SUPPLEMENTATION TO PREVENT NEURAL TUBE DEFECT Title 8@ _PID_HLINKSAL3Dmailto:psnz@paradise.net.nz-phttp://www.paediatrics.org.nz/rmailto:vcasey@xtra.co.nz  !#$%&'()*+,-./012345679:;<=>?ABCDEFGJRoot Entry FPEoLData 1Table"+WordDocument02SummaryInformation(8DocumentSummaryInformation8@CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89qRoot Entry F|oSData 1Table"+WordDocument02  !#$%&'()*+,-./012345679:;<=>?RQP  Title@$Lx _PID_HLINKS_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayNameAL3Dmailto:psnz@paradise.net.nz-phttp://www.paediatrics.org.nz/rmailto:vcasey@xtra.co.nzQFolate Responsevcasey@xtra.co.nzVeronica CaseySummaryInformation(8DocumentSummaryInformation8@CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q՜.+,D՜.+,\ hp  <Capital Coast Health Ltd.aBA \RESPONSE TO CONSULTATION DOCUMENT: FOLIC ACID SUPPLEMENTATION TO PREVENT NEURAL TUBE DEFECT Paediatric Society of New Zealand: Submissions
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Submissions

The Paediatric Society believes all children and youth should, by right, attain optimal physical, mental and social health and wellbeing.  By working as a coordinated national network of health professionals the Society dedicates its efforts and resources to making official submissions to both Government and Non-Government organisations on issues that will impact on the health and wellbeing of children and young people.

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